1 BLS For Healthcare Providers 2 Time is Critical! begins to die in 4 to 6 minutes Brain matter cannot regenerate itself In order to sustain life, the human body must have going in and out and must be going around and around 3 Elements of Basic Life Support 4 Cardiopulmonary Resuscitation (CPR) (heart)= chest compressions Pulmonary ( )= artificial breathing CPR is normally a pattern only -drugs and defibrillation normally required -CPR will sustain perfusion until these can be obtained 5 AHA Age Guidelines Infant: to year of age Child: 1 to the onset of Males: Development of underarm hair Females: Development of breasts Adult: over 6 ABC s of Basic Life Support A= -Is Airway open and clear? B= -Is the victim breathing spontaneously? C= -Does the victim have a pulse? 7 Cardiac Arrest No - Look, Listen, Feel No -Child and adult pulse is checked at the artery -Infant pulse checked at the artery 8 Respiratory Arrest Victim is not breathing but a is present Requires only artificial and monitoring for presence of pulse Ventilation rates -once every seconds (8-10 per min.) 9 Causes of Cardiac Arrest Electrical shock Other diseases or age process
Other diseases or age process Heart attack In infants and children, the most common cause of cardiac arrest is severe and breathing problems 10 Heart Attack Acute myocardial (AMI) Death of the heart muscle due to lack of Most people deny that they are having a heart attack and wait several hours before seeking treatment Often blamed on bad If signs/symptoms resist, EMS should be called. 11 Signs/Symptoms of AMI Chest -may -might be described as dull, sharp, crushing or may be totally absent Shortness of breath (sweating) Nausea/vomiting Sudden or gradual 12 Stroke Caused by an interruption of blood flow to the Nausea/vomiting, or weakness to one side, slurred speech, drooling May occur or suddenly 13 Communicable Diseases and CPR Try to avoid mouth to mouth Use a or a barrier device -pocket -mouth to mouth shield Wear if possible hands after every patient contact Shower and change clothes if contaminated by body fluids 14 Beginning CPR If witnessed collapse, call 911 and return to begin CPR If unwitnessed arrest, perform minutes of CPR prior to calling 911 If patient is an infant, CPR can be done while carrying patient to call 911 Drowning victims have been successfully revived even after prolonged submersion (40-60 minutes) Victim should be face up on surface All on chest must be removed 15 When NOT to Begin CPR death
15 When NOT to Begin CPR death -rigor mortis - incompatible with life -dependent -body Mass Casualty Incident 16 When Should CPR Be Stopped? S - patient breathing and has a pulse T- patient is to another person of equal or higher certification O - you are of strength P - a asks you to stop 17 Opening the Airway Head Tilt/Chin Lift Maneuver 18 Opening the Airway Jaw-thrust maneuver without head tilt 19 Chest Compressions Always on half of sternum Adult and Child Compressions: On sternum between Infant Compressions: 1 finger width nipple line 20 Chest Compressions Compression Technique -Adult: two handed technique. Fingers locked, heel of one hand on -Child: Heel of one hand on sternum or 2 handed technique -Infant: fingers on sternum Compression Rates -Adult and child: per minute -Infant: to per minute 21 Chest Compressions Compression Depths -Adult: to inches -Child and Infant: depth of chest 22 Chest Compressions Compression to Ventilation Ratios Adult 1 man: compression to breaths (30:2) Adult 2 man: compression to breaths (30:2) Child and Infant 1 man: compressions to ventilations (30:2) Child and Infant 2 man: compressions to ventilation (15:2)
Child and Infant 2 man: compressions to ventilation (15:2) Should use the two hand encircling technique for rescuer infant 23 Chest Compressions The effectiveness of chest compressions can be verified by having another person check for a or pulse during compressions. Chest compressions should generate a pulse if done correctly 24 Reassessing During CPR CPR should be stopped after the first minutes to check for pulse and then every few minutes thereafter -after cycles of all 1-rescuer CPR -after about cycles of 2 rescuer infant or child CPR 25 Complication of CPR Broken ribs and Punctured Lacerated Gastric distension: air in the stomach -caused by too forceful ventilations -if severe, can be relieved by pressing on stomach. Be prepared for vomiting 26 Adult/Child 1 Rescuer CPR 1. Check for 2. Call 911 3. Open Airway with head-tilt/chin-lift 4. Check - seconds 5. Give breaths Use pocket mask 1 second per breath < seconds 27 Adult/Child 1 Rescuer CPR (cont d) 6. Check Carotid Pulse 5 to 10 seconds 7. Locate CPR Position On between nipples 8. Deliver 1st cycle of 30 compressions to 2 breaths 30 compressions in 23 seconds (100/min) Push, Push Fast Allow chest to between compressions 9. Give 2 breaths (1 second each) Use a pocket 28 Adult/Child 1 Rescuer CPR (cont d) 10. Deliver cycle of compressions using hand placement. (
Use a pocket 28 Adult/Child 1 Rescuer CPR (cont d) 10. Deliver cycle of compressions using hand placement. ( compressions in seconds) 11. Give breaths 12. Deliver 3rd cycle of compressions Complete cycles. After 5th cycle (about 2 minutes), stop and check for return of pulse and apply AED 29 Adult/Child 2 Rescuer CPR Sequence is the same, just one person gives breaths. Rescuer performing compressions should for the 2 breaths Second rescuer should check for a being generated by compressions If AED is available, one rescuer performs CPR while the second rescuer sets up the AED 30 Infant 1 and 2 Rescuer CPR 1. Check for responsiveness 2. Activate EMS System 3. Open Head-Tilt/Chin-Lift 4. Check (5-10 seconds) 5. Give 2 breaths Use pocket mask 1 second each (DO NOT OVER ) 31 Infant 1 and 2 Rescuer CPR (cont d) 6. Check pulse (5-10 seconds) 7. Locate finger position On sternum just below line 8. Deliver 1st cycle of 30 compressions 30 compressions in 23 seconds Push Hard, Push Fast Allow chest to re-expand compressions 9. Give 2 breaths (same as before) 32 Infant 1 and 2 Rescuer CPR (cont d) If continuing 1 rescuer CPR repeat until 5 cycles given then stop and check 2nd Rescuer will help perform CPR, taking over breathing using a 10. Deliver 2nd cycle of compressions using 2- thumb encircling hands technique ½ of sternum 11. compressions to allow 2 breaths
½ of sternum 11. compressions to allow 2 breaths 33 Infant 1 and 2 Rescuer CPR (cont d) 12. Deliver 3rd cycle 13. Pause for 14. Give 2 breaths during pause 15. Repeat until 5 cycles given then stop and check pulse and 34 Neonatal CPR compressions to ventilation Rate of Given if heart rate is absent OR below after other methods fail Drying, warming, tactile stimulation, oxygenation, ventilation, intubation 35 Recovery Position 36 Airway Obstruction 37 Foreign Body Airway Obstruction (FBAO) Causes of Airway Obstruction : most common cause : due to trauma, infection, or allergic reaction bodies 38 Total Airway Obstruction No air movement at all Victim unable to, cough, or breathe Victim turns (cyanotic) around lips Victim grasps neck with both hands Requires Maneuver 39 Partial Airway Obstruction Victim can speak,, and breathe somewhat If cyanosis (bluish color) is present, perform the Heimlich Maneuver If no cyanosis, monitor carefully, give 40 Heimlich Maneuver (1 of 2) Stand or kneel behind victim and wrap your arms around the victim s waist Make a with one hand Place the side of your fist against the victim s abdomen, in the midline, just above the naval and well below the breastbone Grasp your fist with your other hand and press your fist into the victim s abdomen with a quick thrust 41 Heimlich Maneuver (2 of 2) Repeat thrusts until the object is or the victim goes unconscious Give each new thrust with a separate, movement to relieve the obstruction
Repeat thrusts until the object is or the victim goes unconscious Give each new thrust with a separate, movement to relieve the obstruction If patient is obese or pregnant, perform procedure on, at nipple line, and thrust straight inward (not upward) 42 FBAO in an Unconscious Adults Activate EMS System Open airway and look into for object Remove the object if found by the mouth Begin and look for object each time you open the airway Remove object if found 43 FBAO in an Unconscious Child Open airway and look into mouth for object the object if found by sweeping the mouth Begin CPR for cycles (2 minutes) and look for object each time you open the airway Remove object if found Activate EMS CPR 44 FBAO in a Conscious Infant (1 of 2) Kneel or sit with infant in your lap Hold infant with head slightly lower than chest. Support head and body Deliver up to back blows forcefully in the middle of the back between shoulder blades with heel of one hand 45 FBAO in a Conscious Infant (2 of 2) While supporting the head and body, turn the infant on his back with head than chest Provide up to quick chest thrusts in the same location as chest compressions Repeat sequence of 5 blows and 5 chest until object is relieved or infant goes unconscious 46 FBAO in an Unconscious Infant Place infant on surface Open airway and look for object. If visible, remove the object Begin CPR with 1 extra step: each time you open the airway, for the object and remove it if found After cycles of CPR activate EMS 47 Finger Sweeps Never perform a blind finger sweep on an or due to the small size of their mouth and airway.
Never perform a blind finger sweep on an or due to the small size of their mouth and airway. A blind finger sweep on a child or infant can result in an object being pushed farther into the airway causing of obstruction 48 Automated External Defibrillation 49 Importance of Early Defibrillation The the defibrillation, the better the chance of survival The goal of defibrillation is to restore the normal conduction thru the heart all patients in cardiac arrest will be defibrillated 50 AED AED should be used on all patients > year of age Apply pads as directed by the picture A more in-depth discussion of AED will take place later in the EMT course 51 Pediatric Defibrillation Use Pediatric D-fib pads if available If not, use adult pads placed in the / positions on small children If pediatric settings are not available, use the settings Do NOT use on infants 52 Basic Operational Steps of an AED ON Power the electrodes to the victim the rhythm -many AEDs analyze automatically if indicated 53 Using an AED Chest compressions take priority over All and touching of Pt must be stopped If motion is detected but no motion is present, check Before shocking always say, and visually make sure everyone is clear 54 Using an AED single shock Older (Most) AED s will shock in groups of Immediately perform 2 minutes of CPR after shock (do NOT check ) If no shock is indicated, do CPR and analyze every minutes