BASIC LIFE SUPPORT -First Aid.pdf
- 2. BASIC LIFE SUPPORT •Early initiation of BLS has been shown to increase the probability of survival for a person experiencing cardiac arrest. To increase the odds of surviving a cardiac event, the rescuer should follow the steps in the Adult Chain of Survival. •Emergencies in children and infants are not usually caused by the heart. Children and infants most often have breathing problems that trigger cardiac arrest. The first and most important step of the Pediatric Chain of Survival is prevention.
- 3. BASIC LIFE SUPPORT •BLS ALGORITHM FOR ADULTS-Adult chain of survival •activation of emergency response •perform early CPR •defibrillate with AED(automated external defibrillator) •advanced life support
- 4. BASIC LIFE SUPPORT •BLS ALGORITHM FOR CHILDREN-Paediatric chain of survival •prevent arrest •activation of emergency response •perform early CPR •defibrillate with AED •advanced life support
- 5. BASIC LIFE SUPPORT • ONE-RESCUER BLS/CPR FOR ADULTS Be Safe Make sure the scene is safe • Move the person out of traffic. • Move the person out of water and dry the person. (Drowning persons should be removed from the water and dried off; they should also be removed from standing water, such as puddles, pools, gutters, etc.) • Be sure you do not become injured yourself. Assess the Person • Shake the person, tap their shoulder hard, and talk to them loudly. •If there is no response, position the victim on their back •With your hand on the forehead and your fingertips under the point of the chin, gently tilt the victim’s head backwards, lifting the chin to open the airway• Check to see if the person is breathing. (Agonal breathing, which is occasional gasping and is ineffective, does not count as breathing.
- 6. BASIC LIFE SUPPORT Call EMS Send someone for help or to call your emergency number and to get an AED. • If alone, call for help while assessing for breathing and pulse. Call for help without leaving the person.) CPR Begin sets of compressions and rescue breaths. Defibrillate • Attach the AED pads when available.
- 7. •An AED, or automated external defibrillator, is used to help those experiencing sudden cardiac arrest. It's a sophisticated, yet easy-to-use, medical device that can analyze the heart's rhythm and, if necessary, deliver an electrical shock, or defibrillation, to help the heart re-establish an effective rhythm.
- 8. BASIC LIFE SUPPORT • CPR STEPS 1.Check for the carotid pulse on the side of the neck • feel for no more than 10 seconds. • If you are not sure you feel a pulse, begin CPR with a cycle of 30 chest compressions and two breaths. 2. Use the heel of one hand on the lower half of the sternum in the middle of the chest 3. Put your other hand on top of the first hand 4. Straighten your arms and press straight down Compressions should be 2 to 2.4” (5 to 6 cm) into the person’s chest and at a rate of 100 to 120 compressions per minute. 5. Be sure that between each compression you completely stop pressing on the chest and allow the chest wall to return to its natural position.
- 9. BASIC LIFE SUPPORT 6.After 30 compressions, stop compressions and open the airway by tilting the head and lifting the chin OR. Do not perform the head-tilt/chin-lift maneuver if you suspect the person may have a neck injury. 7. Give a breath while watching the chest rise. Repeat while giving a second breath. Breaths should be delivered over one second. 8. Resume chest compressions. Switch quickly between compressions and rescue breaths to minimize interruptions in chest compressions
- 12. BASIC LIFE SUPPORT TWO-RESCUER BLS/CPR FOR ADULTS •Many times there will be a second person available that can act as a rescuer. •Direct the second rescuer to call Emergency Medical Services (EMS) without leaving the person while you begin CPR. This second rescuer can also find an AED while you stay with the person. When the second rescuer returns, the CPR tasks can be shared.
- 13. BASIC LIFE SUPPORT 1.The second rescuer prepares the AED for use. 2. You begin chest compressions and count the compressions out loud. 3. The second rescuer applies the AED pads. 4. The second rescuer opens the person’s airway and gives rescue breaths. 5. Switch roles after every five cycles of compressions and breaths. One cycle consists of 30 compressions and two breaths. 6. Be sure that between each compression you completely stop pressing on the chest and allow the chest wall to return to its natural position
- 14. BASIC LIFE SUPPORT •7.Quickly switch between roles to minimize interruptions in delivering chest compressions. •8. When the AED is connected, minimize interruptions of CPR by switching rescuers while the AED analyzes the heart rhythm. If a shock is indicated, minimize interruptions in CPR. Resume CPR as soon as possible.
- 16. BASIC LIFE SUPPORT • ADULT MOUTH-TO-MASK VENTILATION • In one-rescuer CPR, breaths should be supplied using a pocket mask, if available. • 1. Give 30 high-quality chest compressions. • 2. Seal the mask against the person’s face by placing four fingers of one hand across the top of the mask and the thumb of the other hand along the bottom edge of the mask • 3. Using the fingers of your hand on the bottom of the mask, open the airway using the head-tilt/chin-lift maneuver. (Do not do this if you suspect the person may have a neck injury) . • 4. Press firmly around the edges of the mask and ventilate by delivering a breath over one second as you watch the person’s chest rise
- 17. BASIC LIFE SUPPORT • ADULT BAG-MASK VENTILATION IN TWO-RESCUER CPR • If two people are present and a bag-mask device is available, the second rescuer is positioned at the victim’s head while the other rescuer performs high-quality chest compressions. Give 30 high-quality chest compressions. 1. Deliver 30 high-quality chest compressions while counting out loud. • 2. The second rescuer holds the bag-mask with one hand using the thumb and index finger in the shape of a “C” on one side of the mask to form a seal between the mask and the face, while the other fingers open the airway by lifting the person’s lower jaw • 3. The second rescuer gives two breaths over one second each as you watch the person’s chest rise. • 4. Practice using the bag-valve-mask; it is essential to forming a tight seal and delivering effective breaths. Quickly switch roles to minimize interruptions.
- 19. BASIC LIFE SUPPORT Criteria for high-quality CPR: • Start chest compressions (hard and fast) within 10 seconds • Allow for complete chest recoil between compressions • Minimize interruptions between chest compressions • Assure that the breaths make chest rise • Do not over-ventilate • Assess for shockable rhythm as soon as AED available in witnessed cardiac arrest as it is most likely a shockable rhythm.
- 20. BASIC LIFE SUPPORT •AED STEPS • 1. Retrieve the AED a. Open the case. b. Turn on the AED. 2. Expose the person’s chest. a. If wet, dry chest. b. Remove medication patches. •3. Open the AED pads a. Peel off backing. b. Check for pacemaker or internal defibrillator. •4. Apply the pads. a. Apply one pad on upper right chest above the breast. b. Apply the second pad on lower left chest below the armpit. •5. Ensure the wires are attached to the AED box. 6. Move away from the person. a. Stop CPR. b. Clear the person to make sure no one is touching any part of the victim.
- 21. BASIC LIFE SUPPORT •If AED message reads “Shock,” a. Be sure the person is “clear” by making sure no one is touching them. b. Press and hold the “shock” button until the AED delivers the shock
- 22. BLS FOR CHILDREN •Many similarities exist between the BLS guidelines for adults and children. Following are the main differences between the two: •For children, the compression to breaths ratio is 15:2 for all age groups. The depth of compression may be different. •For children, compress the chest at least one-third the depth of the chest. This may be less than two inches for small children (4 -5 cm) but will be approximately two inches for larger children (5 cm). •• If you are the only rescuer at the scene and find an unresponsive child, perform CPR for two minutes before you call EMS or before you go look for an AED
- 23. BLS FOR INFANTS •BLS for both children and infants is almost identical. Following are the main differences between BLS for children and BLS for infants: • Check the pulse in the infant using the brachial artery on the inside of the upper arm between the infant’s elbow and shoulder. •During CPR, compressions can be performed on an infant using two fingers, if only one rescuer; or with two thumb-encircling hands, if there are two rescuers and rescuer’s hands are big enough to go around the infant’s chest. • Compression depth should be one-third of the chest depth; for most infants, this is about 1.5 inches (4 cm).
- 24. BASIC LIFE SUPPORT • If you are the only rescuer at the scene and find an unresponsive infant, perform CPR for two minutes before calling EMS or using an AED. • In infants, primary cardiac events are not common. Usually, cardiac arrest will be preceded by respiratory problems. Survival rates improve when you intervene with respiratory problems as early as possible. •Remember that prevention is the first step in the Pediatric Chain of Survival.
- 25. BASIC LIFE SUPPORT •ONE-RESCUER BLS FOR INFANTS •If you are alone with the infant at the scene, do the following: •1. Tap the heel of their foot and talk loudly at the infant to determine if they are responsive. •2. Assess if they are breathing while simultaneously checking for the infant’s brachial pulse for 5 but no more than 10 seconds. If the infant does not respond and is not breathing (only gasping), yell for help. •3. If someone responds, send the second rescuer to call EMS and get an AED.
- 26. BASIC LIFE SUPPORT •If you cannot feel a pulse (or if you are unsure), begin CPR by doing 15 compressions followed by two breaths(15:2). If you can feel a pulse but the rate is less than 60 beats per minute, begin CPR. This rate is too slow for an infant. •To perform CPR on an infant, do the following: a. Be sure the infant is face-up on a hard surface. b. Using two fingers, perform compressions in the center of the infant’s chest ; do not press on the end of the sternum as this can cause injury to the infant. c. Compression depth should be about 1.5 inches (4 cm) and 100-120 compressions per minute. •5. Perform CPR for about two minutes (using cycles of 15 compressions and two breaths). If help has not arrived, call EMS and get an AED.
- 27. BASIC LIFE SUPPORT •TWO-RESCUER BLS FOR INFANTS • If you are not alone with the infant at the scene, do the following: •1. Tap the bottom of their foot and talk loudly at the infant to determine if they are responsive. •2. If the infant does not respond, have the second rescuer call EMS and get an AED •3. Assess if they are breathing while simultaneously feeling for the infant’s brachial pulse for 5 but no more than 10 seconds. •4. If you cannot feel a pulse (or if you are unsure), begin CPR by doing 15 compressions followed by two breaths. If you can feel a pulse but the rate is less than 60 beats per minute, begin CPR. This rate is too slow for an infant.
- 28. BASIC LIFE SUPPORT •5.When the second rescuer returns, begin CPR by performing 15 compressions by one rescuer and two breaths by the second rescuer. If the second rescuer can fit their hands around the infant’s chest, perform CPR using the two thumb-encircling hands method. Do not press on the bottom end of the sternum as this can cause injury to the infant. •6. Compressions should be approximately 1.5 inches (4 cm) deep and at a rate of at least 100-120 per minute. •7. Use and follow AED prompts when available while continuing CPR until EMS arrives or until the infant’s condition normalizes.
- 30. BASIC LIFE SUPPORT AED FOR CHILDREN AND INFANT 1.Retrieve the AED a. Open the case. b. Turn on the AED. 2. Expose the person’s chest. a. If wet, dry the chest. b. Remove any medication patches. 3.Open the Pediatric AED pads. a. Peel off backing. b. Check for pacemaker or implanted defibrillator. 4. Apply the pads. a. Apply one pad on the upper right chest above the breast. For infants, apply on front of chest b. Apply the second pad on lower left chest below the armpit. For infants, apply second pad to back 5. Ensure wires/ probes are attached to the AED devise 6. Move away from the child. a. Stop CPR. b. Instruct others not to touch the person.
- 31. AED ELECTRODE PADS PLACEMENT
- 32. NOTE: If no AED is available, OR whilst waiting for one to arrive, continue CPR •Do not interrupt resuscitation until: •A health professional tells you to stop OR •The victim is definitely waking up, moving, opening eyes, and breathing normally •OR •You become exhausted. •If you are certain that the victim is breathing normally but still unresponsive, place them in the recovery position •Be prepared to restart CPR immediately if the victim becomes unresponsive, with absent or abnormal
- 33. BASIC LIFE SUPPORT NOTE: The compression rate for all persons is always 100-120 per minute. BLS CAN BE DONE BY ONE PERSON, TWO OR A TEAM. Always have a team leader if being done by a team