BASIC LIFE SUPPORT IN ADULTSby Majtania.pptx
- 1. BASIC LIFE SUPPORT IN ADULTS PRESENTED BY MAJ TANIA BOSE
- 2. BASIC LIFE SUPPORT ā¢ IT REFERS TO THE CARE HEALTH CARE PROVIDERS OR ANY PUBLIC CAN ADMINISTER TO A PERSON WHO IS EXPERIENCING RESPIRATORY ARREST, CARDIAC ARREST OR AIRWAY OBSTRUCTION. ā¢ BLS INCLUEDS PERFORMING EFFECTIVE CPR, MAINTAINANCE EFFECTIVE AIRWAY AND USE OF EXTERNAL DEFEB OR AED.
- 3. QUALITIES REQUIRED TO PERFORM BLS ā¢ CRITICAL THINKING ā¢ CALM ā¢ PROBLEM SOLVING ATTITUDE ā¢ AWARENESS AND ALERTNESS ABOUT ENVIRONMENT ā¢ GOOD COMMUNICATION SKILLS
- 4. OBJECTIVE OF THIS CLASS ā¢ ASSESSING AN EMERGENCY SITUTATION ā¢ PERFORMING EFFECTIVE CHEST COMPRESSION ā¢ SECURING AN EFFECTIVE AIRWAY ā¢ PLACING A VICTIM AWAY FROM DANGER
- 5. BASIC MANTRA OF BLS ā¢ C ( circulation) ā¢ A (Airway) ā¢ B (breathing)
- 7. WHAT TO DO ā¢ APPROACH SEAFTY ā¢ CHECK FOR RESPONSE ā¢ SHOUT FOR HELP ā¢ OPEN AIRWAY ā¢ CLEAR VISIBLE OBSTRUCTION ā¢ CHECK BREATHING ā¢ CHECK FOR PULSE( CAROTID/CENTRAL) ā¢ START CPR - MAINTAIN EFFECTIVE AIRWAY ā¢ ADMINISTER BREATHS
- 8. PRIMARY ASSESMENT OF UNRESPONSIVE PATIENT ā¢ SEE FOR AVPU 1. A= Alertness 2. V =Verbal Response (response to verbal stimuli) 3. P= Pain( Response to painful stimuli) 4. U= Unresponsiveness (do not respond)
- 9. COMMUNICATE 1. SHOUT FOR HELP 2. CALL FOR MEDICAL HELP/ ACTIVATE CODE BLUE
- 10. OPEN THE AIRWAY ā¢ Make sure the patient is in supine position ā¢ Apply techniques of opening airway
- 11. Contdā¦ ā¢ Open airway by head extension
- 12. HEAD TILL CHIN LIFT TECHNIQUE ā¢ Finger swipe the mouth if visible solid material is found ā¢ Suction the airway if in a health care set up (press down on the forehead while Pulling up the bony part of chin with Two or three finger)
- 13. JAW THRUST TECHNIQUE ā¢ If neck or spine injury is suspected (kneel above the patients Head, put one hand on each side of patients head,with Thumbs towards chin,using Elbow for support. Thrust The jaw upwards,without Moving the head or neck and Open the airway)
- 14. CHECK FOR BREATHING ā¢ Look, feel, listen and assess the breathing ā¢ Donāt get confused with agonal breathing. (isolated or infrequent Grasping)
- 15. CHECK FOR PULSE ā¢ Central pulse ( preferably carotid pulse) ā¢ For 10 sec
- 16. PRIMARY ASSESMENT RESULT RESPIRATORY ARREST CARDIAC ARREST 1. If patient is not breathing but having definitive pulse 1. If there is no breathing and no pulse, but cardiac arrest is different from MI 2. Priority is ventilation 2. When assessed that patient is in cardiac arrest initiate CPR followed by ventilation 3. 1 ventilation every 5-6 sec for adult, each ventilation of 1 sec duration, making chest rise 4. Continue till patient starts breathing or being intubated 5. Assess for effective ventilation
- 17. CHEST COMPRESSION ā¢ Make sure patient is on a firm and flat surface ā¢ Chest has to be exposed , to ensure proper recoil ā¢ Hands are correctly positioned with heel of one hand in the centre of chest on the lower half of sternum with other hand on top ā¢ Arms are straight, preferably 90 degree ā¢ Compression at rate of 100 to 120 beats/min, ā¢ Proper depth of at least 2 inches ā¢ Chest must be allowed to recoil between each compression. ā¢ Change CPR operator every 2 min
- 18. VENTILATION ā¢ Ventilation supply oxygen to a patient via different way 1. Moth to mouth breathing 2. Bag mask ventilation (during CPR give 2 ventilation that last approx 1 sec each and make the chest rise) ā¢ RECOMMENDATION ā¢ Tidal volume 500-600 ml ā¢ With ratio of 30:2(2 ventilation with 30 compression)
- 19. MOUTH TO MOUTH BREATHING ā¢ Pinch the nose ā¢ Take a normal breath ā¢ Place lips over mouth ā¢ Blow until the chest rise ā¢ Take 1 sec to allow the chest fall ā¢ Repeat
- 20. BAG MASK VENTILATION ā¢ Open the airway at the top of the patients head ā¢ Use E-C hand position , seal the mask completely around the patients mouth and nose by lifting the jaw into the mask while maintaining an open airway
- 21. SPECIAL CONSIDERATION IN ADVANCE AIRWAY ā¢ If the patient is having an advance airway eg supraglottic airway or ET , the CPR is slightly different 1. At least two rescuer must be present 2. One gives ventilation , 1 ventilation every 6-8 sec, about 8-10 ventilation per min 3. Other continues a CPR with100 to 120 compression per min 4. No pause between compression 5. Not to maintain 30:2 ratio in this case
- 22. AUTOMATED EXTERNAL DEFIBRILATORS ā¢ It is a portable electronic device that automatically analyse the patients heart rhythm and can provide defibrillation, ā¢ When a patient experience a cardiac arrest , an AED should be applied as soon as one is readily available ā¢ AED deliver defibrillation with two specific dysrhythmias, ventricular fibrillation and ventricular tachycardia.
- 23. USING AED ā¢ Turn it on ā¢ Make sure the chest is clearly exposed and dry ā¢ Use adult pad( over age of 8 years and weight more than 50 pounds) ā¢ Place one pad on the upper chest, below the right clavicle to the right of the sternum, other pad on the left side of the chest on the mid axillary line a few inches below the left armpit. ā¢ Tell everyone to clear while AED analyse a shockable rhythm ā¢ Deliver the shock by pressing shock button if indicated ā¢ After shock delivered continue the compression and continue about 2 min compression ā¢ While AED prompts that it is reanalyzing
- 24. DOāS AND DONāT OF FOR AED USE ā¢ DOāS 1. Before shocking no one is touching the patient 2. Use AED for a patient in cardiac arrest 3. AED can be used in pregnant patient, as the shock donāt herm the fetus ā¢ Donts 1. Do not use alcohol to wipe the patients chest dry 2. Do not defibrillate someone when inflammable object is around.
- 25. STOPPING CPR ā¢ Sign of ROSC(return of spontaneous circulation)/ recovery ā¢ An AED is always kept ready to analyse the heart rate and also rhythm , which is showing no chance of revival , cardiac arrest more than 30 mins. ā¢ Presented with valid DNR order( do not rescue order) ā¢ Scene around become unsafe
- 27. CAUSES OF CPR TO BE FAILED ā¢ Delay in initiation ā¢ Improper procedure ā¢ No ACLS follow up and delayed in defibrillation ā¢ Massive heart attack