Transcript Slide 1
Dept. of Anaesthesiology.
K.G.M.C.H.
BASIC LIFE SUPPORT
GUIDELINES
RESUSCITATION
Means Cardiopulmonary
resuscitations
Anywhere Anybody can do
CPR…
Considered when an individual
cannot adequately breathe and
maintain circulation to vital
organs.
WHY& WHEN TO DO IT ?
Without CPR , irreversible
brain damage occurs within
3-4 minutes
Should be done immediately
by a bystander
TIME is the crucial factor
here to decide the survival
Minutes counts...
when the heart stops,
damage occurs to the
Brain within < 5
minutes
start BLS early
CPR…
BLS
ACLS
ALS
ANLS
CPCR – Cardio Pulmonary
Cerebral resuscitation
CPR… ABCDEF
How ?
Airway
Breathing
Circulation
BLS
Drugs
ECG
Fibrillation
ACLS
The Sequence of BLS
Establish Unresponsiveness
If no response call for help
Start BLS------- A- Airway
B- Breathing
C- Circulation
CPR…
RECOGNITION
Is crucial in BLS
Determine
Unresponsiveness
Breathlessness
Pulselessness
No victim should
undergo CPR
until the need
for resuscitation
is established.
2. Check the Victim and see if he
responds
Gently SHAKE his shoulder
Ask loudly “Are you all
right?”
3A. Responds by answering or
moving
Leave him in the position.
Reassess him regularly.
3B. If no response
SHOUT for help (Call for
defibrillator)
Turn to his back and open airway.
HEAD TILT Hand on forehead.
Remove any visible obstruction.
CHIN LIFT finger tips under the
point of chin.
Avoid head tilt in
Trauma
CPR…
Activation
of EMS
Call
for help
Call
for ambulance
services
Emergency
BLS
CHECK
ALGORHYTHM
RESPONSIVENESS
A
OPEN
AIRWAY
B
CHECK
BREATHING
ventilation
C
CIRCULATION
CPR…
Airway - First basic skill
Head tilt
Chin lift
Jaw thrust
Airways
ET
intubation
Newer airways
CPR…
AIRWAY
Jaw thrust
Chin lift
Head tilt
CPR…
Breathing – Second basic skill
LOOK for chest movement
LISTEN for breath sounds
FEEL for air on your cheek
2 slow effective rescue breathing
LOOK
LOOK, LISTEN
AND FEEL
LISTEN
FEEL
5A. Breathing Normally
Turn him into recovery Position.
Send or go for help.
Check for continued breathing.
Recovery position.
To maintain a good airway
To minimize the risk of aspiration
Recovery Position
To Maintain a good airway.
To Minimize the risk of aspiration.
5B. Not Breathing
Rescue breathing
Ensure head tilt and
chin lift.
Pinch the Nose.
Two Slow effective
breaths.
Rise and fall of the
Chest
Rescue Breathing
Required if breathing is absent
or inadequate
Give 2 slow breaths sufficient
to make the chest rise
Adult: Over 2 seconds
Child & Infant: Over 1 – 1 ½
seconds
Rescue Breathing Techniques
Mouth-to-Mouth
Mouth-to-Barrier
Mouth-to-Nose
Mouth-to Mask
Bag-mask
device
Any difficulty achieving an
effective breath.
Recheck Victims mouth.
Recheck head tilt and chin lift.
Make up to 5 attempts.
Even in unsuccessful, move on
to assessment of circulation.
NO - Circulation
Absent carotid pulse.
Sign of Cardiac arrest.
Lay Rescuer.
Normal Breathing.
coughing
Movement.
No More than 10 Sec.
CAROTID PULSE
Identify Adam’s apple (Thyroid
Cartilage).
Slide down to the groove.
Palpate pulse in the groove.
Never Palpate on both sides
simultaneously.
7A. Circulation Present
Continue rescue breathing.
Recheck rescue breathing.
Normally breathing Recovery
Position.
7B. No signs of Circulation
Chest compressions.
Identity middle of Lower half of
Sternum.
compressions by heel of the hands.
After 15 Compressions tilt the head,
lift the chin and give 2 effective
breaths.
Chest Compressions
No pulse present
START CHESTCOMPRESSIONS
Compression Rate:
Adult, Child, & Infant – 100/min
TECHNIQUE OF EXTERNAL
CARDIAC COMPRESSION
Rescuer to one side of the patient
Patient’s chest exposed and
xiphisternum identified
Xiphisternum –Bony prominence in
the mid line at the junction of lower
borders of the ribs
The index and middle fingers of the
lower hand placed on the
xiphisternum and heel of the other
hand is placed adjacent to them on
the sternum
Heel of the second hand placed
on the back of the hand on the
sternum
Fingers may be interlocked
Sternum depressed vertically45cm and then released rapidly
Repeated at a rate of 80100/minwith compression and
relaxation each taking the same
length of time
Locate rib cage
Position your hands over middle of lower
half of sternum and fingers away from
Chest
Compression of Chest
Arms Vertical
Arms Straight
Press
Depress
4-5Cm
CPR
One Rescuer
Chest compressions
15 x
Breathing
2x
Two rescuers
Depth of Compression
Adult: 1 ½ - 2 inches or enough
to generate a pulse
Child & Infant: 1/3 – ½ the depth
of the chest or enough to generate
a pulse
Continue
Resuscitation
Until
Qualified help arrives and takes
over.
Victim shows signs of life.
You become exhausted.
Reassessment (10 seconds)
Should be performed after the first
minute of CPR and every few
minutes thereafter
If no pulse- resume CPR
If pulse and breathing presentplace in recovery position
If pulse present but no breathingprovide rescue breathing
BLS Algorithm
CHECK RESPONSIVENESS
Shake & Shout
OPEN AIRWAY
Head tilt / Chin lift
CHECK BREATHING
Look, Listen and Feel
BREATHE
2 Effective Breaths
ACCESS CIRCULATION
10 seconds only
Signs of a Circulation
CIRCULATION PRESENT
Continue Rescue Breathing
NO CIRCULATION
Compress Chest
Check Circulation every Minute
100 Per Minute 15:2 Ratio
CPR…
Nutshell
Adult
Paediatric
Breath rate
10 – 12
bpm
20 bpm
Pulse check
Carotid
Brachial
Compression 100/min
rate
>100/min
Compression Hands
method
interlaced
Two or three
fingers or heel
of one hand
CV ratio
15 : 2
5:1
FB
obstruction
Heimlich
maneuver
Back blows
and chest
thrusts
ACLS
Special
equipments and
techniques
ECG monitoring
Defibrillation
iv access
Drug therapy
Post resuscitation care
NOW HE IS SAFE IN HELPING
HANDS