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