BLS Flashcards
What are the changes with BLS for cardiac arrest since covid
- Wear non-AGP PPE for assessment and chest compressions
- AGP PPE needs to be worn for airway interventions and ventilations
- The A (airway) in DRS ABC has now been removed - do not open the airway and do not do head tilt chin lift
- Humidity moisture exchange filter added to bag valve mask
What is the sequence for dealing cardiac arrest
- check for danger
- check for response
- shout for help
- check breathing and circulation
- start chest compressions
- AED
- Airway intervention/ventilation
- Post-resus care
What is the process for checking for response
- Make sure patients mouth and nose covered
- Gently shake
- Speak loudly
When shouting for help, what should you ask the person to do
Get the emergency kit
Call 999
What should the person calling 999 say to emergency services
- Cardiac arrest
- Not breathing
- Location
- Contact number
- Covid status
What is the process of checking breathing and circulation
- Palpate carotid pulse
- Hand on chest
- Check at same time for 10 seconds
- Agonal breathing may be seen - ignore it
What PPE must be worn for chest compressions
non AGP PPE at least
What is the technique for chest compressions
- Interlock fingers & straight elbows
- Compress 5-6cm
- 100-120 compressions per minnute
How do we prepare the patient for AED
- Cut through clothing
- Dry up any sweat
- Shave chest if required
What should you ensure when delivering shock
ensure you are far from the patient, do not touch any equipment and move oxygen 1m away
What levels of the dental school will you find an AED
- 1
- 3
- 4
- 6
- 7
What must be worn for airway intervention / ventilation
full AGP PPE
What has been added to the bag valve mask since covid
HME
What should oxygen be set at
15L of 100% oxygen per minute
If patients chest doesn’t rise and fill in first 2 ventilations what should you do
use oropharyngeal airway adjuncts
How do we size oropharyngeal airway adjuncts
- Rule of thumb is green for female and orange for male
- To size, one finger on mandible and size from here to the incisors
How do we insert oropharyngeal airway adjuncts
- To insert, put in upside down and twist 180
- Once inserted keep going with 30:2
- If patient chest still doesnt rise, just continue
What is the post resus care
- Reassess B + C
- Reassure casualty even if unconscious
- Maintain airway
- Deliver oxygen via bag valve masque
- Do not remove AED pads
- Can cover up to maintain dignity and keep warm
- Be prepared for re-arrest
What is the sequence for choking
- ask can the cough
- if unable to cough, 5 back blows
- if doesn’t work, 5 abdominal thrusts
- keep going between the 2 until relieved or unresponsive
- CPR if becomes unresponsive
How do you do back blows
- Lean person forward, supporting them at the front
- Apply blows between shoulder blades using heel of one hand
How do you do abdominal thrusts
- Stand behind the person and put both your arms around upper part of abdomen
- Lean person forward
- Clench your fist and place it between the navel and ribcage
- Grab fist with other hand and pull sharply inwards and upwards
How many rhythms are there in a cardiac arrest and how many are shockable?
4 - 2 are shockable
What are the shockable rhythms?
Ventricular fibrilation (Vfib)
Pulseless ventricular tachycardia (V-tach)
(asystole and pulseless electrical activity are the non-shockable ones)
What do you do if you pt does not have a shockable rhythm?
Continue CPR till ambulance arrives (remember everyone is an organ donar now)
