BLS Flashcards
BLS top 5 messages
- Recognise CA and start CPR
- Alert emergency medical services
- Start CPR
- Get AED
- Learn to do CPR
When should CPR be started
Any person who is unresponsive with absent or abnormal (agonal) breathing
BLS algorithm
1) unresponsive w absent/abnormal breathing
2) call emergency services
3) 30 compressions
4) 2 rescue breaths
5) continue CPR 30:2
6) as soon as AED arrives switch on and follow instructions
How to recognise CA
Unresponsive with abnormal or absent breathing
Slow laboured breathing (agonal) should be considered sign of CA
Short period of seizure like movement can occur at start of CA - assess breathing after seizure stops
When should you leave a person in CA
To contact emergency medical services
Do not leave pt to get an AED
How deep should CPR compressions be
5-6cm
CPR rate
100-120/min
What is the max amount of time to interrupt compressions for rescue breaths
10 seconds
Even if 1 or both breaths not effective
Reasons to interupt CPR
Health professional tells you to stop
Victim definitely waking up/moving/opening eyes/breathing normally
Exhaustion
High quality chest compressions
Lower half of sternum
5-6cm depth
100-120/min rate
As few interruptions as possible
Full recoil after each compression
Firm surface
When should choking be suspected
Pt suddenly unable to speak, esp if eating
Foreign body airway obstruction management
1) Encourage pt to cough
2) 5 back blows
3) 5 abdominal thrusts
4) alternate between 5 back blows or abdo thrusts until choking relived or pt becomes unconscious
6) if pt becomes unconscious start CPR
Back blows
Lean pt foreward, strike between shoulder blades w heel of hand
Abdo thrusts
Lean pt foreward, pull sharply in and up with fist clenched between rib cage and navel
What characteristics are associated with a CA that starts with seizure-like activity
Younger pt
Witnessed arrest
Initial shockable rhythm
Survival to hospital discharge
What are the main factors that prevent a CA being recognised
Agonal breathing
Initial Seizure like activity
If a phone is not immediately available, should a lone bystander call EMS or start CPR first
Call EMS, but controversial which is better for survival
Factors effecting quality of chest compressions
Depth
Rate
Degree of chest wall recoil
Pauses in compressions
Why should compressions be done on lower 1/3 of sternum
Overlies Maximal ventricular cross sectional area in most adults/children
What structures may be compressed by chest compressions in centre of chest
Ascending aorta
Left ventricular outflow tract
When should a pt not be moved from bed to floor for CPR
Hospital setting
What outcome is improved by a 30:2 ratio over a 15:2 ratio
Neurological outcome
How much does chance of successful resuscitation decrease for every minute defibrillation is delayed
3-5%
Most effective pad position for atrial and ventricular arrhythmias
Atrial - anterior posterior
Ventricular - - antero lateral
Factors increasing risk of foreign body airway obstruction
Psychotropic medication
Alcohol intoxication
Neuro conditions reducing swallowing and cough reflexes
Mental impairment
Developmental disability
Dementia
Poor dentition
Older age
Severe airway obstruction signs
Unable to speak
Weakened cough
Struggling/unable to breath
Rationale for CPR in unconscious pt with airway obstruction
Chest compressions provide higher airway pressures than abdo thrusts, while providing some cardiac output
Which choking pts should recieve medical review after obstruction is relieved
Persistent cough
Difficulty swallowing
Sensation of object still stuck in throat
Recieved abdo thrusts or chest compressions
