BLS COVID Update 2020 Flashcards
ILCOR 2015
International Liaison Committee on Resuscitation
Consensus on Science and Treatment Recommendations (CoSTR) for BLS/AED
National Resuscitation Councils:
- Resuscitation Council UK
- European Resuscitation Council
information from
D
R
S
A
B
C
old
Danger
Response
Shout
Airway
Breathing
Circulation
D
R
S
B
C
now used
Danger
Response
Shout
Breathing
Circulation
PPE worn for assessment and chest compressions
Basic PPE
- face mask (fluid resistant surgical mask) - single use
- gloves - single use
- disposable apron
- visor/eye protection
PPE worn for airway interventions and ventilations
AGP procedures
- visor/full face shield/eye protection
- FFP 3 face mask
- gloves - single use
- long sleeved fluid repellent gown
Danger
assess environment for dangers - e.g. cars, wires
Cover victim’s nose and mouth with a surgical mask or cloth
Response
Gently shake
Speak loudly
- Hello can you hear me?
Victim – cover their face
Checker – wears basic PPE
Shout
HELP
- get assistant (need you and someone else to do CPR and then gatekeeper outside of surgery to minimise spread)
DON’T GO NEAR THE AIRWAY/OPEN IT
- No head tilt/chin lift
Breathing and Circulation
STAY CLEAR OF THE AIRWAY
- Keep face far away even if face covered
- Look and feel for rise and fall in chest
Palpate a carotid pulse
Hand on the chest
Simultaneously check for 10 seconds
agonal breathing
Infrequent noisy gasps
Not normal
Ignore, continue CPR sequence
what to say when dial 999
Cardiac arrest
Not breathing
Location
Contact number
COVID status
- If know – say.
- If not say “COVID status unknown”
chest compressions
can wear basic PPE
- Interlock the fingers
- Straight elbows
- Compress the sternum 5cms to 6cms
- 100 -120 compressions pm
- 2 per second
Continue until help arrives
- carry on with just compressions if no more PPE or AED
prepare patient for AED
Cut clothes away
Shave hair
Dry torso – sweat, water, blood
Defibrillation
Attach pads to the patients chest
- ASAP even if only wearing droplet-protection PPE
Left side – 10 cm below armpit
Right side – jaunty angle at clavicle
Listen to the voice prompts
Early defibrillation is a key intervention associated with improved neurological outcomes
- Success rate drops with every minute
AED
Stand clear
Do not touch the patient
Do not touch equipment - Chair - Bracket table - Standing on base plate Move the O2 a meter away
150 joules = 4800 volts
No airway intervention or ventilation until, you don full AGP PPE
Only 2 people allowed with person in the area – Gatekeeper outside with red bag, they will pass items needed into surgery when requested to minimise contact with victim
when can do airway intervention
you don full AGP PPE
Only 2 people allowed with person in the area – Gatekeeper outside with red bag, they will pass items needed into surgery when requested to minimise contact with victim
oxygen tank and BVM
15 litres of 100% O2 per minute
15-25 mins Titration valve – litres/min (15l) Age on side Black open and close valve on side] Back has attachment for BVM – end away from rugby ball
Humidity Moisture Exchange (HME)
Added to BVM due to COVID
- Between BVM and pt mask
Limit exchange
HME attached to BVM
ventilations
Use a 2 person technique
Want best possible seal
- Thumbs 11
- Fingers under mandible
Squeeze bag gently, let refill and squeeze again and see chest rise and fall to ensure working
- Check Seal and head tilt chin left, if still no success get airway adjunct from gatekeeper
AGP PPE must be worn
FFP3 mask for all staff before airway interventions commence
Give 2 rescue breathes via BVM (100% O2)
- Not via mouth to mouth or mouth to mask
airway adjuncts
Oropharyngeal airway (OPA)
Insert upside down
180 degree twist
Measure – end of airway at angle of mandible and line with mid-point of incisors
- Finger of labial of teeth and colour block lines up
Green – adult female
Orange – adult male
defibrillator locations in GDH (5)
Level 1 Level 3 Level 4 Level 6 Level 7
post resuscitation care ROSC
return of spontaneous circulation without any neurological deficit is what the goal is
REASSESS B + C
- Reassure casualty (even if unconscious)
- Chat away, keep calm
Maintain airway
- Deliver O2 via BVM
To supplement their limited breathing until cannot cope with BVM
- Then attach oxygen mask – two pieces of rubber when bag pops up
DO NOT remove AED pads
Cover up to maintain dignity and keep warm
The casualty could rearrest - cause of cardiac arrest not resolved
- be prepared to deliver CPR again
Keep all emergency equipment to hand
Don’t give anything back so have everything to hand util paramedics arrive
how to maintain airway after ROSC
- Deliver O2 via BVM
To supplement their limited breathing until cannot cope with BVM - Then attach oxygen mask – two pieces of rubber when bag pops up
how often should rescuer be swapped
every 2 mins (“analysing rhythm” said on AED)
CPR
Cardiopulmonary resuscitation
BLS
basic life support
AED
Automated external defibrillator
BVM
bag valve mask
O2
oxygen
SAS
scottish ambulance service
AGP
aersol generating procedure
PPE
personal protective equipment
OHCA
Out of hospital cardiac arrest
VT
Ventricular tachycardia
VF
Ventricular fibrilation
ROSC
Return of spontaneous circulation
HME filter
Humidity moisture exchange filter
OPA
Oropharyngeal airway
4 possible heart rhythms
Ventricular fibrillation (VF)
Ventricular tachycardia (VT).
Asystole
Pulseless electrical activity (PEA)
2 shockable heart rhythms
Ventricular fibrillation (VF) Ventricular tachycardia (VT).
