Week 7 - Basic life support Flashcards
Basic life support - definition
‘A technique employed to sustain life of a person
apparently dead or dying, which includes rescue breaths and chest compressions’
Chain of survival
-Early recognition and call for help
-Early CPR
-Early defibrillation
-Post resuscitation care
DR ABC R
Danger
check Response
open Airway
check Breathing
Chest compressions
Rescue breaths
Check for danger
Is it Safe?
-Scene
-Yourself
-Victim
-Bystanders
Try to eliminate or minimise risk;
-Electricity
-Gas
-Water
-Violence
-Weapons
-Traffic
-Animals
-Consider Infection
Check response
A – Alert
V – Voice
P – Pain
U – Unresponsive
->Gently squeeze shoulders and
ask “Are you all right?”
If he responds:
-Leave as you find him
-Take history and find out what is wrong
If unresponsive…
-Shout for help!
-Lay the patient supine on a hard surface such as the floor
Open airway
Head Tilt and Chin Lift
Remove any visible obstruction from the victims mouth, including dislodged dentures -> leave well fitting dentures in place
DO NOT ATTEMPT ANY BLIND FINGER SWEEPS !!!
Check breathing
-Look, Listen and Feel for
NORMAL breathing for no
longer than 10 seconds
-Those experienced in clinical
assessment may wish to
check the carotid pulse
simultaneously when
checking for breathing
-Do not confuse agonal
breathing with NORMAL
breathing
Agonal breathing
-An abnormal pattern of breathing characterized by slow,
laboured, noisy gasps
-One gasp every 10-15 seconds
-Occurs shortly after the heart stops in up to 40% of cardiac arrests
->Not to be confused with normal breathing !!!
-If unsure act as if breathing is not normal
If breathing normally…
…place the patient in the recovery position
If NOT breathing normally, shout for a defib and start 30 Chest compressions
-Place the heel of one hand
in the centre of the chest
-Place other hand on top
and Interlock fingers
-Compress the chest 30
times:
–Depth 5-6 cm
–Rate 100-120/min
->If possible change CPR provider every 2 minutes to prevent fatigue
-2 Rescue Breaths: (head tilt and chin lift):
-Pinch the nose
-Take a normal breath
-Place lips over mouth
-Blow until the chest rises
-Take about 1 second
-Allow chest to fall
-Repeat
When can you stop…
-When the patient shows signs of life AND starts breathing normally
-When more qualified medical
help takes over
-When you become physically
exhausted
Choking
-Clutching throat
-Ineffective cough
-Excessive salivation
-Fear
-> If unsure ask them!
Management
1-Encourage to cough
2-Give up to 5 back blows
-Back blows are more effective if the patients head is positioned head down
-Lean the patient over your arm or something like a chair
-Do not compress the soft tissues under the jaw, as this can exacerbate the airway
obstruction
-Deliver up to 5 sharp back blows with the heel of one hand in the middle of the back between the shoulder blades
-The aim is to relieve the obstruction with each blow rather than to give all 5
3-Give up to 5 abdominal thrusts
-Stand or behind the patient
-Place your arms under their arms and encircle their torso
-Clench your fist and place it between the umbilicus (tummy button) and xiphisternum
-Grasp this hand with your other hand and pull sharply inwards and upwards
-Repeat up to 4 more times
-Ensure that pressure is not applied to the xiphisternum or the lower rib cage as this may cause abdominal trauma
-The aim is to relieve the obstruction with each thrust rather than to give all 5
Following abdominal thrusts, reassess the patient:
-If the object has not been expelled and the patient is still
conscious, continue the sequence of back blows and
abdominal thrusts, whilst encouraging to cough
-Call out, or send for help if it is still not available
-Do not leave the patient at this stage
-If the object is expelled successfully, assess the clinical
condition -> it is possible that part of the object may remain in
the respiratory tract and cause complications
If there is any doubt -> seek medical assistance !!!
If the patient becomes unconscious
-Place on a firm, flat surface
-Call out, or send for help 999
-Check airway - (this is vital as you know there is something in
it)
-The muscles in the airway relax on loss of consciousness –
obstruction may have moved!
-Start CPR
Defibrillation
Automatic External Defibrillators (AED’s)
-An AED is specifically designed to be used by anyone
-As soon as an AED is
available, turn it on and attach the pads to your patient’s bare chest
-If there is anyone else helping you, attach the defib whilst they continue chest compressions
Pad placement
-The pads should be placed
as shown on the pad’s
pictures
-One on the top right of the
patient’s bare chest, and the
other on the bottom left
-This means the shock will
travel through the heart
AED sequence
-When attached the AED will tell
you to stop compressions whilst it analyses the patients heart
rhythm - it will then say
something along the lines of :
“Shock advised – charging – press the shock button now.”
Or
“No-shock advised – continue
CPR if necessary
If it says… shock advised – charging – press the shock button now
- This means the
patient’s heart is a type of
rhythm which does not
sustain life. So, we need to
shock the patient to make
the heart come out of this
rhythm - If possible, do some chest compressions whilst the machine is charging
- When the machine is
charged but before pressing the shock button: - Look at the top, the middle and the bottom of the patient to make sure nothing is touching them -> shout “stand clear” and
press the button
If it says…“No-shock advised – continue CPR if necessary”
- This means the patient’s heart is either pumping normally, or it’s in a cardiac arrest rhythm which will not respond to being shocked
- So after hearing this look at your patient
- If they are still not breathing normally and have no signs of life continue CPR
- If they start breathing and show signs of life you’ve just saved them
Sequence
After analysing the patient’s heart and telling you the
instructions, the AED will remain quiet for 2 minutes
-This give you 2 minutes to do the best CPR you can do -> go hard and fast!
-After the 2 minutes the AED will tell you to stop CPR and it will re-analyse the patient’s heart
-This is the perfect time to swap CPR providers
When can you stop…
- When the patient shows signs of life AND starts breathing normally
- When more qualified medical help takes over
- When you become physically exhausted
