1.CPR

ADULT BASIC LIFE SUPPORT (BLS)

OBJECTIVES
Students should be able to demonstrate: How to assess the collapsed victim How to perform chest compression and rescue breathing How to place an unconscious breathing victim in the recovery position.

BACKGROUND

Approximately 700,000 cardiac arrests per year in EuropeSurvival to hospital discharge presently approximately 5-10%Bystander CPR vital intervention before arrival of emergency services – double or triple survival from SCA (sudden cardiac arrest) Early resuscitation and prompt defibrillation (within 1-2 minutes) can result in >60% survival

CHAIN OF SURVIVAL

 BASIC LIFE SUPPORT
SEQUENCES OF PROCEDURES PERFORMED TO RESTORE THE CIRCULATION OF OXYGENATED BLOOD AFTER A SUDDEN PULMONARY AND/OR CARDIAC ARREST CHEST COMPRESSIONS AND PULMONARY VENTILATION PERFORMED BY ANYONE WHO KNOWS HOW TO DO IT, ANYWHERE, IMMEDIATELY, WITHOUT ANY OTHER EQUIPMENT Protective devices

Approach safely

Check response
Shout for help
Open airway
Check breathing
Call 112
30 chest compressions
2 rescue breaths

APPROACH SAFELY!

Scene Rescuer Victim Bystanders
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 112
30 chest compressions
2 rescue breaths

CHECK RESPONSE

Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 112
30 chest compressions
2 rescue breaths



Shake shoulders gentlyAsk “Are you all right?”If he responds Leave as you find him. Find out what is wrong. Reassess regularly. CHECK RESPONSE

SHOUT FOR HELP

Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 112
30 chest compressions
2 rescue breaths

OPEN AIRWAY

Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 112
30 chest compressions
2 rescue breaths

 OPEN AIRWAY

Head tilt and chin lift - lay rescuers - non-healthcare rescuers

No need for finger sweep unless solid material can be seen in the airway

 OPEN AIRWAY
Head tilt, chin lift + jaw thrust - healthcare professionals

CHECK BREATHING

Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 112
30 chest compressions
2 rescue breaths



CHECK BREATHING
Look, listen and feel for NORMAL breathing Do not confuse agonal breathing with NORMAL breathing

AGONAL BREATHING

Occurs shortly after the heart stops in up to 40% of cardiac arrests Described as barely, heavy, noisy or gasping breathing Recognise as a sign of cardiac arrest Erroneous information can result in withholding CPR from cardiac arrest victim

Approach safely

Check response
Shout for help
Open airway
Check breathing
Call 155 / 112
30 chest compressions
2 rescue breaths

 FOREIGN-BODY AIRWAY OBSTRUCTION (FBAO)

Approximately 16 000 adults and children receive treatment for FBAO in the UK yearly

SIGNS

MILD obstruction
SEVERE obstruction
“Are you choking?” “YES” Unable to speak, may nod
Other signs
Can speak, cough, breathe
Can not breathe/wheezy breathing/silent attempts to cough/ unconsciousness

 ADULT FBAO TREATMENT

BACK BLOWS

 ABDOMINAL THRUSTS

30 CHEST COMPRESSIONS
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 112
30 chest compressions
2 rescue breaths



Place the heel of one hand in the centre of the chest Place other hand on top Interlock fingers Compress the chest Rate 100 min-1 Depth 4-5 cm Equal compression : relaxation When possible change CPR operator every 2 min
CHEST COMPRESSIONS

RESCUE BREATHS

Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 112
30 chest compressions
2 rescue breaths

RESCUE BREATHS

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

 RESCUE BREATHS

RECOMMENDATIONS:- Tidal volume 500 – 600 ml- Respiratory rate give each breaths over about 1s with enough volume to make the victim’s chest rise- Chest-compression-only continuously at a rate of 100 min


CONTINUE CPR

30 2

Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 112
30 chest compressions
2 rescue breaths

DEFIBRILLATION

Call 112
Approach safely
Check response
Shout for help
Open airway
Check breathing
Attach AED
Follow voice prompts

AUTOMATED EXTERNAL DEFIBRILLATOR (AED)

Some AEDs will automatically switch themselves on when the lid is opened

ATTACH PADS TO CASUALTY’S BARE CHEST

ANALYSING RHYTHM DO NOT TOUCH VICTIM

SHOCK INDICATED

Stand clear Deliver shock

SHOCK DELIVEREDFOLLOW AED INSTRUCTIONS

30 2

NO SHOCK ADVISEDFOLLOW AED INSTRUCTIONS

30 2

IF VICTIM STARTS TO BREATHE NORMALLY PLACE IN RECOVERY POSITION

Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 112
30 chest compressions
2 rescue breaths
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 112
Attach AED
Follow voice prompts

 CONTINUE RESUSCITATION UNTIL

Qualified help arrives and takes over The victim starts breathing normally Rescuer becomes exhausted

 REPETITION

1. Name adult basic life support sequences of actions.2. What is the manoeuvre for keeping the airway open called? 3. What is the numeral combination of chest compression and rescue breaths in adult basic life support?4. Where do you place your hands while performing chest compressions?5. How would you describe „agonal breathing“?6. What is the telephone number of emergency response system?7. Name 2 techniques applied in severe airway obstruction?

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