“GET THAT RN IN NOVEMBER 2023”
BASIC LIFE SUPPORT
CHAIN OF SURVIVAL (ADULT) Mobitz 2 – Normal PR interval & Drop beat
Early recognition of Cardiac Arrest Third Degree – Varied PR interval & sometimes
o Check for 3 signs: there is something (QRS)
Responsiveness If the issue is the prolongation in the PR interval,
Pulse (5 to 10 seconds only) define such if it is CONSTANT progressive or
Early Initiation of HQCPR varied to the succeeding wave
Early Defibrillation – AED Constant – First Degree heart block
Early Transport/ ACLS 3rd
1st Mobit
Post Cardiac Arrest Care (PCAC) Mobitz 1 Degre
Degree z2
e
Recovery
Rate ↓ ↓ ↓ ↓
SCENE SAFETY & ASSESSMENT P Wave ✓ ✓ ✓ ✓
The Scene is Safe QRS
Hey! Are you Okay? Unresponsive Comple ✓ x x X
x
Check pulse & breathing simultaneously Constantl
o Agonal Gasping/Breathing Irregular breath Progressiv
PR y Norma
around 10 times in a minute – not a normal e Varied
Interval Prolonge l
breathing Sign of early Cardiac Arrest Prolonged
d
Active EMS and get AED
Start HQCPR 5 MECHANICAL CRITERIA FOR HQCPR
Push hard 2” (5cm) Injury (Do not stop),
CPR is done to initiate electrical impulses (When alive, address the complication)
DEAD 4 SCENARIOS Push fast 100 to 120 cpm Adult – Child –
Iso-electric signal or asystole Infant
Ventricular Fibrillation The heart is so weak Allow complete chest recoil
that all it can do is to quiver; Consider as dead Limit interruption to CPR ≤ 10 seconds
rhythm Do not Hyperventilate/ Avoid excessive ventilation
Pulseless Ventricular Tachycardia Disruption o Tidal Volume = 500 to 600m = ½ squeeze of the
in an electrical conduction; all electrical impulses bag
are rooting from the ventricles o The intrathoracic pressure will go up, the venous
PEA Normal but no pulse return of blood to heart will go down, cardiac
output will go down
P wave is from the Atria
QRS complex is from the Ventricles AED – Automated External Defibrillator
Look For Rule 1: Turn it on
- P wave are there? Positive Deflection Rule 2: Follow the prompts
- QRS complex Present or absent; narrow or COMPLETE 5 CYCLES IN 2 MINUTES
wide 8 years and older Adult Pad
- PR interval Narrow or wide; < 0.20 sec; 1 big
8 years and younger Pediatric Pad
box in ECG strip; 1 big box prolongation
Place them the same if the patient is dextrocardia
- Rate N., Bradycardia, Tachycardia, zero
(the heart is positioned on the right side of the
1 BIG BOX PROLONGATION chest)
AV Blocks The child can use an adult pad, but an adult cannot
First Degree use a pediatric pad
Mobitz 1 – Progressive PR interval & drop beat
(Missing QRS) 4 CONSIDERATIONS
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“GET THAT RN IN NOVEMBER 2023”
BASIC LIFE SUPPORT
Water – Dry the chest and patient
Hairy Chest – Shave the needed area only
Medication patches where the packs is needed to be
placed – remove the patch, clean the area by wiping
and place the AED pads
Pacemaker – Avoid the metal plate beside or below
such
CHILD
Younger than 18 years old Proceed only if you
know the age; if the patient looks old but is younger
than 18 years old should be considered an adult
Pulse: Brachial if not, Femoral
CHILD & INFANT
Witnessed Arrest
Unwitnessed Arrest – Delayed 2 mins before calling
EMS
15 compressions is to 2 breaths 2 rescuers
Responsiveness: Tap the sole of the feet; Turn the
baby towards your side and rub the back
Pulse: Brachial
Depth: 1½ inches (4cm)
30:2 1 responder
15:2 2 responders
Shock is advised for disorganized rhythm
CHOKING
Heimlich Maneuver or Abdominal Thrust Thrust
above the navel (Responsive)
Chest Thrust – For Fat/obese people In between
nipple (Unresponsive)
Treat it like a BLS patient
Do HQCPR before providing breath, look for the
blockage Blind finger sweep is not recommended
CHOKING INFANT
5 Back slaps
5 Chest thrust (Like chest compression)
Do it until the aspirated objects go out or the patient
becomes unresponsive
Do finger sweep if the obstructing object is visible
ROSC – Patient’s pulse returns but no breathing
Rescue Breaths:
1 every 6 seconds – adult
1 every 3 to 5 seconds - Infant
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