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BLS Lab

Cardiac arrest is the cessation of normal blood circulation in the heart due to failure of the heart to contract effectively. It can be reversible through rapid intervention but will lead to death without treatment. The causes of cardiac arrest include issues related to the heart itself like coronary artery disease as well as other medical conditions. Basic life support involves cardiopulmonary resuscitation with chest compressions, opening the airway, rescue breathing, and defibrillation if needed. It is important to act quickly to restore circulation through high-quality CPR and use of an AED or defibrillator if available.

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Rosemarie Quibol
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19 views54 pages

BLS Lab

Cardiac arrest is the cessation of normal blood circulation in the heart due to failure of the heart to contract effectively. It can be reversible through rapid intervention but will lead to death without treatment. The causes of cardiac arrest include issues related to the heart itself like coronary artery disease as well as other medical conditions. Basic life support involves cardiopulmonary resuscitation with chest compressions, opening the airway, rescue breathing, and defibrillation if needed. It is important to act quickly to restore circulation through high-quality CPR and use of an AED or defibrillator if available.

Uploaded by

Rosemarie Quibol
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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WHAT IS CARDIAC

ARREST
. Cessation of normal circulation of blood due
to failure of heart to contract
effectively.
. Sudden cessation of mechanical activity
of
heart with some or no electrical activity.
. May be reversible by a rapid intervention
but will lead to death in its absence.
REVERSIBLE CAUSES OF CARDIAC
ARREST

5 Ts :
 Pulmonary
thromboembolism
5 Hs:
 Hypoxia
Tension
 Hypovolemia
pneumothorax
 Hypo/hyperkalemia
 Cardiac Tamponade
 Hydrogen ions
Toxins (TCAs,b-
 Hypothermia
bloCoronary
thrckers,ca channel
blocker,digoxin)
thrombosis
CAUSES OF CARDIAC ARREST
CARDIAC: OTHERS
 Coronary artery disease Severe anaphylaxis
 M.I.  Suffocation
 Arrhythmia  Electrocution
 Low C.O.,failure,shock  Trauma
 Cardiomyopathy  Stroke
 Myocarditis 
 Massive pulmonary Exsanguination
emboli (severe loss of
blood)
 Drowning
BLS
 Its Cardiopulmonary Resuscitation (CPR).
 ItCombines rescue breathing and chest
compressions
 Itrequires knowledge and skill to perform
CPR
and how to operate AED / defibrillartor.
 These are Sequences of procedures performed
to
restore the circulation of oxygenated blood
after a sudden pulmonary and/or cardiac arrest
ABC to CAB
Basics of BLS
• Chest compressions
• Airway
• Breathing
• Defibrillation
STEPS of BLS
. Assessment and scene safety
1. Scene is safe??
2. Asses the patient
3. Check breathing
Assess the patient
 Shake shoulders gently
 Ask “Are you all right?”
 If he responds

 Find out what is wrong.


 Reassess regularly.
Check for pulse: no more than 10
sec
Locate the trachea

Using 2 or3
fingures

Slide the finger laterally

Into the groove between trachea and muscle

Feel the pulse

Feel the pulse at least for 5 seconds


SHOUT FOR
HELP
Start CPR
 Push hard and push
 Ratio: 30:2 fast
 High quality CPR  100-120/min
 2.5-2-1.5 inch depth
 Chest compression
 Allow complete chest
is foundation of CPR recoil
 Avoid excessive
ventilation
 Minimize
interruption
 <10 seconds

 Effective rescue
breaths
Chest
Compressions
Position yourself at the patient’s side

 Victim should be laid on firm, flat surface

 Remove the clothings of the patient.


 Put the heel of one hand on the centre of
chest(sternum) at the level of nipples and put
your other hand on the top of the former hand.
 Strengthen arms and shoulders ditrectly over
hands
 Lock all joints ; movement is allowed only at
hipjoint

 Push hard and fast (100 - 120 times / min)


 At the end of each compression, chest is
allowed
torecoil completely
 Avoid excessive
ventilation
 Then give next compression
immediately
Chest
Compressions
Mechanisms
• Cardiac Pump–
1. Blood pumping is assured by compression
of
heart between sternum and spine
2. Between compressions, thoracic cage expands
and
heart gets filled with blood.
Thoracic Pump
Opening the airway
Caution
. Do not press deeply into the soft tissue
. Don’t use thumb to lift the chin
. Don’t close mouth completely
Jaw thrust
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

26
Types
 Mouth to mouthbreathing

 Mouth to barrier device breathing

 Mouth to noseand mouth tostoma ventilation

 Ventilation with bag and mask


Mouth-To-Mouth breath
Mouth-To-Nose breath
 Given when mouth cant be open
 Good seal cant be made
 Severe injury present over area of
mouth
Mouth-To-Barrier device
Bag and Mask
ventilation
 Positionyourself directly above
patient’shead
o Make “C”with thumb and index finger to seal the
mask
o Perform head tilt
o And other 3 fingers,forms“E” jaw thurst

o Chest rise is checked while squeezing the bag to


give
breaths to the patient.
Bag And Mask
Ventilation
Defibrillation
 Defibrillation is used for the treatment
of
tachydysrhythmias.
 Defibrillation depolarises the critical mass
of
myocardial cell at once. It recaptures the SA
node as its role as the pacemaker .
 Is treatment of choice for pulseless VT/VF.

Prof. Dr. RS Mehta, BPKIHS


DEFIBRILLATION
Ventricular
tachycardia

35 Prof. Dr. RS Mehta, BPKIHS


Ventricular
fibrillation

36 Prof. Dr. RS Mehta, BPKIHS


Defibrillator
Defibrillators can be classified as :
Monophasic(delivers current of
one polarity only)

Biphasic (deliver current of 2


polarity)

37 Prof. Dr. RS Mehta, BPKIHS


Position of defibrillator paddle:

1 paddle - on the right


st

side of the chest just


below the clavicle
 2 at precordial,
nd

region.
 Paddle should be applied
with pressure equivalent
to 10 kg.

38 Prof. Dr. RS Mehta, BPKIHS


Paddle
size

 Adult: 13cm
 Children:8cm
 Infants:4.5cm
Latest Recommendation for shock protocol ;
Previous recommendation of 3 successive shock
(200,300,360J)
Now a days only single shock is recommended .i.e.
360J by monophasic
150-200J by biphasic
39
Nurses role while performing
defibrillation
 Apply conducting jelly between the
paddle and the skin.
 Place the paddle so that they don't
touch patient’s clothing and bed
linen and aren't near medication and
direct oxygen flow.
 Ensure that defibrillator is not in
synchronized mode.
 Don't charge the device until ready to
shock
 keep the thumbs and fingers off
discharge button until paddle are on
Nurses role in
defibrillation

 Before pressing the discharge button call “ all


clear” 3 times
1st clear: Ensures" YOU” aren’t touching
patient,bed, equipment

2nd clear: Ensures “no one" is touching patient,bed ,


equipment
3rd clear: Ensures “you and everyone" else are clear off
the patient and anything touching the patient.
Nurses role in
defibrillation
 Recordthe delivered energy and the results (cardiac
rhythm and pulse).

 After the event is complete inspect the skin


under
the pads and paddles for burns , and if any
detected consult about the treatment.

42 Prof. Dr. RS Mehta, BPKIHS


Using an AED

First turn it on.


Then simply follow
instructions.

43
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 DELIVERED
FOLLOW AED INSTRUCTIONS

30 2
IF VICTIM STARTS TO BREATHE
NORMALLY PLACE IN RECOVERY
POSITION
DRUGS

1. Adrenaline(all types of cardiac arrest)- 1mg


every 3-5 mins
2. Amidarone(VF,VT)- 1st
dose:300mg IV bolus,
2nd dose 150 mg
3. Lidocaine- ( 1 to 1.5 mg/kg)
4. Sodium bicarbonate(only if cardiac arrest is
associated with hyperkalemia ) (2- 5 meq/kg)
5. Calcium gluconate- 10 mg iv slowly
6. Magnesium sulphate – 2 gms iv in 100 ml NS
(refractory VT / VF)
51
THANK YOU
FOR YOUR ATTENTION

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