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Basic Concept of BLS: Shaheen Fatima Bs (Siut Karachi) MSPH (Jsmu Karachi)

The document provides information about basic life support including definitions of adults, children and infants, the steps of high quality CPR, the adult chain of survival, signs of cardiac arrest and heart attack, basic life support sequences, opening the airway, use of an automated external defibrillator, indications for stopping CPR, outcomes after CPR, injuries related to CPR, complications of CPR and rescuer safety.

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31 views26 pages

Basic Concept of BLS: Shaheen Fatima Bs (Siut Karachi) MSPH (Jsmu Karachi)

The document provides information about basic life support including definitions of adults, children and infants, the steps of high quality CPR, the adult chain of survival, signs of cardiac arrest and heart attack, basic life support sequences, opening the airway, use of an automated external defibrillator, indications for stopping CPR, outcomes after CPR, injuries related to CPR, complications of CPR and rescuer safety.

Uploaded by

adnanreshun
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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Basic concept of BLS

SHAHEEN FATIMA
BS(SIUT KARACHI)
MSPH(JSMU KARACHI)
AGE DEFINITIONS
• ADULTS
After the onset of puberty and older
• CHILDREN
1 year of age to puberty
• INFANTS
Less than 1 year of age(excluding newly born infants in
delivery room)
HIGH QUALITY CPR
 Start compressions within 10 seconds of recognition of
cardiac arrest
 Push hard, push fast. Compress at a rate of at least 100 to 120
times per minute with depth of
 At least 5 cm for adults
 At least 1/3 the depth of the chest about 5cm for children
And 4cm for for infants
 Allow complete chest recoil after each compression.
 Minimize interruptions in compressions
 Give effective breaths
 Avoid excessive ventilation
ADULT CHAIN OF SURVIVAL
1.OHCA
The term Chain of Survival provides a useful metaphor for the elements of
the ECC systems concept.

The 5 links in the adult Chain of Survival who has out hospital cardiac arrest are,

• Immediate recognition of cardiac arrest and activation of the emergency


response system

• Early cardiopulmonary resuscitation (CPR) with an emphasis on chest


compressions

• Rapid defibrillation

• Effective advanced life support

• post-cardiac arrest care


CONT..
2.IHCA
• Prevention and treatment of pre arrest conditions
• Recognition of cardiac arrest and activation of emergency
response system
• Early CPR with an emphasis on chest compressions
• Rapid defb
• Post cardiac arrest care
WHAT IS CARDIAC ARREST AND
HEART ATTACK
Signs of cardiac arrest
1. Unconsciousness in several seconds
2. Respiratory arrest ( apnea) or the last gasps (1-3
minutes after cardiac arrest)
3. Pulse-less on large ( major) arteries
(carotid or femoral artery)
4. Changed general appearance
(colour changes, face changes
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
AIRWAY OPENING
HEAD TILT/CHIN LIFT,
• The head-tilt chin-lift is the most reliable method of opening
the airway. The simplest way of ensuring an open airway in an
unconscious patient is to use a head tilt chin lift technique,
thereby lifting the tongue from the back of the throat
CONT…
• Head tilt/Chin lift. The head-tilt/chin-lift is a procedure used
to prevent the tongue obstructing the upper airways. The
maneuver is performed by tilting the head backwards in
unconscious patients, often by applying pressure to the
forehead and the chin
• It is performed by placing the index and middle fingers to
physically push the posterior aspects of the
lower jaw upwards while their thumbs push down on the chin
to open the mouth. When the mandible is displaced forward,
it pulls the tongue forward and prevents it from obstructing
the entrance to the trachea.
AED
• Most sudden cardiac arrests are triggered by abnormal heart rhythms
called arrhythmias.
• Two life-threatening arrhythmias that can cause cardiac arrest are
pulseless ventricular tachycardia (pVT) and ventricular fibrillation (VF),
where the heart’s electrical impulses suddenly become chaotic and
ineffective
• Blood flow to the brain stops abruptly and the victim loses consciousness.
Death usually follows unless a normal rhythm and pulse are restored
within minutes
• The AED uses voice prompts, lights, and on-screen messages to tell the
rescuer the steps to take
• AEDs are simple to operate, allowing layperson and healthcare providers
to attempt defibrillation safely
Cont…
• Anterolateral Placement
• Both pads will be placed on the victim's bare chest.
• Place one AED pad directly below the right collarbone.
• Place the other pad to the side of the left nipple, with the top
edge of the pad a few inches below the armpit.
When Can I Stop CPR
Victim revives
Trained help arrives
Too exhausted to continue
Unsafe scene
Physician directed (do not resuscitate orders)
Cardiac arrest of longer than 30 minutes
(controversial)
Outcome after CPR
– Special emphasis

– Soon defibrilation

–  1 minute - survival - 90%,


–  5 minutes - survival - 50%,
–  7 minutes - survival - 30%
–  10 - 12 minutes - survival - 2 – 5%.
Cont…

• In first 4 minutes – brain damage is unlikely, if


CPR started
• 4 – 6 minutes – brain damage possible
• 6 – 10 minutes – brain damage probable
• > 10 minutes – severe brain damage certain
–
– Cells of the brain cortex
• Most sensitive for the stop of pefusion and
oxygenation
– Without perfusion and oxygenation
–  irreversibly damaged after 3-5 minutes
WHY CPR MAY FAIL
• Delay in starting
• Improper procedures (ex. Forget to pinch nose)
• No ACLS follow-up and delay in defibrillation
– Only 15% who receive CPR live to go home
– Improper techniques
• unmanageable disease (massive heart attack)
Injuries Related to CPR

• Rib fractures

• Laceration related to the tip of the sternum


– Liver, lung, spleen
Complications of CPR
• Vomiting
• Aspiration
• Place victim on left side
• Wipe vomit from mouth with fingers
wrapped in a cloth
• Reposition and resume CPR
Rescuer’ s safety

The rescuer should never place him/herself or others at more


risk than the victim

• before starting resuscitation – assess the risks of ongoing


traffic, electrocution, toxic fumes and poisons
• risk of infections transmission
• bloodborne infections (hepatitis B and C, HIV)
can be transmitted by blood and other body
» solutions, excretes
• airborne infections (TB and several infectious diseases -
herpetic, meningococcal etc.
» can be transmitted by mouth-to-mouth breathing
THANK YOU
1.The compression to ventilation ratio for one rescuer giving CPR to individuals of ANY age
is:
30:1
30:2
15:1
15:2
2. How often should rescuers switch roles when performing two-rescuer CPR?
After every cycle of CPR
After every two cycles of CPR
After every five cycles of CPR
After every 10 cycles of CPR
3. The proper steps for operating an AED are:
Power on the AED, attach electrode pads, shock the individual, and analyze the rhythm
Power on the AED, attach electode pads, analyze the rhythm, clear the individual, and
deliver shock
Attach electrode pads, check pulse, shock individual, and analyze rhythm
Check pulse, attach electrode pads, analyze rhythm, shock patient
5. The initial Basic Life Support (BLS) steps for adults are:
Assess the individual, give two rescue breaths, defibrillate, and start CPR
Assess the individual, activate EMS and get AED, check pulse, and start CPR
Check pulse, give rescue breaths, assess the individual, and defibrillate
Assess the individual, start CPR, give two rescue breaths, and defibrillate
6. The critical characteristics of high-quality CPR include which of the following?
Starting chest compressions within 10 seconds of recognition of cardiac arrest
Pushing hard and fast
Minimizing interruptions
All of the above
7. The five steps in the Adult Chain of Survival include all of the following EXCEPT:
Early CPR
Rapid defibrillation
Advanced airway placement
Integrated post-cardiac arrest care
9. Which of the following are signs of airway obstruction?
Poor air exchange
High-pitched noise while inhaling
Inability to speak
All of the above

10. In an adult with an advanced airway in place during two-rescuer CPR, how often should the
breaths be administered?
Every 2 to 3 seconds (20 to 30 breaths per minute)
Every 3 to 5 seconds ( > 15 breaths per minute)
Every 5 to 6 seconds (10 to 12 breaths per minute)
Every 10 to 12 seconds (5 to 6 breaths per minute)
Cont…..
11.Which is the third link in adult OHCA chain survival
a.ALS
b. High quality CPR
c. Prevention
d. Rapid defib
12.Which statement best describe the sudden cardiac arrest
a. When the RD in adult occur and heart rate dosnt change
b. When the HR 40 60/mint and respiration increase
c. When blood flow to he heart is blocked and HR increase
d. When an abnormal rhythm develops and the heart stops beating
unexpectedly

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