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- 2. European Resuscitation Council BASIC LIFE SUPPORT SEQUENCES OF PROCEDURES PERFORMED TO RESTORE THE CIRCULATION OF OXYGENATED BLOOD AFTER A SUDDEN PULMONARY AND/OR CARDIAC ARREST involves CHEST COMPRESSIONS AND PULMONARY VENTILATION PERFORMED BY ANYONE WHO KNOWS HOW TO DO IT, ANYWHERE, IMMEDIATELY, WITHOUT ANY OTHER EQUIPMENT
- 3. European Resuscitation Council • Healthcare institutions have an obligation to provide an effective resuscitation service • Failure to provide an effective service is a failure in duty of care
- 4. European Resuscitation Council OBJECTIVES Rescuer 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.
- 5. European Resuscitation Council BACKGROUND • Approximately 700,000 cardiac arrests per year in Europe . Indian statistics ? • Survival to hospital discharge presently approximately 5-10% • Bystander CPR vital intervention before arrival of emergency services – doubles survival from sudden cardiac arrest • Early resuscitation and prompt defibrillation (within 1-2 minutes) can result in >60% survival
- 8. European Resuscitation Council Approach safely Check response Shout for help Open airway Check breathing Call 108 / 64 (psg) 30 chest compressions 2 rescue breaths
- 9. European Resuscitation Council APPROACH SAFELY! Scene Rescuer Victim Bystanders Approach safely Check response Shout for help Open airway Check breathing Call 108 / 64 (psg) 30 chest compressions 2 rescue breaths
- 10. European Resuscitation Council CHECK RESPONSE Approach safely Check response Shout for help Open airway Check breathing Call 108 / 64 (psg) 30 chest compressions 2 rescue breaths
- 11. European Resuscitation Council Shake shoulders gently Ask “Are you all right?” If he responds • Find out what is wrong. • Reassess regularly. If he does not respond CHECK RESPONSE
- 12. European Resuscitation Council SHOUT FOR HELP Approach safely Check response Shout for help Open airway Check breathing Call 108 / 64 (psg) 30 chest compressions 2 rescue breaths
- 13. European Resuscitation Council OPEN AIRWAY Approach safely Check response Shout for help Open airway Check breathing Call 108 / 64 (psg) 30 chest compressions 2 rescue breaths
- 14. European Resuscitation Council OPEN AIRWAY Head tilt and chin lift lay rescuers No need for finger sweep unless solid material can be seen seen in airway
- 15. European Resuscitation Council OPEN AIRWAY Head tilt, chin lift + jaw thrust - For healthcare professionals
- 16. European Resuscitation Council CHECK BREATHING Approach safely Check response Shout for help Open airway Check breathing Call 108 / 64(psg) 30 chest compressions 2 rescue breaths
- 17. European Resuscitation Council CHECK BREATHING • Look, listen and feel for NORMAL breathing • Do not confuse AGONAL breathing with normal breathing
- 18. European Resuscitation Council 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
- 19. European Resuscitation Council Approach safely Check response Shout for help Open airway Check breathing Call 108 / 64 (psg) 30 chest compressions 2 rescue breaths
- 20. European Resuscitation Council 30 CHEST COMPRESSIONS Approach safely Check response Shout for help Open airway Check breathing Call 108 / 64 ( psg) 30 chest compressions 2 rescue breaths
- 21. European Resuscitation Council • 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
- 22. European Resuscitation Council RESCUE BREATHS Approach safely Check response Shout for help Open airway Check breathing Call 108 / 64 (psg) 30 chest compressions 2 rescue breaths
- 23. European Resuscitation Council 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
- 24. European Resuscitation Council 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
- 26. European Resuscitation Council CONTINUE RESUSCITATION UNTIL – Qualified help arrives and takes over – Victim starts breathing normally – Rescuer becomes exhausted
- 27. European Resuscitation Council Approach safely Check response Shout for help Open airway Check breathing Call 108 / 64 (psg) 30 chest compressions 2 rescue breaths
- 28. European Resuscitation Council IF VICTIM STARTS TO BREATHE NORMALLY PLACE IN RECOVERY POSITION
- 30. European Resuscitation Council 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
- 34. European Resuscitation Council Guideline changes for BLS WHY? Simplifying guidelines to aid retention of BLS skills To reflect the greater importance placed on chest compression To reduce the number and duration of pauses 1) Make a diagnosis of cardiac arrest if a victim is unresponsive and not breathing normally. 2) Teach rescuers to place their hands in the centre of the chest, rather than to spend more time using the ‘rib margin’ method. 3) Give each rescue breath over 1 sec rather than 2 sec. 4) Use a ratio of compressions to ventilations of 30:2 for all adult victims of sudden cardiac arrest. Use this same ratio for children when attended by a lay rescuer. 5) For an adult victim, omit the initial 2 rescue breaths and give 30compressions immediately after cardiac arrest is established.
- 35. European Resuscitation Council Special circumstances Child needs expertise and training Ideally, pediatric resuscitation team knowledge of equipment & doses for a child Trauma multidisciplinary trauma team skilled in RSI and intubation Pregnancy Early involvement of an obstetrician and neonatologist Possibility of Peri-mortem Caesarean section
- 36. European Resuscitation Council Training of Health Personnel • regular resuscitation training • should be able to: recognize the arrest summon help start CPR using airway adjuncts, and attempt defibrillation within 3 minutes of collapse. This is the minimum standard. • New staff should have resuscitation training as part of their induction programme.