bls edited 2012.ppt

7/24/2019 BLS edited 2012.ppt

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11

d

AHA ECC Chain of survival


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22 Resuscitation UpdateResuscitation Update Saturday, NovemberSaturday, November, 2!1", 2!1"


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ife Support System

#$y%enAtmospheric air 21 & #$y%en

E$haled air 1' & #$y%en (un%s e$tract " & #$y%en ##22


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ife Support System

(un%s E$chan%e of #$y%en and

carbon dio$ide


5/74

ife Support System

Heart )o pump o$y%enated blood

to the rest of the body


6/74

ife Support System

*rain *rain cells +ill start to die if

no o$y%en received for -'minutes


7/74

FUNCTION OF THE HEART &

UNGS

BLOOD+ O2

O2

BLOOD - O2 BLOOD + O2


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Saturday, NovemberSaturday, November, 2!1", 2!1"

..

CPR through the ages

PR through the ages

ChallengesChallenges


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//

Some !ot so "e#e$rate%

ome !ot so "e#e$rate%

i!sta!"es

!sta!"es


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1!1!

19561956 James ElamJames Elamandand Peter SafarPeter Safar

0outh-to-mouth resuscitation0outh-to-mouth resuscitation

19601960 Dr KouwenhowenDr Kouwenhowenand teamand team

E$ternal chest compressionE$ternal chest compression

19631963 AHA formally endorses CRAHA formally endorses CR

19661966 irst conference on CRirst conference on CR

Standardi3e trainin% andStandardi3e trainin% and

performance standardsperformance standards

19721972 0ass citi3en4s trainin% in CR0ass citi3en4s trainin% in CR

#ver 1!!,!!! trained over 2 years#ver 1!!,!!! trained over 2 years

1970s1970s More than 60% !stan"ers w#llMore than 60% !stan"ers w#ll

$erform P&$erform P&

CPR i#esto!e

PR i#esto!e


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CPR i#esto!e

PR i#esto!e

1970s5 citi3en4s CR in US

19'5 5 0alaysian Society of Anesthesiolo%ists

6 0in7 #f Health 8AHA9

1997 5 Utstein style for reportin% of CR

2000 5 ne+ %uidelines on CR

2005 5 update on international %uidelines

2!1! 5 latest update on international %uidelines


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'H( CPR)

Help to save lives

0ost of the sudden

cardiopulmonaryarrest may be

successfully

resuscitated

rompt CR canprevent permanent

brain dama%e


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Cha##e!ges to%ay

)oo fe+ people :no+ CR

)oo fe+ people +illin% to perform CR

;e are not trainin% the most important %roup ofpeople

)rained providers cannot remember ho+ toperform CR

;e have for%otten the importance of time

#ur duty to train others


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CPR Pri!"ip#es

PR Pri!"ip#es


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Remem$er *********

emem$er *********

The human body may live forThe human body may live for

4 weeks without food;4 weeks without food;

4 days without water;4 days without water;

BUTBUT

Only 4 minutes withoutOnly 4 minutes withoutoxygenoxygen


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Dont waitDont wait

Call Call

!tart C"#"$"!tart C"#"$"


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Time of the esse!"e


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1.1.

%very &'( minute )ass *after +ardia+ arrest,-

'. /


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&EMEM(E& )*+ *,-) ./E

M,+ES


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-oo4 out for"aner efore

!ou start P&


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Are you #


23/74

/-/)S/-/)S/P/P .E M *,.E M *,

.E S.*+-DE&S.E S.*+-DE&S/,D /SK/,D /SK

.E M.E M /&E )*+ *K/&E )*+ *K

P*S*, M *, / ./&D S+&/E

S.*+


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0ook0ook

O)en airway maneuversO)en airway maneuvers


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Ope! the A r+ay

erform head tilt-chin lift to

open the air+ay

Head tilt5 place one hand

on the forehead and not

the eyes, to tilt the head

bac:

Chin lift5 place fin%ers of

the other hand on the bony

part and not the soft tissueof the >a+, to lift the chin


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OPEN AIR'A(

?a+ )hrust


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NOTOT

,REATHING

REATHING

or

r

GASPING)

ASPING)

""


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8#e :!:les of 30 :om$ress#ons to 2 reaths

+nt#l /ED; Def#; /-S Pro#"er ta4e oer;

or #:t#ms start to moe

Push ./&D an" /S

an" release :om$letel!

M#n#m#se :om$ress#on #nterru$t#ons


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Saturday, NovemberSaturday, November, 2!1", 2!1" @!@!

AE, efibrillator ARRBES

SH#C


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Re"o-ery positio!

e"o-ery positio!

0ain purpose50ain purpose5

)o maintain the)o maintain the patency of the air+ay 6patency of the air+ay 6

prevent aspirationprevent aspirationin a non-traumain a non-traumapatient +hile +aitin% for the ambulancepatient +hile +aitin% for the ambulance

after patient successfully resuscitatedafter patient successfully resuscitated


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@@@@

N# RES#NSE G 0#E0EN)N# RES#NSE G 0#E0EN)

CA(( #R HE(

et AE G efibrillator

#pen ABR;AD, Chec: *REA)HBN

ive cycles of @! compressions and 2 breath

Until AE, efib, A(S rovider ta:e over, victims start to move

ush HAR and AS) 81!!Gmin9 and release completely0inimise compression interruptions

AE, efibrillator ARRBES

SH#C


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Res"ue

es"ue

,reath

reath

1 res+ue breaths-- that make the +hest1 res+ue breaths-- that make the +hest

rise"rise"

%a+h res+ue breath should be given over '%a+h res+ue breath should be given over '

se+ond *Class 22a,"se+ond *Class 22a,"

This re+ommendation a))lies to all res+uers"This re+ommendation a))lies to all res+uers"


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Res"ue

es"ue

,reath

reath

ace shield


36/74

Res"ue

es"ue

,reath

reath


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Res"ue

es"ue

,reath

reath


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3ealth )roviders

Che+k )ulse within '.se+safter 1 minutes 5 +y+lesof C#$

6on health +are)roviders 7 no need to+he+k for )ulses

Pu#se "he".

u#se "he".


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if 8%D or De9b ma+hine available : $hythm

+he+k on monitor every 1 minutes *together with)ulse +he+king,

!ho+kable De9b

Rhythm

hythm

"he".

he".


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Compressio! / 0e!ti#atio!

Ratios

uidelines 2!!! 1" 5 2 ratio for adultsF rate 1!! G min

cycles

uidelines 2!!" @! 5 2 ratio for all rescuers, all a%es a%e of 1 yr

Rate 1!! G minF push hard and push fast

" cycles in 2 minutes

No interruptions e$cept for defibrillation and rhythm analysisuidelines 2!1!

ChangesChanges


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22uideline 2!1!uideline 2!1!


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1efi$ri##atio! 2o!e3sho".

strategy4

E!ergy e-e#s use% for

0F50T

0anual defibrillation

0onophasic @'! ? for all shoc:s

*iphasic *)E 1"! to 2!! ? initial shoc:

Bf unsure +hich +aveform, use default 2!! ?

or second and subseIuent shoc:s, use same

or hi%her ener%ylevels

AE defibrillation

*iphasic evice specific

ChangesChanges


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1efi$ri##atio!

ChangesChanges

Attention must be paid to E)AB(S Reducin% interruptions to chest

compressions

roper techniIue

roper placement

roper eIuipment

roper ener%y levels

Resumin% chest compressions immediately

0a:e each shoc: countJJ


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Termi!ati!g a Resus"itatio!

i! a ,LS out3of3Hospita#SystemRescuers +ho start *(S should continue until one of

the follo+in% occurs5

17 Restoration of effective, spontaneous circulation

and ventilation7

27 Care is transferred to a more senior-level

emer%ency medical professional +ho may

determine that the patient is unresponsive to the

resuscitation attempt7


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@7 Reliable criteria indicatin% irreversible death

are present

7 )he rescuer is unable to continue because ofe$haustion or

"7 the presence of dan%erous environmental

ha3ards or because continuation of

resuscitative efforts places other lives in>eopardy7

'7 A valid NAR order is presented to rescuers7


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PAE1IATRIC CPR

ANER

P*SS(-E &EM*E .E S*+&E *

D/,8E& ?

*,-) &EM*E .E M /S / -/S

&ES*&


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PAE1IATRIC CPR

RES#NSE 8 entle tappin% or sha:in%

the shoulder7


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PAE1IATRIC CPR

Bf unresponsive , shout for HE( J


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PAE1IATRIC CPR

A - ABR;AD 8 head tilt chin lift or >a+

thrust 9


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PAE1IATRIC CPR

* K *reathin% 5 loo: , listen and feel L1!s

Absent =


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PAE1IATRIC CPR

* K *reathin% 8" initial rescue breaths9


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PAE1IATRIC CPR

C K Circulation 5L1! s

eel#n for the ra:h#al $ulse #n #nfant an" :arot#" $ulse #f the :h#l"

#s oer 1 !ear of ae?


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PAE1IATRIC CPR

Chest Compression 5 No ulse or ulseL '!Gmin

Child


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PAE1IATRIC CPR


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PAE1IATRIC CPR

Bnfant and children

one

res:uer

two

res:uer

ive cycle of 1" compressions and

2 breath for " cycle

ive cycle of @! compressions and 2

breath for " cycle


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Bf there is palpable pulse '!Gmin but inBf there is palpable pulse '!Gmin but in

adeIuate breathin% , to continue rescueadeIuate breathin% , to continue rescue

breaths 12-2!Gmin7breaths 12-2!Gmin7

Saturday, NovemberSaturday, November

, 2!1", 2!1"'!'!


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'1'1uideline 2!1!uideline 2!1!


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A%u#t Foreig!3$o%y

Air+ay O$stru"tio!


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A%u#t "ho.i!g

2"o!s"ious4

No fin%er s+eep unless forei%n body

visible

Bn conscious pt, %ive " bac:slapsfollo+in% +ith " abdomen thrustGchest

thrust

Noabdominal thrust in unconscious ptbut CR instead7


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A%u#t "ho.i!g


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A$%omi!a# Thrust


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Chest Thrust


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Foreig!3,o%y Air+ay

O$stru"tio! i!fa!t

Conscious 5 Serious si%ns Chec: serious difficulty in breathin%

Bneffective cou%h

No stron% cry

us:y colour


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Foreig!3,o%y Air+ay

O$stru"tio! i!fa!t

Conscious

ive " bac: blo+s and " chest thrusts


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Foreig!3,o%y Air+ay

O$stru"tio! i!fa!t

Bf *A# becomes Unconscious

Activate E0S

#pen Air+ay 8 if * seen, remove it 9 Start CR


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M hone fast or phone first for lone rescuerM aediatric chain of survival77M Assessment in conscious adult cho:in% victim by as:in%

Iuestion77

M Reference

M uidelines for Resuscitation )rainin% Bn 0inistry of Health

0alaysia Hospitals and Health Care acilities 2!12 - NC#R)


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bls edited 2012.ppt

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