Basic Life Support Guidelines (2016) PDF

Guidelines from American Heart Association 2016 MEADINA G. CRUZ Pediatric intensivist  Objectives  Health Picture / General Concepts  How to assess the collapsed victim.  How to perform chest compression and rescue breathing.  How to operate an automated external...

Guidelines from American Heart Association 2016 MEADINA G. CRUZ Pediatric intensivist  Objectives  Health Picture / General Concepts  How to assess the collapsed victim.  How to perform chest compression and rescue breathing.  How to operate an automated external defibrillator safely. How to place an unconscious breathing victim in the Health Picture  Despite advances in prevention... Sudden cardiac arrest remains a leading cause of death 70% of outinof the Unitedcardiac hospital States arrests occur in the home, about half are unwitnessed Only 10% of adult patients survive http://www.who.int/cardiovascular_diseases/en/Accessed July 24, 2017 WHO 2017 Updates o n >75% i ll i 17. 5 m of CV ye a r D de ie ea d c h occu aths people C V D s , low- r in from inco e d 3 1% midd me a a t nd an estim a ths coun l e -i n com l d e of a l t r i es e or l dw i de. w 80% of all CVD deaths are due to heart attacks and strokes. http://www.who.int/cardiovascular_diseases/en/Accessed July 24, 2017  MORTALITY: TEN (10) LEADING CAUSES NUMBER AND RATE/100,000 POPULATION, Philippines 5-Year Average 2010 CAUSES (2005-2009) Number Rate Number Rate 1. Diseases of the Heart 88,299 99.4 102,936 109.5 2. Diseases of the Vascular System 58,761 66.2 68,553 72.9 3. Malignant Neoplasms 44,627 50.3 49,820 53.0 4. Pneumonia 37,865 42.6 45,591 48. 5. Accidents** 34,704 39.9 35,990 39.0 Note: Excludes ill-defined and unknown causes of mortality * reference year ** External causes of Mortality http://www.doh.gov.ph/node/2573, Accessed July 24, 2017 http://www.doh.gov.ph/mortality, Accessed July 34, 2017 http://www.doh.gov.ph/mortality, Accessed July 34, 2017 http://www.doh.gov.ph/mortality, Accessed July 34, 2017 Definition of Terms What is Basic Life Support? Why Basic Life Support? Who provides Basic Life Support? What is Basic Life Support? It is the foundation for saving lives after cardiac arrest. Life is Why, Basic Life Support,©2016 Americal Heart Association Why Basic Life Support? is a level of medical care which is used for victims of life-threatening illnesses or injuries until they can be https://en.wikipedia.org/wiki/Basic_life_support, Accessed July 24, 2017 Who provides Basic Life Support? It can be provided by trained medical personnel, including emergency medical technicians, paramedics, and by https://en.wikipedia.org/wiki/Basic_life_support, Accessed July 24, 2017 For the purposes of BLS... Age Definition Adolescents (ie, after the onset of Adults puberty) and older Childre 1 year of age to puberty n Less than 1 year of age (excluding Infants Newborn infants in the delivery room) Signs of puberty: chest or underarm hair in males; breast development in females Life is Why, Basic Life Support,©2016 Americal Heart Association  ke Ta Action! CHAIN OF SURVIVAL These mutually dependent links - important action in the management of cardiac arrest !!!  ADULTS 1. Immediate recognition of cardiac arrest and activation of Emergency Response System 2. Early CPR with an emphasis on chest compression 3. Rapid defibrillation with an AED 4. Effective advanced life support  PEDIATRI 1. Prevention of arrest CS 2. Early high-quality bystander CPR 3. Rapid activation of Emergency Response System 4. Effective advanced life support Basic Framework for CPR Teamwork. Emergency responders will perform multirescuer coordinated CPR: one rescuer - CC; 2nd rescuer - rescue breaths via bag-mask 30:2 CPR. A lifeguard who rescues a device; drowning 3rd rescuer - defi brillator (AED) child/adult will provide both chest compressions and breaths with 30:2 Hands-Only CPR. A single rescuer ratio with little training and limited equipment might provide on chest compressions (CC) until help arrives ©2016 American Heart Association Verify scene safety Check response Shout for help Activate emergency response system Open airway Check breathing & pulse 30 chest compressions 2 rescue breaths  Verify scene safety Scene Rescuer Make sure before proceeding Victim aid, that the scene is Bystanders clear and This means pulling the safe victim out of standing water, other The Rescuer dangerous (You) or situation should site be Verify scene safety Check response Shout for help Activate emergency response system Open airway Check breathing & pulse 30 chest compressions 2 rescue breaths  Check response Shake shoulders gently Ask “Are you all right?” If he responds Leave as you find him. Find out what is wrong. Reassess regularly. Verify scene safety Check response Shout for help Activate emergency response system Open airway Check breathing & pulse 30 chest compressions 2 rescue breaths Verify scene safety Check response Shout for help Activate emergency response system Open airway Check breathing & pulse 30 chest compressions 2 rescue breaths Verify scene safety Check response Shout for help Activate emergency response system Open airway Check breathing & pulse 30 chest compressions 2 rescue breaths Check breathing & pulse Look, listen and feel for NORMAL breathing Do not confuse agonal breathing with NORMAL breathing  Check breathing &...Agonal pulse Gasps Occurs shortly (in the first minutes) after sudden cardiac arrests May appear forceful or weak May sound like snort, snore or groan Recognize as a  Check breathing & pulse Locate the trachea, using 2 or 3 fingers Slide these 2 or 3 fingers into the groove between the trachea and the muscles at the side begin CPR, of the neck start Feel for a pulse for at chest least 5 but Verify scene safety Check response Shout for help Activate emergency response system Open airway Check breathing & pulse 30 chest compressions 2 rescue breaths  30 chest compressions Place the heel of one hand on the breastbone (sternum), in the center of the chest Place other hand on top Interlock fingers Compress the chest – Rate 100 min-1 – Depth 4-5 cm – Equal compression : When possible change relaxation CPR operator every 2 Verify scene safety Check response Shout for help Activate emergency response system Open airway Check breathing & pulse 30 chest compressions 2 rescue breaths  2 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  Continue CPR 30 chest compressions : 2 Verify scene safety Check response Shout for help Activate emergency response system Open airway Check breathing & pulse 30 chest compressions 2 rescue breaths  Defibrillation  It is a shock delivered intended to stop the abnormal rhythm (ventricular fibrillation or pulseless ventricular tachycardia) and allow Automated External Defibrillator (AED)  it is a lightweight, portable, computerized device that can identify an abnormal heart rhythm that needs a shock  Verify scene safety Check response Shout for help Activate emergency response system Open airway Check breathing & pulse Attached AED Follow voice prompts  Switch on AED Some AEDs will automatically switch themselves on when the lid is opened Attach pad to patient's bare chest Analyzing rhythm...... DO NOT TOUCH THE PATIENT ! Shock indicated Stand clear Deliver shock Shock delivered follow AED instructions 30 : 2 No Shock advised follow AED instructions 30 : 2 If victim starts to breathe normally, place in recovery  Verify scene safety Verify scene safety Check response Check response Shout for help Shout for help Activate emergency Activate emergency response system response system Open airway Open airway Check breathing & pulse Check breathing & pulse 30 Chest compressions Attached AED 2 Rescue breaths Follow voice prompts Team Leader - Every resuscitation team must have a defined leader - Assign/ roles Timer to team Recorder members - Records all time of -inter- Makes treatment decisions ventions & Administrator -medications Provides feedback to Medications the - announces when team - administers these as needed medications -are Assumes next due responsibility - Records the for roles not assigned frequency & duration of AED/Monitor/ Airway Defibrillator - Opens and maintains - Brings & operates the the airway AED/ - Provides ventilation Monitor/Defibrillator - Alternates with Compressor Compressor every 5 cycles or 2 - Assesses the patient mins (or - Does 5 cycles of earlier if signs of fatigue chest The sets in), ideally duringteam owns the code. No compressions rhythm analysis team member leaves- the Alternates with AED/ - If a monitor istriangle present, except to protect his Monitor/Defibrillator places it in a position or her safety. every 5 cycles or 2 where it can be seen by mins (or earlier if signs all specially the Team of fatigue sets in) Let's now watch the videos... BLS Healthcare Provided Pediatric Cardiac Arrest Algorithm for 2 or More Rescuers  MOUTH TO MOUTH RESUSCITATION !!!