BLS For Adults PDF

PROF. JEHAN AHMED SAYED PROFESSOR OF ANESTHESIA, INTENSIVE CARE AND PAINE MANAGEMENT FACULTY OF MEDICINE, ASSUIT UNIVERSITY What is BLS ?  Basic Life Support, or BLS, generally refers to the type of care that first-responders, healthcare providers and public safety p...

PROF. JEHAN AHMED SAYED PROFESSOR OF ANESTHESIA, INTENSIVE CARE AND PAINE MANAGEMENT FACULTY OF MEDICINE, ASSUIT UNIVERSITY What is BLS ?  Basic Life Support, or BLS, generally refers to the type of care that first-responders, healthcare providers and public safety professionals provide to anyone who is experiencing cardiac arrest, respiratory distress or an obstructed airway.  It requires knowledge and skills in cardiopulmonary resuscitation (CPR), using an automated external defibrillator (AED) and relieving airway obstructions in patients of any age. Chain of survival : The “Chain of Survival” refers to the chain of events that must occur in rapid succession to maximize the chances of survival from sudden cardiac arrest (SCA). Chain of Survival include the following: 1. Recognition of cardiac arrest and activation of the emergency response system. 2. Early cardiopulmonary resuscitation (CPR) with an emphasis on chest compressions. 3. Rapid defibrillation 4. Advanced resuscitation by Emergency Medical Services and other healthcare providers. 5. Post-cardiac Arrest Care. 6. Recovery (including additional treatment, observation, rehabilitation, and psychological support) A strong Chain of Survival can improve chances of survival and recovery for victims of cardiac arrest. BLS For Adults  Cardiopulmonary Resuscitation (CPR): life-saving procedure utilizing chest compressions and rescue breathing. The latest guidelines put more emphasis on chest compressions. It aims to keep blood and oxygen flowing through the body when a person's heart and breathing have stopped.  A rescuer who arrives at the side of a potential cardiac arrest should follow these sequential steps : 1. Verify scene safety 2. Check for responsiveness 3. Assess for breathing and a pulse 4. START HIGH-QUALITY CPR 5. Use The Automated External Defibrillator “AED” 1. Verify scene safety : Make sure that the scene is safe for you and the victim 2. Check for responsiveness : Tap the victim’s shoulders Shout, “ Are you OK?“ If the victim is not responsive, activate the emergency response system via mobile device Get the AED or send someone to do so 3. Assess for breathing and a pulse : N.B. To minimize delay in starting CPR, you should assess breathing and pulse at the same time. This should take no more than 10 seconds If the victim is breathing normally and a pulse is felt, monitor the victim If the victim is not breathing normally but a pulse is felt :  Provide rescue breathing at a rate of 1 breath every 6  Seconds, or 10 breaths per minute  Check for a pulse about every 2 minutes. Perform high-  Quality CPR if you do not feel a pulse  If you suspect opiod use, give naloxone if available and  Follow your local protocols If the victim is not breathing normally or is only gasping and has no pulse, begin high-quality CPR 4. Start high-quality CPR : Start with 30 chest compressions followed by 2 breaths.Use an AED as soon as it is available  Chest compressions : 1. Position yourself at the victim’s side and make sure the victim is lying faceup on a firm, flat surface. 2. Position your hand and body to perform chest compressions: 3. Give chest compressions at a rate 100 to 120/min. 4. Push straight down at least 5 cm but no more than 6 cm with each compression. 5. At the end of each compression, allow the chest to recoil completely. Avoid leaning on the chest between compressions. 6. Minimize interruptions in chest compressions.  Airway : For breaths to be effective, the victim’s airway must be open. Two methods for opening the airway are : Head tilt-chin lift Jaw thrust N.B. If you suspect a head or neck injury, use the jaw-thrust maneuver to reduce neck and spine movement. If the jaw thrust does not open the airway, use the head tilt-chin lift maneuver  Head tilt-chin lift : - Place one hand on the victim’s forehead and push with your palm to tilt the head back. - Place the fingers of the other hand under the bony part of the lower jaw, near the chin. - Lift the jaw to bring the chin forward.  Jaw thrust : - Position yourself at the victim’s head. - Place one hand on each side of the victim’s head. You may rest your elbows on the surface where the victim is lying. - Place your fingers under the angle of the victim’s lower jaw and lift with both hands, displacing the jaw forward. - If the victim’s lips close, push the lower lip with your thumbs to open the lips.  Breathing : Methods of rescue breathing : Pocket Masks for mouth-to-mask breaths Bag-Mask Devices to provide positive-pressure ventilation Mouth-to-mouth breathing when a barrier device is not available  Pocket Masks : - Position yourself at the victim’s side. - Place the pocket mask on the victim’s face, using the bridge of the nose as a guide for correct positioning. - Seal the pocket mask against the face : a. Using your hand that is closer to the top of the victim’s head, place your index finger and thumb along the top edge of the mask. b. Place the thumb of your other hand along the bottom edge of the mask. c. Place the remaining fingers of your second hand along the bony margin of the jaw a and lift the jaw. Perform head tilt-chin lift to open the airway. d. While you lift the jaw, press firmly and completely around the outside edge of the mask to seal the pocket mask against the face. - Deliver each breath over 1 second, enough to make the victim’s chest rise.  Bag-Mask Devices : - Position yourself directly above the victim’s head. - Place the mask on the victim’s face, using the bridge of the nose as a guide for correct positioning. Use the E-C clamp technique to hold the mask in place. while you lift the jaw to hold the airway open : a. Perform a head tilt. b. Place the mask on the face with the narrow portion at the bridge of the nose. c. Use the thumb and index finger of one hand to make a “C” on the side of the mask, pressing the edges of the mask to the face. d. Use the remaining fingers to lift the angles of the jaw (3 fingers form an “E”). Open the airway, and press the face to the mask. - Squeeze the bag to give breaths while watching for chest rise. Deliver each breath over 1 second.  Mouth-to-mouth breathing : Hold the victim’s airway open with a head tilt-chin lift. Pinch the nose closed with your thumb and index finger (using the hand on the forehead). Take a regular (not deep) breath and seal your lips around the victim’s mouth, creating an airtight seal. Deliver 1 breath over 1 second. Watch for the chest to rise as you give the breath. If the chest does not rise, repeat the head tilt-chin lift. - Give a second breath (blow for about 1 second). Watch for the chest to rise. - If you are unable to ventilate the victim after 2 attempts, promptly return to chest compressions. 5. Use the Automated External Defibrillator “ AED” : Use the AED as soon as it ia available.  What is AED ? An automated external defibrillator (AED) is a lightweight, portable device. It delivers an electric shock through the chest to the heart when it detects an abnormal rhythm and changes the rhythm back to normal.  How does an AED work?  The AED uses voice prompts, lights and text to tell the rescuer the steps to take.  AEDs may have two sets of pads :adult pads and child pads.  Make sure you use the adult pads for anyone 8 years or older.  Follow these steps when using the AED:  Turn on the AED and follow the voice prompts.  Remove all clothing covering the chest. If necessary, wipe the chest dry.  Peel away the backing from the pads and attach the pads to the person’s bare chest following the illustration on the pads.  Plug the pads connector into the AED, if necessary.  The AED will check to see if the person needs a shock and will automatically give one or tell you when to give one. While the AED is analyzing, make sure no one is touching the person.  Resume CPR if no shock is needed. If a shock is needed, make sure no one is touching the person and press the shock button, then immediately resume CPR.  Continue CPR until emergency medical personnel arrive.  Recovery Position (lateral recumbent or 3/4 prone position): This position is used to maintain a patent airway in the unconscious person. Place the patient close to a true lateral position with the head dependent to allow fluid to drain. Assure the position is stable. Avoid pressure of the chest that could impairs breathing. Position patient in such a way that it allows turning them onto their back easily. Take precautions to stabilize the neck in case of cervical spine injury. Continue to assess and maintain access of airway.