Basic Life Support ( BLS ) Automated External Defibrillation (AED )
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Transcript of Basic Life Support ( BLS ) Automated External Defibrillation (AED )
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Basic Life Support ( BLS )
Automated External Defibrillation
(AED )
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Reza AzizkhaniEmergency Medicine Department
Isfahan University Of Medical Sciences
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At the end of this courseparticipants 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.
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OBJECTIVES
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Despite important advances in prevention, cardiac arrest
remains a substantial public health problem and a leading
cause of death in many parts of the world(46% in Iran).
Cardiac arrest occurs both in and out of the hospital.
approximately 350 000 people/year (approximately half of them in-hospital) suffer a cardiac arrest and receive attempted resuscitation. 4
BACKGROUND
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Survival to hospital discharge presently approximately 5-10%
Early resuscitation & prompt defibrillation
(within 1-2 minutes) can result in >60% survival
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CHAIN OF SURVIVAL
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Immediate recognition and activation
Early CPR
Defibrillation,
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Advanced life support
Integrated post-cardiac arrest care.
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BLS 2005
ارزیابی سطح
هوشیاری
ارزیابی وضعیت تنفس
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BLS 2005
ارزیابی سطح
هوشیاری
ارزیابی وضعیت تنفس
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LOOK , LISTEN ,FEEL
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12BLS 2010
همزمان ارزیابیتنفس و هوشیاری سطح
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BLS 2010
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Start CPR When …… :
UnresponsivenessAbnormalBreathing
OrNo breathing
Start CPR
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ABC ???
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A B C
SINCE 1960
C A B GIUDELINE 2010
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Arterial Blood O2 Content(ABC)
Arrest
Resuscitation
RescueBreathes
ChestCompression
O2 Content
Time
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Arterial Blood O2 Content(CAB)O2 Content
Time
Arrest
Resuscitation
ChestCompression
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CAB vs ABCO2 Content
Time
CAB
ABC
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* Approach safely
Check response Check breathing
Shout for help & Call 115
30 chest compressions
2 rescue breaths
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BASIC LIFE SUPPORT
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APPROACH SAFELY!Scene
Rescuer
Victim
Bystanders
Approach safely Check response Check breathing
Shout for help & Call 115
30 chest compressions
2 rescue breaths
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CHECK RESPONSE - CHECK BREATHING
Approach safely
Check responseCheck breathing
Shout for help & Call 115 30 chest compressions
2 rescue breaths
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CHECK RESPONSEShake shoulders gently
Ask “Are you all right?”
If he responds• Leave as you find
him.• Find out what is
wrong.• Reassess regularly.
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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
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AGONAL BREATHING & GASPING
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SHOUT FOR HELPApproach safely
Check responseCheck breathing
Shout for help & Call 115
30 chest
compressions2 rescue breaths
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Call 115Approach safelyCheck responseCheck breathingShout for help &
Call 115 30 chest
compressions2 rescue breaths
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Feel within 1. definite pulse give 1 breath / q 5-6 s
2. recheck pulse q 2 min.
3. no pulse next step28
10 sec
Check pulseOnly for healthcare provider
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Number of Compressions Delivered
Affected by Compression Rate and by Interruptions.
The total number of compressions delivered during resuscitation
is an important determinant of survival from cardiac arrest.
The number of compressions delivered is affected by the
compression rate and by the compression fraction.
(the portion of total CPR time during which compressions are
performed).
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Chest compressions are the foundation of
CPR
All rescuers, regardless of training, should
provide chest compressions to all cardiac arrest victims.
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Minimal Interruptions During Chest CompressionCardiac Output
Time2 min
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Minimal Interruptions During Chest CompressionCardiac Output
Time2 min
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Cardiac Output
Time2 min
With Interruptions
Without Interruptions
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CHEST COMPRESSIONS
Approach safelyCheck responseCheck breathingShout for help &
Call 115 30 chest
compressions2 rescue breaths
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CHEST COMPRESSIONS
• supine victim on a hard
surface
• Place the heel of one hand
in the centre of the chest
( lower half )
• Place other hand on top
• Interlock fingers
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CONTINUE CPR
30 2
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CHEST COMPRESSIONS
• Push hard and fast the chest:– Rate at least 100 /min– Depth 5 cm– Equal compression / relaxation– Minimize interruptions in chest
compressions.
• When possible change CPR operator every 2 min
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RESCUE BREATHSApproach safelyCheck response
Check breathing
Shout for help & Call 115 30 chest
compressions2 rescue
breaths
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OPEN AIRWAY (head tilt , chin lift -- jaw
thrust )
Approach safely
Check responseCheck breathing
Shout for help & Call 115
30 chest
compressions2 rescue breaths
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● Deliver each breath over 1 second
• Give a sufficient tidal volume produce visible chest rise .
● Avoid rapid or forceful breaths.40
Give 2 BREATH
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2 RESCUE BREATHSPinch the nose
Take a normal breathPlace lips over mouthBlow until the chest
risesTake about 1 secondAllow chest to fallRepeat
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Approach safelyCheck responseCheck breathingShout for help &
Call 115 30 chest
compressions2 rescue breaths
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BASIC LIFE SUPPORT
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Nature
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AUTOMATED EXTERNAL DEFIBRILLATOR
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In settings with 1-lay rescuer AED programs (AED on-site and available) 2-in-hospital environments
3-EMS rescuer witnesses the collapse,
The rescuer should use the defibrillator as soon as( within first 3-5 min) it is available for children and adults.
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Out-of-hospital cardiac arrest not witnessed by EMS personnel
EMS may initiate CPR while
checking the rhythm with the AED or on the electrocardiogram
(ECG) and preparing for defibrillation.
In such instances, 1½ to 3 minutes of CPR may be considered
before attempted defibrillation.
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AED Use in Children Now Includes Infants2010 (New)
For infants (<1 year of age),
defibrillator is preferred. If a manual defibrillator is not available,
an AED with pediatric dose attenuation is desirable. If neither is
available, an AED without a dose attenuator may be used.
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The precordial thump 2010 (New)
should not be used for unwitnessed out-of-hospital cardiac arrest.
1-for patients with witnessed monitored,
2-unstable VT (including pulseless VT)
3-if a defibrillator is not immediately ready for use,
but it should not delay CPR and shock delivery.
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*Approach safelyCheck responseCheck breathing
Shout for help and call 115, get AEDAttach AED
Follow voice prompts
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SWITCH ON AED
Some AEDs will automatically switch them-selves on when the lid is opened
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ATTACH PADS TO CASUALTY’S BARE CHEST
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ANALYSING RHYTHM
DO NOT TOUCH VICTIM
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SHOCK INDICATED
Stand clearDeliver shock
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SHOCK DELIVEREDresume CPR
immediately for 5 cycles
30 2
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NO SHOCK ADVISED
resume CPR immediately for 5
cycles
30 2
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If victim starts to breathe normally place in recovery
position
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Recovery position
1 2
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Approach safely
Check responseCheck breathing
Shout for help & Call 115 30 chest
compressions2 rescue
breaths
Approach safely
Check responseCheck breathing
Shout for help and call 115,
get AEDAttach AEDFollow voice
prompts
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