Bls Acls Final

8/7/2019 Bls Acls Final

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BBASICASICLLIFEIFE

SSUPPORTUPPORT

MonalynMonalyn B. LaB. La--aoao, RN, RN

KeverneKeverne Colas,Colas, RNRN


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1. Plan of Action

2. Gathering of Needed MaterialsThe emergency response begins with

the preparation of equipment and

personnel before any emergencyoccurs.

GETTING STARTED

Emergency plans should be

established based on anticipated

needs and available resources


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GETTING STARTED

3. Initial Response: Ask f r H LP.

I t r

D f rt r r .

4. Instruction to Helper/sProper information and

instruction to a helper/s would

provide organized first aid care.


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Call First and Care first

adult victim = call first.

infants and children = care first

ActivateMedical

Assistance

In some emergency,

you will have enough time

to call for specific medical

advice before administering

first aid. But in somesituations, you will need to

attend to the victim first.

EMERGENCY ACTION PRINCIPLES


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1. Check forConsciousness

In every emergency situation,

you must first find out if there are

conditions that are an immediate

threat to the victims life.

2. Check for Airway

3. Check for Breathing

4. Check forCirculation

Do a

PrimarySurvey



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It is a systematic method of

gathering additional information

about injuries or conditions that

may need care.

Do a

SecondarySurvey



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A. INTERVIEW T E VICTIM.

Victims name

Address

Phone number

Ask what happen

S A M P L E history



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Signs & symptoms

Allergies

Medications

Past medical history

Last oral intake

Events prior to the episode



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B. CHECK VITA SIGNS.

PULSE Rate, Strength & Rhythm

Respiration = 1 inhalation & 1

exhalation

RESPIRATION

SKIN APPEARANCE

PUPILS

BLOO PRESSURE

Temperature, color &

capillary refillPERRLA



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C. PERFORM HEA -TO-TOE EXAMINATION.

Contusions

Deformities

Abrasions

Punctures/penetrations

Burns

Tenderness

Lacerations

Swelling

C

D

A

P

B

T

L

S



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HEA

NECK

CHEST

PELVIS

AB OMEN

EXTREMITIES

BACK

C. PERFORM HEA -TO-TOE EXAMINATION.



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Basic Precautions and Practices

Personal Hygiene Protective EquipmentEquipmentCleaning

& isinfecting


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Review on breathing and circulation

Air that enters the lungs contains about

_____% oxygen and only a trace of carbondioxide.

Air that is exhaled from the lungs contains

about ______% oxygen and ______% carbondioxide.


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BASIC LIFE SUPPORT

An emergency procedure

that consists of recognizing

respiratory or cardiac arrest orboth and the proper application

of CPR to maintain life until a

victim recovers or advanced lifesupport is available.


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GUIDELINES

The American Heart Associations Guidelines

for CPR and ECC provide science-basedrecommendations for treating cardiovascular

emergencies, particularly sudden cardiac

arrest in adults, children, infants and

newborns.Every five years, hundreds of leading

resuscitation experts from around the world

review all new and existing research as part

of an international consensus process. This isthe basis for any revisions to the American

Heart Associations Guidelines for CPR and

ECC.


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HISTORY OF CPR

In 1960, researchers combined breathsand compressions to create CPR as we

know it today.

CPR training has been recommended for

healthcare professionals and for thegeneral public for more than 40 years.

2010 marks a change in the sequence of

CPR from Airway-Breaths-Compressions

(A-B-C) to Compressions-Airway-Breaths

(C-A-B) sequence.


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SUDDEN CARDIACARREST

EMS treats nearly 300,000 victims of out-of-hospital cardiac arrest each year in the

U.S.

Less than eight percent of people who

suffer cardiac arrest outside the hospitalsurvive to make it home from the hospital.

Sudden cardiac arrest can happen to

anyone at any time. Many victims appear

healthy with no known heart disease orother risk factors.

Sudden cardiac arrest is not the same as

a heart attack.


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STRENGTHENING

THE LINKS IN THE CHAIN OF SURVIVAL

Immediate recognition of cardiac arrest and

activation ofthe emergency response system

Early CPR with an emphasis on chest

compressions Rapid defibrillation

Effective advanced life support

Integrated post cardiac arrest care


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RESPIRATORYARREST

the condition in which the breathingstops or inadequate

Causes:

1. ObstructionAnatomical

Mechanical

2. Diseases

Bronchitis

Pneumonia

COPD


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RESPIRATORYARREST

3. Other causes of Respiratory Arrest

Electrocution

Circulatory collapse

External strangulation

Chest compression (by physical

forces)

DrowningPoisoning

Suffocation


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RESCUE BREATHING

a technique of breathing

air into a persons lungs to

supply him / her with the

oxygen needed to survive


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CARDIOPULMONARY-CEREBRO

RESUSCITATION (CPCR)

Less than one-third of out-of-hospital

sudden cardiac arrest victims receive

bystander CPR.

Effective bystander CPR, providedimmediately after sudden cardiac arrest,

can double or triple a victims chance of

survival.

Chest compressions should be provided at

a rate of at least 100 compressions per

minute the same rhythm as the beat of

the Bee Gees song, Stayin Alive.


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CARDIOPULMONARY CEREBRO

RESUSCITATION (CPCR)

Compressions of adequate rate and

depth

allowing complete chest recoilbetween compressions

minimizing interruptions in

compressions

avoiding excessive ventilation


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BUILDING BLOCKS OF CPR


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SIMPLIFIEDADULT BLS

ALGORITHM.


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YOUR ROLE IN ACODE BLUE

PHASE I: Putting the code in motion

NURSE 1 NURSE2

- LOC

- Call for help

- Check circulation

- Initiate CPCR

-

make sure the code hasbeen called according to

hospital procedure

- Obtain emergency

equipment (Crash cart)

-Begin 2-responder CPCRwith nurse 1


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PHASE I: PUTTING THE CODE IN MOTION

NURSE 3 / 4

- Connect the patient to amonitor

-Set up AED or defibrillator,oxygen, and suction equipment

- Get intubation equipment ready

-Set up IV equipment


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PHASE II: DRUGS AND DEFIBRILLATION

Initiate ACLS protocols

and evaluation of the

patients response totherapy


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CODE TEAM

Team Leader - Usually a physician directs and coordinates the

resuscitation effort, but a nurse whos trained in

ACLSmay direct the code until a physician arrives

- The team leader usually stands at the foot or head

of the bed: she needs a clear view of the patient to

ensure that procedures and patient assessments

are performed rapidly and correctly

Defibrillator

Operator

- A physician or a specially prepared nurse actually

delivers the shock

Rapid defibrillation is the key to survival fromventricular fibrillation, so the teammust be prepared

to defibrillate immediately.


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CODE TEAM

Recorder - At the start of the code, one nurse should begin

recording the events and interventions

- Document all events and interventions, including

the type and time of arrest, respiratory

management, procedures,medication

adm

inistration, Iv fluids, VS, cardiac rythm

s,defibrillations, patient response to treatment,

patient outcome, and termination of code.

- The role of a recorder is vital. She shouldnt be

asked to participate in any other way that distracts

her from this responsibility.- An important duty of a recorder is to announce

when amedicationmaybe due

- Identify which clock should be the official code

clock and be precise about the timing on the

resuscitation record.


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CODE TEAMIntubationist - A physician (anaesthesiologist), respiratory

therapist, nuse anesthetist, or other specially

prepared nurse may do so.- Prepare: Laryngoscope

: endotracheal tube and a stylet

: 10 ml syringe

: Lubricating gel

: Suction to remove oral secretions

and improve visualization of

anatomical landmarks

: Stethoscope

-If patient cant be intubated within 30 seconds,

stop and hyperventilate and hyperoxygenate


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CODE TEAM

IV nurse-

Solutions typically used duringresuscitation efforts include .9% sodium

chloride and lactated ringers solution

Medication

nurse

- Familiarize self with the drugs used during

codes

- As you prepare a drug, repeat the drug

name and dosage order out loud, so no

ones confused about what youre drawing

up. Again, announce the drug and dosage

prior to administration

Floor nurse - Throughout the entire code, the other

patients in the unitm

ust be cared for


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PHASE III: WINDING DOWN

Typically begins after initial ACLS

measures have been instituted and

their effectiveness evaluated.

In this phase, the team leader

continues to coordinate all the

medical therapies, vital signs,

cardiac rhythm, and patientresponse must be assessed

frequently throughout the code.


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PHASE III: WINDING DOWN

Efforts are now aimed at one of the

following:

-

Maintaining the patient in stablecondition until he can be transported

to a critical care bed

- Attempting other strategies to

restore cardiac function

- Deciding to terminate the code


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. KEY CHALLENGES TO IMPROVE CPR

QUALITY FORADULTS,

CHILDREN,AND INFANTS

Recognition Failure to recognize gasping

as sign of cardiac arrest

Unreliable pulse detection

Initiation of CPR Low bystander CPRresponse rates

Incorrect dispatch

instructions

Compression rate Slow compression rate Compression depth Shallow compression depth

Chest wall recoil Rescuer leaning on the chest


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QUALITY FORADULTS,


Compression Interruptions

Excessive interruptions for

rhythm/pulse checks

ventilations defibrillation

intubation

intravenous (IV) access

other


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QUALITY FORADULTS,


Ventilation Ineffective ventilations

Prolonged interruptions incompressions to deliver breaths

Excessive ventilation (especially with

advanced airway) Defibrillation Prolonged time to defibrillator

availability

Prolonged interruptions in chestcompressions pre- and post-shocks

Team Performance Delayed rotation, leading torescuer fatigue and decay in compressionquality

Poor communication among rescuers,leading to unnecessary interruptions in compressions


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BEING PREPARED

Each code situation is unique.

Knowing that a code usually

progresses through threephases will help you feel

more confident when the

actual event occurs.


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BEING PREPARED

Tips to fine-tune your skills

Keep your CPCR skills up-to-date and

review hospital policy on code procedures

and documentation

Know current BLS guidelines

If rule permit, open your crash cart and

medication box every 1 to 2 months andreview where supplies and medications

are located.


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BEING PREPARED

Review the drugs used most frequently

during a code and their indications, usual

dosages, dilutions, and administration

times. Know how to operate the cardiac monitor

and AED in you unit.

Make sure you know how to change

batteries in the laryngoscope handle and

the lightbulb in the blade. Practice

connecting the handle to the blade


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BEING PREPARED

These preparations will help

you stay calm and focused

during a code and maymake the difference between

chaos annd a smooth-

running, well-organizedcode.!!


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