Group 2_presentation 2 (CPR BLS AED)

7/27/2019 Group 2_presentation 2 (CPR BLS AED)

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Basic Life SupportSadam John Eclipse

Jeru Lising


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Basic Life Support

Basic life support is providing oxygen to

the brain, heart and other vital organs

until help arrives

It is also known as cardiopulmonaryresuscitation


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Key Principles in Resuscitation: Strengthening

the Links in the Chain of Survival

Successful resuscitation following

cardiac arrest requires an integrated set

of coordinated actions represented by

the links in the Chain of Survival


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The links include the following:

Immediate recognition of cardiac arrest and

activation of the 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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Conceptual Framework for CPR:

Interaction of Rescuer(s) and Victim

The Rescuer: Everyone can be a rescuer. CPRskills and their application depends on the rescuerstraining, experience and confidence.

Chest Compression: All rescuers, regardless of

training, should provide chest compressions to allcardiac arrest victims. Because of their importance,chest compressions should be the initial CPR actionfor all victims regardless of age. Rescuers who areable should add ventilations to chest compressions.

Highly trained rescuers working together shouldcoordinate their care and perform chestcompressions as well as ventilations in a team-based approach.


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Conceptual Framework for CPR:

Interaction of Rescuer(s) and Victim

Most cardiac arrests in adults are sudden,

resulting from a primary cardiac cause;

circulation produced by chest

compressions is therefore paramount. Incontrast, cardiac arrest in children is most

often asphyxial, which requires both

ventilations and chest compressions for

optimal results. Thus rescue breathing maybe more important for children than for

adults in cardiac arrest


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CPR Guidelines


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A. Response

1. Assessing the victim of sudden illness

or accident for unconsciousness is the

initial action.

2. Gently tap the patient shoulder and askAre you okay?. Be alert for potential

head/neck injury

3. Activate EMS when the victim is foundunconscious; if asphyxial arrest is likely,

call after 5 cycles of CPR


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4. For an unresponsive infant or child, theHCP should perform 5 cycles of CPRthen activate EMS . HCP must assess

the most likely cause of the arrest.5. If the infant or child has a sudden

witnessed collapse, the collapse is likelyto be cardiac in origin (hypoxic cardiac

arrest) ; in this situation, the HCP shallactivate the EMS after verifying that thevictim is unresponsive


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A. Response

6. Place the victim in a supine position on

a flat firm surface (logroll the victim with

spine precaution)


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Circulation

Palpate the carotid artery to assess

circulation. Always check for the

absence of a pulse before beginning

chest compression on the victim. If thevictim is older than 1 yr, asses the

circulation via the carotid or femoral

pulse. If the victim is younger than 1 yrof age, assess via brachial or femoral


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Circulation

If + pulse, continue to rescue breathing

If no pulse, initiate CPR immediately:

Landmark: Lower half of the sternum

Method (Child) : Use two hands with the heelof one hand on the chest and second handon top; or, use one hand only with the heel of

the hand on chest of victim Method (Infant): Two fingers


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Airway (Overview)

A change in the 2010 AHA Guidelines for CPR and ECCis to recommend the initiation of compressions beforeventilations. While no published human or animalevidence demonstrates that starting CPR with 30compressions rather than 2 ventilations leads to

improved outcomes, it is clear that blood flow dependson chest compressions. Therefore, delays in, andinterruptions of, chest compressions should beminimized throughout the entire resuscitation. Moreover,chest compressions can be started almost immediately,while positioning the head, achieving a seal for mouth-

to-mouth rescue breathing, and getting a bag-maskapparatus for rescue breathing all take time. BeginningCPR with 30 compressions rather than 2 ventilationsleads to a shorter delay to first compression


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How to open the airway?

Head tilt Chin Lift

Jaw Thrust Method


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Rescue Breaths

Deliver each rescue breath over 1

second

Give a sufficient tidal volume to produce

visible chest rise


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Airway (Overview)

Techniques:Adult: Mouth to mouth, mouth to

nose, mouth to stoma, Mouth to Barrier

deviceInfant: Mouth to mouth and nose

Deliver each rescue breath over 1 sec

Compression to ventilation ratio is 30-2


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When can we say that the

patient is revived?

According to the PRC BLS-CPR training

for HCP workbook, the patient is revived

when there is positive pulse and the

patient is breathing spontaneously


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When to stop CPR?

Pulse and respiration return

EMS arrives

Administration of AED

Physician declares the victim

deadRescuer is exhausted


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Lets do it!

1. Scan the area. If scene is safe,approach the victim.

2. Ask if theres any bystander who can

help.3. Assess for responsiveness

4. Activate EMS (see previous topic onguidelines for when to activate EMS)

5. Assess for signs of circulation for nolonger than 10 seconds.


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6. If no breathing but with pulse, do rescue

breathing.

7. If no pulse and breathing, do CPR.

8. Recheck for breathing and circulation

not longer that 10 seconds after 5 CPR

cycles.

9. If respiration and circulation resumes.Place the patient in recovery position.


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Defibrillation

andDefibrillator


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Defibrillation: Introduction

According to the AHA websiteDefibrillation is a process in which anelectronic device gives an electric shock

to the heart. This helps reestablishnormal contraction rhythms in a hearthaving dangerous arrhythmia or incardiac arrest. In recent years small

portable defibrillators have becomeavailable. These are called automatedexternal defibrillators or AEDs.
http://www.heart.org/HEARTORG/Conditions/Arrhythmia/AboutArrhythmia/About-Arrhythmia_UCM_002010_Article.jsphttp://www.heart.org/HEARTORG/Conditions/More/CardiacArrest/About-Cardiac-Arrest_UCM_307905_Article.jsphttp://www.heart.org/HEARTORG/Conditions/More/CardiacArrest/About-Cardiac-Arrest_UCM_307905_Article.jsphttp://www.heart.org/HEARTORG/Conditions/Arrhythmia/AboutArrhythmia/About-Arrhythmia_UCM_002010_Article.jsp


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It's essential to integrate early defibrillationinto an effective emergency cardiovascularcare system. This means employing the five-part "chain of survival" concept.

Immediate recognition of cardiac arrest and

activation of the emergency responsesystem quickly calling the EmergencyMedical Services (9-1-1) system.

Early cardiopulmonary resuscitation (CPR)

with an emphasis on chest compressions promptly giving cardiopulmonaryresuscitation when needed. Order a CPRAnytime Kit.


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Contd

Rapid defibrillation having properequipment and being trained to use it whenindicated.

Effective advanced life support includingairway management, ventilation support,and treatment of rhythm disorders.

Integrated post-cardiac arrest care a

comprehensive, structured, integrated,multidisciplinary system of care should beimplemented in a consistent manner


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All emergency personnel should be trained

and allowed to use a properly maintained

defibrillator if they're likely to respond to

cardiac arrest victims. This includes all first-responding emergency personnel, both

hospital and non-hospital.

To make early defibrillation possible, a

defibrillator must be immediately available to

emergency personnel responding to a cardiac

arrest. Thus, all emergency ambulances andother emergency vehicles that respond to or

transport heart patients should have a

defibrillator.


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The American Heart Association

recommends that AEDs be

available wherever large numbers

of people congregate. Such places

include airports, convention

centers, sports stadiums and

arenas, large industrial buildings,

high-rise offices, large health

fitness facilities, etc.


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Defibrillation

Treatment of choice for Vfib and

pulseless Vtach

Not used for patients with pulse and

conscious

Defibrillation depolarizes a critical mass

of myocardial muscle all at once, when

they repolarize, the SINUS NODEusually recaptures its role as pacemaker


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Defibrillator

Classified into monophasic and biphasic

Monophasic delivers current in only onedirection and requires increased energy

loads Biphasic defibrillators delivers the

electrical charge to the positive paddles,which then reverses back to the

originating paddle. This system requireslower possibly non-progressive energylevels


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Defibrillator

The lower the energy emitted by the

defibrillator, the lesser the myocardial

damage

If defibrillation is unsuccessful, CPR isinitiated and other acls treatments are

begun.


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Automated

External Defibrillator


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Description

Device used to convert ventricular

fibrillation into a perfusing rhythm

The AED differentiates nonventricular

from ventricular fibrillation rhythms andallows for early defibrillation by first

responders.

AED is not recommended for infantyounger than 1 year


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AED: For Adult

Use adult pads

For out of hospital

response: Provide 5

cycles of CPR beforedefibrillating if

response time was

longer that 5-5minutes


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AED: For Child

Child pad and child system are used for

a child 1-8 years of age


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AED: Interventions

Attach pads to the victim

Turn on the AED and push button to activate the

analyzer

Follow instruction given for AED usually assess,

stand back, shock, and reassess

CPR guidelines to treat cardiac arrest associated

with ventricular fibrillation or pulseless ventricular

tachycardia recommend the delivery of single

shocks by a period of CPR; interruption of chestcompressions to check circulation should not be

done until about five cycles or approximately 2

minutes of CPR have been providedafter the

shock


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References

Silvestri, L. (2008). Comprehensive

Review for the NCLEX-RN Examination.

Elsevier Singapore.

American Heart Association (2010).Highlights of the 2010 American Heart

Association Guidelines for CPR and

ECC.


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Group 2_presentation 2 (CPR BLS AED)

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