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Resuscitation Training

Adult Basic Life Support

Resuscitation OfficersBruce Kerr, HHGH; ext 2317/bleep 2307Juliet Quine, WGH; ext 7218/bleep 1447

Proceed through the presentation using the arrow keys

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Activating the Cardiac Arrest Call

• Dial 2222

• State adult OR paediatric OR maternal (for pregnant women) cardiac arrest

• State exact location; ward, level, building and site

Please note that 2222 is the number for any emergency

e.g. fire, assault, fast bleeping etc

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Adult Cardiac Arrest TeamHHGH & WGH

• On call Medical Registrar, SHO & PRHO

• On call Anaesthetic Registrar/SHO

• Operating Department Practitioner/ Anaesthetic Nurse if available

• Senior Nurse

• PorterIf more staff attend than is necessary, the team leader should request that

excess staff leave.

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Adult Cardiac Arrest TeamSACH

• On call RMO• Care of elderly SHO if available• Anaesthetist if available• Operating Department Practitioner/anaesthetic

nurse if available• Senior Nurse if available• Porter

• If a cardiac arrest call is activated, switchboard will automatically call 999 ambulance service

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Adult Cardiac Arrest TeamMVH

• On call care of the elderly RMO• On call Anaesthetic Registrar/SHO if available• Operating Department Practitioner/ Anaesthetic

Nurse if available• On call Oncology SHO• Senior Nurse• PorterIf more staff attend than is necessary, the team leader should request that

excess staff leave.

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Emergency Bleep TestingHHGH, SACH & WGH

• Any bleep that is programmed to receive emergency calls will be tested daily before midday

• If your bleep is programmed to receive emergency calls (of any type) and this test is not received by midday, switchboard should be contacted immediately

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Emergency Bleep TestingMVH

• Any bleep that is programmed to receive emergency calls will be tested daily before midday

• On receiving the test bleep, switchboard should be contacted to confirm receipt of the test

• If confirmation is not received switchboard will contact bleep holders individually

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Adult Basic Life Support Demonstration

Click on picture to commence video

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Adult Basic Life SupportDemonstration with commentary

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Summary of Adult Basic Life Support

• Safety – Check surrounding area for hazards. Do not put yourself at risk.

AND

• Shout – Shout for help and activate emergency buzzer if available

• Stimulate – Talk to patient and gently shake to elicit response

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Summary of Adult Basic Life Support

• Airway – Check mouth and clear with suction if necessary. Leave well fitting dentures in situ. Open airway using head tilt and chin lift or jaw thrust if C-spine injury suspected

• Breathing and Circulation – Assess for breathing, carotid pulse and other signs of life for up to 10 seconds. Agonal gasps are not a sign of life.

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Summary of Adult Basic Life Support• If no definite signs of life activate cardiac arrest call

and begin CPR• Start with 30 chest compressions at a rate of 100

per minute and a depth of 4-5cm. Hands should be placed in the centre of the chest.

• Following chest compressions administer 2 breaths if a pocket mask or bag-valve-mask is available (mouth to mouth is not acceptable practice within WHHT). Do not attempt more than 2 breaths each time before returning to chest compressions.

• If no pocket mask or bag valve mask is immediately available begin continuous compressions until equipment arrives.

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Summary of Adult Basic Life Support

• Continue with CPR at ratio of 30:2 until advanced life support is commenced or the patient exhibits signs of life.

• If the patient is intubated continuous compressions at a rate of 100 per minute and continuous breaths at a rate of 10 per minute should be administered

• Ideally a rescuer should do no more than 2 minutes of chest compressions (to avoid fatigue)

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Modifications to basic life support

• If the patient is noticeably pregnant they should be tilted 15-300 to their left by means of a Cardiff wedge or pillow. Alternatively the uterus can be displaced manually. This is to reduce the effects of aorto-caval compression. Both basic and advanced life support should be continued following the standard adult European Resuscitation Council guidelines.

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Respiratory ArrestDemonstration with commentary

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Respiratory Arrest

After full S, S, S, A, B, C assessment, if a

patient is found to be unresponsive,

apnoeic, but has a DEFINITE pulse• The cardiac arrest call should be activated• Ventilations should be commenced at a rate of

10 per minute (inspiration 1 second, expiration 5 seconds).

• Breathing and circulation should be reassessed every 10 breaths/minute

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Resuscitation of ‘Neck-Breathers’Demonstration with commentary

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ChokingDemonstration

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ChokingDemonstration with commentary

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Choking Summary

• Confirm that the patient is choking (as opposed to anaphylaxis, myocardial infarction, seizure etc)

• If patient is coughing effectively encourage them to continue coughing but do nothing else

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Choking Summary

• If the patient is not coughing effectively and is conscious give up to 5 back blows

• If these are not successful give up to 5 abdominal thrusts

• Continue to alternate 5 back blows and 5 abdominal thrusts until airway is cleared or the patient becomes unconscious

• The cardiac arrest team should be called if initial back blows are unsuccessful

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Choking Summary

• If the patient becomes unconscious begin CPR 30:2 (even if signs of life/pulse are present)

• This should be continued until the obstruction is relieved – at which point the patient should be reassessed and appropriate treatment administered

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The Recovery PositionDemonstration with commentary

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Preparation of Cardiac Arrest Drugs

Demonstration with commentary

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