Basic Life Support and Automated External Defibrillation

1. Basic Life Support and Automated External Defibrillation

2. Objectives At the end of this course participants should be able to demonstrate: How to assess the collapsed casualty. How to perform Basic Life Support (BLS). How to place an unconscious breathing victim in the recovery position. Introduction to operating an automated external defibrillator (AED) safely.

3. Background In the UK approximately 30,000 people sustain cardiac arrest outside hospital and are treated by emergency services each year. Bystander CPR and early Defibrillation are vital interventions before the arrival of emergency services. If defibrillation is delivered promptly, survival rates as high as 75% have been reported. The chances of successful defibrillation decline at a rate of about 10% with each minute of delay.

4. Anyone can do it?

5. 2% 4% 30%

6. Angina Suspected Heart Attack Cardiac conditions

7. Cardiac Conditions Coronary heart disease is the UK's biggest killer, with 1 in every 4 men and 1 in every 6 women dying from the disease. In the UK, approximately 300,000 people have a heart attack each year. Angina affects about 1 in 50 people, and in the UK there are an estimated 1.2 million people with the condition. It affects men more than women, and your chances of being affected increase with age.

8. Blood returning from upper body Oxygenated blood to upper body Blood to lungs Blood to lungs Oxygenated blood from lungs Oxygenated blood from lungs Blood returning from lower body Oxygenated blood to lower body

9. How many times does the human Heart beat in a day ? 100,800 beats per day (70 beats x 60 minutes x 24 hours = 100,800 beats)

10. Suspected Heart Attack

11. Heart Attack

12. Suspected Heart Attack • Pale, cold & clammy skin • Rapid weak pulse • Rapid shallow breathing • -Nausea • Vomiting • Pain in chest possibly radiating into arm, back and/or jaw • Sweating • Impending sense of doom • Some or all of these symptoms may be present, no two Heart attacks are the same......

13. Cardiac Conditions Angina is a pain or discomfort felt in the chest caused by coronary heart disease. Typically presents as heaviness or tightness in the chest Often brought on by physical activity. Symptoms usually subside after a few mins. Angina Suffers usually carry GTN medication in the form of a spray or tablet

14. Suspected Heart attack Dial 999 or 112 for Ambulance • Rest in a comfortable position • Reassure • Help casualty to take their own GTN • Be prepared to resuscitate • Have AED available If in any Doubt dial 999 or 112

15. Primary Survey Performing CPR Recovery Position Basic Life SUPPORT

16. Primary Survey Initial assessment using the primary survey - Danger (Global overview) - Response - Shout for help - Airway- Breathing- Call 999/112 - commence CPR

17. Airway Management Airway Open Airway Closed Airway Obstructed • An unconscious casualty has no control over their muscles, including the muscles that control the tongue.

18. Approach safely Check response Shout for help Open airway Check breathing Recovery Position? Dial 999/112 Monitor Patient

19. APPROACH SAFELY! Approach safely Rescuer Scene Victim Bystanders Check response Shout for help Open airway Check breathing Recovery Position Dial999/112 Monitor

20. CHECK RESPONSE Approach safely Check response Shout for help Open airway Check breathing Recovery Position? Dial 999/1123 Monitor

21. CHECK RESPONSE Shake shoulders gently “Hello can you hear me?” If he responds • Leave as you find him. • Find out what is wrong. • Reassess regularly. • If no response.....

22. SHOUT FOR HELP Approach safely Check response Shout for help Open airway Check breathing Recovery Position? Dial 999/112 Monitor

23. OPEN AIRWAY Approach safely Check response Shout for help Open airway Check breathing Recovery Position Dial 999/112 Monitor

24. Look, listen and feel for NORMAL breathing for 10 sec Do not confuse Agonal breathing with NORMAL breathing If you have any doubts act as if breathing is not normal CHECK BREATHING

25. Not Breathing normally ? No sign of Chest Movement No sounds of Breathing No feeling of breath against your ear Agonal Breathing • Occurs shortly after the heart stops in up to 40% of cardiac arrests • Described as barely, heavy, noisy or gasping breathing Recognised as a sign of cardiac arrest

26. Agonal Breathing

27. Approach safely Check response Shout for help Open airway If no help arrives and you are alone dial 999/112 After putting into recovery position. Check breathing Recovery Position Dial 999/112 Monitor

28. Recovery position 1 • Kneel next to the person. Place the arm closest to you straight out from the body. Position the far arm with the back of the hand against the near cheek.

29. Recovery position 2 • Grab and bend the person's far knee

30. Recovery position 3 • Protecting the head with one hand, gently roll the person toward you by pulling the far knee over and to the ground

31. 30 CHEST COMPRESSIONS Approach safely Check response Shout for help Open airway Check breathing Dial 999/112 30 chest compressions 2 rescue breaths 2 rescue breaths

32. Recovery position 4 • Tilt the head up slightly so that the airway remains open. Make sure that the hand is under the cheek, checking the airway and also for eventual wakening. Place a blanket or coat over the person (unless he or she has a heat illness or fever) and stay close until help arrives

33. If Not Breathing Don’t Panic

34. CHEST COMPRESSIONS • Place the heel of one hand in the centre of the chest • Place other hand on top • Interlock fingers • Compress the chest • Rate 100 to 120 • Depth 5-6 cm • Equal compression : relaxation • When possible change CPR operator every 2 min

35. RESCUE BREATHS Approach safely Check response Shout for help Open airway Check breathing Dial 999/112 30 chest compressions 2 rescue breaths

36. Pinch the nose Take a normal breath Place lips over mouth Blow until the chest rises Deliver rescue breath for 1 second Allow chest to fall Repeat This should not take longer than 5sec , then return to chest compressions without delay RESCUE BREATHS

37. Combine Compressions and Rescue breaths at a ratio of 30:2 30 2 30

38. ANY QUESTIONS ?Time to practice.....

39. Child CPR Many children do not receive resuscitation because potential rescuers fear causing harm. This fear is unfounded; it is far better to use the adult BLS sequence for resuscitation of a child than to do nothing. Bystander resuscitation significantly improves outcome in children. Outcomes could be further improved if bystanders who would otherwise do nothing, were encouraged to begin resuscitation.

40. Children and babies

41. COMPRESSION only CPR If a rescuer is unable or unwilling to perform rescue breaths it is expectable to perform compressions only CPR However, chest compression combined with rescue breaths is the method of choice for CPR by trained lay rescuers and professionals.

42. When to stop CPR • Once CPR is started the rescuer should only stop CPR when the casualty shows signs of regaining conscious by : • Coughing • Opening eyes • Speaking or moving purposefully • Starts to Breath NORMALLY again • Or • Qualified help arrives and takes over • You become exhausted • It is unsafe to continue

43. Pocket Mask The pocket mask is an effective barrier device. It has a one-way valve which prevents the casualty's exhaled air being inhaled by the Rescuer.

44. ANY QUESTIONS ?Time to practice.....

45. Understanding Defibrillation Safe use of an AED Defibrillation

46. AutomatedExternalDefibrillators • An AED is an “electric shock box” used to stop the electrical activity of the heart when it is in a life threatening rhythm, this allows the Heart to re-establish an effective rhythm. • The AED will; • analyse the presenting rhythm • only advise a shock for a shockable rhythm • advise the operator step-by-step what to do

47. Automated External Defibrillators An AED can be used safely and effectively without previous training. Therefore, the use of an AED should not be restricted to trained rescuers. However, training should be encouraged to help improve the time to shock delivery and correct pad placement.

48. There are 2 types of AED: • Automatic- will deliver shock automatically • Semi Automatic – rescuer intervention required to deliver shock. • Once you have completed this training • you will be able to use any make or model AED’s can be found in many public buildings e.g. Sports centres, Railway stations, Shopping centres and Schools

49. 2% 4% 30%

50. Understanding Defibrillation • The heart’s pumping action controlled by electrical system • Electrical rhythm normally very organized • Normal heart’s rhythm is called “Sinus Rhythm” • Normal heart rate of 60 - 100 beats per minute