Basic Life Support (BLS)

1. Basic Life Support (BLS) Date: July / august 2018

2. Session Content • Chain of Survival • Basic Life Support (BLS) • Collapsed patient assessment • CPR • Chest compression – best practice • Airway Management • Automated External Defibrillators (AED) • Recovery position • Paediatric Modifications to CPR

3. Chain of Survival

4. Basic Life Support (BLS) Collapsed Patient Assessment D R S A B C Check for DANGERS Check for RESPONSE SHOUT for HELP(call 999) Assess & Open AIRWAY Assess for NORMAL BREATHING & NORMAL signs of life (CIRCULATION) for 10 Seconds

5. Adult Basic Life Support (BLS) Algorithm Call 999 and ask for an Ambulance

6. Quality Chest compressions (RaDaR) R – Rate 100-120 bpm a–and D – Depth 5-6cm a–and R – Recoil Allow chest to recoil between each compression

7. Airway Management • Rescue breaths • Duration - 1 second • sufficient volume to make the victim’s chest rise. • Avoid rapid or forceful breaths. • Resume chest compressions ASAP (within 10 seconds) • Mouth-to-nose ventilation • alternative to mouth-to-mouth ventilation if: • The victim’s mouth is seriously injured • a mouth-to-mouth seal is difficult to achieve. Barrier devices for use with rescue breaths (pocket masks / bag masks) ?decrease transmission of bacteria during rescue breathing (…In controlled laboratory settings. Their effectiveness in clinical practice is unknown.) If used, care should be taken to avoid unnecessary interruptions in CPR.

8. CPR Demonstration and Practical

9. Any Questions ?

10. Automated External Defibrillators (AED) • Between 1-5 per 1000 admissions have a cardiac arrest • Overall survival to discharge from hospital cardiac arrest is 13.5% (All rhythms) • The majority of these (80%) are non-shockable and only 7% survive to discharge • Only 20% of these are shockable rhythms and 44% of these survive to discharge In shockable rhythms for every minute defibrillation is delayed, the chances of survival reduce by 10 – 12% FR2

11. Automated External Defibrillators (AED) Pad location This could be used as an alternative adult pad location

12. Automated External Defibrillators (AED) Safety • Ensure the pads are clear of: • Fluid • Medicated skin patches • Pacemaker • Jewellery • Environmental Factors • Fluid • Oxygen / Gas – Keep Oxygen at least 1 meter away • Available space • Metalic surfaces • Listen carefully to the AED prompts, ensure nobody is touching the patient on Analysis and on the Shock Delivery

13. Automated External Defibrillators (AED) On Children • SHOCKABLE RHYTHMS ARE VERY RARE • Use adult pads on children > 8 years. • Use Paediatric Defib Key (If available) • Preferably Use Paediatric Pads on Children 1 – 8 years • If no Paed pads available, use adult pads • AED under 1 year – use it if it is available and says shockable rhythm

14. Automated External Defibrillators (AED) Demonstration and Practical

15. Recovery Position

16. Any Questions ?

17. Paediatric BLS modifications (Healthcare professionals with a duty to respond)

18. Paediatric BLS modifications • Compress the chest by about AT LEAST 1/3 of its depth. • For a child over 1 year use one or two hands to achieve an adequate depth • For a baby under 1 year, use two fingers • If you are on your own, perform resuscitation for about 1 minute before going for help.

19. Any Questions ?

20. Summary • Chain of Survival • Early Recognition, Early CPR, Early Defibrillation, Post resuscitation care • Basic Life Support (BLS) Collapsed patient assessment • DRS ABC: Danger, response, shout for help, Open Airway, assess for breathing and circulation for 10 seconds – call 999 • Adults: 30:2 (begin with chest compressions) • Children: 15:2 (begin with 5 rescue breaths) • Quality CPR • Begin CPR ASAP • Rate 100-120 BPM • Depth 5-6cm and allow chest recoil between compressions (child 1/3 of depth of chest) • Airway Management • Rescue breaths • Good seal around airway • 1 second duration • Look for rise of chest

21. Summary • Automated External Defibrillators (AED) • AED increased Survival rate • Pad position • Safety