Resuscitation Training Adult Basic Life Support Resuscitation Officers Bruce Kerr, HHGH; ext 2317/bleep 2307 Juliet Quin

1. Resuscitation TrainingAdult Basic Life SupportResuscitation OfficersBruce Kerr, HHGH; ext 2317/bleep 2307Juliet Quine, WGH; ext 7218/bleep 1447 Proceed through the presentation using the arrow keys

2. 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

3. 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 • Porter If more staff attend than is necessary, the team leader should request that excess staff leave.

4. 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

5. 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 • Porter If more staff attend than is necessary, the team leader should request that excess staff leave.

6. 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

7. 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

8. Adult Basic Life Support DemonstrationClick on picture to commence video

9. Adult Basic Life SupportDemonstration with commentary

10. 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

11. 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.

12. 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.

13. 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)

14. 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.

15. Respiratory ArrestDemonstration with commentary

16. 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

17. Resuscitation of ‘Neck-Breathers’Demonstration with commentary

18. ChokingDemonstration

19. ChokingDemonstration with commentary

20. 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

21. 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

22. 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

23. The Recovery PositionDemonstration with commentary

24. Preparation of Cardiac Arrest DrugsDemonstration with commentary

25. To register your training you must complete a short quiz by clicking here. Registration will only work on a computer that has access to the Trust Intranet. For more information please contact the Postgraduate Centre.