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BBASICASICLLIFEIFE
SSUPPORTUPPORT
MonalynMonalyn B. LaB. La--aoao, RN, RN
KeverneKeverne Colas,Colas, RNRN
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1. Plan of Action
2. Gathering of Needed MaterialsThe emergency response begins with
the preparation of equipment and
personnel before any emergencyoccurs.
GETTING STARTED
Emergency plans should be
established based on anticipated
needs and available resources
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GETTING STARTED
3. Initial Response: Ask f r H LP.
I t r
D f rt r r .
4. Instruction to Helper/sProper information and
instruction to a helper/s would
provide organized first aid care.
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Call First and Care first
adult victim = call first.
infants and children = care first
ActivateMedical
Assistance
In some emergency,
you will have enough time
to call for specific medical
advice before administering
first aid. But in somesituations, you will need to
attend to the victim first.
EMERGENCY ACTION PRINCIPLES
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1. Check forConsciousness
In every emergency situation,
you must first find out if there are
conditions that are an immediate
threat to the victims life.
2. Check for Airway
3. Check for Breathing
4. Check forCirculation
Do a
PrimarySurvey
EMERGENCY ACTION PRINCIPLES
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It is a systematic method of
gathering additional information
about injuries or conditions that
may need care.
Do a
SecondarySurvey
EMERGENCY ACTION PRINCIPLES
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A. INTERVIEW T E VICTIM.
Victims name
Address
Phone number
Ask what happen
S A M P L E history
EMERGENCY ACTION PRINCIPLES
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Signs & symptoms
Allergies
Medications
Past medical history
Last oral intake
Events prior to the episode
EMERGENCY ACTION PRINCIPLES
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B. CHECK VITA SIGNS.
PULSE Rate, Strength & Rhythm
Respiration = 1 inhalation & 1
exhalation
RESPIRATION
SKIN APPEARANCE
PUPILS
BLOO PRESSURE
Temperature, color &
capillary refillPERRLA
EMERGENCY ACTION PRINCIPLES
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C. PERFORM HEA -TO-TOE EXAMINATION.
Contusions
Deformities
Abrasions
Punctures/penetrations
Burns
Tenderness
Lacerations
Swelling
C
D
A
P
B
T
L
S
EMERGENCY ACTION PRINCIPLES
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HEA
NECK
CHEST
PELVIS
AB OMEN
EXTREMITIES
BACK
C. PERFORM HEA -TO-TOE EXAMINATION.
EMERGENCY ACTION PRINCIPLES
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Basic Precautions and Practices
Personal Hygiene Protective EquipmentEquipmentCleaning
& isinfecting
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Review on breathing and circulation
Air that enters the lungs contains about
_____% oxygen and only a trace of carbondioxide.
Air that is exhaled from the lungs contains
about ______% oxygen and ______% carbondioxide.
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BASIC LIFE SUPPORT
An emergency procedure
that consists of recognizing
respiratory or cardiac arrest orboth and the proper application
of CPR to maintain life until a
victim recovers or advanced lifesupport is available.
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GUIDELINES
The American Heart Associations Guidelines
for CPR and ECC provide science-basedrecommendations for treating cardiovascular
emergencies, particularly sudden cardiac
arrest in adults, children, infants and
newborns.Every five years, hundreds of leading
resuscitation experts from around the world
review all new and existing research as part
of an international consensus process. This isthe basis for any revisions to the American
Heart Associations Guidelines for CPR and
ECC.
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HISTORY OF CPR
In 1960, researchers combined breathsand compressions to create CPR as we
know it today.
CPR training has been recommended for
healthcare professionals and for thegeneral public for more than 40 years.
2010 marks a change in the sequence of
CPR from Airway-Breaths-Compressions
(A-B-C) to Compressions-Airway-Breaths
(C-A-B) sequence.
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SUDDEN CARDIACARREST
EMS treats nearly 300,000 victims of out-of-hospital cardiac arrest each year in the
U.S.
Less than eight percent of people who
suffer cardiac arrest outside the hospitalsurvive to make it home from the hospital.
Sudden cardiac arrest can happen to
anyone at any time. Many victims appear
healthy with no known heart disease orother risk factors.
Sudden cardiac arrest is not the same as
a heart attack.
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STRENGTHENING
THE LINKS IN THE CHAIN OF SURVIVAL
Immediate recognition of cardiac arrest and
activation ofthe 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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RESPIRATORYARREST
the condition in which the breathingstops or inadequate
Causes:
1. ObstructionAnatomical
Mechanical
2. Diseases
Bronchitis
Pneumonia
COPD
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RESPIRATORYARREST
3. Other causes of Respiratory Arrest
Electrocution
Circulatory collapse
External strangulation
Chest compression (by physical
forces)
DrowningPoisoning
Suffocation
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RESCUE BREATHING
a technique of breathing
air into a persons lungs to
supply him / her with the
oxygen needed to survive
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CARDIOPULMONARY-CEREBRO
RESUSCITATION (CPCR)
Less than one-third of out-of-hospital
sudden cardiac arrest victims receive
bystander CPR.
Effective bystander CPR, providedimmediately after sudden cardiac arrest,
can double or triple a victims chance of
survival.
Chest compressions should be provided at
a rate of at least 100 compressions per
minute the same rhythm as the beat of
the Bee Gees song, Stayin Alive.
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CARDIOPULMONARY CEREBRO
RESUSCITATION (CPCR)
Compressions of adequate rate and
depth
allowing complete chest recoilbetween compressions
minimizing interruptions in
compressions
avoiding excessive ventilation
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BUILDING BLOCKS OF CPR
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SIMPLIFIEDADULT BLS
ALGORITHM.
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YOUR ROLE IN ACODE BLUE
PHASE I: Putting the code in motion
NURSE 1 NURSE2
- LOC
- Call for help
- Check circulation
- Initiate CPCR
-
make sure the code hasbeen called according to
hospital procedure
- Obtain emergency
equipment (Crash cart)
-Begin 2-responder CPCRwith nurse 1
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PHASE I: PUTTING THE CODE IN MOTION
NURSE 3 / 4
- Connect the patient to amonitor
-Set up AED or defibrillator,oxygen, and suction equipment
- Get intubation equipment ready
-Set up IV equipment
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PHASE II: DRUGS AND DEFIBRILLATION
Initiate ACLS protocols
and evaluation of the
patients response totherapy
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CODE TEAM
Team Leader - Usually a physician directs and coordinates the
resuscitation effort, but a nurse whos trained in
ACLSmay direct the code until a physician arrives
- The team leader usually stands at the foot or head
of the bed: she needs a clear view of the patient to
ensure that procedures and patient assessments
are performed rapidly and correctly
Defibrillator
Operator
- A physician or a specially prepared nurse actually
delivers the shock
Rapid defibrillation is the key to survival fromventricular fibrillation, so the teammust be prepared
to defibrillate immediately.
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CODE TEAM
Recorder - At the start of the code, one nurse should begin
recording the events and interventions
- Document all events and interventions, including
the type and time of arrest, respiratory
management, procedures,medication
adm
inistration, Iv fluids, VS, cardiac rythm
s,defibrillations, patient response to treatment,
patient outcome, and termination of code.
- The role of a recorder is vital. She shouldnt be
asked to participate in any other way that distracts
her from this responsibility.- An important duty of a recorder is to announce
when amedicationmaybe due
- Identify which clock should be the official code
clock and be precise about the timing on the
resuscitation record.
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CODE TEAMIntubationist - A physician (anaesthesiologist), respiratory
therapist, nuse anesthetist, or other specially
prepared nurse may do so.- Prepare: Laryngoscope
: endotracheal tube and a stylet
: 10 ml syringe
: Lubricating gel
: Suction to remove oral secretions
and improve visualization of
anatomical landmarks
: Stethoscope
-If patient cant be intubated within 30 seconds,
stop and hyperventilate and hyperoxygenate
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CODE TEAM
IV nurse-
Solutions typically used duringresuscitation efforts include .9% sodium
chloride and lactated ringers solution
Medication
nurse
- Familiarize self with the drugs used during
codes
- As you prepare a drug, repeat the drug
name and dosage order out loud, so no
ones confused about what youre drawing
up. Again, announce the drug and dosage
prior to administration
Floor nurse - Throughout the entire code, the other
patients in the unitm
ust be cared for
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PHASE III: WINDING DOWN
Typically begins after initial ACLS
measures have been instituted and
their effectiveness evaluated.
In this phase, the team leader
continues to coordinate all the
medical therapies, vital signs,
cardiac rhythm, and patientresponse must be assessed
frequently throughout the code.
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PHASE III: WINDING DOWN
Efforts are now aimed at one of the
following:
-
Maintaining the patient in stablecondition until he can be transported
to a critical care bed
- Attempting other strategies to
restore cardiac function
- Deciding to terminate the code
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. KEY CHALLENGES TO IMPROVE CPR
QUALITY FORADULTS,
CHILDREN,AND INFANTS
Recognition Failure to recognize gasping
as sign of cardiac arrest
Unreliable pulse detection
Initiation of CPR Low bystander CPRresponse rates
Incorrect dispatch
instructions
Compression rate Slow compression rate Compression depth Shallow compression depth
Chest wall recoil Rescuer leaning on the chest
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. KEY CHALLENGES TO IMPROVE CPR
QUALITY FORADULTS,
CHILDREN,AND INFANTS
Compression Interruptions
Excessive interruptions for
rhythm/pulse checks
ventilations defibrillation
intubation
intravenous (IV) access
other
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. KEY CHALLENGES TO IMPROVE CPR
QUALITY FORADULTS,
CHILDREN,AND INFANTS
Ventilation Ineffective ventilations
Prolonged interruptions incompressions to deliver breaths
Excessive ventilation (especially with
advanced airway) Defibrillation Prolonged time to defibrillator
availability
Prolonged interruptions in chestcompressions pre- and post-shocks
Team Performance Delayed rotation, leading torescuer fatigue and decay in compressionquality
Poor communication among rescuers,leading to unnecessary interruptions in compressions
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BEING PREPARED
Each code situation is unique.
Knowing that a code usually
progresses through threephases will help you feel
more confident when the
actual event occurs.
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BEING PREPARED
Tips to fine-tune your skills
Keep your CPCR skills up-to-date and
review hospital policy on code procedures
and documentation
Know current BLS guidelines
If rule permit, open your crash cart and
medication box every 1 to 2 months andreview where supplies and medications
are located.
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BEING PREPARED
Review the drugs used most frequently
during a code and their indications, usual
dosages, dilutions, and administration
times. Know how to operate the cardiac monitor
and AED in you unit.
Make sure you know how to change
batteries in the laryngoscope handle and
the lightbulb in the blade. Practice
connecting the handle to the blade
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BEING PREPARED
These preparations will help
you stay calm and focused
during a code and maymake the difference between
chaos annd a smooth-
running, well-organizedcode.!!
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