Dept. of Anaesthesiology. K.G.M.C.H.BASIC LIFE SUPPORTGUIDELINES

RESUSCITATIONMeans Cardiopulmonary resuscitationsAnywhere Anybody can do

CPRConsidered when an individualcannot adequately breathe and maintain circulation to vital organs.

WHY& WHEN TO DO IT ? Without CPR , irreversible brain damage occurs within 3-4 minutesShould be done immediately by a bystander TIME is the crucial factor here to decide the survival

Minutes counts...when the heart stops, damage occurs to the Brain within < 5 minutes

start BLS early

CPRBLSACLSALSANLSCPCR Cardio Pulmonary Cerebral resuscitation

CPR ABCDEFHow ?AirwayBreathing BLSCirculation

DrugsECG ACLSFibrillation

The Sequence of BLS

Establish Unresponsiveness

If no response call for help

Start BLS------- A- Airway B- Breathing C- Circulation

CPRRECOGNITIONIs crucial in BLSDetermineUnresponsivenessBreathlessnessPulselessness

No victim should undergo CPR until the need for resuscitationis established.

2. Check the Victim and see if he responds Gently SHAKE his shoulder

Ask loudly Are you all right?

3A. Responds by answering or movingLeave him in the position.

Reassess him regularly.

3B. If no responseSHOUT for help (Call for defibrillator) Turn to his back and open airway.HEAD TILT Hand on forehead.Remove any visible obstruction.CHIN LIFT finger tips under the point of chin.Avoid head tilt in Trauma

CPRActivation of EMS Call for helpCall for ambulance services

BLS ALGORHYTHMCHECK RESPONSIVENESS OPEN AIRWAY CHECK BREATHINGventilation ABCIRCULATION C

CPRAirway - First basic skillHead tiltChin liftJaw thrust

AirwaysET intubationNewer airways

CPR AIRWAY Head tiltJaw thrustChin lift

CPRBreathing Second basic skillLOOK for chest movementLISTEN for breath soundsFEEL for air on your cheek2 slow effective rescue breathing

LOOK, LISTEN AND FEELLOOKLISTENFEEL

5A. Breathing NormallyTurn him into recovery Position.Send or go for help.Check for continued breathing.

Recovery position.

To maintain a good airway

To minimize the risk of aspiration

Recovery PositionTo Maintain a good airway.To Minimize the risk of aspiration.

5B. Not BreathingRescue breathingEnsure head tilt and chin lift.Pinch the Nose.Two Slow effective breaths.Rise and fall of the Chest

Rescue Breathing Required if breathing is absent or inadequate Give 2 slow breaths sufficient to make the chest riseAdult: Over 2 secondsChild & Infant: Over 1 1 seconds

Rescue Breathing Techniques

Mouth-to-Mouth

Mouth-to-Barrier

Mouth-to-Nose Mouth-to Mask

Bag-mask device

Any difficulty achieving an effective breath.Recheck Victims mouth.Recheck head tilt and chin lift.Make up to 5 attempts.Even in unsuccessful, move on to assessment of circulation.

NO - CirculationAbsent carotid pulse. Lay Rescuer.Normal Breathing.coughingMovement.Sign of Cardiac arrest.No More than 10 Sec.

CAROTID PULSEIdentify Adams apple (Thyroid Cartilage).Slide down to the groove.Palpate pulse in the groove.Never Palpate on both sides simultaneously.

7A. Circulation PresentContinue rescue breathing.Recheck rescue breathing.Normally breathing Recovery Position.

7B. No signs of CirculationChest compressions.Identity middle of Lower half of Sternum.compressions by heel of the hands.After 15 Compressions tilt the head, lift the chin and give 2 effective breaths.

Chest CompressionsNo pulse present START CHESTCOMPRESSIONS

Compression Rate: Adult, Child, & Infant 100/min

TECHNIQUE OF EXTERNAL CARDIAC COMPRESSIONRescuer to one side of the patientPatients chest exposed and xiphisternum identifiedXiphisternum Bony prominence in the mid line at the junction of lower borders of the ribsThe index and middle fingers of the lower hand placed on the xiphisternum and heel of the other hand is placed adjacent to them on the sternum

Heel of the second hand placed on the back of the hand on the sternum Fingers may be interlocked Sternum depressed vertically4-5cm and then released rapidly Repeated at a rate of 80-100/minwith compression and relaxation each taking the same length of time

Locate rib cage

Position your hands over middle of lower half of sternum and fingers away from Chest

Compression of Chest

Arms VerticalArms StraightPress Depress 4-5Cm

CPR

15 x2 xChest compressions Breathing One Rescuer

Two rescuers

Depth of CompressionAdult: 1 - 2 inches or enough to generate a pulse

Child & Infant: 1/3 the depth of the chest or enough to generate a pulse

Continue Resuscitation UntilQualified help arrives and takes over.Victim shows signs of life.You become exhausted.

Reassessment (10 seconds)Should be performed after the first minute of CPR and every few minutes thereafter

If no pulse- resume CPR If pulse and breathing present- place in recovery position

If pulse present but no breathing- provide rescue breathing

BLS AlgorithmCHECK RESPONSIVENESSOPEN AIRWAYCHECK BREATHINGBREATHEACCESS CIRCULATION10 seconds only CIRCULATION PRESENTContinue Rescue BreathingNO CIRCULATIONCompress ChestShake & ShoutHead tilt / Chin liftLook, Listen and Feel2 Effective BreathsSigns of a Circulation100 Per Minute 15:2 RatioCheck Circulation every Minute

CPRNutshell

AdultPaediatricBreath rate10 12 bpm20 bpmPulse checkCarotidBrachialCompression rate100/min>100/minCompression methodHands interlacedTwo or three fingers or heel of one handCV ratio15 : 25 : 1FB obstructionHeimlich maneuverBack blows and chest thrusts

ACLSSpecial equipments and techniquesECG monitoringDefibrillationiv accessDrug therapyPost resuscitation care

NOW HE IS SAFE IN HELPING HANDS

***Considered when an individual cannot adequately breathe and maintain circulation to vital organs.**********************************************