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Podstawowe czynności resuscytacyjne

BLS

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Cel

Zrozumieć:

• Zagrożenia dla ratownika

• Jak przeprowadzić BLS

• Różnice pomiędzy BLS przeprowadzanym przez osoby niefachowe i personel medyczny

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Risks to the rescuer

• Eliminate or minimise risk

• Manual Handling

• Beware of environmental danger:

– traffic

– electricity

– gas

– water

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Risks to the rescuer:poisoning

• Hydrogen cyanide or hydrogen sulphide gas–mask and non-return

• Corrosive chemicals–absorbed through skin and respiratory

tract–protective clothing

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• 15 documented cases of CPR related infection - mainly Neisseria meningitidis

• Tuberculosis

• Not hepatitis B or C, or CMV

• 3 cases of HIV transmission from high-risk cutaneous exposure

Risks to the rescuer:infection

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• Gloves and eye protection

• Sharps box

• Face-mask with one-way valves

• Manikins

– clean regularly

Risks to the rescuer:precautions against infection

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Assessment

Ensure safety of

rescuer and victim

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Shake and Shout

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Is the victim responsive?

YES

• Check for injuries

• Reassess

• Get help

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Is the victim responsive?

NO

• Shout for help• Open their airway• Check for breathing

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Opening the airway

• Head tilt

• Chin lift

• If cervical spine injury suspected:

– jaw thrust

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Assess Breathing• Look for chest

movement• Listen for breath

sounds• Feel for expired air• Assess for 10 seconds

before deciding breathing is absent

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Is the victim breathing?

YES

• If safe, use recovery position

• Telephone for help

• Reassess at intervals

RC (UK)Recovery Position 1st Stage

RC (UK)Recovery Position 2nd Stage

RC (UK)Recovery Position 3rd Stage

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Recovery Position 4th Stage

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Is the victim breathing?

NO

• Telephone for help• Give two slow effective rescue breaths• Make up to 5 attempts

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Rescue breathing(Expired air ventilation)

• Occlude victim’s nose• Maintain chin lift• Take a deep breath• Ensure a good

mouth-to-mouth seal

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Rescue breathing(Expired air ventilation)

• Blow steadily (2 sec) into victim’s mouth

• Watch for chest rise

• Maintain chin lift, remove mouth

• Watch chest fall

RC (UK)Watch for chest fall

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Finger sweep

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Assess Circulation

• Look, listen and feel for normal breathing, coughing, or movement by the victim

• Check the carotid pulse (if trained)

• Take no more than 10 seconds

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Is a circulation present?

YES

• Continue with rescue breathing

• Reassess for signs of a circulation

about every minute

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Is a circulation present?

NO

• Start chest compressions

• Continue with rescue breathing

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Identify costal margin

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Identify xiphisternum

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Identify hand position on sternum

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Chest compressions:Depress sternum 4-5 cmRate: 100 per minute

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Chest compressions

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One Person CPR

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Chest compression: breath ratio

• 15 compressions : 2 breaths for

– 1-person CPR

– 2-person CPR

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When to go for help?

Go for help immediately:

• More than one rescuer

• Single rescuer:

– adult with cardiac problem, once established that patient not breathing

CPR for 1 minute first:

• Trauma

• Drowning

• Drug or alcohol intoxication

• Infant or child

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Continue resuscitation until:

• Qualified help arrives and takes over

• The victim shows signs of life

• You become exhausted

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Mouth-to-nose ventilation

• If mouth-to-mouth technically difficult

• If mouth seriously injured

• Rescue from water

• Resuscitation carried out by a child

• Aesthetic reasons

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Compression-only CPR

• Reluctance to perform mouth-to-mouth ventilation

• Chest compression alone better than no CPR

• If possible combine with head tilt

• Appropriate for telephone-CPR

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Cervical spine injury?

• If possible, maintain alignment of head, neck and chest

• Minimum head tilt only

• Jaw thrust preferable

• Assistance often required

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Choking:

Back Blows

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Abdominal Thrusts

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In-hospital Basic Life Support Patient Collapsed

Shout for HELP and assess responsiveness

Not responsive Responsive

Call cardiac arrest team / Get defibrillatorStart BLS if defibrillator not immediately

available

Call for medical assistance

Definite Pulse and Breathing Present?

Apply pads / monitorDefibrillate if appropriate

Ventilate with oxygen

Chest compressions

ALS on arrival of Cardiac Arrest Team

Airway manoeuvresOxygen, monitor, i.v.

Find notesPrepare handover

YesNo

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Any Questions?

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Summary

• ABC of basic life support

– rescue breathing

– chest compressions

– modifications