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Resuscitation Training
Adult Basic Life Support
Resuscitation OfficersBruce Kerr, HHGH; ext 2317/bleep 2307Juliet Quine, WGH; ext 7218/bleep 1447
Proceed through the presentation using the arrow keys
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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
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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
• PorterIf more staff attend than is necessary, the team leader should request that
excess staff leave.
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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
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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• PorterIf more staff attend than is necessary, the team leader should request that
excess staff leave.
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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
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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
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Adult Basic Life Support Demonstration
Click on picture to commence video
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Adult Basic Life SupportDemonstration with commentary
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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
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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.
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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.
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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)
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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.
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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
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Resuscitation of ‘Neck-Breathers’Demonstration with commentary
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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
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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
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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
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The Recovery PositionDemonstration with commentary
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Preparation of Cardiac Arrest Drugs
Demonstration with commentary