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Basic Life Support

Basic Life Support

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01/31/2013

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BASIC LIFE SUPPORT
GUIDELINES IN GIVING EMERGENCY CARE GETTING STARTED
1. Plan of ActionEmergency plans should be established based on anticipated needs and available resources2. Gathering of Needed MaterialsThe emergency response begins with the preparation of equipment and a personnel before any emergency occurs.3. Initial Response
 
 Ask for HELP.
 
Intervene
 
Do no further harm4. Instruction to Helper/sProper information and instruction to a helper/s would provide organized first aid care.
EMERGENCY ACTION PRINCIPLES
 Activate Medical AssistanceIn some emergency, you will have enough time to call for specific medical advice before administering first aid. But in some situations, you will need to attend to the victim first.Call First and Care first adult victim = call first.infants and children = care first Do a Primary Survey In every emergency situation, you must first find out if there are conditions that are an immediate threat to the victims life1. Check for Consciousness2. Check for Airway 3. Check for Breathing4. Check for Circulation
A.
INTERVIEW THE VICTIM
 
Victims name
 
Addr
ess
 
Phone numbe
r
 
 
A
sk what happen
 
S
A
M P L E histo
ry
 
 
Signs & s
y
mptoms
 
All
e
r
gies
 
Me
d
ications
 
Past me
d
ica
l
histo
ry
 
 
Last o
r
a
l
intake
 
Events p
r
io
r
to the episo
d
eB
.
CHECK VIT
A
L SIGNS
 
PULSE - Rate, St
r
ength &Rh
y
thm
 
RESPIR
A
TION - Respi
r
ation = 1inha
l
ation & 1 exha
l
ation
 
SKIN
A
PPE
A
R
A
NCE -Tempe
r
atu
r
e, co
l
o
r
& capi
ll
a
ry
 
r
efi
ll
 
 
PUPILS - PERRL
A
 
 
BLOOD PRESSUREC
.
PERFORM HE
A
D-TO-TOE EX
A
MIN
A
TION
 
Defo
r
mities
 
Contusions
 
A
b
r
asions
 
Punctu
r
es/penet
r
ations
 
Bu
r
ns
 
Ten
d
e
r
ness
 
Lace
r
ations
 
Swe
ll
ingBasic P
r
ecautions an
d
P
r
actices
 
Pe
r
sona
l
H
y
giene
 
P
r
otective Equipment
 
Equipment C
l
eaning & DisinfectingReview on b
r
eathing an
d
ci
r
cu
l
ation
 
A
i
r
that ente
r
s the
l
ungs contains about _____% ox
y
gen an
d
on
ly
a t
r
ace of ca
r
bon
d
ioxi
d
e
.
 
 
A
i
r
that is exha
l
e
d
r
om the
l
ungs contains about ______% ox
y
gen an
d
______% ca
r
bon
d
ioxi
d
e
.
 
BASIC LIFE SUPPORT
A
n eme
r
genc
y
p
r
oce
d
u
r
e that consists of 
r
ecognizing
r
espi
r
ato
ry
o
r
ca
rd
iac a
rr
est o
r
both an
d
the p
r
ope
r
app
l
ication of CPR to maintain
l
ife unti
l
a victim
r
ecove
r
s o
r
a
d
vance
d
 
l
ife suppo
r
t is avai
l
ab
l
e
.
 Gui
d
e
l
ines
 
The
A
me
r
ican Hea
r
t
A
ssociations Gui
d
e
l
ines fo
r
CPR an
d
ECC p
r
ovi
d
e science-base
d
 
r
ecommen
d
ations fo
r
t
r
eating ca
rd
iovascu
l
a
r
eme
r
gencies,pa
r
ticu
l
a
rly
su
dd
en ca
rd
iac a
rr
est in a
d
u
l
ts, chi
ldr
en, infants an
d
newbo
r
ns
.
 
 
Eve
ry
five
y
ea
r
s, hun
dr
e
d
s of 
l
ea
d
ing
r
esuscitation expe
r
ts
r
om a
r
oun
d
the wo
rld
 
r
eview a
ll
new an
d
existing
r
esea
r
ch as pa
r
t of an inte
r
nationa
l
 consensus p
r
ocess
.
This is the basis fo
r
an
y
 
r
evisions to the
A
me
r
ican Hea
r
t
A
ssociations Gui
d
e
l
ines fo
r
CPR an
d
ECC
.
 Histo
ry
of CPR
 
In 1960,
r
esea
r
che
r
s combine
d
b
r
eaths an
d
comp
r
essions to c
r
eate CPR as we know it to
d
a
y.
 
 
CPR t
r
aining has been
r
ecommen
d
e
d
fo
r
hea
l
thca
r
e p
r
ofessiona
l
s an
d
fo
r
the gene
r
a
l
pub
l
ic fo
r
mo
r
e than 40
y
ea
r
s
.
 
 
2
010 ma
r
ks a change in the sequence of CPR f 
r
om
A
i
r
wa
y
-B
r
eaths-Comp
r
essions (
A
-B-C) to Comp
r
essions-
A
i
r
wa
y
-B
r
eaths (C-
A
-B) sequence
.
 Su
dd
en Ca
rd
iac
Arr
est
 
EMS t
r
eats nea
rly
300,000 victims of out-of-hospita
l
ca
rd
iac a
rr
est each
y
ea
r
in the U
.
S
.
 
 
Less than eight pe
r
cent of peop
l
e who suffe
r
ca
rd
iac a
rr
est outsi
d
e the hospita
l
su
r
vive to make it home f 
r
om the hospita
l.
 
 
Su
dd
en ca
rd
iac a
rr
est can happen to an
y
one at an
y
time
.
Man
y
victims appea
r
hea
l
th
y
with no known hea
r
t
d
isease o
r
othe
r
 
r
isk facto
r
s
.
 
 
Su
dd
en ca
rd
iac a
rr
est is not the same as a hea
r
t attack
.
 St
r
engthening the Links in the Chain of Su
r
viva
l
 
 
Imme
d
iate
r
ecognition of ca
rd
iac a
rr
est an
d
activation of the eme
r
genc
y
 
r
esponse s
y
stem
 
Ea
rly
CPR with an emphasis on chest comp
r
essions
 
Rapi
d
 
d
efib
r
i
ll
ation
 
Effective a
d
vance
d
 
l
ife suppo
r
t
 
Integ
r
ate
d
post ca
rd
iac a
rr
est ca
r
e
Respiratory Arrest
- the con
d
ition in which the b
r
eathing stops o
r
ina
d
equate
 
 
Causes:1
.
Obst
r
uction
A
natomica
l
 Mechanica
l
 
2
.
DiseasesB
r
onchitisPneumoniaCOPD3
.
Othe
r
causes of Respi
r
ato
ry
 
Arr
estE
l
ect
r
ocutionCi
r
cu
l
ato
ry
co
ll
apseExte
r
na
l
st
r
angu
l
ationChest comp
r
ession (b
y
ph
y
sica
l
fo
r
ces)D
r
owningPoisoningSuffocationRescue B
r
eathing - a technique of b
r
eathing ai
r
into a pe
r
sons
l
ungs to supp
ly
him / he
r
with the ox
y
gen nee
d
e
d
to su
r
viveCa
rd
iopu
l
mona
ry
-ce
r
eb
r
o Resuscitation (CPCR)
 
Less than one-thi
rd
of out-of-hospita
l
su
dd
en ca
rd
iac a
rr
est victims
r
eceive b
y
stan
d
e
r
CPR
.
 
 
Effective b
y
stan
d
e
r
CPR, p
r
ovi
d
e
d
imme
d
iate
ly
afte
r
su
dd
en ca
rd
iac a
rr
est, can
d
oub
l
e o
r
t
r
ip
l
e a victims chance of su
r
viva
l.
 
 
Chest comp
r
essions shou
ld
be p
r
ovi
d
e
d
at a
r
ate of at
l
east 100 comp
r
essions pe
r
minute  the same
r
h
y
thm as the beat of the Bee Gees song, Sta
y
in
Al
ive
.
 
 
Comp
r
essions of a
d
equate
r
ate an
d
 
d
epth
 
a
ll
owing comp
l
ete chest
r
ecoi
l
between comp
r
essions
 
minimizing inte
rr
uptions in comp
r
essions
 
avoi
d
ing excessive venti
l
ation
Building Blocks of CPR Simplified Adult BLS Algorithm.YOUR ROLE IN A CODE BLUEPHASE I: Putting the code in motion
NURSE 1 NURSE
2
NURSE 3 / 4- LOC- Ca
ll
fo
r
he
l
p- Check ci
r
cu
l
ation- Initiate CPCR-
 
make su
r
e the co
d
e has been ca
ll
e
d
acco
rd
ing tohospita
l
p
r
oce
d
u
r
e-
 
Obtain eme
r
genc
y
equipment (C
r
ash ca
r
t)-
 
Begin
2
-
r
espon
d
e
r
CPCR with nu
r
se 1-
 
Connect the patient to a monito
r
 -
 
Set up
A
ED o
r
 
d
efib
r
i
ll
ato
r
, ox
y
gen, an
d
 suction equipment-
 
Get intubation equipment
r
ea
dy
 -
 
Set up IV equipment
Phase II: Drugs and Defibrillation
Initiate
A
CLS p
r
otoco
l
s an
d
eva
l
uation of the patients
r
esponse to the
r
ap
y
 
CODE TEAMTeam Leader
-
 
Usually a physician directs and coordinates the resuscitation effort, but a nurse whos 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 patientto 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 from ventricular fibrillation, so the team must be preparedto defibrillate immediately.
 
 
 
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, respiratorymanagement, procedures, medication administration, Iv fluids, VS, cardiac rythms, defibrillations,patient response to treatment, patient outcome, and termination of code.
-
 
The role of a recorder is vital. She shouldnt be asked to participate in any other way that distractsher from this responsibility.
-
 
An important duty of a recorder is to announce when a medication maybe due
-
 
Identify which clock should be the official code clock and be precise about the timing on theresuscitation record.Intubationist
-
 
A physician (anaesthesiologist), respiratory therapist, nuse anesthetist, or other specially preparednurse may do so.
-
 
Prepare: Laryngoscope: endotracheal tube and a stylet: 10 ml syringe: Lubricating gel: Suction to remove oral secretionsand improve visualization of anatomical landmarks: Stethoscope
-
 
If patient cant be intubated within
3
0 seconds, stop and hyperventilate and hyperoxygenateIV nurse
-
 
Solutions typically used during resuscitation efforts include .9% sodium chloride and lactated ringerssolutionMedication 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 ones confused aboutwhat youre drawing up. Again, announce the drug and dosage prior to administrationFloor nurse
-
 
Throughout the entire code, the other patients in the unit must be cared for
Phase III: Win
d
ing
d
own
 
T
y
pica
lly
begins afte
r
initia
l
 
A
CLS measu
r
es have been institute
d
an
d
thei
r
effectiveness eva
l
uate
d.
 
 
In this phase, the team
l
ea
d
e
r
continues to coo
rd
inate a
ll
the me
d
ica
l
the
r
apies, vita
l
signs, ca
rd
iac
r
h
y
thm, an
d
patient
r
esponse must be assesse
d
 
r
equent
ly
th
r
oughout the co
d
e
.
 Effo
r
ts a
r
e now aime
d
at one of the fo
ll
owing:
-
 
Maintaining the patient in stab
l
e con
d
ition unti
l
he can be t
r
anspo
r
te
d
to a c
r
itica
l
ca
r
e be
d
 
-
 
A
ttempting othe
r
st
r
ategies to
r
esto
r
e ca
rd
iac function
-
 
Deci
d
ing to te
r
minate the co
d
eKe
y
Cha
ll
enges to Imp
r
ove CPR Qua
l
it
y
fo
r
 
Ad
u
l
ts, Chi
ldr
en, an
d
Infants
 
Recognition
Fai
l
u
r
e to
r
ecognize gasping as sign of ca
rd
iac a
rr
est
Un
r
e
l
iab
l
e pu
l
se
d
etection
 
Initiation of CPR
Low b
y
stan
d
e
r
CPR
r
esponse
r
ates
Inco
rr
ect
d
ispatch inst
r
uctions
 
Comp
r
ession
r
ate
S
l
ow comp
r
ession
r
ate
 
Comp
r
ession
d
epth
Sha
ll
ow comp
r
ession
d
epth
 
Chest wa
ll
 
r
ecoi
l
 
Rescue
r
 
l
eaning on the chest
 
Comp
r
ession Inte
rr
uptions
Excessive inte
rr
uptions fo
r
  
r
h
y
thm/pu
l
se checks  venti
l
ations 
d
efib
r
i
ll
ation  intubation  int
r
avenous (IV) access  othe
r
 
 
Venti
l
ation
Ineffective venti
l
ations
P
r
o
l
onge
d
inte
rr
uptions in comp
r
essions to
d
e
l
ive
r
b
r
eaths
Excessive venti
l
ation (especia
lly
with a
d
vance
d
ai
r
wa
y
)
 
Defib
r
i
ll
ation
P
r
o
l
onge
d
time to
d
efib
r
i
ll
ato
r
avai
l
abi
l
it
y
 
P
r
o
l
onge
d
inte
rr
uptions in chest comp
r
essions p
r
e- an
d
post-shocks
 
Team Pe
r
fo
r
mance
De
l
a
y
e
d
 
r
otation,
l
ea
d
ing to
r
escue
r
fatigue an
d
 
d
eca
y
in comp
r
ession qua
l
it
y
 
Poo
r
communication among
r
escue
r
s,
l
ea
d
ing to unnecessa
ry
inte
rr
uptions in comp
r
essionsBeing p
r
epa
r
e
d
 
y
 
Each co
d
e situation is unique
.
 
y
 
Knowing that a co
d
e usua
lly
p
r
og
r
esses th
r
ough th
r
ee phases wi
ll
he
l
p
y
ou fee
l
mo
r
e confi
d
ent when the actua
l
event occu
r
s
.
 Tips to fine-tune
y
ou
r
ski
ll
s
 
Keep
y
ou
r
CPCR ski
ll
s up-to-
d
ate an
d
 
r
eview hospita
l
po
l
ic
y
on co
d
e p
r
oce
d
u
r
es an
d
 
d
ocumentation
 
Know cu
rr
ent BLS gui
d
e
l
ines
 
If 
r
u
l
e pe
r
mit, open
y
ou
r
c
r
ash ca
r
t an
d
me
d
ication box eve
ry
1 to
2
months an
d
 
r
eview whe
r
e supp
l
ies an
d
me
d
ications a
r
e
l
ocate
d.
 
 
Review the
dr
ugs use
d
most f 
r
equent
ly
 
d
u
r
ing a co
d
e an
d
thei
r
in
d
ications, usua
l
 
d
osages,
d
i
l
utions, an
d
a
d
minist
r
ation times
.
 
 
Know how to ope
r
ate the ca
rd
iac monito
r
an
d
 
A
ED in
y
ou unit
.
 
 
Make su
r
e
y
ou know how to change batte
r
ies in the
l
a
ry
ngoscope han
dl
e an
d
the
l
ightbu
l
b in the b
l
a
d
e
.
P
r
actice connecting the han
dl
e to the b
l
a
d
e

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