EMERGENCY NURSING: WEEK 1

BASIC LIFE SUPPORT (BLS)

- Trains participants to promptly recognize several CARDIO PULMONARY RESUSCITATION (CPR)
life-threatening emergencies, give high-quality
- Is an emergency life-saving procedure performed
chest compressions, deliver appropriate
when the heart stops beating.
ventilations and provide early use of an AED
- Is an emergency procedure that combines chest
- Is the foundation of saving lives after cardiac
compressions often with artificial ventilation in an
arrest.
effort to manually preserve intact brain function
- A level of medical care which is used for victims of
until further measures are taken to restore
life threatening illnesses or injuries until they can
spontaneous blood circulation and breathing in a
be given full medical care at the hospital. It can be
person who is in cardiac arrest.
provided by trained medical personnel, including
emergency medical technicians, paramedics, and • PURPOSE
by qualified bystanders. - To support life by means of hemodynamics,
- Includes psychomotor skills to perform high quality through chain of activities.
CPR, using automated external defibrillator (AED) - To reverse the initialing pathophysiological event.
and relieving an obstructed airway. - To prevent irreversible damage from anoxia
- Foundation of saving lives after cardiac arrest (absence of oxygen)
- “Cardiac arrest happens in our home”
• MAIN COMPONENTS
CHAIN OF SURVIVAL
1. Chest compression
- Actions in the chain of survival differ according to 2. Airway
settings (in-hospital vs. out-of-hospital) and age 3. Breathing
group
CARDIAC ARREST
• ADULT OUT-OF-HOSPITAL CHAIN OF SURVIVAL
- Sudden cessation of mechanical activity of heart
1. Activation of Emergency response with some or no electrical activity.
2. High-quality CPR - Cessation of normal circulation of blood due to
3. Defibrillation failure of heart to contract effectively.
4. Advanced resuscitation - Maybe reversible by rapid intervention but will
5. Post Cardiac Arrest Care lead to death in tis absences.
6. Recovery
• CAUSES
• ADULT IN-HOSPITAL CHAIN OF SURVIVAL
- Acute Myocardial Infarction
1. Early Recognition and Prevention - Cardiomyopathy
2. Activation of Emergency Response - Rhythm disturbances
3. High-Quality CPR - Congestive Heart Failure
4. Defibrillation - Cardiac Tamponade
5. Post Cardiac Arrest Care - Hypoxia
6. Recovery - Pulmonary Embolism
• PEDIATRIC OUT-OF-HOSPITAL CHAIN OF SURVIVAL - Tension Pneumothorax
- Respiratory Failuret
1. Prevention
- Airway obstruction
2. Activation of Emergency Response
- Sepsis
3. High-Quality CPR
- Electrolyte Imbalance
4. Advanced Resuscitation
- Hypoglycemia
5. Post Cardiac Arrest Care
- Anaphylaxis
6. Recovery
- Hypovolemia
• PEDIATRIC IN-HOSPITAL CHAIN OF SURVIVAL
CARDIO-PULMONARY RESUSCITATION
1. Early Recognition and Prevention
- 30:2
2. Activation of Emergency Response
- To support life by means of hemodynamic through
3. High-Quality CPR
chain of activities
4. Advanced Resuscitation
5. Post Cardiac Arrest Care • MAIN COMPONENTS (CAB)
6. Recovery  Compression
 Airway
 Breathing
 - Allow complete chest recoil
- Minimize interruption in compression
• WHEN TO GIVE CPR?
- Change compressor every 2 minutes or sooner if
BLS is needed when the individual: fatigued
- Is unconscious - If no advanced airway, 15:2 compression
- Is not breathing ventilation ratio
- Has an abnormal pulse rate - If advanced airway provide continuous
compressions and give a breath every 2-3 seconds
• WHEN NOT TO GIVE CPR?
AIRWAY ASSESSMENT AND BREATHING
- Neither scene nor the victim and the rescuer is
safe To open airway:
- Patient has developed rigor mortis (stiff body) 1. Head-Tilt Chin Lift
- Has normal pulse and breathing 2. Jaw Thrust
• WHY C-A-B? RESCUE BREATH
- To emphasize the simplest but the most important • MOUTH-TO-MOUTH
step
- Open airway. Pinch the nose. Seal mouth-to-
- To increase survival rate in sudden cardiac arrest
mouth contact. Blow.
- Patient’s blood stays oxygenated for 4-6 minutes
after last breath but circulation should be • MOUTH-TO-NOSE
restarted at the earliest
- Lockjaw. Seal mouth to nose contact. Blow with
- Rescue breathing almost always delays chest
more force.
compression
- Tidal volume: 500-600ml
• COMPONENTS - Each breath over 1 seconds with enough volume
to rise victim’s chest
1. Ensure scene safety
2. Check for response and assessment • MOUTH-TO-BARRIER DEVICE BREATHING
3. Call for help
- Head tilt chin lift. Seal from nasal bridge to chin in
4. Activate EMS
a ‘C’ pattern. Blow.
5. Chest Compression
- Protects rescuer from contact with a victim’s
• OUTCOME OF ASSESSMENT blood, vomitus and saliva, and from breathing the
air that the victim exhales.
Normal breathing (+) Pulse Monitor
felt • BAG-VALVE-MASK RESUSCITATIONS
No normal breathing (+) pulse Rescue breaths
No normal breathing (-) pulse Start CPR immediately - Open airway. First rescuer seals the mask in ‘E-C’
CHEST COMPRESSION pattern. Second rescuer provide ventilation.
- 2020 AHA guidelines for CPR has re-emphasized EARLY DEFIBRILLATION
early initiation of CPR (compression) by rescuers. AUTOMATED EXTERNAL DEFIBRILLATOR (AED)
- Is the foundation of CPR. - AED is an integral component of BLS protocol
- Push hard, push fast. - AED deliver defibrillations to specific two
- Hands-only CPR. shockable dysrhythmias (VFib and VTach)
HIGH-QUALITY CPR • AED SAFETY
• ADULT - Make sure the patient is as dry as possible.
Rescuers should not be in contact with water
- Push hard (at least 2 inches [5 cm]) and fast (100-
- Avoid getting AED or AED pads wet if possible
120/min)
- Make sure pads are not touching metal surface
- Allow complete chest recoil
- Position the pads at least an inch away from metal
- Minimize interruptions in compressions
piercings, 3cm away from pacemakers.
- Avoid excessive ventilation
- Be cautious with medication patches. Remove the
- Change compressor every 2 minutes, or sooner if
patch beforehand.
fatigued
- Excessive chest hair can affect pad-to-skin contact
- If no advanced airway, 30:2 compression
- When advised ‘CLEAR’, make sure no one is in
ventilation ration
contact
• PEDIATRIC - Do not use alcohol to wipe
- Do not use defibrillator around inflammable
- Push hard (2 ½ of antero-posterior diameter of
materials.
chest) and fast (100-120/min)