BASIC CARE & LIFE

SUPPORT

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Go change the world
 Basic Life Support Module

Has 4 sessions:
1. Common Emergencies
• What is an emergency?
• How to manage?
2. Ensuring Scene Safety and Primary Assessment
3. Cardiac Arrest
• Chest Compression
• Use of Automated External Defibrillator (AED)
4. Relieving Airway Obstruction due Choking
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 ON-SITE CARE CARE DURING TRANSIT CARE IN THE HOSPITAL

Universal centrally operated 108 India is having one of the best hospital
Early recognition and quick
ambulance service is a great infrastructure in the world. Medical
response by a trained
achievement in emergency care. tourism is a 5-6 billion USD business.
personal improves the
There is a lot of support from The issue is the accessibility to the
chances of survival by 70% in
different organizations and care but there is lot of effort from
commonly encountered
Government towards this private and government to improve
emergencies.
operation. the accessibility.
 SESSION 1
COMMON EMERGENCIES
 OBJECTIVES

• Understand how to recognize common emergencies

• Manage COVID 19 safely in community

• Understand simple interventions that can stabilize the

patient
 EMERGENCY
What is an Emergency?
• A condition which threatens the life or well-being of a
patient

Patient’s perception of an “emergency”

• Based on layman’s knowledge
• May or may not be an actual emergency
• Sometimes reassurance is all that is required
 COMMON EMERGENCIES
• Heart Attack
• Snake Bite
• Stroke
• Infections e.g. COVID 19
• Diabetic collapses
• Fits
• Fractures, wounds, burns and Life Threatening Bleeding
 HEART ATTACK

• How to Recognise?
• Chest pain is classic but not always present
• If person has Diabetes, smoker, high BP or overweight, older age
• May just have sweating, tiredness, nausea, back ache, tingling, arm pain

• Reassure, Aspirin is life saving

• GTN spray
• Rush to Emergency Department
• ECG, Blood Tests – thrombolysis, stents, CABG
• Most common cause of cardiac arrest
• Need immediate chest compression
• Shock with AED if available
 SNAKE BITE: DO IT R.I.G.H.T

• R: Reassure the patient

❖ 70% of snakebites: from non- poisonous snakes
❖ Only 50% poisonous snakes inject poison
• I: Immobilize the injured extremity and the person
❖ Splint (support) as you would for a fracture
❖ No tourniquets or ligatures: they can harm
• G, H: Get to the Hospital immediately!
❖ Don’t waste valuable time: treatment most effective if given early
❖ Traditional remedies have no proven benefit
• T: Tell the doctor about any symptoms you have developed
❖ Pain, weakness, bleeding, etc
 STROKE

Transport to ED for CT scan, to dissolve the clot and supportive therapy

TIME IS BRAIN
 INFECTIONS
• Pneumonia, Urinary Infection, Skin Infection
• Seasonal:- Dengue, Malaria, Swine Flu, Chikungunya
• COVID 19 (Corona Virus) Pandemic
• Keep eyes nose and mouth free of contamination
• Wear face masks in public
• Do not touch face with hands
• Keep a distance of 1 meter from others
• Wash/Clean hands frequently with sanitizer gel or soap + water
• Seek medical help for difficulty in breathing
• Drink plenty of fluids
 DIABETES

Low sugar problems: more dangerous than high sugar levels

• Tired, sweating, confusion, seizures, unconscious
• May be confused with stroke
• Give Sugar by mouth
• If no improvement rush to the hospital

High sugar problems:

• Increased urination, thirst, severe dehydration, nausea, abdominal discomfort
• Seek medical care urgently
 FITS (SEIZURES)

• Generalized: Involves shaking of the whole body

• Person is on the floor and vigorously shaking
• Will be confused or may loose consciousness
• Focal: Involves only some parts of the body
• repetitive movements (chewing/blinking) or rhythmic twitching
• Do not
• attempt to hold mouth open
• restrain arms/legs tightly
• Keep surrounding safe.
• eg: Keep pillows to avoid injury from surrounding objects
• If known to have diabetes: May have low glucose
• Turn patient on side (recovery position) after seizure
 WOUNDS BURNS OR BREAKS

• Wounds: Wash with clean water and soap

• Avoid contamination
• If large seek medical care
• If fracture or sprain (will have severe pain)
• Splints, ice and restrict movement
• Burns
• Cold water for burns, wrap with clean polythene film
• If bleeding: Direct pressure, if still bleeding
• Tight bandage
• Tourniquets

• Take them to ED if any of these are significant

 CONTROL MASSIVE BLEEDING

• Severe bleeding can kill in minutes

• Control bleeding by:
• Direct pressure
• Tight dressing
• Tourniquet

• Tourniquet
• Apply above level of bleeding
• DON’T apply over the joint
• Must be at least 3-4 finger breaths wide
 SESSION 2
Scene Safety &
Primary Assessment
 OBJECTIVES

• Understand the importance of personal and scene safety in

an emergency
• Steps to be taken to prevent further damage including
infection control
• Using others in ensuring scene safety
• Perform primary assessment
 SCENE SAFETY

You are hiking and you see this:

• What do you see here?

• Is it safe to touch?

• Surrounding area?

• Is the source of harm still

present?
 SCENE SAFETY

v/s
 DO NOT..

• Start resuscitation before securing the area

• Before covering the patient’s face
• in the middle of traffic
• Apply tourniquet on a snake bite victim
• Touch pesticide stained area with bare hands
• Ignore fire hazards

Only after scene safety is ensured proceed to primary assessment

 PRIMARY ASSESSMENT

1. Assess Conscious level

2. Cover, Look & Feel: Is it cardiac arrest?

Assessing Conscious level

• Awake: talking normally

• Verbal: wakes up after shouting
• Pain: responds to pain
• Unresponsive (unconscious)
 PRIMARY ASSESSMENT

If unresponsive then,

2. Cover, Look and Feel: Is it cardiac arrest?

• Cover faces with masks

• Look for chest rise

• Feel for pulse in the neck

If no response call for HELP!

 SUMMARY

1. Scene Safety

2. Primary Assessment:
• Assess Consciousness: AVPU
• Cover, Look, Feel: chest rise, breathing, carotid pulse
• Is it Cardiac Arrest?
SESSION 3
CARDIAC ARREST
 OBJECTIVES

• Understand what is Cardiac Arrest

• Understand the importance of calling for help

• Learn the correct steps to follow in such a
situation
 CARDIAC ARREST

If there is no effective chest movement, no pulse and the patient is

unconscious, the patient is in cardiac arrest.

• Call for help (☎ 108)

• Early CPR
• Early Defibrillation
• Early transport to hospital
 CARDIAC RESUSCITATION

In cardiac arrest the 2 most important things are:

•Effective Chest Compressions

•Early use of Defibrillator (shock)
 CHEST COMPRESSIONS

For chest compression to be effective:

• Firm flat surface

• Compress one third the height of the chest

wall
• Slow recoil

• Continuous for 2 minutes

• Reassess every 2 minutes for less than 10 s

 CHEST COMPRESSIONS

Compressions should be stopped in only 4 situations

• After every 2 minutes: while reassessing

• When defibrillator is assessing rhythm
• When shock is delivered by defibrillator
• If patient pushes you away/pulse felt on checking
 ADULTS (FACES COVERED)

• 100 per minute

• Continuous for 2 minutes
• Heel of dominant hand in midline on the lower half of
sternum & other hand locked, on top
• Straight arms, locked elbows and shoulders
aligned to patient’s midline
• Extend your back
 CHEST COMPRESSIONS

Adults (Masks on)

• 100 per minute
• Continuous for 2 minutes
• Heel of one hand in the center of the chest on
the lower half of sternum with the other hand on top
• Straight arms, locked elbows and
shoulders in line with patient’s midline
• Extend your back
 COMPRESSIONS IN CHILDREN

• Faces Covered!
• Provide compression at 120 per minute.
• Compress 1/3rd the height of chest wall
• Provide chest compression in Unconscious
infant with HR<60/min.
 TWO PERSON CPR

• Scene safety and infection control

• Assess patient
• If in cardiac arrest, call for help (☎108)
• Start CPR 100 compressions per min
• Recheck for signs of life every 2 mins
• Connect AED asap if available
 ONE PERSON CPR

• Person 1 (leader) does scene safety ensures

infection control, assess patient and start CPR
• Person 2 calls for help and then assumes
hovering
position
• Person 2 swaps with Person 1 continuing CPR
• Swap compression provider every 2 minutes
• Faces Covered!
 AED

• Automated External Defibrillators

• For ventricular arrhythmias

• Increases chances of survival if shocked early

Every minute of delay in Compression and Defibrillation reduces

patient’s chance of survival by up to 10%
Note: slight changes can happen in device based on brand used. This AED is only for training, can not be used in actual situation
SESSION 4
CHOKING
 OBJECTIVES

• Be able to recognize a choking victim

• Be able to demonstrate proper technique to

relieve choking in all age groups

• Know how to help yourself if you choke and

have airway obstruction
 CHOKING

• Choking: Difficulty breathing due airway obstruction

• Common in children and older people
• Very common emergency scenario
• E.g. 4th leading cause of unintentional death in the USA!
• More than 60% associated with food
• If obstruction not relieved immediately
• becomes unconscious with in seconds in front of your eyes
• and will develop cardiac arrest
 CHOKING IN ADULTS:
CONSCIOUS

• If the person is coughing

• Bend the person forward and give BACK BLOWS
• Support with one arm across their chest
• With the other arm, apply 5 back blows in center of upper back

• If unable to cough: obstruction is severe

• Abdominal Thrust: Hug from behind and squeeze
the upper abdomen (Heimlich’s Manoeuvre)
 CHOKING IN ADULTS:
ABDOMINAL THRUSTS
(Heimlich’s Manoeuvre)
• Stand behind the person with one leg forward between
• the buttock and your other leg a little back so you don’t fall
back
• Make a fist with one hand and grasp it with the other
hand
• just above the umbilicus/navel
• Thrust abdomen with ‘quick forceful jerks’ inwards &
backwards
• until choking is relieved or person becomes unresponsive
 ABDOMINAL THRUSTS:
SPECIAL SITUATIONS
• Pregnant woman or big frame (obese)
• Place hands in lower chest

• Children and short people kneel down

• to get correct position

• In very tall patients help the person to sit

• On a stool: Position yourself by kneeling down
• The floor with legs stretched forward
 IF YOU CHOKE WHEN YOU ARE
ALONE!
• Call for help and Dial 108

• Place the person flat on hard floor

• Start Chest compression 100 per minute

• Reassess after every 2 minutes

• Check and remove foreign body from mouth only if you see it
• No blind sweeps: You can push it down further!

• If no response continue CPR as in Cardiac Arrest

 CHOKING : UNCONSCIOUS

If able to cough
• Lean forward and cough vigorously until the
foreign body is out

If unable to cough
• Give yourself abdominal thrusts
• Lean over and push your abdomen against the
back of a chair, table or other firm object.
 CHOKING IN INFANTS

5 back slaps Turn and Look 5 chest compressions

If the child becomes unconscious do only chest compression

 CHEST COMPRESSIONS
TECHNIQUES
1 hand for small babies 2 hand for bigger babies