1 August 2017 v 21 Overview BLS CPR amp FA 2 Topics Basic Life Support Respiration and Circulation Scene Safety Initial Assessment Cardiopulmonary Resuscitation Use of AEDs Foreign Body Airway Obstruction ID: 734038
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Basic Life Support: CPR & First Aid
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August 2017 v 2.1Slide2
Overview BLS: CPR & FA
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Topics
Basic Life Support
Respiration and Circulation
Scene SafetyInitial Assessment
Cardiopulmonary Resuscitation
Use of AEDs
Foreign Body Airway Obstruction
First-aid Assessments
Temperature Related InjuriesLifting and Moving Slide3
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What does BLS
mean?BLS is
Basic Life
Support Providing care for life threatening injuries, including cardiac arrest
BLS Goal – provide & maintain critical blood flow to vital organsBLS also ensures that EMS has been activated
4-6 minutes without oxygen, organs (especially the brain) may start dying
Basic Life SupportSlide4
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Key Steps during
C
ardio-P
ulmonary Resuscitation
Check for responsiveness activate EMS
Quickly check
for normal breathing
Provide chest compressions
if not breathing normally
Provide ventilationsBasic Life SupportSlide5
Duty of Care No legal obligation to provide care
May have an obligation to notify authorities that someone in in need of medical careALWAYS ask permission before rendering aid of any kind
State “My name is _____. I am a first-aid provider. May I help you?”
Responsive person should give permissionPermission is assumed for unresponsive person
Basic Life Support
5Slide6
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5 Links inThe Chain of Survival
Basic Life SupportSlide7
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Recognition of a problem should
be followed by rapid actionCall for help
immediately after determining an adult is unresponsiveThe sooner EMS is called, the sooner advanced medical care is available
Early Access
Basic Life SupportSlide8
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Early and aggressive CPRvastly improves survival chances
CPR keeps oxygenated blood circulating to the brain and heart
Basic Life Support
Early CPRSlide9
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Basic Life Support
Rapid Defibrillation
Cardiac arrest often results f
rom abnormal heart rhythm called Ventricular Fibrillation,
where the heart muscle quivers instead of contracting
Defibrillation
is the
single
most important intervention in cardiac arrestSlide10
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Includes:Advanced Airways
IV MedicationsAdvanced Heart Monitoring
Stabilizes patient for transport to hospitalGood ALS care depends on good BLS care !
Basic Life Support
Advanced Life SupportSlide11
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Involves:
Maintaining airway
Heart Monitoring
Hospital interventions
to treat the underlying cause of the cardiac arrest
Basic Life Support
Post Cardiac-Arrest CareSlide12
Basic Life Support
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Emotional Stress
Anxiety is normal CPR does not always work
Even when coupled with advanced cardiac care Seek counseling
rather than blame yourselfYou did not do anything wrong
You did not make the condition worseSlide13
Respiration and
Circulation
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Circulatory System
includes the heart and blood vessels
Primary function is pumping blood, transporting oxygen and nutrients to tissues and removing waste productsArteries
carry blood from the heart
to the body tissues
Veins
carry blood from the body tissues back to the heartCapillaries the smallest blood vessels where nutrients and waste products are exchanged at the tissue cellular levelSlide14
Respiration and
Circulation
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Oxygen is essential for life and required for cellular function
Hypoxia is oxygen deficiencyAnoxia is the absence of oxygen
Respiratory system
provides the interface
between the atmosphere and the
bloodstream for gas exchange
Intake of oxygenRemoval of CO2 Respiratory system
is comprised of theupper airway (mouth, nose, pharynx), the trachea, and the lungs
The smallest structures are the alveoli
Pulmonary gas exchange
takes place at the alveolar-capillary membraneSlide15
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Avoid becoming injured yourself
Think S A F E
Scene SafetySlide16
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Risk Infection
Minimal, but presentInfection may happen
via contact with infected blood and other body tissuesNot transmitted through casual contact
Not transmitted through intact skin
Use barriers to further minimize riskIf you believe you have been exposed to a
bloodborne
pathogen immediately seek medical evaluation
Scene SafetySlide17
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Hepatitis B (HBV)
Affects the liver50-100 x more infectious than HIV
Effective vaccination is available5-10% of infected people develop
chronic disease15-25% with chronic disease develop liver failure or liver cancer
Scene SafetySlide18
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Hepatitis C
Affects the liverAbout 40% of infected people recover fully
Symptoms may take many years to developMany infected people become chronic carriers,
and may not realize they are infected.Less contagious than Hepatitis BNo immunization
available
Scene SafetySlide19
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Human Immunodeficiency Virus (HIV)
Affects the immune system, causes AIDS
HIV is the virus
AIDS is the disease
caused by the virusSymptoms may take years to develop
Least infectious
of the 3 major pathogens
No immunization
available
Scene SafetySlide20
Scene Safety
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Standard Precautions
Use PPE (Personal Protective Equipment) Gloves, face masks, eye protection, clothing
Avoid contaminated sharp objectsDispose of sharps in an approved container
Thoroughly wash hands after providing careSlide21
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Assessing Responsiveness
Tap firmly on collar bone and
shout “are you OK?”
State your name and ask permission to helpIf the injured diver responds, continue with secondary assessment
If the injured diver does not respond, scan quickly to determine if he is breathing normally
Call or send someone to call EMS immediately
Initial AssessmentSlide22
Initial Assessment
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Recovery Position
Good positioning to help protect the airwayContinually
check to ensure that his condition does not deteriorate
Do not use for individual’s with suspected spinal injurySlide23
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Log Roll
Used to move the person onto his back
Protect
neck and spineIf the person is unresponsive and not breathing normally, call for EMS & initiate CPR
Nothing is more important than compressions (after calling for help)
Initial AssessmentSlide24
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Blockage in heart arteries
May be severe enough to stop the heartIf individual is conscious and breathing
Keep in position of comfort Consider giving 4 baby aspirin (81mg)If history of heart attack, may have nitroglycerine
Administer under tongue
Heart Attack
Cardiopulmonary ResuscitationSlide25
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Possible warning signs of a heart attackPressure/squeezing mid-chest Nausea and vomiting
Arm, shoulder, neck, or jaw pain Heartburn/indigestionShortness of breath Sense of impending doom
Unusual sweating Back pain between shouldersMany individuals have “silent” heart attacks
, with no obvious signs or symptoms. Especially common in women, diabetics, and others with pre-existing medical conditions.
Heart Attack
Cardiopulmonary ResuscitationSlide26
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If normal breathing is not present:
Call for helpBegin
with compressions
at a rate of 100-120 compressions per minuteCompress to a depth of 2-2 ½ inches/5-6 cm
Push HARD30 compressions, then 2 ventilations
Starting CPR
Cardiopulmonary ResuscitationSlide27
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Critical Steps for Compressions
Maximize compression quality -
hard with controlled speedRelease pressure - without loosing contact with chest wall
Cardiopulmonary ResuscitationSlide28
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CPR for Drowning Victims
Conduct CPR
beginning with ventilations for 2 minutes before activating EMS
Use the A-B-C protocol acronym to guide CPR efforts when responding to a drowning or immersion incident
Cardiopulmonary ResuscitationSlide29
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Critical Steps for Ventilations
Use head-tilt-chin-lift
to open airway
Create seal
with barrier device or directly on person’s mouthVentilations should be sufficient for chest rise-and-fall, no more
1 second breath
1 second for exhale
1 second for next breath
Cardiopulmonary ResuscitationSlide30
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Use of Oxygen
Supplemental oxygen improves tissue oxygenation during resuscitation after immersion incidentsImportant for
victims of drowning or scuba diving accidents
Cardiopulmonary ResuscitationSlide31
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Special Circumstances with Resuscitation
Pregnancy
Effective compressions may require manual displacement of the uterus to her left
Reduces pressure on returning blood flowOpioid Overdose
Became the leading cause of death between 25-60 year-olds in 2012Can lead to respiratory arrest and cardiac arrestTreat with
Naxolone
– interferes with action of opioids
Cardiopulmonary ResuscitationSlide32
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The heart has a natural electrical system
Electrical impulse should generate a heart contraction
Contraction pumps blood to the bodyMost common abnormality during cardiac arrest is ventricular fibrillation
Use of AEDs During CPR
Contractions stop therefore circulation stops
The
solution
for
fibrillation
is . . . de
fibrillationSlide33
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Defibrillation generates a large shock to reset the electrical system
Assists in re-establishing a normal heart rhythm
AEDs universally provide audible user prompts
“Attach pads to patient’s bare chest”CPR in conjunction with early defibrillation
provides the highest rate of survival from SCA
Use of AEDs During CPR
Survival rates
drop 7-10%
for every
minute the heart is in ventricular fibrillationSlide34
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Cautions
Do not use in standing water
Discontinue use of oxygen and move it away from the individual
Troubleshooting
Pad placement/attachment most frequent problemFollow illustrations on pads then assure firm attachment
Removing moisture or shaving off chest hair may be required
Maintenance
Check AED status indicator
Replace battery if required
Replace expired pads
Use of AEDs During CPRSlide35
Foreign Body Airway Obstruction
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Choking
Most common obstruction in adults is food
Partial obstructions (the person can speak and/or cough) do not require active intervention
Complete obstructions (the person cannot speak, breath, or cough) require rapid assistance
If the person
becomes unconscious,
call for help and
start CPR
Finger sweep should only be used when obstruction can be seenSlide36
First Aid
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Basic Life Support
is care for life threatening injuries
First Aid is care for injuries or illnesses that are not immediately life threatening Slide37
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General Assessment
First-aid AssessmentsSlide38
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History
Should be brief Focus on events leading to the problem
Use S A M P L ES
igns/symptoms of current problemAllergies (medications, bee stings, peanuts)
MedicationsPertinent medical history
L
ast oral intake (both food and liquid)
E
vents leading up to current problem
First-aid AssessmentsSlide39
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Illness Assessment
Areas of common concern Breathing difficulties
Chest pain Abdominal pain Altered level of Consciousness
First-aid AssessmentsSlide40
First-aid Assessments
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Secondary Assessment
Obtain person’s permission before evaluation
Head-to-toe evaluation, looking for other injuriesGently palpate in a systematic manner
Work from head to footSlide41
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Hypothermia (cold)
– body core temperature <95◦ F/35◦
CPrevent further heat loss
Remove wet clothingProvide warm dry coverings
Consider use of hot-water bottles or heating padsActivate EMS for moderate to severe casesAVOID
rough handling
May cause heart arrhythmias
Temperature Related InjuriesSlide42
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Hyperthermia (hot)
– body’s normal cooling mechanisms are overwhelmedHeat rash – pimple-like rash
Due to excessive sweatingCool individual
Keep area dryHeat Cramps – muscle spasmsDue to excessive fluid loss due
Associated with strenuous activityStop all activity
Rest in cool place
Drink clear fluids (sport drinks)
Temperature Related InjuriesSlide43
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Heat Exhaustion
Also due to excessive fluid loss
Warning signs Heavy sweating Nausea/Vomiting
Headache Muscle cramps Fatigue
Weakness Fainting
First Aid
Remove from heat
Rest
Remove unnecessary clothing
Place in cool environment Drink clear liquids (sport drinks) Cool with sponging head, neck, torso
Temperature Related InjuriesSlide44
Temperature Related Injuries
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Heat Stroke
Life-threatening conditionBody core temperatures may exceed 106
◦F/41◦C
Warning signs Rapid pulse Red, hot, often dry skin
Strange behavior
Hallucinations
Confusion
Seizures
Coma DeathFirst Aid
Remove from heat Activate EMS
Rest
Remove unnecessary clothing
Place in cool environment
Aggressive cooling
Cold packs, Water soaked towels,
Fans/VentsSlide45
Lifting and Moving
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General Considerations
Moving an injured person strongly discouraged
Exceptions:To move the person to their back for CPR
Imminent danger (fire, explosive, traffic)When moving is necessary
–
Protect both first-aid provider and injured or ill person
Move in orderly, planned and unhurried fashion
Use the safest and easiest methodSlide46
Skills
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Scene Safety Assessment
Donning and Doffing Gloves
Initial AssessmentRecovery Position
Chest CompressionsVentilationsFull CPR
AED Use
Foreign Body Airway Obstruction
Secondary AssessmentSlide47
Questions?
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