Basic Life Support: CPR & First Aid - PowerPoint Presentation

Slide1

Basic Life Support: CPR & First Aid

1

August 2017 v 2.1Slide2

Overview BLS: CPR & FA

2

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

3

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

4

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

6

5 Links inThe Chain of Survival

Basic Life SupportSlide7

7

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

8

Early and aggressive CPRvastly improves survival chances

CPR keeps oxygenated blood circulating to the brain and heart

Basic Life Support

Early CPRSlide9

9

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

10

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

11

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

12

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

13

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

14

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

15

Avoid becoming injured yourself

Think S A F E

Scene SafetySlide16

16

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

17

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

18

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

19

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

20

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

21

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

22

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

23

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

24

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

25

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

26

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

27

Critical Steps for Compressions

Maximize compression quality -

hard with controlled speedRelease pressure - without loosing contact with chest wall

Cardiopulmonary ResuscitationSlide28

28

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

29

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

30

Use of Oxygen

Supplemental oxygen improves tissue oxygenation during resuscitation after immersion incidentsImportant for

victims of drowning or scuba diving accidents

Cardiopulmonary ResuscitationSlide31

31

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

32

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

33

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

34

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

35

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

36

Basic Life Support

is care for life threatening injuries

First Aid is care for injuries or illnesses that are not immediately life threatening Slide37

37

General Assessment

First-aid AssessmentsSlide38

38

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

39

Illness Assessment

Areas of common concern Breathing difficulties

Chest pain Abdominal pain Altered level of Consciousness

First-aid AssessmentsSlide40

First-aid Assessments

40

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

41

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

42

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

43

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

44

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

45

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

46

Scene Safety Assessment

Donning and Doffing Gloves

Initial AssessmentRecovery Position

Chest CompressionsVentilationsFull CPR

AED Use

Foreign Body Airway Obstruction

Secondary AssessmentSlide47

Questions?

47