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Basic Life Support ( BLS ) Automated External Defibrillation (AED )

Basic Life Support ( BLS ) Automated External Defibrillation (AED ) . Farhad Heydari Emergency Medicine Deprtment Isfahan University Of Medical Sciences. OBJECTIVES. At the end of this course participants should be able to demonstrate: How to assess the collapsed victim.

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Basic Life Support ( BLS ) Automated External Defibrillation (AED )

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  1. Basic Life Support ( BLS ) Automated External Defibrillation (AED ) FarhadHeydari Emergency Medicine Deprtment Isfahan University Of Medical Sciences

  2. OBJECTIVES • At the end of this course participants should be able to demonstrate: • How to assess the collapsed victim. • How to perform chest compression and rescue breathing. • How to place an unconscious breathing victim in the recovery position.

  3. BACKGROUND • Despite important advances in prevention, cardiac arrest remains a substantial public health problem and a leading cause of death in many parts of the world. • Cardiac arrest occurs both in and out of the hospital. • approximately 350 000 people/year (approximately half of them in-hospital) suffer a cardiac arrest and receive attempted resuscitation.

  4. Survival to hospital discharge presently approximately 5-10% • Early resuscitation & prompt defibrillation (within 1-2 minutes) can result in >60% survival

  5. CHAIN OF SURVIVAL GUIDELINE 2010

  6. ارزیابی سطح هوشیاری ارزیابی وضعیت تنفس BLS 2005

  7. ارزیابی سطح هوشیاری ارزیابی وضعیت تنفس BLS 2005

  8. LOOK , LISTEN ,FEEL

  9. ارزیابی همزمان سطح هوشیاری و تنفس BLS 2010

  10. Start CPR When …… :

  11. ABC ???

  12. A B C SINCE 1960 C A B GIUDELINE 2010

  13. Arterial Blood O2 Content(ABC) O2 Content Arrest Resuscitation Chest Compression Rescue Breathes Time

  14. Arterial Blood O2 Content(CAB) O2 Content Arrest Resuscitation Chest Compression Time

  15. CAB vs ABC O2 Content CAB ABC Time

  16. Basic life support • * Approach safely • Check response • Check breathing • Shout for help & Call 115 • 30 chest compressions • 2 rescue breaths

  17. APPROACH SAFELY! Scene Rescuer Victim Bystanders • Approach safely • Check response • Check breathing • Shout for help & Call 115 • 30 chest compressions • 2 rescue breaths

  18. CHECK RESPONSE - CHECK BREATHING • Approach safely • Check response • Check breathing • Shout for help & Call 115 • 30 chest compressions • 2 rescue breaths

  19. CHECK RESPONSE • Shake shoulders gently • Ask “Are you all right?” • If he responds • Leave as you find him. • Find out what is wrong. • Reassess regularly.

  20. AGONAL BREATHING & GASPING • Occurs shortly after the heart stops in up to 40% of cardiac arrests • Described as barely, heavy, noisy or gasping breathing • Recognise as a sign of cardiac arrest

  21. SHOUT FOR HELP • Approach safely • Check response • Check breathing • Shout for help & Call 115 • 30 chest compressions • 2 rescue breaths

  22. Call 115 • Approach safely • Check response • Check breathing • Shout for help & Call 115 • 30 chest compressions • 2 rescue breaths

  23. Call 115 • How? • How many? • When? • Where?

  24. Once a cardiac arrest is identified, dispatchers can then give CPR instructions to a bystander over the phone until further help arrives. • Telephone instructions have been shown to increase the rates of bystander CPR and enhance outcomes. • Studies have also shown that the time to initiation of chest compressions is more rapid if the caller is given hands-only instructions (ie, no rescue breaths) rather than standard CPR instructions. (2012)

  25. Check pulse Only for healthcare provider Feel within 1.definite pulse give 1 breath / q 5-6 s 2. recheck pulse q 2 min. 3.no pulse or suspicious pulse next step 10 sec

  26. Chest compressions are the foundation of CPR • All rescuers, regardless of training, should provide chest compressions to all cardiac arrest victims.

  27. Number of Compressions Delivered • The total number of compressions delivered during resuscitation is an important determinant of survival from cardiac arrest. rate and the compression fraction. (the portion of total CPR time during which compressions are performed).

  28. Minimal Interruptions During Chest Compression Cardiac Output Time 2 min

  29. Minimal Interruptions During Chest Compression Cardiac Output Time 2 min

  30. Cardiac Output Without Interruptions With Interruptions Time 2 min

  31. CHEST COMPRESSIONS • Approach safely • Check response • Check breathing • Shout for help & Call 115 • 30 chest compressions • 2 rescue breaths

  32. CHEST COMPRESSIONS • Proper positioning of the patient and rescuer is fundamental to proper compression delivery. • The recommended position in out-of-hospital scenarios is to kneel perpendicular beside the patient’s torso. • For in-hospital cardiac arrest response, the rescuer should stand beside the bed at the level of the patient’s torso.(2012)

  33. CHEST COMPRESSIONS • supine victim on a hard surface • Place the heel of one hand in the centre of the chest ( lower half ) • Place other hand on top • Interlock fingers

  34. CONTINUE CPR 30 2

  35. CHEST COMPRESSIONS • Push hard and fast the chest: • Rate at least 100 /min • Depth 5 cm • Equal compression / relaxation • Minimize interruptions in chest compressions. • When possible change CPR operator every 2 min

  36. Providers delivering chest compressions should rotate every 2 minutes to minimize the effects of rescuer fatigue, and the switch should take less than 5 seconds. • One technique to minimize the interruption is to position a rescuer on either side of the patient for more seamless transitions. (2012)

  37. Interposed abdominal compression (IAC) is another strategy that has been proposed to increase cardio cerebral perfusion. • The first provider performs conventional chest compressions, while the second compresses the abdomen with similar hand position and depth midway between the xiphoid process and umbilicus during chest wall recoil. The third provider delivers intermittent ventilation, typically via an advanced airway management device. (2012) • This technique could be considered for victims of in-hospital cardiac arrest if a sufficient number of trained providers are present. (2012)

  38. RESCUE BREATHS • Approach safely • Check response • Check breathing • Shout for help & Call 115 • 30 chest compressions • 2 rescue breaths

  39. OPEN AIRWAY (head tilt , chin lift - jaw thrust ) • Approach safely • Check response • Check breathing • Shout for help & Call 115 • 30 chest compressions • 2 rescue breaths

  40. Give 2 BREATH ●Deliver each breath over 1 second • Give a sufficient tidal volume produce visible chest rise . ●Avoidrapid or forceful breaths.

  41. Pinch the nose Take a normal breath Place lips over mouth Blow until the chest rises Take about 1 second Allow chest to fall Repeat 2 RESCUE BREATHS

  42. However, an advanced airway device should be inserted and used to provide ventilations only after the patient has received 2 to 3 minutes of chest compressions and attempted defibrillation, if appropriate. (2012)

  43. Basic life support • Approach safely • Check response • Check breathing • Shout for help & Call 115 • 30 chest compressions • 2 rescue breaths

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