BLS for Health Care Providers Course

7/21/2019 BLS for Health Care Providers Course

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BLS for Health Care Providers Course

By:

Dr. Nariman Singmamae

M.B.B.S (DMC) M.!m.Med ("#M)

Le$turer % !mergen$y Physi$ian

"N&M'S S H

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>he Chain of Survival $om*rises @ ( ve) vital lin5s that $an save a life in

$ardia$ emergen$ies:

9.!arly re$ognition and a$$ess

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9.>he sim*li ed universal adult BLS algorithm has ,een $reated ( gure


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Summary of #ey &ssues and Ma or Changes

L' !SC"! 'D"L> CP

?>here has ,een a $hange in the re$ommended se4uen$e for the lone res$uer toinitiate $hest

$om*ressions ,efore giving res$ue ,reaths (C-'-B rather than '-B-C). >he loneres$uer

should ,egin CP +ith /= $om*ressions rather than < ventilations to redu$e delay torst

$om*ression.

?Com*ression rate should ,e at least 9== min (rather than Va**ro7imatelyU9== min).

?Com*ression de*th for adults has ,een $hanged from the range of 9 to < in$hes to

at least hese $hanges are designed to sim*lify lay res$uer training

'H'


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9 9< HC' ! P ;R&D! BLS


?Be$ause $ardia$ arrest vi$tims may *resent +ith a short *eriod of sei ure-li5e

a$tivity or agonal gas*s that may $onfuse *otential res$uers dis*at$hers should ,e

s*e$i $ally trained to identify these *resentations of $ardia$ arrest to im*rove

$ardia$ arrest re$ognition.

?Dis*at$hers should instru$t untrained lay res$uers to *rovide Hands-;nly CP for

adults +ith sudden $ardia$ arrest.

? e nements have ,een made to re$ommendations for immediate re$ognition and

a$tivation of the emergen$y res*onse system on$e the health$are *rovider

identi es the adult vi$tim +ho is unres*onsive +ith no ,reathing or no normal

,reathing (i.e. only gas*ing).

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H!'L>HC' ! P ;R&D! BLS


?>he health$are *rovider ,rieIy $he$5s for no ,reathing or no

normal ,reathing (i.e. no ,reathing or only gas*ing) +hen the

*rovider $he$5s res*onsiveness.

? >he *rovider then a$tivates the emergen$y res*onse system and

retrieves the '!D (or sends someone to do so).

'H' HC' ! P ;R&D! BLS


?>he health$are *rovider should not s*end more than 9= se$onds $he$5ing for a

*ulse and if a *ulse is not de nitely felt +ithin 9= se$onds should ,egin CP and

use the '!D +hen availa,le.

?TLoo5 listen and feel for ,reathingU has ,een removed from the algorithm.

?&n$reased em*hasis has ,een *la$ed on high-4uality CP ($om*ressions of

ade4uate rate and de*th allo+ing $om*lete $hest re$oil ,et+een $om*ressions

minimi ing interru*tions in $om*ressions and avoiding e7$essive ventilation).

?"se of $ri$oid *ressure during ventilations is generally not re$ommended.

?Com*ression rate is modi ed to at least 9== min from a**ro7imately 9== min.

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9 9< HC' ! P ;R&D! BLS


? es$uers should initiate $hest $om*ressions ,efore giving res$ue ,reaths (C-'-B

rather than '-B-C). Beginning CP +ith /= $om*ressions rather than here is an in$reased fo$us on using a team a**roa$h during CP .

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W . 'P diameter

W. 'P diameter

'ir+ay

Head-tilt-$hin lift

(trauma: a+ thrust)

Head-tilt-$hin lift

(trauma: a+ thrust)

Head-tilt-$hin lift

(trauma: a+ thrust)

Com*ression:

ventilation ratio

/=: @

elieving Cho5ing in 'dult % Children

Ste* ,y Ste* '**roa$h

C: "sers ne$ Des5to* images /O. *g


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Cho5ing in 'dult % Children

!arly re$ognition of the air+ay o,stru$tion is the 5ey to su$$essful

out$ome.

&t is im*ortant to distinguish this !mergen$y from fainting fainting heart

atta$5 sei ure drug overdose or other $ondition that $ause res*iratory

failure ,ut re4uired diAerent treatment.



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6oreign ,ody may $ause either mild or severe air+ay o,stru$tion



Mild 'ir+ay ;,stru$tion Signs

es$uer '$tion

ood air e7$hange

's long as good air+ay e7$hange $ontinues

en$ourage the vi$tim to $ontinue

s*ontaneous $oughing and ,reathing eAort

es*onsive and $an $ough for$efully

Do not interfere +ith the vi$timYs o+n

attem*t to e7*el the foreign ,ody ,ut stay

+ith vi$tim and monitor the $ondition

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Mild 'ir+ay ;,stru$tion Signs

es$uer '$tion

es*onsive and $an $ough for$efully

&f mild air+ay o,stru$tion *ersists

a$tivate the emergen$y res*onse

system

May +hee e ,et+een $oughs

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Severe 'ir+ay ;,stru$tion Signs

es$uer '$tion

Poor or no air e7$hange

's5 the vi$tim if he or she is $ho5ing .

&f the vi$tim nods yes and $an not tal5

severe air+ay o,stru$tion is *resent and

must a$tivate the emergen$y res*onse

system

2ea5 ineAe$tive $ough or no $ough at all

High- *it$hed noise +hile inhaling or no

noise at all

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Severe 'ir+ay ;,stru$tion Signs

&n$rease res*iratory diZ$ulty

Possi,le $yanosis

"na,le to s*ea5

Clut$hing the ne$5 +ith the thum,

and ngers ma5ing the universal sign

"na,le to move air

C: "sers ne$ Des5to* $ho5ing adult. *g

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?"se ',dominal >hrust ( Heimli$h Maneuver) to relive $ho5ing in adults %

$hildren over 9 year .

?Do Not use a,dominal thrust in infant.

?"se ea$h individual thrust +ith the intent of relieving the o,stru$tion.

?&t may ,e ne$essary to re*eat the thrust several times to $lear the air+ay.



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if the vi$tim is *regnant or o,ese

*erform Chest >hrust instead of

',dominal >hrust.



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',dominal >hrust in a es*onsive Standing Ri$tim

('dult % Children)



Ste*

'$tion

9

Stand or 5neel ,ehind the vi$tim and +ra* your arms around the vi$tim s

+aist

he $ause of unres*onsiveness is the air+ay o,stru$tion

9)&f in 'dult '$tivate !MS ;*en the 'ir+ay. emove the ;, e$t if you see and,egin CP .


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Se4uen$e of a$tions after elief of Cho5ing

9.6eel air movement and see the $hest rise +hen you give

,reaths.


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6ollo+ the ste*s after relieving $ho5ing in unres*onsive vi$tim



Ste*

'$tion

9

Provide < Breaths

he most $ommon rhythm is Rentri$ular 6i,rillation (R6).

?>he most eAe$tive treatment for R6 is !le$tri$al de ,rillation.

?>he *ro,a,ility of su$$essful de ,rillation de$reases over time.

?R6 deteriorates to 'systole if not treated.



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'utomated !7ternal De ,rillator ('!D)

Common Ste*s to ;*erate all '!Ds


Ste*s

'$tion

9

Po+er ;N the '!D.

? ;*en the $arrying $ase or the to* of the '!D.

? >urn the *o+er on.

Documents

BLS for Health Care Providers Course