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CARDIAC LIFE SUPPORT
Dr.Dhananjaya Bulathwatta
BLS
ALS
BLS
Defined
as “the preservation or restoration of life by the establishment and/or the maintenance of airway, breathing and circulation, and related emergency care.
Importance
Importance
CPR TIME LINE 0-4 mins. brain damage
unlikely 4-6 mins. brain damage
possible 6-10 mins. brain damage
probable >10 mins. probable
brain death
Urgency60%
40%
20%
0%
Background
The best chance of long term neurologically intact survival occurs if:
The victim’s collapse is witnessed CPR is commenced immediately The cardiac rhythm is VF or pulse less
VT
ADULT BLS SEQUENCE
Check for Response - “touch and talk” Shout – “HELP” Call Emergency No.[s] Airway Breathing Circulation Disability
AIRWAY
Head tilt- Chin lift
Jaw Thrust with Support
BREATHING
LOOK
LISTEN
FEEL
for rise and fall of the chest.
for breath sounds.
for the exhaled air
TAKE AT LEAST 5 BUT NOT MORE THAN 10 SECONDS
BREATHING….
2 Resque breaths within 2-4 seconds
Make the chest rise
CIRCULATION
Signs of Circulation Carotid pulse Cyanosis Cold peripheries
“There is reasonable evidence that rescuers are no more likely to be able to correctly determine if a pulse is present than simply tossing a coin” (ARC, 2006)
TAKE AT LEAST 5 BUT NOT MORE THAN 10 SECONDS
CIRCULATION…
Push down on the chest 11/2 to 2 inches 30 times right between the nipples. Pump at the rate of 100/minute, faster than once per second.
Minimize interruptions to 10 seconds or less.
DISABILITY PREVENTION
ADULT CHOKING SEQUENCE
CHILD CPR DEFERENCES Pulse less than 60 bpm
2 Rescuer CPR
-Concider as poor perfusion
-15 : 2
INFANT CPR DIFFERENCES Brachial Pulse less
than 60 bpm
Just below the nipple line on breast bone
2 Rescuer CPR
-Consider as poor perfusion
-2 fingers
-15 : 2
ALS
Intubation
Cardiac Monitor
Precordial Thumb
ALS… Pulseless VT
Asystole
VF
E.M.D.
VT/VF Defibrillation (one shock - 150-200 J biphasic or 360 J
monophasic). Immediately resume chest compressions (30:2)
without reassessing the rhythm or feeling for a pulse. Continue CPR for 2 min, then pause briefly to check
the monitor. If VF/VT persists give adrenaline 1 mg IV [every 3-5
min] followed immediately by a shock.
ASYSTOLE CPR 30:2 till pt. becomes shockable Give adrenaline 1 mg IV as soon as intravascular
access is achieved and every 3-5 min (alternate loops).
Give atropine 3 mg IV
E.M.D. CPR Give further adrenaline 1 mg IV every 3-5 min
(alternate loops)
ENSURE YOUR SKILLS ARE
UPDATED EACH YEAR
THANK YOU
Adult Child Infant
1Response, Shout for help, Emergency Call
2Head tilt, Chin lift [Suspected trauma: Jaw thrust]
3Look, Listen, Feel for breathing 5-10 seconds
42 Rescue Breaths. [1 second each]
5No carotid Pulse No carotid Pulse No brachial Pulse
start CPR or <60 with signs or <60 with signs
of poor perfusion of poor perfusion
start CPR start CPR
6Center of the breast bone Just below the nipplebetween two nipples line on breast bone
7With both hands [interlaced fingers] 2 Fingers
81.5-2 Inches 1/3 - 1/2 of the depth of chest
9 100 per minute
1030 for 2 30 for2 [1 Resquer], 15 for 2 [2 Resquer]