Podstawowe czynności resuscytacyjne BLS
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RC (UK)
Podstawowe czynności resuscytacyjne
BLS
RC (UK)
Cel
Zrozumieć:
• Zagrożenia dla ratownika
• Jak przeprowadzić BLS
• Różnice pomiędzy BLS przeprowadzanym przez osoby niefachowe i personel medyczny
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Risks to the rescuer
• Eliminate or minimise risk
• Manual Handling
• Beware of environmental danger:
– traffic
– electricity
– gas
– water
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Risks to the rescuer:poisoning
• Hydrogen cyanide or hydrogen sulphide gas–mask and non-return
• Corrosive chemicals–absorbed through skin and respiratory
tract–protective clothing
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• 15 documented cases of CPR related infection - mainly Neisseria meningitidis
• Tuberculosis
• Not hepatitis B or C, or CMV
• 3 cases of HIV transmission from high-risk cutaneous exposure
Risks to the rescuer:infection
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• Gloves and eye protection
• Sharps box
• Face-mask with one-way valves
• Manikins
– clean regularly
Risks to the rescuer:precautions against infection
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Assessment
Ensure safety of
rescuer and victim
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Shake and Shout
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Is the victim responsive?
YES
• Check for injuries
• Reassess
• Get help
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Is the victim responsive?
NO
• Shout for help• Open their airway• Check for breathing
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Opening the airway
• Head tilt
• Chin lift
• If cervical spine injury suspected:
– jaw thrust
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Assess Breathing• Look for chest
movement• Listen for breath
sounds• Feel for expired air• Assess for 10 seconds
before deciding breathing is absent
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Is the victim breathing?
YES
• If safe, use recovery position
• Telephone for help
• Reassess at intervals
RC (UK)Recovery Position 1st Stage
RC (UK)Recovery Position 2nd Stage
RC (UK)Recovery Position 3rd Stage
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Recovery Position 4th Stage
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Is the victim breathing?
NO
• Telephone for help• Give two slow effective rescue breaths• Make up to 5 attempts
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Rescue breathing(Expired air ventilation)
• Occlude victim’s nose• Maintain chin lift• Take a deep breath• Ensure a good
mouth-to-mouth seal
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Rescue breathing(Expired air ventilation)
• Blow steadily (2 sec) into victim’s mouth
• Watch for chest rise
• Maintain chin lift, remove mouth
• Watch chest fall
RC (UK)Watch for chest fall
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Finger sweep
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Assess Circulation
• Look, listen and feel for normal breathing, coughing, or movement by the victim
• Check the carotid pulse (if trained)
• Take no more than 10 seconds
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Is a circulation present?
YES
• Continue with rescue breathing
• Reassess for signs of a circulation
about every minute
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Is a circulation present?
NO
• Start chest compressions
• Continue with rescue breathing
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Identify costal margin
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Identify xiphisternum
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Identify hand position on sternum
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Chest compressions:Depress sternum 4-5 cmRate: 100 per minute
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Chest compressions
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One Person CPR
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Chest compression: breath ratio
• 15 compressions : 2 breaths for
– 1-person CPR
– 2-person CPR
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When to go for help?
Go for help immediately:
• More than one rescuer
• Single rescuer:
– adult with cardiac problem, once established that patient not breathing
CPR for 1 minute first:
• Trauma
• Drowning
• Drug or alcohol intoxication
• Infant or child
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Continue resuscitation until:
• Qualified help arrives and takes over
• The victim shows signs of life
• You become exhausted
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Mouth-to-nose ventilation
• If mouth-to-mouth technically difficult
• If mouth seriously injured
• Rescue from water
• Resuscitation carried out by a child
• Aesthetic reasons
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Compression-only CPR
• Reluctance to perform mouth-to-mouth ventilation
• Chest compression alone better than no CPR
• If possible combine with head tilt
• Appropriate for telephone-CPR
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Cervical spine injury?
• If possible, maintain alignment of head, neck and chest
• Minimum head tilt only
• Jaw thrust preferable
• Assistance often required
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Choking:
Back Blows
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Abdominal Thrusts
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In-hospital Basic Life Support Patient Collapsed
Shout for HELP and assess responsiveness
Not responsive Responsive
Call cardiac arrest team / Get defibrillatorStart BLS if defibrillator not immediately
available
Call for medical assistance
Definite Pulse and Breathing Present?
Apply pads / monitorDefibrillate if appropriate
Ventilate with oxygen
Chest compressions
ALS on arrival of Cardiac Arrest Team
Airway manoeuvresOxygen, monitor, i.v.
Find notesPrepare handover
YesNo
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Any Questions?
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Summary
• ABC of basic life support
– rescue breathing
– chest compressions
– modifications