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Basic Life Support Learning outcomes
By the end of this session, learners should be able to;
Describe the components of BSL
Define cardiopulmonary resuscitation
List steps for performing BLS
Describe how to help a person chocking BLS
BLS = cardiopulmonary resuscitation and, when
available, defibrillation using automated external
defibrillators (AED).
The keys to survival from sudden cardiac arrest
(SCA ) are:
recognition and treatment, specifically, immediate
initiation of excellent CPR and early defibrillation. Cardio Pulmonary Resuscitation
CPR is an emergency first -aid procedure that
is used to maintain respiration and blood
circulation in a person, whose breathing and
heartbeats have suddenly stopped.
Involves a series of immediate actions to take
to restore the flow of oxygenated blood to a
person's brain and organs when they suffer
Sudden Cardiac Arrest ( SCA ). Chain of survival Chain of survival Cardio Pulmonary Resuscitation
Three basic vital functions:
Breathing
Circulation
Consciousness Cardio Pulmonary Resuscitation
Thoracic pump theory -
the chest compression propels blood out of the thorax by
increasing intrathoracic pressure
the time of the chest compression and decompression should
be equal
Pressure should be completaly released
Hands should remain in the contact with the chest CardioPulmonary Resuscitation
Oxygene content
In atmospheric air - 21%
In alveoli - 14,5%
Expired air diluted by air from the airways (dead
space)
16 18 % O2 At best
chest compressions provide only 30% of normal perfusion
brain + heart
Time! Time! Time! Time! Time! Time! Time!
Time!
Failure of the circulation 3 - 5 minutes irreversible cerebral
damage.
Chances of successful CPR - restoration of spontaneous
circulation (ROSC) decreases by 10% with each minute
following sudden cardiac arrest Indication of CPR
to victims with unexpected cardiac arrest in
otherwise healthy individuals
to those, who can be described as having
heart too good to die CONDUCTING BLS
This will be conducted basing on the
guidelines for Cardiopulmonary Resuscitation
and Emergency Cardiovascular Care
The guidelines are published jointly by the
> International Liaison Committee on
> Resuscitation,
> American Heart Association, and
> European Resuscitation Council.
The Algorithm Performance of excellent chest compressions
Most important element of CPR
The mantra of the CPR -ECC Guidelines was: "push hard and push fast
on the center of the chest
To perform excellent chest compressions, the rescuer and patient
must be in optimal position
The patient must lie on a firm surface - may require a backboard on a
bed or the patient should be placed on the floor Place the heel of one hand in
the center of the chest over
the lower ( caudad ) portion of
the sternum and the heel of
their other hand atop the
first.
The rescuer's own chest
should be directly above
their hands to enable them
use their body weight to
compress the patient's chest,
rather than just the muscles
of their arms, which may
fatigue quickly.
Performance of excellent chest compressions Copyrights apply Goals For Excellent
## chest compressions
100 to 120 compressions / minute
Compress the chest at least 5 cm (2 inches) but no more than 6 cm
(2.5 inches) with each down -stroke
Allow full recoil of chest wall
Change over every 2 minutes (if poss .) but m inimize the frequency
and duration of any interruptions
30:2 ratio (compression / ventilation)
Compression only much better than nothing Ventilation
Open airway (head tilt, chin lift, jaw
thrust)
Check for normal breathing
Agonal gasps = not normal!
Watch for chest movement
In hospital: bag / mask (laryngeal
mask) The importance of compressions supersedes ventilations
Properly performed ventilations become increasingly important as
pulselessness persists
Give each ventilation over no more than one second
Give two ventilations after every 30 compressions, discontinuing
compressions during the ventilations
Avoid excessive ventilation (rate or volume )
10 breaths per minute is recommendable, however, 6 to 8 breaths
are adequate
Proper Ventilation MOUTH TO MOUTH ADJUNCT Mouth to mouth in adults Defibrillation is the non -synchronized delivery of a shock during
the cardiac cycle .
This can done using an AED or normal defibrillator
As soon as a defibrillator is available, assess the cardiac rhythm
and, when indicated, perform defibrillation as quickly as
possible .
For BLS, a single shock when prompted from an automated
external defibrillator ( AED) is delivered followed immediately
by the resumption of excellent chest compressions .
## Defibrillation Defibrillation COMPLICATIONS OF CPR
Injuries caused by CPR can be of a concern.
More frequent when incorrect technique is employed.
However, injuries from chest compressions can occur despite
excellent technique.
Some may include:
> Rib and sternal fractures
> Cardiac and pulmonary contusions
> Pneumo -and hemothorax
> Intra -abdominal trauma
Despite the possibility of such complications, the risk of
withholding potentially lifesaving treatment from a patient
in cardiac arrest is far exceeded by the potential benefit of
brain -saving resuscitation Mouth to mouth in
children Chest compressions in
children Chest compressions in very
young children CHOKING Choking occurs when a foreign object lodges in the air
way, blocking the flow of air.
In adults, a piece of food often is the culprit. Young
children often swallow small objects.
Because choking cuts off oxygen to the brain, give first
aid as quickly as possible. You will know that someone is choking when hands are clutched
to the throat. Other signs could be:
Inability to talk
Difficulty breathing or noisy breathing
Squeaky sounds when trying to breathe
Cough, which may either be weak or forceful
Skin, lips and nails turning blue or dusky
Skin that is flushed, then turns pale or bluish in color
Loss of consciousness Tachypnea
Inspiratory stridor, wheezing
Suprasternal or supraclavicular
retractions
Prolonged inspiratory phase
Drooling
Dysphagia
Positions of comfort to help maintain
airway patency in patients with severe
obstruction:
"Sniffing" position (neck is mildly flexed
and head is mildly extended)
Tripod position (leaning forward while
bracing on the arms with neck
hyperextended and chin thrust forward) Give 5 back blows. Stand to the side and just behind a
choking adult. For a child, kneel down behind. Place one arm
across the person's chest for support. Bend the person over
at the waist so that the upper body is parallel with the
ground. Deliver five separate back blows between the
person's shoulder blades with the heel of your hand.
Give 5 abdominal thrusts. Perform five abdominal thrusts
(also known as the Heimlich maneuver).
Alternate between 5 blows and 5 thrusts until the blockage
is dislodged. To perform abdominal thrusts (Heimlich maneuver) on someone else:
Stand behind the person. Place one foot slightly in front of the other
for balance. Wrap your arms around the waist. Tip the person
forward slightly. If a child is choking, kneel down behind the child.
Make a fist with one hand. Position it slightly above the person's
navel.
Grasp the fist with the other hand. Press hard into the abdomen with
a quick, upward thrust as if trying to lift the person up.
Perform between six and 10 abdominal thrusts until the blockage is
dislodged. Paediatric Foreign Body
Airway Obstruction References
https:// www.uptodate.com/contents/basic -principles -and -technique -
of -external -electrical -cardioversion -and -defibrillation?csi=e6433540 -
7bbe -41b0 -88b6 -e1967a1c45d6&source=contentShare
https:// www.uptodate.com/contents/adult -basic -life -support -bls -for -
health -care -providers?csi=ca66da4a -8787 -4bb2 -a7c1 -
66b4ad76736e&source=contentShare
https:// www.uptodate.com/contents/emergency -evaluation -of -
acute -upper -airway -obstruction -in -children?csi=ed6158b3 -5cff -4b5f -
ab07 -f42df2fac53e&source=contentShare
https://cpr.heart.org/en /
Advanced Malawian Paediatric life support 1 st Edition.