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BASIC LIFE SUPPORT (BLS) Fremantle Hospital Staff Development
BASIC LIFE SUPPORT (BLS) Fremantle Hospital Staff Development

BASIC LIFE SUPPORT (BLS)

Fremantle Hospital Staff Development

BASIC LIFE SUPPORT (BLS) Fremantle Hospital Staff Development
BASIC LIFE SUPPORT (BLS) Fremantle Hospital Staff Development
BASIC LIFE SUPPORT (BLS) Fremantle Hospital Staff Development
ANY ANY ATTEMPT ATTEMPT IS IS BETTER BETTER THAN THAN NO NO ATTEMPT ATTEMPT
ANY ANY ATTEMPT ATTEMPT IS IS BETTER BETTER THAN THAN NO NO ATTEMPT ATTEMPT
ANY ANY ATTEMPT ATTEMPT IS IS BETTER BETTER THAN THAN NO NO ATTEMPT ATTEMPT

ANYANY ATTEMPTATTEMPT ISIS BETTERBETTER THANTHAN NONO ATTEMPTATTEMPT

Objectives

Objectives  Chain of Survival  Discuss legal and infection concerns  Introduce cardiac anatomy and
Objectives  Chain of Survival  Discuss legal and infection concerns  Introduce cardiac anatomy and
Objectives  Chain of Survival  Discuss legal and infection concerns  Introduce cardiac anatomy and

Chain of Survival Discuss legal and infection concerns Introduce cardiac anatomy and emergencies Introduce DRSABCD Describe Cardiopulmonary Resuscitation Describe differences between adult, child and infant resuscitation Describe the actions for someone choking Describe actions following a resuscitation

Chain of Survival The chain of survival symbolises the best approach to the treatment of
Chain of Survival The chain of survival symbolises the best approach to the treatment of

Chain of Survival

The chain of survival symbolises the best approach to the treatment of sudden cardiac arrest.

Early
Early

Recognition

Early

CPR

Early

Defibrillation

Post

Resus

Care

to the treatment of sudden cardiac arrest. Early Recognition E a r l y CPR Early
Good Samaritan Rule • A ‘Good Samaritan’ is defined in legislation as a person acting
Good Samaritan Rule • A ‘Good Samaritan’ is defined in legislation as a person acting

Good Samaritan Rule

Good Samaritan Rule • A ‘Good Samaritan’ is defined in legislation as a person acting without

A ‘Good Samaritan’ is defined in legislation as a person acting without expecting financial or other reward for providing assistance.

Volunteers acting as ‘Good Samaritans’ are under no obligation to assist a fellow being.

The Australian Resuscitation Council encourages the provision of assistance to any person in need.

Good Samaritan Rule • Having decided to assist, a standard of care appropriate to the
Good Samaritan Rule • Having decided to assist, a standard of care appropriate to the

Good Samaritan Rule

Good Samaritan Rule • Having decided to assist, a standard of care appropriate to the volunteer’s

Having decided to assist, a standard of care appropriate to the volunteer’s level of training is expected.

Do not need to fear litigation if coming to the aid of a fellow human in need.

No ‘Good Samaritan’ or volunteer has ever been successfully sued in Australia for consequences of rendering assistance to a person in need.

Infection Control How infection can be passed on: Contact – blood or body fluids contact
Infection Control How infection can be passed on: Contact – blood or body fluids contact

Infection Control

Infection Control How infection can be passed on: Contact – blood or body fluids contact membranes

How infection can be passed on:

Contact

blood or body fluids contact membranes of the mouth and eyes

infected objects pierce the skin

Breathing

air borne infection risk is no greater than in normal social interaction

Bites

rare, usually only occur with fitting casualties

To Prevent Infection • Wash hands thoroughly before, if possible, and after • Avoid direct
To Prevent Infection • Wash hands thoroughly before, if possible, and after • Avoid direct

To Prevent Infection

To Prevent Infection • Wash hands thoroughly before, if possible, and after • Avoid direct contact

Wash hands thoroughly before, if possible, and after

Avoid direct contact with wounds and body fluids

Have a pocket mask or disposable mask and gloves available

Avoid direct contact with contaminated objects

Avoid touching personal belongings

Wash and disinfect all equipment used or dispose of correctly

objects • Avoid touching personal belongings • Wash and disinfect all equipment used or dispose of
Anatomy & Physiology • All cells need oxygen to function • How do they get
Anatomy & Physiology • All cells need oxygen to function • How do they get

Anatomy & Physiology

Anatomy & Physiology • All cells need oxygen to function • How do they get this?

All cells need oxygen to function

How do they get this?

Breathe in air to our lungs

Heart pumps blood through the lungs and around the body

If lungs stop or heart stops = NO OXYGEN to organs…cells die

pumps blood through the lungs and around the body • If lungs stop or heart stops
Possible Causes of Collapse  Heart attack (MI)  Heart disease  Airway diseases 
Possible Causes of Collapse  Heart attack (MI)  Heart disease  Airway diseases 

Possible Causes of Collapse

Possible Causes of Collapse  Heart attack (MI)  Heart disease  Airway diseases  Poisoning

Heart attack (MI)

Heart disease

Airway diseases

Poisoning

Toxic fumes

Smoke inhalation

Drug overdoses

Electrocution

Chest injuries

Crush injuries

Head injury

Blood loss

Low/high blood sugar

Feint

How do we help with CPR? • Open AIRWAY • COMPRESSIONS to pump heart and
How do we help with CPR? • Open AIRWAY • COMPRESSIONS to pump heart and

How do we help with CPR?

Open AIRWAY

How do we help with CPR? • Open AIRWAY • COMPRESSIONS to pump heart and circulate

COMPRESSIONS to pump heart and circulate blood with oxygen

Give BREATHS to add oxygen

Cardio Pulmonary Resuscitation • CPR is the technique of inflation of the lungs and compression
Cardio Pulmonary Resuscitation • CPR is the technique of inflation of the lungs and compression

Cardio Pulmonary Resuscitation

Cardio Pulmonary Resuscitation • CPR is the technique of inflation of the lungs and compression of

CPR is the technique of inflation of the lungs and compression of the heart

It combines External Cardiac Compressions (ECC) and ventilation which may be delivered as Expired Air Resuscitation (EAR), commonly called Mouth to Mouth

It may be referred to as Basic Life Support (BLS)

as Expired Air Resuscitation (EAR), commonly called Mouth to Mouth • It may be referred to

DRSABCD

Dangers? Responsive? Send for help Open Airway Normal Breathing? Start CPR Attach Defibrillator

– Responsive? – Send for help – Open Airway – Normal Breathing? – Start CPR –
– Responsive? – Send for help – Open Airway – Normal Breathing? – Start CPR –
– Responsive? – Send for help – Open Airway – Normal Breathing? – Start CPR –
Dangers? To yourself and others may include:  Electricity  Poisonous gases  Drowning/surf 
Dangers? To yourself and others may include:  Electricity  Poisonous gases  Drowning/surf 

Dangers?

Dangers? To yourself and others may include:  Electricity  Poisonous gases  Drowning/surf  Envenomation

To yourself and others may include:

Electricity

Poisonous gases

Drowning/surf

Envenomation

Glass/road surfaces

Vehicles

include:  Electricity  Poisonous gases  Drowning/surf  Envenomation  Glass/road surfaces  Vehicles
Responsive? Determine if the casualty is conscious or unconscious • Squeeze & shout • Ask
Responsive? Determine if the casualty is conscious or unconscious • Squeeze & shout • Ask

Responsive?

Responsive? Determine if the casualty is conscious or unconscious • Squeeze & shout • Ask casualty

Determine if the casualty is

conscious or unconscious

Determine if the casualty is conscious or unconscious • Squeeze & shout • Ask casualty for

Squeeze & shout

Ask casualty for their name

Give a simple command: “squeeze my hand”

Send for Help RESPONSIVE CASUALTY • Place in a comfortable position & reassess • •
Send for Help RESPONSIVE CASUALTY • Place in a comfortable position & reassess • •

Send for Help

Send for Help RESPONSIVE CASUALTY • Place in a comfortable position & reassess • • Send

RESPONSIVE CASUALTY

Place in a

comfortable position & reassess SendSend forfor HELPHELP ifif appropriateappropriate

UNRESPONSIVE CASUALTY ContinueContinue toto assessassess SendSend forfor HELP!HELP!

UNRESPONSIVE CASUALTY • • Continue Continue to to assess assess • • Send Send for for

Send for help

STAY CALM

Send for help  STAY CALM  In the hospital dial ‘55’ and state Code Blue
Send for help  STAY CALM  In the hospital dial ‘55’ and state Code Blue
Send for help  STAY CALM  In the hospital dial ‘55’ and state Code Blue

In the hospital dial ‘55’ and state Code Blue and the patient’s location

In the community dial ‘000’ and answer questions asked by operator

On a mobile - ‘112’ or ‘000’

Open Airway  Look into airway first  Identify causes of an airway obstruction 
Open Airway  Look into airway first  Identify causes of an airway obstruction 

Open Airway

Open Airway  Look into airway first  Identify causes of an airway obstruction  Clear

Look into airway first

Identify causes of an airway

obstruction

Clear the airway - suction or turn on side if the blockage is caused by secretion/vomit

Airway Opening Open airway – head tilt & chin lift – jaw thrust
Airway Opening Open airway – head tilt & chin lift – jaw thrust

Airway Opening

Airway Opening Open airway – head tilt & chin lift – jaw thrust
Airway Opening Open airway – head tilt & chin lift – jaw thrust

Open airway

head tilt & chin lift jaw thrust

Airway Opening Open airway – head tilt & chin lift – jaw thrust
Lateral Position The lateral position can facilitate drainage but is only indicated if absolutely necessary
Lateral Position The lateral position can facilitate drainage but is only indicated if absolutely necessary

Lateral Position

Lateral Position The lateral position can facilitate drainage but is only indicated if absolutely necessary to

The lateral position can facilitate drainage but is only indicated if absolutely necessary to clear fluid from the airway

lateral position can facilitate drainage but is only indicated if absolutely necessary to clear fluid from
Normal Breathing? • Is the victim breathing normally? • If you have any doubt whether
Normal Breathing? • Is the victim breathing normally? • If you have any doubt whether

Normal Breathing?

Normal Breathing? • Is the victim breathing normally? • If you have any doubt whether breathing

Is the victim breathing normally?

If you have any doubt whether breathing is normal, act as if it is not normal.

Do not be mislead by abnormal breathing/gasping

If NOT, commence Compressions immediately

Normal Breathing? Yes… • Place in lateral position • Ensure help is coming • Provide

Normal Breathing?

Yes…

Place in lateral position

Ensure help is coming

Provide reassurance

Monitor breathing

Yes… • Place in lateral position • Ensure help is coming • Provide reassurance • Monitor
Yes… • Place in lateral position • Ensure help is coming • Provide reassurance • Monitor
External Cardiac Compressions  Position  Rate  Depth  Ergonomics All influence effectiveness of

External Cardiac Compressions

Position

Rate

Depth

Ergonomics

Cardiac Compressions  Position  Rate  Depth  Ergonomics All influence effectiveness of compressions
Cardiac Compressions  Position  Rate  Depth  Ergonomics All influence effectiveness of compressions

All influence effectiveness of compressions

Position  Locate the middle of the chest  Place heel of hand on the
Position  Locate the middle of the chest  Place heel of hand on the

Position

Position  Locate the middle of the chest  Place heel of hand on the lower

Locate the middle of the chest Place heel of hand on the lower half of the sternum Cover first hand with other hand by interlocking fingers or support wrist if required

Rates - Compressions • Adults • 100 compressions in a minute • Children & Infants
Rates - Compressions • Adults • 100 compressions in a minute • Children & Infants

Rates - Compressions

Rates - Compressions • Adults • 100 compressions in a minute • Children & Infants •

Adults 100 compressions in a minute

Children & Infants 100 compressions in a minute

Depth

Depth Always Always one one third third of of the the depth depth of of the
Depth Always Always one one third third of of the the depth depth of of the
Depth Always Always one one third third of of the the depth depth of of the

AlwaysAlways oneone thirdthird ofof thethe depthdepth ofof thethe chestchest

At least 5 cm in adults Requires 50 kg pressure on the average adult

Ergonomics Patient should be on a firm flat surface Position yourself between chest and head
Ergonomics Patient should be on a firm flat surface Position yourself between chest and head

Ergonomics

Ergonomics Patient should be on a firm flat surface Position yourself between chest and head to

Patient should be on a firm flat surface

Ergonomics Patient should be on a firm flat surface Position yourself between chest and head to

Position yourself between chest and head to decrease the amount of energy expended

Compression to Ventilation Ratio: 30:2
Compression to Ventilation Ratio: 30:2
Compression to Ventilation Ratio: 30:2

Compression to Ventilation Ratio:

30:2

Administering Breaths • Pocket Mask • Disposable face shield, e.g. key rings • Bag and

Administering Breaths

Pocket Mask

Administering Breaths • Pocket Mask • Disposable face shield, e.g. key rings • Bag and Mask
Administering Breaths • Pocket Mask • Disposable face shield, e.g. key rings • Bag and Mask

Disposable face shield, e.g. key rings

Bag and Mask

If unable or unwilling to administer breaths…deliver continuous Chest Compressions

Complications -Rescue breaths

Complications -Rescue breaths Abdominal distension Vomiting & aspiration No ventilation due to: • Poor head
Complications -Rescue breaths Abdominal distension Vomiting & aspiration No ventilation due to: • Poor head

Abdominal distension

Vomiting & aspiration

No ventilation due to:

Poor head position Obstruction Inadequate seal

distension Vomiting & aspiration No ventilation due to: • Poor head position • Obstruction • Inadequate
distension Vomiting & aspiration No ventilation due to: • Poor head position • Obstruction • Inadequate
distension Vomiting & aspiration No ventilation due to: • Poor head position • Obstruction • Inadequate
Defibrillation • Attach defibrillator as soon as available • Allows analysis of need to defibrillate
Defibrillation • Attach defibrillator as soon as available • Allows analysis of need to defibrillate

Defibrillation

Attach defibrillator as soon as available

Allows analysis of need to defibrillate

Chances of successful defibrillation decrease rapidly with time

Good CPR may increase likelihood of defib success

Chances of successful defibrillation decrease rapidly with time • Good CPR may increase likelihood of defib
Chances of successful defibrillation decrease rapidly with time • Good CPR may increase likelihood of defib
Chances of successful defibrillation decrease rapidly with time • Good CPR may increase likelihood of defib
When To Stop CPR  Return of responsiveness or breathing  Help arrives  You
When To Stop CPR  Return of responsiveness or breathing  Help arrives  You

When To Stop CPR

When To Stop CPR  Return of responsiveness or breathing  Help arrives  You are

Return of responsiveness or breathing

Help arrives

You are exhausted and physically unable to continue

It has become unsafe to continue A doctor pronounces the patient dead

Special Circumstances • Children • Choking • Third Trimester of Pregnancy
Special Circumstances • Children • Choking • Third Trimester of Pregnancy

Special Circumstances

Special Circumstances • Children • Choking • Third Trimester of Pregnancy

Children

Choking

Third Trimester of Pregnancy

CPR - Infants and Children AGE AIRWAY BREATHING COMPRESSION TYPE POSITION INFANT  Neutral neck
CPR - Infants and Children AGE AIRWAY BREATHING COMPRESSION TYPE POSITION INFANT  Neutral neck

CPR - Infants and Children

CPR - Infants and Children AGE AIRWAY BREATHING COMPRESSION TYPE POSITION INFANT  Neutral neck 

AGE

AIRWAY

BREATHING

COMPRESSION TYPE

POSITION

INFANT

Neutral neck Chin support

Small puff of cheeks Cover mouth & nose

Two fingers

< 12

Lower half sternum

months

   

1/3 the depth of the chest

CHILD 1- 8 years

Modified head tilt ‘sniffing’ Chin support

Half a breath

Heal of one hand

Lower half of sternum

 

1/3 the depth of the chest

Choking

Choking Acute obstruction can be caused by an impacted foreign body! If the person is responsive
Choking Acute obstruction can be caused by an impacted foreign body! If the person is responsive
Choking Acute obstruction can be caused by an impacted foreign body! If the person is responsive

Acute obstruction can be caused by an impacted foreign body!

Choking Acute obstruction can be caused by an impacted foreign body! If the person is responsive

If the person is responsive

- encourage to cough.

Choking If the victim has an ineffective/cannot cough:  Open airway  Deliver 5 back
Choking If the victim has an ineffective/cannot cough:  Open airway  Deliver 5 back
Choking If the victim has an ineffective/cannot cough:  Open airway  Deliver 5 back

Choking

If the victim has an ineffective/cannot cough:

Open airway

Deliver 5 back blows between shoulder blades with heel of hand

If this fails deliver 5 chest thrusts - similar to chest compressions but sharper and more interspersed

Continue alternating 5 back blows and 5 chest thrusts as necessary

Back Blows In An Infant
Back Blows In An Infant

Back Blows In An Infant

Back Blows In An Infant
Back Blows In An Infant
Choking - if becomes unresponsive • If removal of foreign object is unsuccessful and the
Choking - if becomes unresponsive • If removal of foreign object is unsuccessful and the

Choking - if becomes unresponsive

Choking - if becomes unresponsive • If removal of foreign object is unsuccessful and the victim

If removal of foreign object is unsuccessful and the victim becomes unresponsive

BEGIN CPR

Third Trimester of Pregnancy For the collapsed pregnant woman insert a wedge under the right
Third Trimester of Pregnancy For the collapsed pregnant woman insert a wedge under the right

Third Trimester of Pregnancy

Third Trimester of Pregnancy For the collapsed pregnant woman insert a wedge under the right buttock

For the collapsed pregnant woman insert a wedge under the right buttock to enable slight pelvic tilt

wedge under the right buttock to enable slight pelvic tilt This assists in shifting the uterus

This assists in shifting the uterus off the major abdominal veins to allow venous return

Recovery  Turn to stable lateral position  Reassess DRSABCD  Maintain airway  Monitor
Recovery  Turn to stable lateral position  Reassess DRSABCD  Maintain airway  Monitor

Recovery

Recovery  Turn to stable lateral position  Reassess DRSABCD  Maintain airway  Monitor breathing

Turn to stable lateral position

Reassess DRSABCD

Maintain airway

Monitor breathing and responsiveness

Ensure help is coming

Protect from environment

Treat injuries

Questions?

Questions?
Questions?
Questions?
Questions?

Summary

Summary  Discussed legal and infection concerns  Reviewed anatomy and cardiac emergencies  Reviewed DRSABCD
Summary  Discussed legal and infection concerns  Reviewed anatomy and cardiac emergencies  Reviewed DRSABCD
Summary  Discussed legal and infection concerns  Reviewed anatomy and cardiac emergencies  Reviewed DRSABCD

Discussed legal and infection concerns Reviewed anatomy and cardiac emergencies Reviewed DRSABCD Described differences between adult, child and infant resuscitation Described the actions for someone choking Described actions following a resuscitation

ANY ANY ATTEMPT ATTEMPT IS IS BETTER BETTER THAN THAN NO NO ATTEMPT ATTEMPT
ANY ANY ATTEMPT ATTEMPT IS IS BETTER BETTER THAN THAN NO NO ATTEMPT ATTEMPT
ANY ANY ATTEMPT ATTEMPT IS IS BETTER BETTER THAN THAN NO NO ATTEMPT ATTEMPT

ANYANY ATTEMPTATTEMPT ISIS BETTERBETTER THANTHAN NONO ATTEMPTATTEMPT