BASICLIFESUPPORTFORHEALTHCAREPROVIDERSSTUDYGUIDE

2015GUIDELINES

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KernCPRBasicLifeSupportforHealthcareProviders(BLS)StudyGuide

AdultCPR

1. Ensurescenesafety,lookup,down,leftandrightatthescene.Youdon’thelpifyoubecomeavictimyourself.

2. Checkforresponsiveness.Tapandshoutattheperson.3. Oncenoresponseisdeterminedshoutfor“Help!”4. Performapulsecheckandlookforbreathingsimultaneously.Lookforthechesttorise

forabout10secondswhileperformingthepulsecheck.Signsofregularbreathingincluderhythmicbreathing.Gaspingorsnoringsoundsarenotconsideredtoberegularbreathing.

5. Callforhelp,911,AEDetc.6. Ifyoudonotfeelapulse,orareunsureifyoudo,begingiving30chestcompressionsat

arateof100-120perminute(ThinkBeeGee’sStayingAlive).Locatethecenterofthelowerhalfofthebreastbonemakingsuretostayoffofthelowertip.Placethehealofyourhandonthelowerhalfofthebreastboneandpushstraightdown2-2.4inches(4to5cm).Pushhardandfast.

7. Afterthe30compressionsgive2breathswhilewatchingforchestrise.Chestriseisthemostimportantsignofeffectivebreaths.Makesuretotilttheheadbackandliftthechin.Thiswillpullthetongueoffthebackofthethroat(Headtiltchinliftshouldbeusedonvictimswithoutasuspectedneckinjury.Useajawthrusttechniqueifoneissuspected).Donotliftfrombehindtheneckasthisisnoteffective.

8. Continue30compressionsto2breathsfor5sets,thiscompletes1fullcycleofCPR.9. WhentheAED(automatedexternaldefibrillator)arrivesfirstturniton.Closelylistento

thepromptsandfollowthemcarefully.ThepersonplacingtheAEDwillworkaroundthe

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persondoingcompressionstominimizehandsofftime.Onepadwillgoontheupperrightchestandtheotherontheleftsidejustbelowthearmpit.

10. IfAEDsaystodeliverashock,ensurenooneisincontactwiththepersonandpushtheshockbutton.AftertheAEDdeliversashockyouIMMEDIATELYbeginchestcompressionsagain.

NotesonAED:

• Ensurethatyoudonotplacethepadsdirectlyonanimplantedpacemakerormedicationpatch.Seefirstimagebelowforwhatanimplantedpacemakerlookslike

• Ifthepatienthasbeensubmergedinwater,removethemfromthewaterandquicklywipethechestdrypriortoapplyingtheAED.DoNOTusetheAEDonsomeonewhoisstillsubmerged.

• OnapatientwithaveryhairchestthehairmayimpedethepadsfromstickingandthereforetheAEDmayfailtoaccuratelyanalyzeanddeliverashock.Ifavailableandtimeallowsthehairshouldbeshavedor“waxed”usinganextrasetofAEDpads(pediatricpadsifavailabletonotdamagetheadultones.)

11. Switchrescuersandreevaluatethepatientevery5cycles,2minutes,whentheAEDinstructsyouto,oryouaretootiredtoadministereffectivecompressions.Continueuntilmoreadvancedmedicalaidhasarrived,youaretootiredtocontinueoryougetapulseback.

12. ThepersoninchargeofbreathsanduseoftheBVM(BagValveMask“Ambu-Bag”)mustensureatightsealusingthe“E-C”clamptechniquewhilemaintaininganopenairway.Theywilldelivertwobreathsafterthesetofcompressionsabout1secondwatchingforchestrise.

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Whatifmyadultpatienthasapulsebutisnotbreathing????

Ifduringpatientassessmentyoufindthepatientisunresponsive,notbreathingbutDOEShaveapalpablecarotidpulseyouwillperformRescueBreathing.Toperformrescuebreathingtoanadultyouwilladministeronebreathevery6seconds.Makesurethechestrisestoensureadequateventilation.Seechartnextpageforchildandinfantinformation.

Whatifmyadultpatienthasanadvancedairwayinplace?

Whatisanadvancedairway?....Anadvancedairwayisatypeofmanagedairwayinwhichyoudonotneedtostopcompressionstodeliverabreath.Rescuer1(alwaysinchargeofcompressions)willcontinueatarateof100-120compressionsaminutewithoutstoppingwhileRescuer2(inchargeofmaintainingtheopenway,deliveringventilationsandencouragingRescuer1toperformproperCPR)willdeliveronebreathevery6-8seconds.

TypesofAdvancedAirways

1)Stoma 2)Intubation

ChildCPR

TherearemanysimilaritiesbetweenadultCPRandchildCPRwithafewdifferences.Achildisconsideredanyonebetweentheagesof1-8yearsold.Ifindoubttreatasanadult.

CPRandAEDisthesameaspreviouslystatedforadultwiththeseadditionalconsiderations:

1. IfyouwitnessthechildcollapseandbecomeunresponsivegogethelpFIRST,thenreturntothechildwiththeAEDandperformCPR.

2. Ifthereare2rescuers,theventilationtocompressionratiochangesto15:2andadepthofabout2inches.

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3. Pediatricpadsarepreferredforuseonachild,howeveriftheyarenotpresentintheAEDcaseadultpadsmaybeused,makingsurethattheydonottouch.

4. Ifachildorinfanthasapulseoflessthan60andisnotbreathingorshowingsignsofpoorperfusion(turningblue)givethechildCPR.Iftheyhaveapulseofmorethan60andarenotbreathinggivethemonebreathevery5seconds,3secondsforaninfant.

InfantCPR

Aninfantisanychildfrombirthto1yearold.

1. Tocheckforresponsivenesstap/flickthebaby’sfoot(doNOTshakethebaby)andshoutatit.Ifnocryorresponseisheardmakesurebabyisonafirm/flatsurface(preferablyabovetheground,i.e.table).

2. Checkthebaby’sbrachialpulsefor5-10seconds.3. Ifnopulseisfeltlocatethelowerhalfofthebreastbonemakingsuretostayoffthevery

tipandthestomacharea.Placethetipsof2fingershereandpressdown30timesabout1½inchesor1/3rdthedepthofthechest.

4. Givingbreathstakeslessairandeffort.Deliveronlyuntilyouseethechestrise.Donottilttheheadtoofarback.Thiscanclosetheairway.Thinkofastraw.Theinfantshouldbeinthe“sniffing”position.Donotplacetowelsbehindthehead.

5. If2rescuersarepresentyouwillusethe“twothumbsencirclinghands”techniquewheretherescuersfaceeachother.Thepersondoingcompressionswillplacetheirthumbssidebysideonthelowerhalfofthebreastboneforcompressions.Rescuer2willagainbeattheheadoftheinfantensuringatight“E-C”techniqueforuseoftheBVMandproperchestrise.

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Choking

Foranadultwhoisactivelychokingbutcannotcleartheobjectyouwillplaceyourhandsslightlyabovethebellybuttonwiththethumbsideofonehand.Grasptheotherhandandpullupandin.IfthepersonstopsrespondingyouwillneedtopreformCPR,checkingfortheobjectafterdeliveringbreaths.Forachildyoumayneedtokneelbehindthemtoperformabdominalthrusts.

Ifthevictimisaninfant,placetheinfant(supportingtheheadandneck)inyourforearmanddeliver5backslapsbetweentheshoulderblades,turntheinfantoversupportingtheheadandneckintotheotherforearmandpreform5chestthrustsinthesamelocationyouwouldforCPR.Makesuretheheadoftheinfantislowerthanthebody.Letgravityhelppullitoutandensurethattheobjectdoesnotgetinhaledagainifdislodged.IftheinfantstopsrespondingyouwillneedtopreformCPR

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Compression/Ventilations 1Rescuer 2Rescuer Depth Rate Ventilation

Adult 30-2 30-2 2-2.4" 100-120bpm every6secondsChild 30-2 15-2 About2" 100-120bpm every5secondsInfant 30-2 15-2 About11/2" 100-120bpm every3seconds

o 1/3thedepthofthechest

PrinciplesofEffectiveTeamDynamics

• ClearRolesandResponsibilities:everypersoninvolvedintheresuscitationeffortneedstounderstandwhattheirspecificroleisandtheresponsibilitiesrequiredforthatposition.

• KnowingYourLimitations:Everymembershouldbeawareofhis/herownlimitations.Iftheroleissomethingthepersonisnotawareof,isnotstronginorisuncomfortablewith,theyneedtoinformtheteamleaderearlyenoughtogetthesituationcorrected.

• ConstructiveIntervention:Ifsomeoneontheteamisnotperformingthetaskcorrectlyorisabouttomakeamistake,itisanyone’sjob,notjusttheteamleadertosaysomethingtotheminaprofessionalmanner.Ifyouseethemabouttomakeamistakeitisyourroletoinformthem.

• KnowledgeSharing:Askfrequentlyforobservationsandfeedback.Thesecanbegoodorbadobservations.Maybesomethingthatneedstobedone,wasn’tdonewellorwasdoneexceptionallywell.

• SummarizingandReevaluating:Overviewingtheinformationoutloudprovidesanongoingrecordoftreatment,recognizeachangingconditionandsummarizesthetreatmentsandinterventionsperformed.

• Closed-LoopCommunication:TeamLeadershouldcalleachmemberbytheirnamewhilegivinginstructionandnotassignnewtasksuntiltheyconfirmthememberunderstandstheinstruction.TheTeamMembershouldconfirmthattheyunderstandeachtaskbyverballyacknowledgingitandinformtheTeamLeaderwhenithasbeencompleted.

• ClearMessages:Useconcise,clearlanguagetopreventmisunderstanding.• MutualRespect:Allteammembersshoulddisplaymutualrespectand

professionalattitudefortheirteammembers,regardlessoftheirskillortraining.TheTeamLeaderneedstomaintainafriendly,controlledvoiceandavoidshoutingoraggression.

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