Emergency Life Support (ELS) Course

V3 ELS Slide Set Approved 30.01.2020

Emergency Life Support (ELS) Course

Resuscitation Services UK Ltd

Emergency Life Support (ELS) Topics

Ø The ABCDE ApproachØ Handout, Podcast & Scenario teaching/assessment

Ø Medical Emergency conditions Ø Slide set and scenario teaching/assessment

Ø Anaphylaxis, Asthma, Bleeding, Chest pain, Choking, Hypoglycaemia (A)Ø Epilepsy, Stroke (B)

Ø Equipment & DrugsØ Slide set & Equipment familiarisation sessionØ Oxygen, high concentration mask & pulse oximeter

Ø Medications - GTN, Aspirin, Salbutamol (nebuliser mask), Glucogel, EmeradeØ Suction & OP Airways

Emergency Life Support (ELS) Topics

Ø Adult CPR & AED Ø AED, CPR mask & protective face shields

Ø Recovery PositionØ Demonstration, practice & Assessment

Ø Paediatric Modifiers for BLSØ Handout / Discussion

Ø Policy & DocumentationØ SBARØ Local protocolsØ Annual training

Emergency Life Support (ELS) Plan

Ø Introduction (10 minutes)Ø Documents – Assessment, Evaluation, ABCDE , Paediatric modifiers

Ø Power point Presentation & Podcast (30 minutes)Ø ABCDE Assessment & treatment guideØ Common medical emergenciesØ Equipment Familiarisation & Documentation

Ø Equipment Familiarisation session (30 minutes)Ø Practical workshop with ELS equipment

Ø ABCDE Scenarios (60 minutes)Ø Minimum of one per candidate, including Recovery Position & all conditions (A)

Ø CPR & AED (40 minutes)Ø Demonstration, practice & Assessment

Ø Closure (10 minutes)

ELS Learning outcomes

} By the end of this session:} Be able to do a full ABCDE assessment of a casualty} Know the common medical emergencies that occur within the mental

health setting and what treatment is expected at an ELS level} Be familiar with the contents of an ELS emergency bag, know what each

item is for and how to use it} Recognise cardiac arrest & be able to do Adult CPR with AED use safely} Know the modifications of the adult CPR guidelines that should be used

on children to improve their chances of survival} Be able to complete an SBAR document} Be aware of the local resuscitation protocol and policy requirements

Emergency Life Support (ELS)

From Resuscitation Council UK

Emergency Life Support (ELS)} Podcast

} ABCDE Assessment & treatment guide

} Assess for Safety} Check response

} If unresponsive & not breathing start CPR} Airway} Breathing} Circulation} Disability} Examine/Expose


Ø Medical Emergency conditions Ø Anaphylaxis

} Symptoms} Adrenaline auto-Injector or Adrenaline ampoules} Check visually it is undamaged & Expiry date} Hold in fist and aim for side of thigh

} Massage the area afterwards


Ø Medical Emergency conditions Ø Asthma

Ø Signs & Symptoms

Ø ELS TreatmentØ Salbutamol needs to be prescribed

Ø DO NOT lie them flat unless unconsciousØ DO NOT take them outside for fresh air


Ø Medical Emergency conditions Ø Bleeding

Ø PPEØ Sit or lie person downØ ExamineØ ElevateØ Pressure (Direct or indirect)Ø Dress


Ø Medical Emergency conditions Ø Chest pain

Ø Signs & SymptomsØ ELS TreatmentØ GTN & Aspirin needs to be prescribed


Ø Medical Emergency conditions Ø Choking

Cough! 5 Back Blows 5 Abdominal Thrusts

From Qualsafe First Aid Made Easy

Choking baby

5 Back Blows 5 Chest Thrusts


Ø Medical Emergency conditions Ø Choking

Ø For baby, child or adult if they become unresponsive during treatment for choking

Ø BEGIN CPR


Ø Medical Emergency conditions Ø Hypoglycaemia

Ø Signs & SymptomsØ ELS TreatmentØ Glucogel does not need to be prescribed


Ø Medical Emergency conditions Ø Epilepsy

Ø Signs & SymptomsØ ELS TreatmentØ Midazolam/Diazepam needs to be prescribed


Ø Medical Emergency conditions Ø Stroke


} Recovery Position} ABCDE Assessment} Start CPR if not breathing normally


} Equipment } AED and immediate access


} Equipment } Airways} CPR Mask} Suction} High concentration Oxygen mask} Pulse oximeter & pen torch


} Oxygen

Emergency Life Support (ELS)In-hospital Resuscitation

Collapsed/sick patient

Shout for HELP and assess patient

Signs of life?

Call resuscitation team

CPR 30:2With oxygen and airway adjuncts

Apply pads/monitorAttempt defibrillation

if appropriate

Advanced Life Supportwhen resuscitation team arrives

NO YES

Assess ABCDERecognise and treat

Oxygen, monitoring, IV access

Call resuscitation team if appropriate

Hand over to resuscitation team

Paediatric modifiersThe following minor modifications to the adult sequence will, however, make it even more suitable for use in children:

If you are on your own, perform resuscitation for about 1 minute before going for help

Give five initial rescue breaths before starting chest compressions

For a babyunder 1 year, use two fingers

(4cm)

For a child over 1 year,use one or two handsto achieve an adequate depth

(5cm)

Compress the chest by at least one-third of its depth:


Ø Policy & DocumentationØ SBAR

V9 SBAR Document for Adults and Children (RSUK) For Approval January 2020

Medical Emergency Documentation – SBAR Communication Form Patient’s Name Name of Person

Completing Form

Signature

Date

MEDICAL EMERGENCY or CARDIAC ARREST

Initiate Alarm & Call 999

DNACPR/ACP order q Yes q No

Witnessed collapse? q Yes q No

Signs of life q Yes q No

CPR Started [ Time ]

AED applied q Yes q No

Patient defibrillated q Yes q No

No of Shocks ……………………

Resuscitation stopped @ [ Time ]

Cardiac Arrest Drugs q Adrenaline 1 in 10,000

AIRWAY: BREATHING: CIRCULATION: DISABILITY:

Initial Observations [ Time ] ….………..

1st Resp Rate & SpO2 RR ……… SpO2 ………

1st Pulse Rate and BP PR……… BP …..…

1st AcVPU A-q C-q V-q P-q U-q

q Patient Talking

q Clear

q Obstructed

q Snoring - q Recovery position

- q Chin lift

- q Jaw Thrust

- q OP tube (Correct size)

- q NP tube (Adult ONLY)

q iGel (Correct size)

q Gurgling airway - q Patient turned

- q Suction

q Foreign Body - q Encourage pt. cough

- q Back blows

- q Abdo/chest thrusts

- q Magill forceps

- q CPR if above fails

q Normal breathing

q Shortness of breath

q Oxygen @ 15 l/min

- q Non-rebreathe mask

q Not breathing

- q Mouth to mouth

- q Pocket mask

- q Bag valve mask

- q CPR

Chest exposed q Yes q No

Chest injury found q Yes q No

Bleeding/Wound Care q External Bleeding

- q Dressing/haemostat

- q Direct pressure

- q Tourniquet

- q Time applied

q Internal Bleeding

Capillary refill time [ Time ] .………secs

IV access q IV access (Correct size)

q IV fluids

[ Time ] .……… ml

Limb Movements - q Yes - q No q Blood glucose (BM) [ Time ] ……. mmol/l

Pain Score (PS) 1 2 3 4 5 6 7 8 9 10

PS After analgesia ……

EXPOSURE:

q Fully Undressed

q Logrolled to check back

q Side checked

q Rashes ?

q Bruises / wounds ?

2nd Resp Rate & SpO2 RR ……… SpO2 ………

2nd Pulse rate and BP PR……… BP …..…

2nd AcVPU A-q C-q V-q P-q U-q

NEWS2/PEWS SCORE Burn treatment q Irrigation for 20 min

q Clingfilm applied 1st score [ Time ] 2nd score [ Time ]

Handover Obs [ Time ] ….………..

3rd Resp Rate & SpO2 RR ……… SpO2 ………

3rd Pulse Rate and BP PR……… BP …..…

3rd AVPU A-q C-q V-q P-q U-q

Treatments (dose adjusted for weight for paediatric or small patients < 50kg)

q Salbutamol q Annexate

q Naloxone q Diazepam q Midazolam

q Adrenaline 1 in 10,000

q GTN spray

q 20% Glucose q 10% Glucose q Glucogel

q Glucagon IM Adrenaline Auto-Injector q 500 microgram q 300 microgram q 150 microgram IM Adrenaline q 0.5ml of 1 in 1000

This communication form is part of the patient’s clinical notes CONFIDENTIAL WHEN complete. Accurate record

keeping will assist with continuity of care and help to provide important medico-legal documentation, when required


Ø Policy & DocumentationØ Local protocols

Ø Must be approved

Ø Must be laminated Ø Must be displayed

November 2019

Emergency Life Support (ELS) Course

Any Questions?

ELS Summary

} By the end of this session:} ABCDE assessment of a casualty} Common medical emergencies that occur within the mental health} Contents of an ELS emergency bag} Recognise cardiac arrest } Adult CPR and AED } Recovery Position} CPR Modifications for children} SBAR document} Local resuscitation protocol} Annual Training