application of pocket mask - singapore general · pdf fileinfant cpr steps action d : danger...
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APPLICATIONOFPOCKETMASK
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Maskconnectionportwithone-wayvalve
Exhalationport
Maskport
Filter
Module 10 APPLICATION OF POCKET MASK
Thepocketmaskisabarrierdeviceusedtoproviderescuebreathing.Ithasaone-wayvalvethatpreventsexchangeofsecretionsbetweenthevictimandrescuer.Itismadeoffirmplasticwithacushionedrimandisroughlytriangularinshape.Therimcreatesaflexiblesealaroundthevictim’snoseandmouth.Themaskfitsoverthevictim’smouthandnose.Thenarrowestportionofthemaskisplacedoverthebridgeofthevictim’snose.
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APPLICATION
STEP 1
• Checkthatfilter(ifincluded)issnappedfirmlyinplace.
STEP 3
• Attachone-wayvalvetomaskport.
• Directexhalationportawayfrom‘nose’endofmask.
STEP 2
• Pushoutthedome.
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Note:Ifvictimvomits,removemaskandclearvictim’sairway.Clearmaskassemblybyshakingorsweepingoutforeignmaterial.Blowthroughvalvetoverifyoperation.Re-applymasktovictimandcontinueventilation.
STEP 6
• Removeyourmouthandallowvictimtoexhale.
STEP 5
• Sealasillustrated.• Opentheairwayby
performingagentleheadtilt-chinlift.
• Blowslowlyuntilchestrises.
STEP 4
• Applytherimofthemaskfirstbetweenthevictim’slowerlipandchin.Thiswillretractthelowerlipandkeepthemouthopenunderthemask.
• Positionendmarked‘nose’overthevictim’snose.
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SUMMARYCHECKLIST
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Module 11 SUMMARY ChECKLIST
ADULT ONE-MAN CPR
STEPS ACTION
D : Danger Lookoutforunsafeenvironment,e.g.Electricalcurrent,Fire,PossibleExplosion,Constructionworks,orPoisonousgas• Ensurethatthesceneissafeforyoutohelp
R : Response Establishunresponsiveness• Call,taporgentlyshakethevictim• Calloutloudly:“Hello!Hello!AreyouOK?”
S : ShoutforHelp • Ifnoresponse,Callforambulance995&AED
A : Airway Openairway:HeadTilt-ChinLift
B : Breathing Checkfornormalbreathing:Look,Listen,&Feel(upto10seconds)LookfortheriseandfallofthechestListenforairescapingduringexhalationFeelfortheflowofairfromthevictim’smouthandnosemovingpastyourcheeks
C : Circulation Checkforpulseupto10seconds(onlyforHealthcareproviders)Ifnopulseandbreathing,startCPRForlaypersons,thereisnoneedtocheckforpulse.Ifvictimhasnobreathing,startCPR• Locatethelandmarkforchestcompression• Properbodyandhandposition• Compressverticallyatleast5cmdownwardswithcompleterelaxation
ofpressureaftereachcompressionatrateofatleast100perminute• Saymnemonic “1&2&3&4&5&1&2&3&4&10&1&2&3&4&151&2&3&4&20 1&2&3&4&251&2&3&4&30”
CPRCycle • Perform30chestcompressionsfollowedby2breaths• Thedurationforeachbreathis1second.• Ventilationvolumeisbetween400-600ml/breath• Allowlungdeflationbetweeneachbreath
Reassessment • Assessthevictimforpulseandbreathingafterevery5cyclesof30:2(forhealthcareprovidersonly)
• Ifpulseisabsent(ifunsureofpulseandvictimhasNobreathing,assumecardiacarrest),continue30:2
• Forlaypersons,continueperformingCPRuntilhelparrivesorvictimstartsmoving
RecoveryPosition
Placethevictimintherecoverypositionif:• Pulseandbreathingarepresent• Victimisunconsciousandhasnoevidenceoftrauma• Continuetomonitorvictim’spulseandbreathingeveryfewminutesas
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ADULT FOREIGN-BODY AIRWAY OBSTRUCTION (CONSCIOUS – UNCONSCIOUS)
STEPS ACTION
Conscious victim Ask:“Areyouchoking?”Victimacknowledgesbynodding.Rescuerreplies:“Icanhelp.”Assessment
HeimlichManoeuvreTechnique(NormalSize)
Standbehindthevictim.Positiononefootbetweenthevictim’slegsLocatethelandmark:• Placeyourarmsaroundthevictim’sabdomenandlocatethenavel• Withonehandplace2fingersjustabovethenavel• Makeafistwiththeotherhand• Placethumb-sideofthefistagainsttheabdomenabovethe2fingers• Releasethe2fingersbutmaintainthefistontheabdomen• Leanthevictimforwardandgraspthefistwiththeotherhand• Givesuccessiveinward-upwardthrusts• Checkifforeignbodyisexpelledaftereverysetof5abdominalthrusts• Repeatthrustsuntiltheforeignbodyisdislodgedorthevictimbecomes
unconscious
ChestThrustTechnique(Pregnant&Obese)
Standbehindthevictim.Positiononefootbetweenthevictim’slegsLocatethelandmark:• Placearmsunderthevictim’sarmpitstoencirclethechest• Makeafistwithonehand• Placethumb-sideoffistonthemiddleofthevictim’sbreastbone• Graspthefistwiththeotherhandandgivesuccessivequickbackwardthrusts• Checkifforeignbodyisexpelledaftereverysetof5chestthrusts• Repeatthrustsuntiltheforeignbodyisdislodgedorthevictimbecomes
unconscious
Unconscious victim
Whenvictimbecomesunconscious.Proceedwiththefollowingsteps:• Positionthevictimonafirm,flatsurface• Callforambulance995
• Start30chestcompressions(Thelandmark&techniqueisthesameasforadultCPR)
• Openairway:HeadTilt-ChinLift• Checkairwayandremoveanyobviousforeignbodies
• Checkfornormalbreathing:Look,Listen,&Feel(upto10seconds)• Ifbreathingisabsent,attempttoventilate(1stattempt)• Ifairwayisstillblocked,re-positionthevictim’sheadandreattempttoventilate• Attempt2ndventilation• Ifairwayisstillblocked,perform30chestcompressions• Proceedtoheadtilt-chintiltandcheckforforeignbody• RepeatSteptillhelparrivesorabletogive2successfulventilations
• Checkpulse(forhealthcareprovidersonly)andbreathingonceairwayiscleared.• Ifpulseisabsent(ifunsureofpulseandvictimhasnobreathing,assumecardiac
arrest),continueCPR30:2
RecoveryPosition Placevictimintherecoverypositionif:• Pulseandbreathingarepresent• Continuetomonitorvictim’spulseandbreathingeveryfewminutesasthiscan
stopsuddenly
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INFANT CPR
STEPS ACTION
D : Danger Lookoutforunsafeenvironment,e.g.Electricalcurrent,Fire,PossibleExplosion,Constructionworks,orPoisonousgas• Ensurethatthesceneissafeforyoutohelp
R : Response Establishunresponsiveness:• Call,taporgentlyshaketheinfant’sshouldertoelicitresponse• Ifyouarealone,immediatelystartCPR30:2forapprox.2minutes
S : ShoutforHelp • Ifasecondrescuerispresent,askhimorhertocallforambulance995
A : Airway Openairway:HeadTilt-ChinLift
B : Breathing Checkfornormalbreathing:Look,Listen,&Feel(upto10seconds)LookfortheriseandfallofthechestListenforairescapingduringexhalationFeelfortheflowofairfromtheinfant’smouthandnosemovingpastyourcheeks
C : Circulation Checkforbrachialpulseupto10seconds(onlyforHealthcareproviders)Ifpulseisabsent(ifunsureofpulseandinfanthasnobreathing,assumecardiacarrest),start30:2Forlaypersons,thereisnoneedtocheckforpulse.Ifinfanthasnobreathing,startCPRLocatelandmarkforchestcompression:• Drawanimaginarylinebetweennipples• Placeindexfingerontheimaginaryline• Placeyourmiddleandringfingersnexttotheindexfinger• Movethe3fingerstothecentreofthesternum(breastbone)• Positionthefingersupright• Liftofftheindexfingerbutmaintainthemiddleandringfingerscontactonthe
sternum(breastbone)• Leanforwardandplaceyourcheekneartheinfant’smouthandnose• Useyourmiddleandringfingerstocompressthesternum(breastbone)by4cm
DemonstratecorrecttechniqueofcompressionKeepfingerscontactonthesternumduringeachupstrokeSaymnemonic“1&2&3&4&5&1&2&3&4&10&1&2&3&4&151&2&3&4&201&2&3&4&251&2&3&4&30”Compressionrateisatleast100perminute
CPRCycle • Perform5cyclesof30chestcompressionsfollowedby2breathsforapproximately2minutes(ForHealthcareprovidersonly)
• Thedurationforeachbreathis1second.• Ventilationvolumeisbetween30ml/breath• Allowlungdeflationbetweeneachbreath
Reassessment • Assessforpulseandbreathingafterevery5cyclesofCPR30:2(forhealthcareprovidersonly)
• Ifpulseisabsent(ifunsureofpulseandinfantisnotbreathing,assumecardiacarrest),continueCPR30:2
• Forlaypersons,continueperformingCPRuntilhelparrivesorinfantstartsmoving
RecoveryPosition • RecoveryPositionPlacetheinfantintherecoverypositionif:• Pulseandbreathingarepresent• Infantisunconsciousandhasnoevidenceoftrauma• Continuetomonitorinfant’spulse&breathingeveryfewminutesasthiscanstop
suddenly
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INFANT FOREIGN-BODY AIRWAY OBSTRUCTION (CONSCIOUS – UNCONSCIOUS)
STEPS ACTION
Conscious infant Assessforsignsofcompleteairwayobstruction(choking)Ifinfantischoking,attempttoAssessmentrelievetheairwayobstructionimmediatelyAssessment
Backblows&Chestthrusts
Supporttheinfant’sheadandbodybetweenyourhandsandforearmsusingthe“SandwichManoeuvre”• Holdtheinfant’sfacedownandrestyourforearmonyourthigh• Keeptheheadlowerthanthetrunk• Deliver5backblowsforcefullybetweentheshoulderbladeswiththeheelofyour
otherhand• Supporttheinfant’sheadandbodybetweenyourhandsandforearmsafter
deliveringthe5backblows• Turntheinfantoveronhis/herback,restingonyourthigh• Keeptheheadlowerthanthetrunk• Deliver5chestthrustsoverthelowerhalfofthesternum(breastbone)bycounting
aloud‘1,2,3,4,5’.(landmarkforchestthrustisthesameasforinfantCPR)
Reassessment Checkifforeignbodyisexpelledaftereverysetof5backblowsand5chestthrustsandremoveifitisvisible• Iftheforeignbodyisexpelledsuccessfully,assesstheinfantforpulse&breathing• Iftheairwayremainsobstructedandtheinfantisconscious,repeatthesequence
of5backblowsand5chestthrustsuntiltheforeignbodyisexpelledortheinfantbecomesunconscious
Unconscious infant
Wheninfantbecomesunconscious.Proceedwiththefollowingsteps:• Positiontheinfantonafirm,flatsurface• Callforambulance995ifasecondrescuerisavailable
• Start30chestcompressions(Thelandmark&techniqueisthesameasforInfantCPR)
• Openairway:HeadTilt-ChinLift• Checkairwayandremoveanyobviousforeignbodies
• Checkfornormalbreathing:Look,Listen,&Feel(upto10seconds)• Ifbreathingisabsent,attempttoventilate(1stattempt)• Ifairwayisstillblocked,re-positiontheinfant’sheadandreattempttoventilate• Attempt2ndventilation• Ifairwayisstillblocked,perform30chestcompressions• Proceedtoheadtilt-chintiltandcheckforforeignbody• RepeatSteptillhelparrivesorabletogive2successfulventilations
• Checkpulse(forhealthcareprovidersonly)andbreathingonceairwayiscleared.• Ifpulseisabsent(ifunsureofpulseandinfanthasnobreathing,assumecardiac
arrest),continueCPR30:2
RecoveryPosition Placetheinfantintherecoverypositionif:• Pulseandbreathingarepresent• Continuetomonitorinfant’spulseandbreathingeveryfewminutesasthiscan
stopsuddenly• ActivateEMSifitisnotdoneearlier
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Inform
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SingaporeGeneralHospitalInstitute for Medical Simulation & Education167JalanBukitMerah,ConnectionOneTower5,#03-10,Singapore150167Tel : 6326 6885 / 6326 6884 /63213651Fax : 68780495Email :[email protected]