BLS for Health Care ProvidersJacki Malone, RN, BSN

Introduction

• BLS= Basic Life Support• Needed for a person whose breathing or heart has stopped• Ventilations (breaths) are given if breathing is inadequate or has

stopped. WHY? • To oxygenate blood

• Chest compressions are given if heart has stopped. WHY?• To circulate that oxygenated blood to vital organs

• Ventilations + Chest compressions = CPR• CPR• Cardiopulmonary Resusciation

https://www.youtube.com/watch?v=fFKCPLHB6i0

CPR Saves Lives

• Commonly given to patients in cardiac arrest• CPR & defibrillation (AED) within 3-5 minutes of arrest

can save over 50% of victims• CPR helps keep victim alive until EMS or AED arrives

Basic Cardiac Info

• Circulatory system consists of heart, blood and blood vessels• Transports blood to lungs• Heart beats more than 3 billion times in an average lifetime• Cardiovascular disease (affects heart and blood vessels)

affects 80 million Americans

Cardiac Arrest

• Complete cessation of heart activity• Causes• Heart attack (muscle damage) *Diabetic Emergency• Coronary heart disease *Prolonged seizures• Drowning *Drug overdose• Suffocation *Electric shock• Stroke• Allergic reaction

Heart Attack

• Decreased blood flow to the heart= chest pain• Reduction in blood and O2 to the heart= heart attack

Heart AttackSigns and Symtpoms

• Chest pain, discomfort or pressure• Persistent• Lasts 3-5 minutes, goes away, then comes back• Can range from discomfort to crushing• Aching or heaviness (“there’s an elephant on my chest”)• Trouble breathing• Change in skin color• Sweating, dizziness, nausea• Discomfort in other areas of upper body

Heart AttackSigns and Symtpoms

•Women:• Back/jaw pain• Nausea & vomiting• Fatigue• Sudden and sharp short lived pain outside the breastbone

Chain of Survival

• Early Access• You get there as it happens or right after

• Early CPR• CPR is quickly began

• Early Defibrillation• EMS/AED arrived

• Early Advanced Care• EMS/ER

CPR Facts

• Blood circulation from compressions are not as strong at circulation from the hearts normal beat

• CPR can help keep brain alive until normal rhythm restored

• Often, electric shock (AED) is needed to restore rhythm• CPR is only effective for a short time• CPR should be started as soon as possible• In some instances, the heart may start spontaneously with

CPR

What to do…..

• 1. Recognize an emergency • signs and symptoms• See someone go down

• Activate emergency response• Call 911 or designate someone to do so

What to do

• Check ABC’s• Head tilt• Look, listen and feel (HOW LONG?)

• 10 seconds

Breathing?Great, check for pulse and place in recovery position

Not breathing?Give two rescue breathsCheck for pulse. Begin CPR (if no pulse)

Chest Compressions

• Position yourself at victim’s side• Victim should be lying face up• FIRM SURFACE• If suspected head/neck injury, remember to support neck

while turning and keep head, neck and torso in one line

Chest compressions

• Hand placement• Put the heel of one hand on the center of the victim’s

chest on the lower half of the sternum • Put the heel of your other hand on top of the first hand • Lock fingers• Position yourself directly over the victim• Straighten your arms and position your shoulders directly

over your hands

Chest Compressions

• Rate and Depth• Push hard and fast• Straight down at least two inches• Compressions should be given in a smooth, constant,

consistant fashion at a rate of at least 100 bpm.• Allow FULL RECOIL between compressions• https://www.youtube.com/watch?v=ILxjxfB4zNk

CPR

• Rescue breathing (ventillation) and Compressions• 30 compressions + 2 breaths=one cycle• Repeat

Putting it all together

• Get a manikin for some guided practice…….

Steps in CPR

• CHECK THE SCENE FOR SAFETY• 1. Assess for responsiveness. Open airway and look for

normal/abnormal breathing. If there is no response and no breathing, shout for help.

• 2. If no one is around, call 911. • Get an AED if available (for these purposes, we are

assuming there is not one available).

Steps in CPR

• 3. Check the victim’s pulse• Carotid artery

Steps in CPR

• 4. If you do not definitely feel a pulse within 10 seconds, perform 5 cycles of compressions/breaths, starting with compressions. • 30 compressions, two breaths• Repeat x 5

Steps in CPR

• Things to remember• Rescue breaths given over 1 second each• Watch your hand position• Keep fingers off• Keep elbows locked• Allow full recoil• Minimize time between ventilations and compressions

REVIEW

• What is the rate for chest compressions for a victim of any age?• 100 compressions per minute

REVIEW

• Why do you need to allow for full recoil between compressions?• This is when the heart fills back up with blood

REVIEW

• After you open the airway and pinch the nose of an unresponsive adult/child, what his the BEST way to give mouth to mouth breaths?• Seal your mouth over the victim’s mouth and give two

breaths (1 second each), watching the chest rise

REVIEW

• What is the best way for a rescuer to know that a rescue breath is effective?• The chest will rise with each breath

REVIEW

• When you do not suspect a cervical spine injury, what is the best way to open the airway of an unresponsive victim?• Head tilt/chin lift technique

REVIEW

• A person shows signs of circulation (a heartbeat) and breathing on their own after CPR was started. What should you do?• Place the victim in the recovery position and monitor until

EMS arrives.

REVIEW

• The purpose of the recovery position is to:• Prevent aspiration (keep the fluids out of their throat/lungs)

REVIEW

• You find a victim lying on his right side. He is not breathing but has a good pulse. What should you do?• Call 911• Give rescue breaths every 5 seconds

REVIEW

• What happens during cardiac arrest?• The heart stops completely and there is no breathing

REVIEW

• Before starting chest compressions, you need to check for a pulse. What pulse site should you use?• Carotid (neck)

REVIEW

• What is the best way to remove a foreign body airway obstruction in a conscious adult?• Back blows and abdominal thrusts (5 & 5)

Any questions??