Prevention Priority, Inc. presents
Basic Life Support for Healthcare Providers
Adult Chain of Survival (Adult = Adolescence and older)
1. Early Access. Call immediately after you establish unresponsiveness. EMS or code team must arrive as quickly as possible to DEFIBRILLATE EARLY.
2. Early CPR with CAB! (Compressions then Airway and Breathing)
A. If no pulse present OR you are UNSURE if a pulse is present, begin compressions. You can always do compressions but airway modalities may not be present. As soon as you can add airway and breathing.
B. Air goes in and out and
C. Blood goes round and round. Remember the secret is
HARD (at least two inches) AND FAST (100/min) CHEST COMPRESSIONS!
D. It really does work! (Well, not ALL the time but. . .)
3. Early Defibrillation.
A. Automated External Defibrillator (AED). An adult AED may be used on ANY age patient. If only pedi pads available, use only on infant/child
B. Immediate CPR and defibrillation within 3 to 5 minutes yields the best possible chance for survival.
C. Available to general public in an increasing number of places. Always send a bystander to inquire if an AED is present.
D. Now low priced! Starting at $1195.
4. Advanced Care. The arrival of the code team or EMS.
Avoid the Rush: Recognize the Emergency
1. Heart Attack (Myocardial Infarction)
A. Denial kills.
B. Early treatment. Within 6 hours.
C. If not allergic or other contraindications, give 160mg to 325mg aspirin, to be chewed
d. Heart Attack signs and symptoms:
2. Stroke
A. Denial still kills
B. Early treatment. Within 3 hours.
C. Signs and symptoms:
Adult Review
Establish unresponsiveness. Call 911 or code. Treat agonal (death) respirations as NO respirations! Check for carotid pulse. In the absence of a pulse, begin
30 compressions using two hands on the lower half of the breastbone between the nipples at a rate of 100 per minute. Continue compressions to breaths at a ratio of 30:2 for 5 cycles (about two minutes) and then reassess victim starting with pulse check. Remember that the compression to breath ratio is now the same regardless of the number of rescuers. Two person CPR is also 30:2 (for Adult ONLY)
Rescue breathing (victim has pulse but has no respirations) is 1 breath every 5-6 seconds (with conventional rescue breathing) or 1 breath every 6-8 seconds with advanced airway (ETT, LMA,etc).
Adult Choking
Choking rescue is identical for the adult and child.
Conscious with complete obstruction: Continue abdominal thrusts until victim can breath or becomes unconscious.
Unconscious adult/child choking:
1. Witnessed collapse: Tongue jaw lift to visualize, sweep ONLY if you see the object.
2. Attempt to ventilate.
3. Reattempt ventilation.
4. Perform CPR as above. Visualize PRIOR to any attempted breaths. Sweep object only if visualized.
Repeat steps 1 – 4 until you are able to ventilate.
Barrier Devices
Don’t leave home without it!
Pediatric Chain of Survival
(Child = 1 – adolescence; Infant = 1 year and under)
1) Prevention: Accidents kill more children than all diseases combined
2) Early CPR. Start the rescue FIRST! The infant or child typically has respiratory difficulty first and then develops cardiac arrest secondary to low oxygen levels. It is imperative that you begin the delivery of oxygen by any means available. If you WITNESS a child collapse, treat like adult: Call First, AED ASAP.
3) Phone 911. After two minute of rescue, call 911. In the health care setting call a code as soon as possible. *
4) Advanced Care. This is the arrival of the code team or EMS.
*If after two minutes of CPR, the child or infant has no pulse, use any AED available (including an adult AED).
Pediatrics by the Numbers:
*Child and Infant ventilation to compression ratio is 30:2, UNLESS you are performing 2-rescuer CPR; it is then 15:2.
Child (Ages 1 to Adolescence)
Establish unresponsiveness. Call 911 or code. Treat agonal (death) respirations as NO respirations! Check for carotid pulse. In the absence of a pulse, begin
30 compressions using two hands on the lower half of the breastbone between the nipples at a rate of 100 per minute. Continue compressions to breaths at a ratio of 30:2 for 5 cycles (about two minutes) and then reassess victim starting with pulse check. For a child with a pulse rate less than 60 and signs shock, begin (or continue) CPR as above. Use any available AED after two minutes of CPR for unwitnessed collapse. Use any available AED immediately for witnessed collapse.
Rescue breathing (victim has pulse but no respirations) is 1 breath every 3-5 seconds, frequently checking pulse. Stop when breathing normally or if CPR needed.
Infant (Ages 1 and under) Observe sniffing position!!
Establish unresponsiveness. Call 911 after two minutes (5 cycles) of CPR or call a code. Treat agonal (death) respirations as NO respirations! Check for brachial pulse. In the absence of a pulse, begin 30 compressions using two fingers just below the nipple line at a rate of 100 per minute. Continue compressions to breaths at a ratio of 30:2 for 5 cycles (about two minutes) and then reassess victim starting with pulse check. For an infant with a pulse rate less than 60 and signs shock, begin (or continue) CPR as above.
Rescue breathing (victim has pulse without respiration) is 1 breath every 3-5 seconds, frequently checking pulse. Stop when breathing normally or if CPR needed.
Infant Choking
Conscious with complete obstruction: Perform 5 back blows followed by 5 chest thrusts until victim can breathe or becomes unconscious.
Unconscious:
1. Tongue jaw lift to visualize, DO NOT perform blind finger sweep. Use finger sweep only if you can see the object.
2. Attempt to ventilate.
3. Reattempt ventilation.
4. Perform CPR as above. Visualize PRIOR to any attempted breaths. Sweep object only if visualized.
Repeat steps 1 – 4 until you are able to ventilate.
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