1 new 2010 bls for healthcare worker ok
TRANSCRIPT
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Adult Basic Life Support for the Health Care
Worker
Adult Basic Life Support for the Health Care
Worker
Philippine Heart Association, Inc.
Council on Cardio Pulmonary Resuscitation
Philippine Heart Association, Inc.
Council on Cardio Pulmonary Resuscitation
A Full Member of the
The Asian Representative of
Based on the New 2010 CPR Guidelines of the AHA and ILCOR
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The Burden: Heart Diseases are the #1 cause of death in the Philippines
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Sudden Cardiac Arrest – A Health Burden
• Approximately 50% of deaths from cardiovascular disease occur as SUDDEN CARDIAC ARREST.
Sudden Cardiac Arrest is the most common mode of death in patients with coronary artery disease.
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• Almost 80 percent of out-of-hospital cardiac arrests occur at home and are witnessed by a family member.
• Only 4-6 % of sudden cardiac arrest victims survive because majority of those witnessing the arrest do not know how to perform CPR .
American Heart Association
Health Burden of Sudden Cardiac Arrest
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Sudden Cardiac Arrest• Unpredictable and can happen to anyone,
anywhere, at anytime
• Risk increases with age
• Pre-existing heart disease is a common cause
• May strike people with no history of cardiac disease or cardiac symptoms
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Effective CPR done immediately after cardiac arrest can double a victim’s chance of survival.
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If sudden cardiac death occurs outside the hospital setting, cardiopulmonary resuscitation (CPR) must begin within 4 to 6 minutes and advanced life support measures must begin within 8 minutes, to avoid brain death.
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Objectives of this Presentation
• To increase awareness and knowledge on Basic Cardiopulmonary Resuscitation (CPR) as a life-saving procedure for victims of sudden cardiac arrest.
• To demonstrate the different steps and techniques of CPR.
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What is C P R ?
• CPR = Cardio-Pulmonary Resuscitation
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The NEW Chain of Survival
• Early access: immediate recognition and activation
• Early CPR
• Early defibrillation
• Early advanced care
• Integrated post-cardiac arrest care
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A well-informed lay person - key in the early access link.
Recognition of signs of heart attack and respiratory failure
Call for help immediately if needed
Activate the Emergency Medical System
The First Link- Early Access
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EARLY WARNING SIGNS OF HEART ATTACK
prolonged compressing pain or unusual discomfort in the center of the chest
may radiate to shoulder, arm, neck or jaw, usually on the left side
may be accompanied by sweating, nausea, vomiting and shortness of breath
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EARLY WARNING SIGNS OFRESPIRATORY FAILURE
unable to speak, breath or cough
clutches neck (universal distress signal)
bluish color of skin and lips
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Life saving technique for cardiac & respiratory arrest
Chest compressions +/- Rescue breathing
Lay persons and medical personnel
Second Link - Early CPR
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Why is early CPR important? CPR is the best treatment for cardiac
arrest until the arrival of ACLS care. prevents VF from deteriorating to
asystole may increase the chance of
defibrillation It significantly improves survival.
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Brain(Cerebral)
Heart(Cardiac)
Lungs(Pulmonary)
How does CPR work?
All the living cells of our body need a steady supply of oxygen to keep us alive.
During CPR, you can breathe air into the victim’s lungs to provide oxygen into the blood.
When you press on the chest, you move oxygen - carrying blood through the body.
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When will you do CPR?
AS SOON AS POSSIBLE!
Brain cells begin to die after
4-6 minutes without oxygen.
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Who may learn about CPR?
• CPR is an easy and life saving procedure and can be learned by anyone.
• One does not need to be a doctor to learn how to do CPR.
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THE TECHNIQUE AND STEPS IN CPR
IF YOU WITNESS A CARDIAC ARREST
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CHECK AREA SAFETY.
Survey the scene.See if the scene is safe to do CPR.Get an idea of what happened.
CHECK UNRESPONSIVENESS.Tap or gently shake the victim
Rescuer shouts “Are you OK?”
Quick check for normal breathing
If the victim is unconscious, rescuer calls for help.
CALL FOR HELP:Ambulance, Emergency Services, Doctor
Rescuer ACTIVATES the EMERGENCY MEDICAL SERVICES.
Get AED/Defibrillator!
1
2
3
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NON-RESPONSIVE,NO NORMAL BREATHING
Get a Defibrillator!A E D !
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PULSE CHECK
Palpate for Carotid Pulse within 10 seconds
(at the same time CHECK FOR BREATHING)
For trained healthcare providers only
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Do Mouth to MouthBreathing
Give one breath every 5-6 secs (about 12 breaths/min)
Recheck pulse every 2 minutes
If with definite pulse but no breathing
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MOUTH TO MOUTH BREATHING and PULSE CHECK
• Deemphasized in the new guidelines• For trained healthcare providers only• As short and quick as possible• Pulse check not more than 10 seconds• If unsure, proceed directly to CHEST
COMPRESSIONS!
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C – A – B C. COMPRESSION Do chest
compressions first
A. AIRWAY Does the victim have an open airway (air passage
that allows the victim to breathe)?
B. BREATHING Is the victim breathing?
After determining unconsciousness,
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After determining unconsciousness and calling for help,
proceed immediately to do
CHEST
COMPRESSIONS!
C – COMPRESSION
(to assist CIRCULATION)
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Chest Compressions
Hand Location
• Kneel facing
victim’s chest
• Place the heel of your hand on the center of the victim's chest. Put your other hand on top of the first with your fingers interlaced.
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Place the heel of one hand on the sternum in the center of the chest between the nipples and then place the heel of the second hand on top of the first so that the hands are overlapped and parallel.
Chest Compressions
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Position shoulders over hands with
elbows locked and arms straight
Give Chest Compressions at 100 per minuteCompress breastbone at least 2 inches deep
Compress at a rate of 100 per minute or more
Compress 30 times initially
Allow the chest to return to its normal position
Compress down and release pressure
smoothly, keeping hand contact with chest at all t imes
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Give 30 Compressions Compress breastbone at least 2
inches
(30 compressions should take 15-18 sec)
Count aloud “1, 2, 3, 4, 5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29, and ONE!”
Minimize interruptions
Allow recoil after each compression
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A - AIRWAY Open the Airway: Use the head tilt/chin lift method
Place one hand on the victim’s forehead
Place fingers of other hand under the bony part of lower jaw near chin
Tilt head and lift jaw--avoid closing victim’s mouth
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Head Tilt Chin Lift Maneuver
This maneuver prevents airway obstruction by the epiglottis.
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B - BREATHINGGive 2 one-second breaths
• Maintain airway• Pinch nose shut• Open your mouth
wide, take a normal breath, and make a tight seal around outside of victim’s mouth
• Give 2 full breaths
(1 sec/ breath)• Observe chest rise &
fall; listen & feel for escaping air
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Repeat cycles of 30 compressions & 2 breaths
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PULSE CHECK• RECHECK PULSE EVERY 2 MINUTES
(equivalent to 5 cycles CPR)• Very brief pulse check – should take
less than 10 seconds (at the same time check for normal breathing)
• In case there is any doubt about the presence or absence of pulse, CONTINUE CHEST COMPRESSIONS
• For trained healthcare providers only
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UNTIL…
•HELP ARRIVES. (Emergency Services, Ambulance, Doctor, AED)
•PERSON IS REVIVED.
CONTINUE CPR
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If the victim is breathing
The unresponsive victim with spontaneous respirations should be placed in the recovery position if no cervical trauma is suspected.
Placement in this position consists of rolling the victim onto his or her side to help protect the airway.
Maintain open airway & position the victim
THE RECOVERY POSITION
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Maneuvers Adults ChildrenRECOGNITION UNRESPONSIVE
No breathing, not breathing normally (eg. only gasping)
No breathing or only gasping
CPR Sequence CAB CAB
Compression Rate At least 100/min
Compression Depth At least 2 inches (5 cm) At least 1/3 AP depth; About 2 inches
Chest wall Recoil Allow complete recoil between compressionsHCPs rotate compressors every 2 minutes
Compression interruptions
Minimize interruptions in chest compressionsAttempt to limit interruptions to less than 10 seconds
Airway Head tilt chin lift (HCP suspected trauma: jaw thrust)
Compression-Ventilation ratio
30 : 2 (one or 2 rescuers) 30:2(single rescuer); 15:2(2 rescuer)
Ventilations: when rescuer untrained or
trained and not proficient
Compressions only Compressions only
Ventilations with advanced airway (HCP)
1 breath every 6-8 seconds (8-10 breaths/min)Asynchronous with chest compressions
About 1 second per breathVisible chest rise
DEFIBRILLATION ( AED ) Attach and use AED as soon as available. Minimize interruptions in chest compressions before and after shock, resume CPR beginning with compressions
immediately after each shock
Summary of Key BLS Components for Adults and Children
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• NOT TRAINED• DO NOT KNOW MOUTH TO MOUTH
VENTILATION• NOT SURE ABOUT MOUTH TO MOUTH
VENTILATION• HESITANT TO DO MOUTH TO MOUTH
VENTILATION• DO NOT WANT TO DO MOUTH TO MOUTH
VENTILATION
IF YOU ARE…
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Compression-only bystander CPR
Hands Only CPR
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Hands Only CPR should only be used for adult victims who have suddenly collapsed or
become unresponsive.
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Recommendations:• All victims of cardiac arrest should receive
high-quality chest compressions
• When an adult suddenly collapses, all bystanders should activate their community EMS and provide high-quality chest compressions, minimizing interruptions (Class I).
Hands Only CPR
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Recommendations:• If not trained in CPR, provide hands-only
CPR (Class IIa) until – AED arrives– EMS providers take over care of the victim
• If trained in CPR, provide either conventional CPR using a 30:2 compression-to-ventilation ratio (Class IIa) or handsonly CPR (Class IIa)
Hands Only CPR
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Key Changes in the New Guidelines
• CAB instead of ABC• Compress first• No more Look Listen and Feel• Harder! At least 2 inches compression (old: 1 ½ to 2
inches)
• Faster! At least 100/min compression (old: up to 100/min)
• Deemphasize pulse checks– For trained healthcare providers not more than 10 secs
• Check for normal breathing together with check for unresponsiveness
• Hands only CPR for the untrained lay rescuer
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Important Points• There are no mistakes when you perform CPR.
The only harm is to delay responding.Start chest compressions now viewed as the most
effective procedure
All victims in cardiac arrest need chest compressions.
• Don't stop pushing.
Keep pushing as long as you can. Push until the AED is in place and ready to analyze the heart. When it is time to do mouth to mouth, do it quick and get right back on the chest.
• 80-90% of cardiac emergencies occur at home.
• Training is now simpler and more accessibleReduced number of steps and simplified process
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• Being trained to do CPR can save a loved one.
• Effective CPR done immediately after cardiac arrest can double a victim’s chance of survival.
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LEARN CPR TODAY!
INQUIRE FROM THE PHILIPPINE HEART ASSOCIATION!www.philheart.org
CPR SAVES LIVES.
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If you want know more about Sudden Cardiac Arrest and CardioPulmonary Resuscitation,
contact the
Philippine Heart Association Council on CPR
PHA Heart HouseSuite 1108, 11th Flr. East Tower, PSE Centre Exchange Road,
Ortigas Center, Pasig City Philippines
Tel. +63 2 470-5525; +63 2 687-7797
www.philheart.org