CPR

BASIC LIFE SUPPORT

AIM
TO MAINTAIN ADEQUATE VENTILATION
AND CIRCULATION UNTIL UNDERLYING CAUSE FOR ARREST CAN BE REVERSED. 3-4 MINUTES WITHOUT ADEQUATE PERFUSION (Less if patient is hypoxic) LEADS TO IRREVERSIBLE DAMAGE.

STEPS
A FOR AIRWAYS B FOR BREATHING
C FOR CIRCULATION

STEPS

ASSESS PATIENT

ASSESS PATIENT
Check if patient is responsive by gently
shaking patient/ giving noxious stimuli as pinching sternum. Avoid shaking patient if suspected for head/Cervical cord injury IF PATIENT UNRESPONSIVE SHOUT FOR HELP AND ALERT CODE BLUE

 As fast as possible position patient on flat

hard surface such as on the floor. If the patient must be moved from face-down position, roll the patient as a unit so that the head, neck and torso move simultaneously.

A FOR AIRWAYS
A ; Open Airway: With two fingertips
under point of chin tilt head up.

(Remove ill fitting dentures/ obvious

obstruction.)

B FOR BREATHING
If patient starts breathing roll the patient
over into recovery position and try to keep airway open until an oro-pharyngeal airway can be inserted. Watch the chest movement and listen and feel at the mouth for breath sounds for a few seconds.

 C: Feel the carotid pulse: Check both

sides SEPERATELY. If the pulse is absent shout for help and get someone to alert for code blue/cardiac arrest team.

CPR
Open Airway (Tilt chin) and blow 2 SLOW
breaths into patient AT rate of 1.5-2.0 seconds per breath. Allow chest to fall after each ventilation. Each ventilation should be performed to make patients chest rise.

 Start Chest compression with the heel of the hand over the middle of the lower half of the sternum.
Aim to depress sternum about 4-5 cm at rate of approx 80 compressions per minute.

 If patient is on bed position yourself on bed with your legs folded under you and give chest compression.

 If you are alone, after every 5

compressions give 1 ventilation by Ambu bag/ Mouth to Mouth until further help arrives./ If patient has been intubated one nurse ventilation by ambu bag. If 2 persons are there, nominate one to breathing and other to compression

 Give 1 full breath after every 5

compressions stopping compressions only just long enough for the breaths. (Compression: Ventilation Ratio to be 5:1)

 If extra nurse /doctor is present CANNULATE PATIENT AS FAST AS POSSIBLE and arrange for fully equipped crash cart, Suction machine. Keep the following injections loaded in syringes: Adrenaline Lignocaine Atropine Amiodorone/Cardarone Hydrocortisone Deriphylline Soda bicorb

 Once patient is intubated ventilation can

be performed at a rate of 12-15/minute without pausing for compressions.

 STOP BLS FOR 5 SECONDS: at the end of

the first minute and every 1-2 minutes thereafter to determine whether patient has resumed spontaneous breathing or circulation

 If a spontaneous pulse has returned,

check BP and continue ventilation.

 BLS should not be withheld for more than

5 seconds other than to intubate or defibrillate the patient. Attempt at intubations should not exceed 30 seconds before CPR is resumed.

 If an unconscious patient cannot be

ventilated after two attempts at positioning the head and chin and a laryngoscope is unavailable 6-10 abdominal thrusts (Heimlich Maneuver) should be performed without damaging any organs.

 After this maneuver is performed, debris

should be swept from the patients mouth with a finger, and then one should attempt to ventilate patient.

This sequence should continue to be

repeated until ventilation is successful.

THANK-YOU