BASIC LIFE SUPPORT

CARDIOPULMONARY

BASIC LIFE SUPPORT

RESUSCITATION INDICATIONS Patient has no signs of lifeunconscious, unresponsive, not moving, and not breathing normally Even if the patient takes occasional gasps, responders should suspect that cardiac arrest has occurred and start CPR

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REASONS TO WITHHOLD CPR Danger to operators Patient has been dead for some time Injuries incompatible with life Diagnosed terminal illness with not for resuscitation direction (hospital) If any doubt exists, CPR should be carried out until ECG rhythm is assessed and the patient meets the criteria to discontinue resuscitation. This applies especially to children and young adults, drug overdose, drowning and hypothermia.

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REASONS TO DISCONTINUE RESUSCITATION

Danger to operators Return of signs of life It is impossible to continue (e.g. physical exhaustion of operators) A higher level of medical care takes over or pronounces life extinct

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CPR PROCEDURE RESUSCITATION STEPSDRABCD D - Check for danger R - Check for response and call for assistance A - Open and clear the airway and look for signs of life. (Consider placement of oropharyngeal airway, but only if this causes no delay). B - NOW DO not need to give two breaths if not breathing C - Give 30 chest compressions (at almost 2 compressions per second) followed by 2 breaths D - Attach an SAED (Semi Automated External Defibrillator) if available and follow procedure for defibrillation (see guideline on Defibrillation).

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COMPRESSIONVENTILATION RATIO Universal compression-ventilation ratio

A universal compression-ventilation ratio of 30 compressions followed by 2 ventilations (30:2) is recommended for all ages regardless of the number of responders present Compressions must be paused to allow for ventilations. When providing 30 compressions (at approximately 100/min) and giving 2 breaths (each given over 1 second per inspiration), this should result in the delivery of 5 cycles in approximately 2 minutes.

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MULTIPLE RESPONDERS

When more than one responder is available, ensure that:

Assistance has been requested All available equipment has been obtainedeg oxygen equipment, defibrillator Frequent rotation of rescuers is undertaken ( (approximately every 2 minutes) to reduce fatigue.

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RECOVERY CHECKS CPR should not be interrupted to check for signs of life. Continue resuscitation until signs of life become obvious. RESUSCITATION IN PREGNANCY In the obviously pregnant woman the uterus causes pressure on the inferior vena cava when she lies flat and reduces return of venous blood to the heart. The pregnant woman should be positioned on her back with her shoulders flat and sufficient padding under the right buttock to give an obvious pelvic tilt to the left.

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DISTENSION OF THE STOMACH Distension of the stomach may occur if the responder overventilates the patient or the airway is partially obstructed, so that air enters the stomach rather than the lungs. If the stomach is distended, do not apply pressure to the stomach. In resuscitation, regurgitation and vomiting are managed in the same way by prompt positioning of the victim on their side and manual clearance of the airway prior to continuing ventilation.

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