Procedure On Basic Life Support: General Concepts

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PROCEDURE ON BASIC LIFE SUPPORT

GENERAL CONCEPTS

Heart disease is still the leading cause of death in the United States; it is responsible for more
than 600,000 deaths annually, according to the Centers for Disease Control (CDC). Studies
are continually looking for ways to improve how we react to emergencies with life-saving
methods. These techniques are derived from the most current research, compiled in a
systematic label called the Chain of Survival, which can be traced to the concept of Basic
Life Support (BLS). The Chain of Survival gives the victim the highest possibility of
receiving the necessary care and returning to a healthy lifestyle.

The lungs receive blood pumped by the heart, and from here the blood receives
oxygen and releases carbon dioxide. This blood flows back to the heart and is injected into
vital organs—the heart and the brain—as well as the rest of the body. A person becomes
unconscious immediately as soon as the heart stops, which ultimately leads to no blood
flowing in the body. The responses taught by BLS are aimed at preventing or slowing down
the problem’s cause until the root of the problem can be inspected by a medical practitioner.
BLS allows people a better chance of survival until further medical care is made available.

Procedure

 Clearing the airway

 Turn child on one side.

 Clearing visible foreign material from mouth and nostrils.

 If suction is available use suction to clear material.

 Back Blows

 Chest Thrust

 Placing the child in the recovery position, if they are breathing, and post airway
clearance can be useful.
 Head tilt/Chin lift

 Tilt head backwards (not neck)

 Support jaw at the point of the chin

 Jaw Thrust

 Good if neck injury is suspected

 Difficulty with obtaining adequate airway with Head tilt/chin lift.

 Airway manoeuvres and appropriate positioning in children can differ from adults,
dependant upon size.

Infants (<1yr) should have their head in the horizontal or neutral position.

 Look, Listen & Feel


 Up to 10 secs
 Look for rise and fall of the chest
 Listen for breath sounds or air arising from the nose or mouth
 Feel for chest wall movement
 If not breathing, and the casualty has a patent airway, rescue breathing should be
commenced.
 In clinical situations use a face mask to deliver breaths.
 CPR = Compression + Ventilation
 COMPRESSION RATE: 100 compressions/min
 Useful tunes to keep the rate are ‘Staying Alive’ – Bee Gees, Another one bites the
Dust and many more.
 RATIO: 30 Compressions to 2 ventilations (breaths)
 CYCLES: 5 cycles of [30:2] in approximately 2 minutes. Recheck for signs of life at
the end of cycle.
 Pause compressions to allow for ventilation.
 Most important step is recognising need for
CPR.
 CPR should be commenced immediately in children if;
 Unresponsive
 Not breathing normally
 Not moving, signs of life.
 Lay rescuers should begin CPR, based upon the above information. Checking for a
pulse is not required or recommended.
 For HCPs, the Brachial or Femoral pulse are typically the easiest to assess. If pulse
not identified within <10 seconds CPR should commence.
Ref: Pulse check versus check for signs of life Peds-002A Kids will generally not
tolerate CPR if they are conscious, so you might as well do it.
 You do Chest Compressions in approximately the same place right through from
infants to adults.
 Compressions are done in the midline on the lower half of the sternum or the ‘centre
of the chest’.
 The nipples can be used as landmarks to guide you to where you should be doing your
compressions. Compressions should not be done over the lower end of the sternum or
abdomen
 Push hard and fast, with straight arms.
 Infants (<1yo)  Use 2 fingers over the centre of the chest.
 Compress to 1/3 depth of chest wall (~4cm).
 Child (1-8yrs)
 Use heel of 1 hand, or alternatively 2 hands, with one positioned on top of the other.
 Compress 1/3 depth of chest wall (~5cm) in the centre of the chest.
 Greater than 8yrs = same as adult
 Don’t stop CPR to check for a response or breathing – except at the end of a cycle.
 Interruptions to CPR should be minimised.
 If possible change the person giving compressions every 2 minutes.
 CPR should continue until the casualty becomes responsive, or a healthcare
professional arrives.
 If a Debrillator (e.g. Automated External Defibrillator – AED) is available, apply and
follow voice prompts.
 CPR continues until the AED is present, all the pads are in place and the AED is on.
AEDs accurately identify heart rhythms as either ‘shockable’ or ‘non- shockable’.
Remember when shocking the casualty to get everyone to stand well back. Do not
touch them!
 AEDs can be used on children of any age.
 However, for small children & infants, paediatric pads and an AED with a Paediatric
functionality should be used if available.
 Large children can use the normal adults pads & AED.
 Pad Placement
 Most pads have a diagram on them illustrating where to place them (e.g. right upper
chest & left lower side).
 Pads should never be touching each other.
 In small children you can alternatively place one pad on the front of the chest, and
one on the back.

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