Basic Life Support And CPR

Question 1

What is the chain of survival

Answer 1

1. Early recognition and call for help
2. Early CPR
3. Early Defibrillation
4. Early advanced life support and post-care

Question 2

Describe the steps of the basic life support algorithm

Answer 2

1. Check for danger- is it safe
2. Check for a response- Shake and shout
3. If they respond- see if you can find out what is wrong
   If they are unconscious but have normal breathing consider recovery position
   If there is no response from the patient- open the airway by tilting the head upwards, check for breathing- look, listen and feel for no more than 10 seconds
4. If the patient is unresponsive and not breathing normally, call 999 and send for an ambulance
5. If you know how to use the SBAR communication tool, if not ask for someone else to call 999, if this isn’t an option place the call on speaker so you can still tent to the patient.
6. See if there is a local AED/Defibrillator close which you know of or is identified by the 999 call handler send someone to collect and you stay with the patient.
7. Continue to help the patient by performing CPR
8. 30 chest compressions in the middle of the sternum with the hands interlocked using the heel of the hand only. Arms should be straight and shoulders over the sternum. Press down twice per second 5-6cm deep. Allow the sternum to rise before the next compression but keep contact with the chest
9. After 30 chest compressions perform 2 rescue breaths. Ensure the airway is open, pinch the patients nose, take a breath and seal your mouth around theirs blowing out steadily for 1 second as a normal breath.
10. After the first rescue breath turn your head to check for the chest falling and then repeat step 9 performing another rescue breath.
11. If rescue breaths are unable to be give or you are unwilling to give the rescue breaths then continue with chest compressions instead
12. Keep going with alternating between 30 chest compressions and 2 rescue breaths until either a health professional tells you to stop, you become to tired and ask someone else to take over or the patient definitely wakes up where there eyes are open, they are moving and breathing normally.
13. When the AED arrives switch it on and follow the instructions it gives you to proceed to give a shock to the patient, while been set up CPR must continue.

Question 3

What is the adult choking algorithm

Answer 3

1. Be alert, if someone looks like they are chocking ask them are they choking
2. If they are able to speak then air is able to pass through the windpipe and so would be a mild obstruction, if they are able to talk this would suggest something more severe and no air is able to pass through the windpipe at all.
3. First thing too do is to ask the patient to cough, to try and dislodge the object from within the trachea
4. If it is a mild obstruction, the cough can generate high and sustained airway pressure to expel to object
5. If the coughing isn’t working and is ineffective give 5 back blows, stand slightly to the side behind the victim, bend the patient over and support them with one hand, give 5 sharp back blows between the shoulder blades with the heel of your free hand
6. If the 5 back blows aren’t working and are ineffective then give up to 5 abdominal thrusts, stand behind the victim and put both arms around the upper part of the patients abdomen, lean them forward, one hand clench into a fist and place it between the umbilicus and the breastbone, grasp your first with the free hand and pull sharply inwards and upwards
7. If the obstruction is still no longer dislodged continue alternating between 5 back blows and 5 abdominal thrusts
8. Make sure you are continuously monitoring the patient as they could fall unconscious at any point is the obstruction is severe, In this case you would lay them down and start CPR while calling an ambulance

Question 4

What are the step of putting a patient into the recovery position

Answer 4

1. Remove glasses if the patient is wearing them
2. Have the patient flat on there back making sure both legs are straight
3. The arm closest to you, out at a right angle to his body, elbow bent and palm facing up
4. Bring the far arm across the chest and hold the back of the palm to the patient cheek nearest to you
5. With your over hand grasp the far leg just above the knee and pull it up, keeping the foot on the ground
6. Keep the hand pressed against the cheek, pull on the far leg to roll the victim towards you on there side
7. Adjust the upper leg so that both the hip and knee are bent at right angles.
8. Tilt the head backwards to make sure that the airway remains open
9. Adjust the hand under the cheek to keep the head tilted and facing downwards to allow liquid to drain from the mouth
10. Check breathing regularly and if breathing changes and becomes abnormal start CPR

Question 5

What is involved in the recognition to anaphylaxis

Answer 5

1. Sudden and rapid onset of symptoms, the patient will feel and look unwell, most occur over several minutes, time of onset will depend on the trigger
2. Assess the condition to check if it is life threatening
   Check the airway- is there swelling around the throat or tongue, do they have difficulty swallowing, does it feel like the throat is closing up. When they speak do they have a hoarse voice or make a high pitched noise on inspiration
   Check breathing- Do they have shortness of breath, a wheeze, are they confused which could be caused by hypoxia , do they look blue in colour (cyanosis)
   Check circulation- Signs of shock which could be pale or clammy, increased pulse rate (tachycardia), low blood pressure feeling faint/dizzy or even collapse or loss of consciousness
3. Skin/mucosal changes (flushing, urticaria, angioedema)
   This is often the first feature and present in over 80% of reactions, maybe just changes to one or the other. Urticaria looks like hives or nettle rash, Erythema is a patchy generalised rash. Angioedema is similar to urticaria but involves the deeper tissue

Question 6

Treatment for anaphylaxis

Answer 6

1. Recognise they are unwell
2. Early call for help
3. Assessment- airway, breathing and circulation
4. Adrenaline- ask if they have an EpiPen
5. Place the person in a comfortable position
6. Remove the trigger if possible

Question 7

What is the SBAR stand for in the communication tool

Answer 7

S= Situation
B= Backgroud
A= Assessment
R= Recommendation

Question 8

What information do you give in the situation part of the SBAR communication tool

Answer 8

Introduce yourself
Check your speaking to the right person
Identify the patient you are calling about
Say what you think the current problem is/appears to be
State what you need advise about

Question 9

What information do you give in the background part of the SBAR communication tool

Answer 9

Background information about the patient
Reason for admission
Relevant past medical history

Question 10

What information do you give in the assessment part of the SBAR communication tool

Answer 10

Include specific observations and vital sign values based on the ABCDE approach
Airway
Breathing
Circulation
Disability
Exposure

Early warning score

Question 11

What information do you give in the recommendation part of the SBAR communication tool

Answer 11

State what you want the person you are calling to do
When do you want them to do it by