What steps in BLS (adult)?
DRS ABC
- Danger
Check for danger to self / others
Sharps / equipment / blood - Response
Check pt for response by gently shaking both shoulders
Speak loudly into each ear
If pt responds place into recovery position - Shout for help
If pt non responsive call for help, call 999 - Airway
Open airway using head tilt / chin lift
If neck injury, use jaw thrust - Breathing
Check it pt is breathing – cheek next to their mouth, listen and feel and watch for chest movement - Circulation
Feel for carotid pulse simultaneously – no more than 10s
What to do if pt unresponsive and in cardiac arrest?
- Commence chest compressions
- Switch every 2 minutes as quality of compressions declines
- Continue until help arrives / AED ready
- 30 compressions, 2 breaths
- Ask someone to bring crash trolley and AED, Specify where you are, type of trolley needed (adult / paediatric etc)
- Once AED arrives, continue chest compressions whilst someone sticks on pads
- Switch on AED machine and shout stand clear
- Shock pt
- Continue chest compressions 30:2 with oxygen
Depth and rate of adult chest compressions?
5-6cm
100-120bpm
What is difference between infant and child (ages)?
Infant = <1 year
Child = 1 up to puberty
How does paeds BLS differ to adult?
Still use DRS ABC
Provide 5 rescue breaths
Paeds depth and rate of chest compressions?
1/3rd chest depth
100-120bpm
How to open airway in infant?
Neutral position - do not extend neck
How to open airway in child?
Only partially extend neck - children have larger tongue than adults so may occlude airway if fully extended
How to give 5 rescue breaths in infants?
Cover both nose and mouth with your mouth
How to give 5 rescue breaths in child?
Pinch nose and then mouth to mouth
Using a bag value mask requires 2 people (one to hold mask in position over mouth and nose, second to squeeze the bag)
How to assess circulation in infants?
Cannot feel carotid due to short neck, so 2 fingers on centre of chest to assess brachial artery
How to assess circulation in children?
Place one hand in centre of the chest to assess carotid artery
Difference between partial and complete airway obstruction?
Partial - pt can verbally confirm choking so encourage to cough
Complete - pt non verbally confirms
How to manage complete airway obstruction?
- Call for assistance
- Back slaps x5
- Abdominal thrusts x5
- Continue in rotation until obstruction clears / victim unconscious
If choking pt becomes unconscious, how to respond?
- Unconscious and not breathing start CPR chest compressions 30:2
- Unconscious and breathing place in recovery position
How to give back slaps?
Stand to side of person, one arm against chest pt lean forward
5 sharp slaps between shoulder blades with heel of hand
How to give abdominal thrusts?
Stand behind, arms around their upper abdomen, person lean forwards
Clench fist and pull sharply inwards and upwards
If after 5 obstruction remains call 999
How to place in recovery position?
- Remove pt glasses, keys, phone etc. from pockets
- Kneel beside pt, straighten limbs to lie flat
- Place arm nearest you at right angle to their body, elbow bent, palm up
- Bring other arm across chest and back of hand to cheek nearest you
- Bring knee furthest away up and roll pt onto their side
- Tilt head back to keep airway open
