BLS Basic Life Support

Transcription

1 BLS Basic Life Support AIMS OF BLS ANOXIC BRAIN INJURY PREVENT THE PERSON THAT ARE COMPROMISE THE VITAL FUNCTIONS consciousness breathing circulation BAY MEANS OF prompt recognition early activation of 118 Respiratory support and the circle WHAY BLS? BLS because a person who has lost consciousness, has not breathing and has no circulation, does not send oxygen to the brain damage after a few minutes become permanent! ANOXIC BRAIN INJURY It starts after about 5 min. with each passing minute there will be irreversible brain injury CHAIN OF SURVIVAL Early access to 118 Early Early CPR - BLS Defibrillation ANATOMY AND PHYSIOLOGYOf RESPIRATORY SYSTEM The respiratory system has the oxygenate the blood function, eliminate carbon dioxide (CO2) accumulated FARINGE in the periphery of our body - It consists of: Upper respiratory tract mouth, nose, pharynx, larynx LARINGE - lower respiratory tracts trachea, bronchus, lungs TRACHEA Respirazione: inspirazione Respirazione: espirazione Early ALS BRONCHI POLMONI O2 CO2 SANGUE Il sangue è un organo deputato al trasporto di Ossigeno e nutrienti dal cuore verso la periferia attraverso i Globuli Rossi che legano l ossigeno cedendolo quando arrivano nei Capillari dei diversi organi. Il sangue ha poi il compito di rimuovere dagli organi periferici la CO2 e riportarla nel polmone dove viene eliminata con la respirazione. 1

2 Causes of respiratory arrest 1. Airway obstruction for: Language fall into unconscious person Foreign bodies 2. Poisoning by drugs, opiate overdoses 3. Drowning 4. Cardiac arrest 5. Trauma 6. Electrocution SUDDEN CARDIAC DEATH Abrupt cessation of circulatory and unexpected respiratory activities in patient with or without known heart disease Sudden cardiac death that result of coronary heart disease, rappresenta It is the most important medical emergency (A.H.A) SYMPTOMS OF ALARM FOR HEART ATTACK Retrosternal pain It is possible radiation of pain in: - Left arm - Shoulders - Epigastrium (mouth of the stomach) - Jaw Other symptoms: - Sweating, nausea and shortness of breath (Dyspnoea ) Onset: - Making an effort, emotional stress, but also at rest ABC of Cardiopulmonary Resuscitation AIRWAY BREATHING CIRCULATION IF THE VICTIM IT IS NOT CONSCIOUS TALKING AT 118 CHE THE PATIENT IS NOT CONSCIOUS POSITIONING THE PATIENT AND DISCOVER THE CHEST ENSURES THE PROPERTY OF THE AIRWAYS RATING OF THE STATE OF CONSCIOUSNESS Kneel side of the patient Shake it gently Call it out loud REMEMBER: It may be deaf or sleep soundly Lord, Lord do you hear me? if he does not answer... Call 118. Person unconscious!! ALIGNMENT ON HARD GROUND AND DISCOVER THE CHEST INSPECTION AND CLEANING OF MOUTH REMOVE VISIBLE FOREIGN BODIES ONLY svuotamento manuale ed aspirazione 2

3 PUBBLICA ASSISTENZA COLLESALVETTI Settore Formazione Hyperextension OF THE HEAD... but only if we are sure that there are no injuries to the cervical spine!!! AIRWAY Hyperextension and LIFTING OF THE HEAD OF THE CHIN MANEUVER OF G.A.S. - I look for ithe patient's chest expands it self - Listening: any breathing noises - I feel: on the cheek if air comes out from the mouth of patient During the maneuver GAS also look for signs of a circulation: Movements, Cough for 10 seconds counting out loud If the patient breathes, but you must leave put it in LATERAL POSITION OF SAFETY It ensures the airway in the patient that is: unconscious breathe has circulatory wrist must be abandoned for rescue other persons or to call for help If you are not sure of the presence of breathing activities, the rescuer should be have as if the victim is not breathing MAKE THE ALERT 118. IF WE ARE ALONE LEAVES THE PATIENT, GO TO CALL AID AND THEN BEGIN ARTIFICIAL CIRCULATION PUT A HAND ON STERNUM (center of the chest) STACK THE OTHER HAND AND BEGIN CARDIOPULMONARY RESUSCITATION (C.P.R.) Correct position of the external heart massage COMPRESSION TECHNOLOGY - COMPRESS STERNUM TO THE COLUMN OF 1/3 THICKNESS CHEST (4-5 cm. in adult persons) - FULLY RELEASE THE PRESSURE - COMPRESSION: RELAXATION = 1: 1 - KEEP THE POINT REPERE DURING RELAXATION - COMPRESSION RATE: 100 PER MINUTE ALTERNATE 30 CHEST COMPRESSIONS TO 2 VENTILATION (a growing cycle!) ARTIFICIAL VENTILATION MOUTH TO MOUTH MOUTH TO NOSE MOUTH IN MASK AMBU BALL SYSTEM MOUTH TO MOUTH VENTILATION 2 BREATHS THE DURATION OF 1.5 sec. EACH Each insufflation It must be interrupted by a break expiratory with nose release to facilitate expiration MOUTH TO MASK VENTILATION Pocket Masks are useful to avoid direct contact with the victim having a filter on the mouthpiece. The ventilation can be performed from the side as for the mouth to mouth BALL MASK VENTILATION It represents the standard for ventilation in the BLS when we used with O2 it is of a Reservoir for greater% O2 delivered. preferred to addition 3

4 VENTILATION 2 RESCUERS It may be useful in addition to the guedel oropharyngeal airway for difficult patients to be ventilated: obese, receding chin, bearded, toothless. OXYGEN PERCENTAGE DELIVERED 1. BALL POCKET MASK = 21% 2. BALL + O2 (10-12 liters per min.) = 40/50% 3. ball + O2 (10-12 liters per min.) + RESERVOIR = 80/90% Ventilation during the cycles of RCP Make 2 breaths of about half a liter (about half ball) Counting the number of cycles TO HIGH VOICE Duration insufflation: 1.5 sec. ALWAYS CHECK THAT THE PATIENT IS CHEST EXPAND Ventilation in case of patient in apnea Make 10 breaths that half a liter (about half ball per min.) Every minute recheck the circle signs Duration insufflation: 1.5 sec. ALWAYS CHECK THAT THE PATIENT IS CHEST EXPAND CHANGE BETWEEN TWO RESCUERS MCE it's very hard MCE run successfully replaces for 20% only the normal function of the heart BEFORE THAT WE ARE SPENT ASK AND GIVE REGULAR CHANGES (about every 2 min.) EVERY 5 CYCLES THE RESCUER RUNNING CHEST COMPRESSIONS MUST BE THE CHANGE Change at end of cycle oppure Change at 15th compression AIRWAYS OBSTRUCTION AIRWAYS OBSTRUCTION FOR FOREIGN BODY - Most frequent causes: PIECES OF FOOD - DENTURES - ECRUITMENT OF ALCOHOL - ALTERATIONS OF SWALLOWING PARTIAL OBSTRUCTION VALID BREATH (the patient is able to cough), NO MANEUVER UNBLOCKING Tries to reassure the patient If the partial obstruction persists activates the 118 Administering oxygen if available RESPIRATORY FLOW WEAK, INADEQUATE: (weak and ineffective cough, cyanosis initial) TO DEAL IT HOW IS COMPLETE OBSTRUCTION!! RESPIRATORY OBSTRUCTION COMPLETE, THE FLOW AWAY IS ABSENT - inability to speak, cough, breathing - universal choking signal (hands to the throat) - rapid cyanosis PATIENT CONSCIOUS interscapular shots and chest compressions (for women with advanced pregnant or obese patient) Conscious patient treatment with complete obstruction: INTERSCAPULAR SHOT AND HEIMLICH MANEUVER. REPEATED BELOW DIAPHRAMMATICS ABDOMINAL THRUST TILL UP TO EXPULSION FOREIGN BODY. Run 5 interscapular shots, alternate at 5 abdominal thrust (HEIMLICH) till resolution or loss the consciousness 4

5 PATIENT FROM COUNSCIOUSNESS TO UNCONSCIOUS Place the victim on hard floor, discover the chest and alerts 118 Repeat the A point of BLS Make G.A.S. maneuver keep hyperextension of the head and checks presence of the circle IF IT IS ABSENT TO PROCEED HOW FOR CPR AT THE END OF 30 COMPRESSIONS VERIFY THE INTERIOR OF MOUTH BEFORE VENTILATE AND CONTINUE UNTIL THE UNBLOCKING OR ALS ARRIVAL PATIENT FOUND UNCONSCIOUS RUN POINTS A-B-C OF BLS CALL 118 If after 30 chest compressions and 2 ventilations detect obstacles YOU START BACK WITH 30 COMPRESSIONS CHECKING IN MOUTH BEFORE VENTILATE RELOCATING THE MASK Continue until arriving expulsion or ALS PATIENT FOUND UNCONSCIOUS If ventilation is positive At the end of 2 ventilations repeat BC phase for 10 sec. If BC is Positive >>> Inspect the oral cavity and possibly performs ventilation10 breaths min If BC Negative >>>> Start BLS 30:2 until arrival ALS or DAE or physical exhaustion of the rescuers BLS: MEDICAL LEGAL ASPECTS WHEN NOT START CPR? WHEN ARE SHOWS SIGNS OF BIOLOGICAL DEATH HYPOSTATIC STAINS DECOMPOSITION RIGOR MORTIS (rigidity of the body and limbs) DECAPITATION START CPR REGARDLESS OF: APPARENT AGE CADAVERIC ASPECT BODY TEMPERATURE MYDRIASIS (dilated eye pupils) none of these is a sure sign HOW MANY TIME TO CONTINUE THE RCP? UNTIL THE ARRIVAL OF A DOCTOR UNTIL PHYSICAL EXHAUSTION OF THE RESCUERS NOTE: There is no scientifically predefined time beyond which it is permissible to interrupt CPR WOMAN IN STATE OF PREGNANCY BLS standard >>> only precaution put a wedge under the right side in order to raise her up 15 cm = 20 degrees approx The reason is that the uterus is pregnant, if the woman is in supine position, tends to compress the inferior venous cava blocking the venous return to the right heart, causing HYPOVOLEMIC SHOCK AORTO-CAVAL COMPRESSION FINE 5