BASIC LIFE SUPPORT healthcare providers

ILCOR GUIDELINE 2005

INTRODUCTION
CPR CARDIOPULMONARY RESUSITATION BASE ON THE CHAIN OF SURVIVOR - early Recognition and call for help (EMS) - early CPR - early defibrillation - early Advance Care and Post Resuscitation care

Objective
To refresh our knowlegde and skill regarding CPR To highlight the major change of the CPR based on ILCOR guideline 2005

Modules
1 man CPR 2 man CPR Adult upper airway obstruction (choking)

BASIC LIFE SUPPORT SYSTEM

1. Oxygen atmosphere 21%, exhaled air 16% 2. Lungs - where the Oxygen absorbed & CO2 excreted 3. Heart a pump, pump oxygenated blood to body 4. Brain major part. If brain cell deprived of O2 for 4-6 mins, will begin to die. After 10 mins brain death is certain.

8 causes of Sudden Death

Ventricular fibrillation Accidental electrical shock Drowning Drug overdose Suffocation/choking Severe allergy/insert sting Trauma Stroke

Emergency Action Principle

Emergency Action Principle

D Danger R Response A Airway B Breathing C Circulation D Defibrillation

Adult Basic Life Support

Major changes
CPR consists of 30 chest compressions with 2 breaths To complete 5 cycles within 2 min which end in 2 breaths before checking the pulse If advance airway inserted, no more synchronization between cardiac compression and ventilation. Chest compression 100/min, ventilation 8-10 breaths/ min (6-8sec/breath)

Adult Foreign-body Airway Obstruction

Adult choking (conscious)

Changes in choking management

No finger sweep unless foreign body visible In conscious pt, give 5 back slaps following with 5 abdomen thrust/chest thrust No abdominal thrust in unconscious pt but we intiate CPR instead.

Adult choking

Abdominal Thrust

Chest Thrust

Adult choking (unconscious)

Call for help

Check for foreign body & breathing

Attempt to ventilate

Check pulse

Chest compression

Ventilate

Check pulse after complete 5 cycles

Reassess the breathing

Recovery Position

Recovery position
Main purpose: To maintain the patency of the airway & prevent aspiration in a non-trauma patient while waiting for the ambulance after patient successfully resuscitated

Automated External Defibrillator (AED)

Automated External Defibrillator (AED)

Computerized devices Voice prompts to guide lay rescuers and healthcare professional Early defibrillation is a key of survivor Use as a first line treatment during ambulance call Use in conjunction during CPR for detection & defibrilate pulseless VT/VF

Paddle position

Withholding and Withdrawing CPR Criteria for Not Starting CPR

In light of this uncertainty, all patients in cardiac arrest should receive resuscitation unless:
1. The patient has a valid Do Not Attempt Resuscitation (DNAR) order 2. The patient has signs of irreversible death (eg, rigor mortis, decapitation, decomposition, or dependent lividity

3. No physiological benefit can be expected because vital functions have deteriorated despite maximal therapy (eg, progressive septic or cardiogenic shock)

Terminating a Resuscitation in a BLS out-of-Hospital System

Rescuers who start BLS should continue until one of the following occurs:
1. Restoration of effective, spontaneous circulation and ventilation. 2. Care is transferred to a more senior-level emergency medical professional who may determine that the patient is unresponsive to the resuscitation attempt.

3. Reliable criteria indicating irreversible death are present 4. The rescuer is unable to continue because of exhaustion or 5. the presence of dangerous environmental hazards or because continuation of resuscitative efforts places other lives in jeopardy. 6. A valid DNAR order is presented to rescuers.

Thank you