dr Bhoomi shah

1. CARDIO PULMONARY RESUSCITATION
BASIC LIFE SUPPORT
BY :DR BHOOMI P SHAH (MPT CARDIO )
AASISTANT PROFESSOR
VINAYAKA INSTITUTE OF PHYSIOTHERAPY
ANAND

2. Objective
• Introduction about cardiac arrest
• Basic life support :
assessment part (adult )
Compression
Airway
Beathing
AED (automated external defibrillator )
Infants and child

3. Cardiac arrest
• Cardiac arrest, also known as cardiopulmonary arrest or circulatory arrest,
is a sudden stop in effective blood circulation due to the failure of the heart
.
• Arrested blood circulation prevents delivery of oxygen and glucose to the
body.
• Lack of oxygen and glucose to the brain causes loss of consciousness, which
then results in abnormal or absent breathing.
• Brain injury is likely to happen if cardiac arrest goes untreated for more
than five minutes.
• For the best chance of survival and neurological recovery immediate
treatment is important

4. • Cardiac arrest is sometimes preceded by certain symptoms such as
fainting, fatigue, blackouts, dizziness, chest pain, shortness of breath,
weakness, and vomiting.
• The arrest may also occur with no warning.
• When the arrest occurs, the most obvious sign of its occurrence will
be the lack of a palpable pulse in the person experiencing it (since the
heart has ceased to contract, the usual indications of its contraction
such as a pulse will no longer be detectable).

5. • Certain types of prompt intervention can often reverse a cardiac
arrest, but without such intervention the event will almost always
lead to death.
• it is an expected outcome of a serious illness where death is
expected.
• Also, as a result of inadequate cerebral perfusion, the patient will
quickly become unconscious and will have stopped breathing.

6. CPR
Advanced Life
support
Basic Life
Support
MEANING
MEANING

7. Basic life support
• Basic Life Support (BLS) refers to the care healthcare providers and
public safety professionals provide to patients who are experiencing
respiratory arrest, cardiac arrest or airway obstruction.
• BLS includes psychomotor skills for performing high-quality
cardiopulmonary resuscitation (CPR),
• using an automated external defibrillator (AED) and relieving an
obstructed airway for patients of all ages Primary Assessment of the
Unresponsive Adult Patient After completing the scene size-up and
determining that it is safe to approach the patient, you need to
conduct a primary assessment.

8. • This assessment involves three major areas:
• assessing the level of consciousness,
• breathing and
• circulation.
•

9. Level of Consciousness (LOC)
• check to see if the patient is responsive.
• This may be obvious from your scene size-up and initial impression—
• for example, the patient may be able to speak to you, or he or she
may be moaning, crying, making some other noise or moving around.
• If the To check for responsiveness, tap the patient on the shoulder
and shout, “Are you okay?” Use the person’s name if you know it.
Speak loudly

10. In addition, use the pneumonic AVPU to help you determine the
patient’s level of consciousness.
See AVPU:
A –Alert : fully awake ,but may still bet confused
V- Verbal : responds to verbal stimulation
P-Painful : responds to painful stimuli
U – Unresponsive : does not respond

11. • information. Remember that a response to verbal or painful stimuli
may be subtle, such as
• some slight patient movement or momentary eye opening that occurs
as you speak to patient or apply a painful stimulus such as a tap to
the shoulder.

12. Airway
• Once assessed the patient’s level of consciousness, evaluate the patient’s
airway.
• Remember, if the patient is alert and talking, the airway is open.
• For a patient who is unresponsive, make sure that he or she is in a supine
(face-up) position to effectively evaluate the airway.
• If the patient is face-down, you must roll the patient onto his or her back,
taking care not to create or worsen an injury.
• If the patient is unresponsive and his or her airway is not open, need to
open the airway.

13. • Two method :
• Head tilt/chin lift
• Modified jaw thrust

14. Simultaneous breathing and pulse rate
• Once the airway is open, simultaneously check for breathing and a
carotid pulse, for at least 5 but no more than 10 seconds.
• When checking for breathing, look to see if the patient’s chest rises
and falls, listen for escaping air and feel for it against the side of
cheek.
• Normal breathing is quiet, regular and effortless. Isolated or
infrequent gasping in the absence of other breathing in a patient

16. Adult Chain of Survival

17. Compressions: Restore blood circulation
• Put the person on his or her
back on a firm surface.
• Kneel next to the person's neck
and shoulders.
• Keep your elbows straight and
position your shoulders directly
above your hands.

18. • Place the heel of one hand over
the center of the person's chest,
between the nipples.
• Place your other hand on top of
the first hand

19. • Use your upper body weight (not just your arms) as you push straight
down on (compress) the chest at least 2 inches (approximately 5
centimeters).
• Push hard at a rate of about 100 compressions a minute.

20. Airway: Clear the airway
• If trained in CPR and performed 30 chest compressions, open the
person's airway using the head-tilt, chin-lift maneuver.
Put your palm on the person's forehead and gently tilt the head back.
Then with the other hand, gently lift the chin forward to open the
airway.
• Check for normal breathing, taking no more than five or 10 seconds.
Look for chest motion, listen for normal breath sounds, and feel for
the person's breath on your cheek and ear.

21. • Gasping is not considered to be normal breathing.
• if the person isn't breathing normally and you are trained in CPR,
begin mouth-to-mouth breathing.
• believe the person is unconscious from a heart attack and you
haven't been trained in emergency procedures, skip mouth-to-mouth
breathing and continue chest compressions.

22. Breathing: Breathe for the person
• Rescue breathing can be mouth-
to-mouth breathing or mouth-
to-nose breathing if the mouth is
seriously injured or can't be
opened.
• With the airway open (using the
head-tilt, chin-lift maneuver),
• pinch the nostrils shut for
mouth-to-mouth breathing and
cover the person's mouth with
yours, making a seal.

23. • Prepare to give two rescue breaths.
• Give the first rescue breath — lasting one second — and watch to see
the chest rises.
• If it does rise, give the second breath.
• If the chest doesn't rise, repeat the head-tilt, chin-lift maneuver and
then give the second breath.
• Thirty chest compressions followed by two rescue breaths is
considered one cycle.

24. • Resume chest compressions to restore circulation.
• If the person has not begun moving after five cycles (about two minutes)
and an automated external defibrillator (AED) is available, apply it and
follow the prompts.
• Administer one shock, then resume CPR — starting with chest
compressions — for two more minutes before administering a second
shock.
• If you're not trained to use an AED, a 911 or other emergency medical
operator may be able to guide you in its use.
• If an AED isn't available, Continue CPR until there are signs of movement or
emergency medical personnel take over.

25. AUTOMATED EXTERNAL DEFIBRILLATOR/AED

26. AED OPERATION :
• Use AED only when patients have the following 3 clinical findings :
No response
Absent or abnormal breathing
No pulse

27. Principle of Early Defibrillation :
• A common initial rhythm in out of
hospital witnessed sudden cardiac
arrest is VF.
• When VF is present, the heart
quivers & does not pump blood.
• Electrical defibrillation is the most
effective way to treat VF.
• The probability of successful
defibrillation decreases quickly
over time.
• VF deteriorates to asystole if not
treated

28. Common Steps to operate all AEDs
• Step 1
• Power on the AED ( this activates voice prompts for guidance in all
subsequent steps )
 Open the carrying case or the top of the
AED.
 Turn the power on ( some devices will “power
on” automatically when you open the lid or
case)

29. • Step 2
• Attach electrode pads to the patient’s bare chest.
• Choose the correct size pads ( adult versus pediatrics ) for the patient
‘s size/age. Peel the backing away from the electrode pads.
• Quickly wipe the patient’s chest if it is covered with water or sweat (
but do not delay attaching the pads or shock delivery).
• Attach the adhesive electrode pads to the patient’s bare chest.

30. • Place the other pad to the left of the nipple, with the top margin of
the pad a few centimeters below the left armpit.
• Place one electrode pad on the upper right side of the bare chest to
the right of the sternum directly below the clavicle.
• Attach the AED connecting cables to the AED box .

32. • Step 3
• Analyze rhythm.
• Always clear the patient during analysis. Be sure no one is touching
the patient, not even the person in charge of giving breaths.
• Some AEDs will instruct you to push a button to allow the AED to
begin analyzing the heart rhythm; others will do that automatically.
The AED rhythm may take about 5 to 15 seconds.
• The AED rhythm analysis will determine if the patient needs a shock.

33. Step 4
• If the AED advises a shock, it will tell you to BE SURE TO CLEAR THE PATIENT (i.e.
do not touch the patient):
• Clear the patient before delivering the shock; be sure no one is touching the
patient.
• Loudly and quickly state a “clear the patient” message, such as “Clear ,I am going
to shock on
• three,” “One, two, three, shocking,” or simply “Clear”.
• Perform a visual check to ensure that no one is in contact with the patient.

34. • Press the SHOCK button.
• The shock will produce a sudden contraction of the patient’s muscles.
• As soon as shock delivered, resume CPR, starting with chest compressions, and
give cycles of 30 compressions and 2 breaths.
• Do not perform a pulse or rhythm check.
• After 2 minutes of CPR the AED will prompt you to repeat steps 3 and 4.

37. Press the SHOCK button.The shock will produce a sudden
contraction of the patient’s muscles.
Press the SHOCK button.The shock will produce a sudden
contraction of the patient’s muscles.
Press the SHOCK button.The shock will produce a sudden
contraction of the patient’s muscles.

41. Reference
• 2017 American heart association guideline ;basic life support
• Basic life support 2017 adult ,Red cross guideline
• American red cross ,basic life support for health care provided hand
book 2017

42. Thank you