Basic life supportfrom Egypt to Ghana

DR/ ABD ELAAL M ELBAHNASY

EMERGENCY MEDICINE SPECIALISTMINISTRY OF HEALTH &POPULATION

EGYPT2016

DEFINITION• Cardio pulmonary resuscitation (CPR) is a technique of basic life support for the purpose of

• oxygenation to the heart, lungs and brain until and unless the appropriate medical treatment can come and restore the normal cardiopulmonary function

• cardio (heart) pulmonary(lung) resuscitation (revive, revitalize) serves as an artificial heartbeat and an artificial respirator.

• CPR may not save the victim even when performed properly, but if started within 4 minute of cardiac arrest and defibrillation is provided within 10 minutes, a person has a 40% chance of survival

purpose

• Restore cardiopulmonary functioning.

• Prevent irreversible brain damage from anoxia

WHEN YOU HAVE TO START CPR.......????

1-No response2-If the victim is not breathing normally  such as gasping for

breath or  not breathing at all

3-No pulse

Chain of Survival

The 5 links in adult chain of survival are:- Early access- Early CPR- Rapid defibrillation- Effective advance life support- Integrated post-cardiac arrest care

C-A-B NOT A-B-C

STEPS OF CPR

1- Check the scene safety2- Check for consciousness

3- check breathing & pulse

4- call for help & get AED

6- start chest compression

1- Check the scene safety

The scene

must be safe and no threat

on rescuer

Simply call the patient by his

name or ask him are you ok ?

2- Check for responsiveness

• Call for help and get AED

• You can use mobile and make the speaker on if you outside hospital

(2015 guidelines)

3- call for help

4- check breathing & pulse

Check the pulse at carotid artery and look for breathing and chest rise at the same moment within 10 seconds(2015 guidelines)

Put your hand on:• lower have of sternum

below intermammary line• perpendicular on chest • with locked elbow joint• Movement from waist• Rate 30 :2 ventilation• Rate from 100-120

compression per minute• At depth not more than 6 cm

5- start chest compression

Airway• Must be patent & clear

• 2 maneuvers:• Head tilt chin lift

• Jaw thrust in trauma

Airway adjuncts

Oropharyngeal airway

Nasopharyngeal airway

Measurement of proper size

ventilation• Mouse to mouse

• Mouse to mask

• Bag mask ventilation

Rescue breathing• If the patient have pulse and no breathing:

• give rescue breathing every 5-6 seconds(10-12 breath per minute)

Defibrillation sequence

Switch ON the deviceApply Paddlesattach cable Clear the patient for analyzing the rhythmCharging if shock neededClear patients before applying the shockContinue CPR

Place over the right side of the upper chest and the apex of the heart (to the left of the nipple over the left lower ribs) so the heart is between the two paddles.

Apply firm pressure

PROF: AHMED EMADMINSTER OF HEALTH

&POPULATION EGYPT

Infant basic life support

Check the scene safety

The scene must be safe and no threat on rescuer

CHECK RESPONSE

• Gentle taping the foot of baby

• And call him baby baby……

No response

Activate emergency response

• If the infant not respond &no breathing

Immediately call for help and get automated external defibrillator (AED)

Check pulse &breathing

• Look for chest rise

• Hear agonal breathing

• Check brachial pulsation within 10 sec

NO pulseNo breathing

Agonal breathing

Start compression

One rescuer By two fingers at lower 1|2 of breast bone (sternum)

30 compression to 2 breaths

Depth about 4 cm

Two rescuer Encircle the chest by both hands

15 compression to 2 breaths

Switch every 2 minutes or 10 cycle

Infant: compress the sternum with 2 fingers placed just below the inter-mammary lineChild: compress the lower half of the sternum at least one third of the AP diameter of the chest (2 inches) with one or two hands

Note: do not compress over the xiphoid or ribs

High quality C P RStart chest compression

within 10 second of recognition

Push hard about 4 cm push fast at least 100-

120 compression in

minuteAvoid

interruptionGive effective breathAvoid

excessive ventilationCount out

loud

DEFIBRRILATION

Defibrillator• Defibrillators are either

manual or automated (AED).• AED can be used for infants

and children up to approximately 25 kg (8 years of age).

• In infants 1 year of age a manual defibrillator is preferred.

Two sizes of hand-held paddle

“Adult” size : 8 to 10 cm for children > 10 kg

( approximately 1 year)

“Infant” size :4-5 cm for infants < 10 kg

Defibrillation sequence

Switch ON the deviceApply Paddlesattach cable Clear the patient for analyzing the rhythmCharging if shock neededClear patients before applying the shockContinue CPR

The recommend

ed first energy dose

for defibrillation is 2 J/kg.

If second dose is

required, it should be doubled to

4 J/kg.

AED with pediatric

attenuator is preferred for children < 8

years of age.

partners

CHOCKING

If I heard “I will forgot”If I saw “I will remember”

If I did “I will become perfect”

SO you must practice

CPR

Take home message

BLS IS LIFE SAVINGYOU MUST PRACTICE BLS ACCORDING TO NEW GUIDELINESC A B NOT A B CPUSH HARD AND FAST FROM 100-120 COMPRESSIONS WITH DEPTH 6 CM IN ADULTINFANT NOT SMALL ADULT TEACH CPR SKILLS TO ALL YOU KNOW FROM NOW

THANK YOU