basic life support american heart association updates 2015

1. DR/ ABD ELAAL M
ELBAHNASY
EMERGENCY MEDICINE
SPECIALIST
MINISTRY OF HEALTH
&POPULATION
EGYPT
2016

2. 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

3. • 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

4. purpose
• Restore cardiopulmonary
functioning.
• Prevent irreversible brain damage
from anoxia

5. WHEN YOU HAVE TO START CPR
????.......
1-No response
2-If the victim is not
breathing normally such
as gasping for breath
or not breathing at all
3-No pulse

6. 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

9. STEPS OF CPR
1- Check the scene
safety
2- Check for consciousness
3- check breathing & pulse
4- call for help & get AED
6- start chest compression

10. 1- Check the scene safety
The scene
must be
safe and
no threat
on rescuer

11. Simply call the
patient by his
name or ask him
are you ok ?
2- Check for responsiveness

12. • 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

13. 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)

14. 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

18. Airway
• Must be patent &
clear
• 2 maneuvers:
• Head tilt chin lift
• Jaw thrust in trauma

19. Airway adjuncts
Oropharyngeal
airway
Nasopharyngeal
airway

20. Measurement of proper size

21. ventilation
• Mouse to
mouse
• Mouse to
mask
• Bag mask

22. Rescue breathing
• If the patient have
pulse and no
breathing:
• give rescue
breathing every 5-
6 seconds(10-12
breath per
minute)

24. Defibrillation sequence
Switch ON the device
Apply Paddles
attach cable Clear the
patient for analyzing the rhythm
Charging if shock needed
Clear patients before
applying the shock
Continue CPR

25. Paddle Position:
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

26. PROF: AHMED EMAD
MINSTER OF HEALTH
&POPULATION
EGYPT

27. Infant basic life support

28. Check the scene safety
The scene must be safe and
no threat on rescuer

29. CHECK RESPONSE
• Gentle taping the foot of
baby
• And call him baby baby……
No response

30. Activate emergency response
• If the infant not respond
&no breathing
Immediately call for help
and get automated
external defibrillator
(AED)

31. Check pulse &breathing
• Look for chest rise
• Hear agonal
breathing
• Check brachial
pulsation within 10
sec NO pulse
No breathing
Agonal
breathing

32. Start compression
One rescuer
By two fingers at
lower 1|2 of breast
bone (sternum)
30 compression
to 2 breaths
Depth about 4 cm

33. Two rescuer
Encircle the chest
by both hands
15 compression to
2 breaths
Switch every 2
minutes or 10 cycle

34. Hand placement
 Infant:
compress the sternum with 2 fingers placed just below
the inter-mammary line
 Child:
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

35. High quality C P R
Start chest compression within 10
second of recognition
Push hard about 4 cm push fast at
least 100-120 compression in minute
Avoid interruption
Give effective breath
Avoid excessive ventilation
Count out loud

37. DEFIBRRILATION

38. 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.

39. Paddle Size
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

40. Defibrillation sequence
Switch ON the device
Apply Paddles
attach cable Clear the
patient for analyzing the rhythm
Charging if shock needed
Clear patients before
applying the shock
Continue CPR

41. Manual Defibrillation Dosing
The recommended 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.

44. partners

46. CHOCKING

49. If I heard “I will forgot”
If I saw “I will remember”
If I did “I will become perfect”
SO you must practice
CPR

50. Take home message
BLS IS LIFE SAVING
YOU MUST PRACTICE BLS ACCORDING TO
NEW GUIDELINES
C A B NOT A B C
PUSH HARD AND FAST FROM 100-120
COMPRESSIONS WITH DEPTH 6 CM IN
ADULT
INFANT NOT SMALL ADULT
TEACH CPR SKILLS TO ALL YOU KNOW
FROM NOW

51. THANK
YOU