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12/02/2015 East of England Ambulance Service NHS Trust Basic Life Support and Automated External Defibrillation.

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Presentation on theme: "12/02/2015 East of England Ambulance Service NHS Trust Basic Life Support and Automated External Defibrillation."— Presentation transcript:

1 12/02/2015 East of England Ambulance Service NHS Trust Basic Life Support and Automated External Defibrillation

2 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Objectives At the end of this course participants should be able to demonstrate: – How to assess the collapsed casualty. – How to perform Basic Life Support (BLS). – How to place an unconscious breathing victim in the recovery position. – Introduction to operating an automated external defibrillator (AED) safely.

3 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Background In the UK approximately 30,000 people sustain cardiac arrest outside hospital and are treated by emergency services each year. Bystander CPR and early Defibrillation are vital interventions before the arrival of emergency services. If defibrillation is delivered promptly, survival rates as high as 75% have been reported. The chances of successful defibrillation decline at a rate of about 10% with each minute of delay.

4 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Anyone can do it?

5 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ %4%30%

6 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ CARDIAC CONDITIONS Angina Suspected Heart Attack

7 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Cardiac Conditions Coronary heart disease is the UK's biggest killer, with 1 in every 4 men and 1 in every 6 women dying from the disease. In the UK, approximately 300,000 people have a heart attack each year. Angina affects about 1 in 50 people, and in the UK there are an estimated 1.2 million people with the condition. It affects men more than women, and your chances of being affected increase with age.

8 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Oxygenated blood to upper body Blood to lungs Oxygenated blood from lungs Oxygenated blood to lower body Blood returning from lower body Blood to lungs Blood returning from upper body Oxygenated blood from lungs

9 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ How many times does the human Heart beat in a day ? 100,800 beats per day (70 beats x 60 minutes x 24 hours = 100,800 beats)

10 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Suspected Heart Attack

11 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Heart Attack

12 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Suspected Heart Attack -Pale, cold & clammy skin -Rapid weak pulse -Rapid shallow breathing -Nausea -Vomiting -Pain in chest possibly radiating into arm, back and/or jaw -Sweating -Impending sense of doom Some or all of these symptoms may be present, no two Heart attacks are the same......

13 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Cardiac Conditions Angina is a pain or discomfort felt in the chest caused by coronary heart disease. Typically presents as heaviness or tightness in the chest Often brought on by physical activity. Symptoms usually subside after a few mins. Angina Suffers usually carry GTN medication in the form of a spray or tablet

14 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Suspected Heart attack Dial 999 or 112 for Ambulance -Rest in a comfortable position -Reassure -Help casualty to take their own GTN -Be prepared to resuscitate -Have AED available If in any Doubt dial 999 or 112

15 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ BASIC LIFE SUPPORT Primary Survey Performing CPR Recovery Position

16 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Primary Survey Initial assessment using the primary survey - D anger (Global overview) - R esponse - S hout for help - A irway - B reathing - C all 999/112 - commence CPR

17 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Airway Management An unconscious casualty has no control over their muscles, including the muscles that control the tongue. Airway Open Airway Closed Airway Obstructed

18 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Approach safely Check response Shout for help Open airway Check breathing Recovery Position? Dial 999/112 Monitor Patient

19 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ APPROACH SAFELY! Rescuer Scene Victim Bystanders Approach safely Recovery Position Dial 999/112 Monitor Check response Shout for help Open airway Check breathing

20 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ CHECK RESPONSE Approach safely Recovery Position? Check response Shout for help Open airway Check breathing Dial 999/1123 Monitor

21 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Shake shoulders gently “Hello can you hear me?” If he responds Leave as you find him. Find out what is wrong. Reassess regularly. If no response..... CHECK RESPONSE

22 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ SHOUT FOR HELP Approach safely Check response Shout for help Open airway Check breathing Recovery Position? Dial 999/112 Monitor

23 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ OPEN AIRWAY Approach safely Check response Shout for help Open airway Check breathing Recovery Position Dial 999/112 Monitor

24 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ CHECK BREATHING Look, listen and feel for NORMAL breathing for 10 sec Do not confuse Agonal breathing with NORMAL breathing If you have any doubts act as if breathing is not normal

25 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Not Breathing normally ? No sign of Chest Movement No sounds of Breathing No feeling of breath against your ear Agonal Breathing Occurs shortly after the heart stops in up to 40% of cardiac arrests Described as barely, heavy, noisy or gasping breathing Recognised as a sign of cardiac arrest

26 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Agonal Breathing

27 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ If no help arrives and you are alone dial 999/112 After putting into recovery position. Approach safely Check response Shout for help Open airway Check breathing Recovery Position Dial 999/112 Monitor

28 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Recovery position 1 Kneel next to the person. Place the arm closest to you straight out from the body. Position the far arm with the back of the hand against the near cheek.

29 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Recovery position 2 Grab and bend the person's far knee

30 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Recovery position 3 Protecting the head with one hand, gently roll the person toward you by pulling the far knee over and to the ground

31 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ CHEST COMPRESSIONS Approach safely Check response Shout for help Open airway Check breathing Dial 999/ chest compressions 2 rescue breaths

32 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Recovery position 4 Tilt the head up slightly so that the airway remains open. Make sure that the hand is under the cheek, checking the airway and also for eventual wakening. Place a blanket or coat over the person (unless he or she has a heat illness or fever) and stay close until help arrives

33 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ If Not Breathing

34 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Place the heel of one hand in the centre of the chest Place other hand on top Interlock fingers Compress the chest –Rate 100 to 120 –Depth 5-6 cm –Equal compression : relaxation When possible change CPR operator every 2 min CHEST COMPRESSIONS

35 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ RESCUE BREATHS Approach safely Check response Shout for help Open airway Check breathing Dial 999/ chest compressions 2 rescue breaths

36 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ RESCUE BREATHS Pinch the nose Take a normal breath Place lips over mouth Blow until the chest rises Deliver rescue breath for 1 second Allow chest to fall Repeat This should not take longer than 5sec, then return to chest compressions without delay

37 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Combine Compressions and Rescue breaths at a ratio of 30:

38 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ ANY QUESTIONS ? Time to practice.....

39 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Child CPR Many children do not receive resuscitation because potential rescuers fear causing harm. This fear is unfounded; it is far better to use the adult BLS sequence for resuscitation of a child than to do nothing. Bystander resuscitation significantly improves outcome in children. Outcomes could be further improved if bystanders who would otherwise do nothing, were encouraged to begin resuscitation.

40 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Children and babies

41 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ If a rescuer is unable or unwilling to perform rescue breaths it is expectable to perform compressions only CPR However, chest compression combined with rescue breaths is the method of choice for CPR by trained lay rescuers and professionals. COMPRESSION only CPR

42 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ When to stop CPR Once CPR is started the rescuer should only stop CPR when the casualty shows signs of regaining conscious by : Coughing Opening eyes Speaking or moving purposefully Starts to Breath NORMALLY again Or Qualified help arrives and takes over You become exhausted It is unsafe to continue

43 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Pocket Mask The pocket mask is an effective barrier device. It has a one-way valve which prevents the casualty's exhaled air being inhaled by the Rescuer.

44 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ ANY QUESTIONS ? Time to practice.....

45 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ DEFIBRILLATION Understanding Defibrillation Safe use of an AED

46 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Automated External Defibrillators An AED is an “electric shock box” used to stop the electrical activity of the heart when it is in a life threatening rhythm, this allows the Heart to re-establish an effective rhythm. The AED will; – analyse the presenting rhythm – only advise a shock for a shockable rhythm – advise the operator step-by-step what to do

47 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Automated External Defibrillators An AED can be used safely and effectively without previous training. Therefore, the use of an AED should not be restricted to trained rescuers. However, training should be encouraged to help improve the time to shock delivery and correct pad placement.

48 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ There are 2 types of AED: Automatic- will deliver shock automatically Semi Automatic – rescuer intervention required to deliver shock. Once you have completed this training you will be able to use any make or model AED’s can be found in many public buildings e.g. Sports centres, Railway stations, Shopping centres and Schools

49 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ %4% 30%

50 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Understanding Defibrillation The heart’s pumping action controlled by electrical system Electrical rhythm normally very organized Normal heart’s rhythm is called “Sinus Rhythm” Normal heart rate of beats per minute

51 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Understanding Defibrillation: Ventricular Fibrillation (VF) VF is the most common rhythm in Sudden Cardiac Arrest (90%) Electrical Problem in Nature Chaotic rhythm results in “quivering of heart” and results in loss of pulse VF will result in brain damage within 5 minutes and death in minutes

52 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Understanding Defibrillation Defibrillation may correct VF Uses DC current delivered across the heart A successful defibrillation “depolarizes” the heart’s cells Depolarization allows the cells to “reorganize” Defibrillation is the ONLY effective cure for VF!

53 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Dial 999/112 – get AED Approach safely Check response Shout for help Open airway Check breathing Attach AED before CPR Follow voice prompts Single Rescuer

54 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ st Rescuer commence CPR Approach safely Check response Shout for help Open airway Check breathing Follow voice prompts 2 nd Rescuer Call 999 /112 gets AED and attaches to Patient 2 or more Rescuers

55 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Minimise interruptions in CPR If alone, attach AED before commencing CPR If 2 rescuers, provide good quality CPR while the AED is brought to the scene, is turned on, and pads attached Interrupt CPR only when it is necessary to analyse the rhythm and deliver a shock

56 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ DEFIBRILLATION SAFETY !  THE PATIENT.  5 point check  Pacemaker  Jewellery  Hair on chest  Damp/Wet skin  Patches (GTN)  THE AED.  In good working order  Do Not use in Heavy rain  Do Not use if they lay in a pool of water  Do Not use in an explosive environment !

57 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ ATTACH PADS TO CASUALTY’S BARE CHEST

58 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ ANALYSING RHYTHM DO NOT TOUCH PATIENT

59 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ SHOCK ADVISED “Stand clear Everyone” ! TOP MIDDLE BOTTOM MYSELF BEHIND YOU DELIVER SHOCK

60 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ DEFIBRILLATION SAFETY ! REMEMBER. Always check that NO PERSON or ANIMALS are touching the patient prior to shocking. That you are not touching the patient in any way.

61 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ DEFIBRILLATION

62 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ SHOCK DELIVERED FOLLOW AED INSTRUCTIONS

63 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ COMMENCE CPR (2 Mins) 30 2

64 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ NO SHOCK ADVISED FOLLOW AED INSTRUCTIONS

65 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ COMMENCE CPR (2 Mins) 30 2

66 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ ANY QUESTIONS ? Time to practice.....

67 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Children and AED’s Standard AEDs are suitable for use on children of 8 years and above. In children between 1 and 7 years paediatric pads or a paediatric mode should be used. Do not use an AED on an Infant less than 1 year.

68 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/

69 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/

70 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Follow up – what to do after? If you have used an Automated External Defibrillator, even by just attaching it to a patient, you must: Dispose of the pads used as clinical waste Replace the pads on the machine Inform named person that the Defibrillator has been used so that any data can be captured from the device Complete a “Defibrillator Event Report Form” If you require any equipment to be replaced, i.e. pads, pocket masks, razors etc. Please contact your named person as soon as possible.

71 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ WHEN NOT TO RESUSCITATE Once CPR is started the rescuer should only stop CPR when the casualty shows signs or regaining conscious by Coughing Opening eyes Speaking or moving purposefully Starts to Breath NORMALLY again Or Qualified help arrives and takes over You become exhausted It is unsafe to continue

72 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ OR IF YOU SEE THIS HAS OCCURRED !

73 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Oop’s ??

74 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ ANY QUESTIONS ?

75 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Bleeding

76 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Bleeding Raise Limb Cover with clean dressing or cloth 999 or 112 Reassure Lay down Raise legs Monitor

77 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Shock

78 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Shock

79 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Choking

80 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Choking

81 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ Choking

82 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/ ANY QUESTIONS ? Time to practice.....

83 Date East of England Ambulance Service NHS Trust BLS & AED 12/02/


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