adult basic life support and advanced cardiac life

7/31/2019 Adult Basic Life Support and Advanced Cardiac Life

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ADULT BASIC LIFE SUPPORT AND ADVANCEDCARDIAC LIFE SUPPORT

By: Chandra Kusuma


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ADULT BASIC LIFE SUPPORT

2010 American Heart Association Guidelines

for Cardiopulmonary Resuscitation and

Emergency Cardiovascular Care


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CHAIN OF SURVIVAL

Immediate recognition of cardiac arrest and activation of the emergency

response system Early CPR with an emphasis on chest compressions

Rapid defibrillation

Effective advanced life support

Integrated post cardiac arrest care

Emergency systems that can effectively implement these links can achieve

witnessed VF cardiac arrest survival of almost 50%.


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CPR SEQUENCE

A

BC

C

AB

2005 2010


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Recognition and Activation of

Emergency Response

A cardiac arrest victim is not responsive.

Breathing is absent or is not normal (agonal gasps) Pulse detection alone is often unreliable

Consequently, rescuers should start CPR immediately if the adult victim is

unresponsive and not breathing or not breathing normally (ie, only

gasping). The directive to look, listen, and feel for breathing to aid recognition is no

longer recommended.


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Recognition and Activation of

Emergency Response


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Chest Compressions

Providing chest compressions of adequate rate (at least 100/minute)

Providing chest compressions of adequate depth adults: a compression depth of at least 5 cm

infants and children: a depth of least 1/3 AP diameter of the chest or

about 4 cm in infants and about 5 cm in children

Allowing complete chest recoil

Minimizing interruptions in compressions

When possible change CPR operator every 2 min


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Chest Compressions


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Airway

Opening the airway with a head tilt chin lift or jaw thrust


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HEAD TILT, CHIN LIFT


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JAW THRUST


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Rescue Breathing

Deliver each rescue breath over 1 second

Give a sufficient tidal volume to produce visible chest rise (500 600 ml) Use a compression to ventilation ratio of 30 chest compressions to 2

ventilations.

When an advanced airway (ETT or laryngeal mask airway [LMA]) is in

place during 2-person CPR, give 1 breath every 6 to 8 seconds (8 to 10breaths/minute).

There should be no pause in chest compressions for delivery of

ventilations


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Rescue Breathing

Pinch the nose

Take a normal breath

Place lips over mouth Blow until the chest rises

Take about 1 second

Allow chest to fall

Repeat


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DEFIBRILLATION


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DEFIBRILLATION

BIPHASIC 120 200J

MONOPHASIC 360J


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1. Verify patient is in cardiac arrest, with no pulse orrespiration. Have someoneprovide CPR, if possible, while the defibrillator is obtained and placed next to the

patient.2. Turn on defibrillator; verify all cables are connected.

3. Turn lead select to paddles or defibrillator.

4. Select initial energy level for an adult to 200 J.

5. Paddles: Use conducting gel and place on apex (lower left chest, midaxillary)

and sternum (right of sternum, midclavicular).Pads: Place in same locations as you would put paddles.

6. Verify rhythm as VF or pulseless VT.

7. Say, Charging defibrillator, stand clear!

8. Charge defibrillator.

9. Say, Im going to shock on three. One, Im clear; two,youre clear; three,everybodys clear. Perform visual sweep to assure all rescue personnel are clearof patient, bed, and equipment.

10. Discharge defibrillator, reassess rhythm, and refer to appropriate treatmentalgorithm for resulting rhythm.

MANUAL DEFIBRILLATION


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MANUAL DEFIBRILLATION


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RECOVERY POSITION


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RECOVERY POSITION


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ADVANCED CARDIAC LIFE SUPPORT

2010 American Heart Association Guidelines

for Cardiopulmonary Resuscitation and

Emergency Cardiovascular Care


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adult basic life support and advanced cardiac life

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