B


B


Basic life support for health care providers


Description


The steps of basic life support (BLS) consist of a series of actions and skills performed by the rescuer or rescuers based on assessment findings.



CPR


The current approach for CPR is the chest compressions-airway-breathing (CAB) sequence. Survival from cardiac arrest is the highest when immediate CPR is provided and defibrillation occurs within 3 to 5 minutes.



■ The first step in CPR is to perform a pulse check by palpating the carotid pulse for at least 5 but no more than 10 seconds. While maintaining a head-tilt position with one hand on the forehead, locate the victim’s trachea using two or three fingers of the other hand. If a pulse is felt, give one rescue breath every 5 to 6 seconds (10 to 12 breaths per minute) and recheck the pulse every 2 minutes. If no pulse is felt, initiate CAB.


■ Chest compression technique consists of fast and deep applications of pressure on the sternum. The victim must be in the supine position when the compressions are performed. Chest compressions are combined with rescue breathing for an effective resuscitation effort of the victim of cardiac arrest. The compression-ventilation ratio for one- or two-rescuer CPR is 30 compressions to 2 breaths (Table 89). To maintain the quality and rate of compressions, rescuers should change roles every 2 minutes.


■ When the AED or advanced cardiovascular life support (ACLS) team arrives, assess the victim’s rhythm. If the victim has a shockable rhythm (e.g., ventricular tachycardia, ventricular fibrillation), deliver one shock followed by five cycles of CPR before checking the rhythm. If the rhythm is not a shockable rhythm, resume CPR and recheck the rhythm every five cycles.


■ If a victim has a pulse but is gasping (e.g., agonal breathing) or not breathing, establish an open airway and begin rescue breathing. Open an adult’s airway by hyperextending the head. Use the head tilt–chin lift maneuver. This involves tilting the head back with one hand and lifting the chin forward with the fingers of the other hand. Use the jaw-thrust maneuver if you suspect a cervical spine injury. Attempt to ventilate the victim using a mouth-to-barrier (recommended) device (e.g., face mask or bag-valve-mask) or mouth-to-mouth resuscitation. Give ventilations with the victim’s nostrils pinched. Take a regular (not deep) breath and tightly seal your lips around the victim’s mouth. Give one breath and watch for a rise in the victim’s chest. Continue rescue breaths at a rate of 10 to 12 per minute.


■ If the victim cannot be ventilated, proceed with CPR. When providing the next rescue breaths, look for any objects in the victim’s mouth and remove them if visible (Table 90 and Figure 19).



Table 89


Adult One- and Two-Rescuer Basic Life Support with Automatic External Defibrillator (AED)
































Assess

Activate Emergency Response System (ERS)

Check for Pulse

Begin High-Quality CPR

Deliver Effective Breaths

Integrate Prompt Use of the AED

Continue CPR

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Oct 26, 2016 | Posted by in NURSING | Comments Off on B

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