Agenda Nurses Educational Opportunities provides BLS classes Monday through Saturday each week. An appointment is required and can be obtained by calling the office in San Diego or Orange County. At the designated appointment time you will be asked to watch a video, take the written test, and demonstrate skills. This First Responder prestudy guide in conjunction with the American Heart Association (AHA) Basic Life Support Text will nicely prepare you for your upcoming class. You must have the new 2010 AHA BLS textbook at the time of the class. This text book is available for an additional charge in both offices. The text book can be shipped to you. An American Heart Association provider card will be presented to you at the completion of the class. Recertification courses require presentation of your recent BLS provider card. A copy of that will also be accepted if you do not have the original. Lay rescuers may provide Hands-Only CPR™ (chest compressions only) once the recognition of unresponsiveness is acknowledged and after 911 is notified. Lay rescuers are not required to check the victims pulse, open the airway or give rescue breaths. (2010 Update)
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NEO Orange County 3303 Harbor Blvd., Suite G3 Costa Mesa, CA 92626 (714) 979-4022
NEO San Diego 10379 Azuaga St, Suite 143 San Diego, CA 92129 (858) 780-2829
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Healthcare Professionals should be trained BLS with the 2010 AHA updates which are described in NEO’s First Responder study guide. Recognition of signs and symptoms for the following life threatening situations is imperative to know: Acute Coronary Syndrome (Heart attack) Acute Cerebral Vascular Accident (Stroke) Foreign Body Airway Obstruction Cardiac Arrest 2
Check the carotid pulse When you check for pulse, you must take less than 10 seconds to assess. Anything greater than 10 seconds takes to long and prolongs initiation of chest compressions. (2010 Update) The key is to keep the blood circulating and minimize interruptions (2010 Update) Do not spend more than 10 sec. checking for a pulse If you find a pulse, support the victim with rescue breathing If you can’t get a pulse within 10 seconds, initiate CPR starting with 30 chest compressions followed by 2 breaths (2010 Update) Immediately!!! Place your hands in the lower half of the breast bone of the chest and begin chest compressions (2010 Update) ♥ ♥
Push hard – at least 2 inches in depth for the adult.
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Push fast – at a rate of at least 100 X minute. When reading the questions on the test, be careful. careful. Look for the word “rate”. That must alert you to the answer of 100X min.
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Allow the chest to fully recoil
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Minimize interruptions
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One-man and two-man adult CPR compression to ventilation ratio should be 30:2
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Provide ventilations Open the airway – head head tilt, chin lift lift or jaw thrust Seal your mouth over the victims mouth and give two rescue breaths – just enough to make the chest rise and fall The healthcare provider should use the barrier device for one-man CPR Two healthcare provider should ventilate using the bag/mask
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With advanced airway in place, compression rate remains at 100 X min with one breath every 6-8 sec. When the AED or Crash Cart arrives, connect the device to the victim as soon as possible. The probability of successful defibrillation diminishes rapidly over time. After the AED delivers a shock, immediately restart CPR beginning with chest compressions.
When the AED or Crash Cart arrives ♥ ♥
Place the AED at the head of the victim
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Power on the AED – That means you “turn it on”
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Choose the correct size pads/paddles
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Attach the pads/paddles to the chest
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Attach the electrode cable to the AED
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Clear to analyze
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If shock indicated, clear the victim and self .
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Deliver a shock. Do not touch the victim during the “shock” or it could shock you while shocking the victim.
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If the AED gives you a “no shock indicated” continue BLS
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Adult
Team Resuscitation of Basic Life Support for Adult, Child and Infant Instructor Presentation and Skills 1. 2. 3. 4.
Check for Scene Safety * Check for responsiveness Activate the EMS/AED Check the carotid pulse Do not take more than 10 seconds to check the pulse*
Provide High Quality CPR Push hard to create blood flow during compressions* Push Fast at a rate of 100X min* Allow the chest to recoil Minimize interruptions Compress the lower half of the breastbone!!!* Provide Effective Ventilation Give 2 slow easy breaths – just enough to see the chest rise and fall. Even Infants!!!! Give 1 breath every 3-5 seconds* After the advanced airway is in place – give one breath every 6-8 sec* 5. When AED arrives Turn it on* Attach appropriate size pads Clear to analyze Clear to shock If indicated - deliver shock Return to chest compressions* If “no shock advised” Return to chest compression* 15
One Man
Two Man
30:2* Depth=2 in*
30:2* Depth=2 in*
Ventilate with barrier device*
Ventilate with Bag/Mask*
During 2 rescuer CPR the second rescuer must maintain and open airway and give ventilation* Child (one year to puberty) One Man
Two Man
30:2*
15:2* Depth ½ Compress 1 -2 in. or One third the depth of the chest* Ventilate with Barrier device*
Ventilate with Bag/Mask*
Heart rate less than 60 bpm is an ominous sign – Begin CPR* *If you have child with a pulse but not breathing – provide breaths without chest compressions*
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Infant (birth to one year)
Skills Practice
One Man
Two Man
Adult CPR
30:2*
15:2*
You’re in the hospital and you see a man lying on the floor as you round the corner headed to the pharmacy. What do you do? ________Check for scene safety ________ Check for response ________Tap and shout “Are you alright” ________Scan chest for movement. (2010 Update)
Depth Compress at least=1 1/2 in or One third the depth of the chest* Ventilate with barrier device*
Ventilate with Bag/Mask*
Heart rate less than 60 bpm is an ominus sign – Begin CPR* Use the 2-thumb encircling and technique for greater Intrathorasic pressure*
Foreign Body Airway Obstruction (FBOA) 1. Encourage Coughing 2. When the victim becomes stridorous and unable to move air – begin abdominal thrust (formerly called the Heimlich Maneuver) Do as many many as it takes to get the obstruction out. 3. When the victim becomes unresponsive – begin CPR starting with chest compression.* Remember when we use to straddle the victim? We don’t do that anymore. Thank God!!!
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He’s not breathing. What do you do? ________Initiate someone to activate the EMS and get the AED ________Check for pulse within 10 seconds ________ Start Chest Compressions ________ Demonstrate your high quality chest compressions What is your next step in resuscitation? _________Open the airway _________Give 2 rescue breaths _________Demonstrate ventilation with Barrier Device _________Demonstrate ventilation with Bag/Mask The AED has arrived. What do you want the second responder to do? ________ Open AED and Turn it on ________Attach Pads ________Clear to Analyze ________Clear to Shock ________Shock if indicated ________Continue chest compressions (30:2). In 2 minutes (5 cycles), you reanalyze. There is a pulse. What do you do? _______Check breathing. Support breathing until advanced help. _______ Place in the recovery position.
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Adult Choking You are at a restaurant and the woman at the table next to you stands up holding her throat. What do you do? _________Encourage coughing She then becomes stridorous and unable to move air. What do you you do? __________Provide abdominal thrust. She then becomes unresponsive. What do you do? ________Initiate someone to activate the EMS and get the AED ________Check for pulse within 10 seconds. If If not pulse, begin CPR starting with chest compressions.*
Child CPR You are at the soccer field, watching children play on the field. Suddenly, a child collapsed on the ground. He doesn’t appear to be moving. What do you do? _________Check for scene safety ________ Check for response ________Tap and shout “Are you alright” ________Scan chest for movement. (2010 Update) He’s not breathing. What do you do? ________Initiate someone to activate the EMS and get the AED ________Check for pulse within 10 seconds ________ Start Chest Compressions ________ Demonstrate your high quality chest compressions What is your next step in resuscitation? _________Open the airway _________Give 2 rescue breaths _________Demonstrate ventilation with Barrier Device _________Demonstrate ventilation with Bag/Mask
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The AED has arrived. What do you want the second responder to do? ________ Open AED and Turn it on ________Attach Child Pads ________Clear to Analyze ________Clear to Shock ________Shock if indicated ________Continue chest compressions (15:2). In 2 minutes (5 cycles), you reanalyze. There is a pulse. What do you do? _______Check breathing. Support breathing until advanced help. _______ Place in the recovery position.
Child Choking You are at a child’s soccer field and you find a child choking. What do you do? ___________ Pat him/her on the back and encourage him to cough He/She then becomes stridorous and unable to move air. What do you do? __________Provide abdominal thrust. He/She then becomes unresponsive. What do you you do? __________Initiate someone to call EMS. __________Check the mouth for FBO and begin CPR starting with chest compressions.
Infant Choking You are in the hospital, and you see a baby choking in his mother’s arms. She is panicked, and does not know what to do. What should you do? 20
_______ Hold the baby face down, support the head and neck. _______ Give 5 back slaps. _______ Turn the baby, with the chest facing up, support the head. ________Give 5 chest thrusts.
Notes
The baby can’t cough out the object, and becomes unresponsive. What do you do? _______ Call for help. Call the Code. _______ Check the pulse. If no pulse, start 30 chest compressions. _______ Give 2 ventilations with a barrier device. A nurse comes to the rescue! Now it’s both of you doing CPR on this baby. How many compresisons : ventilations do you do? _______15:2 for 2-rescuer CPR for the infant.
Infant CPR You are babysitting your neighbor’s 6 month old daughter when you notice that she is no longer breathing. What should you do? _________ Check for responsiveness _________ Tap and Shout “Are you alright?” __________Scan chest for movement. (2010 Update) Baby’s not breathing and no signs of circulation. What do you do if you’re a healthcare provider? _________ Call out for someone to activate EMS __________Check for pulse within 10 seconds _________ Start Chest Compressions What is your next step in resuscitation? __________Give 2 rescue breaths The AED has arrived. What do you do now? ________ Open AED and power up ________Attach Pads ________Follow prompts ________Continue with chest compressions.
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The American Heart Association strongly promotes knowledge and proficiency in BLS, ACLS, and PALS and has developed instructional materials for this purpose. Use of these materials in an educational course does not represent course sponsorship by the American Heart Association. Any fees charged for such a course, except for a portion of fees needed for AHA course material, do not represent income to the Association.
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