CPR for an adult, AED ERC guidelines 2021 Chvátal Zdeněk Korbička Tomáš Vrbica Kamil Learning objectives ̶ The student will learn the BLS algorithm. ̶ The student will learn the BLS algorithm with AED. ̶ The student will learn when to start and when to end CPR. 1. Basic BLS algorithm without AED BLS – Basic Life Support Approach carefully Check consciousness Open the airway Check breathing Call 155/112 for help 30 chest compressions 2 rescue breaths 30 chest compressions Approach carefully Check consciousness Open the airway Check breathing Call 155/112 for help 30 chest compressions 2 artificial breaths2 rescue breaths Chest compression ̶ Position of the victim on the back, hard surface ̶ The rescuer is kneeling by the side of the victim ̶ Place the heel of your hand in the centre of the chest with the other hand on top ̶ Interlock your fingers (make sure that the fingers are kept off the ribs) ̶ Upper limbs outstretched, straight back Chest compression ̶ Compress the chest regularly ̶ rate of 100 – 120 per minute ̶ to a depth of 5 - 6 cm ̶ compression to release ratio 1:1 ̶ We make sure that the chest is sufficiently relaxed, but we do not lose contact ̶ Replace the rescuer every 2 minutes (if possible) Approach safely Approach carefully Check consciousness Open the airway Check breathing Call 155/112 for help 30 chest compressions 2 rescue breaths 2 rescue breaths Mouth-to-mouth respiration (adults) ̶ Open the airway ̶ tilt head back and lift the chin ̶ Squeeze the nostrils ̶ Take a breath ̶ Place lips around victim’s mouth ̶ Blow into the victim’s mouth, normal tidal volume -> until the chest rises (about 500ml, 6ml / kg) Mouth-to-mouth ventilation (adults) ̶ A complete rescue breath should take one second ̶ Let the casualty passive breathe out, approximately 1s ̶ Try to minimize the interruption of chest compression ̶ Rescue breaths in a cycle of 30:2, maximum 5s Ineffective breathing ̶ during 2 attempts to breathe into the casualty’s mouth - resistance or the chest does not rise !! don't waste time!! ̶ perform another cycle of 30 chest compressions ̶ before another attempt to breathe, look for the cause : * open mouth and with 2 fingers remove visible foreign bodies * check/improve head tilt * leave firmly adhered denture/remove loose denture Continue with CPR 30 : 2 Hands-only resuscitation Alternative to provide BLS for cases : ̶ If we are not willing to blow into the victim’s mouth ̶ If we are worried that we might do breathing wrong or we don't want to do that, we only perform an uninterrupted chest compression 2. BLS algorithm with using AED ̶ AED = automatic external defibrillator with visual and acoustic help ̶ Designed for use by lay rescuers ̶ Better CPR outcomes ̶ Located at airports, in sports halls, in main square… Changes in algorithm with using AED Approach carefully Check consciousness Open the airway Check breathing Call 155/112 for help Connect the AED Follow the AED instructions Connect the AED Follow the AED instructions Turn on AED Some devices turn on automatically by opening the top cover Sticking the electrodes on the exposed chest - In case of 2 rescuers – continue in CPR during sticking the electrodes Heartbeat analysis: Do not touch! Shock recommended ̶ Step back! ̶ Perform defibrillation (the device usually prompts you to press the button) 30 : 2 Follow the instructions after defibrillation Follow the instructions of the device 30 : 2 Shock is not recommended If the casulty starts breathing normally – place victim in recovery position and monitor vital signs Approach carefully Check consciousness Open the airway Check breathing Call 155/112 for help 30 chest compressions 2 rescue breaths Approach carefully Check consciousness Open the airway Check breathing Call 155/112 for help Connect the AED Follow the AED instructions When to start CPR? unconsciousness + breathless = without circulation When not to start CPR ̶ with certain signs of death (long delay) ̶ postmortem stiffness = rigor mortis ̶ putrid odor, etc.. ̶ injury incompatible with life (decapitation) ̶ rescuer in direct danger of life ̶ terminal state of incurable disease When stop CPR? ̶ Circulation restore: spontaneous defensive movements, consciousness or occurrence of normal breathing → recovery position and monitoring of vital functions until the arrival of the emergency medical service CAVE: gasping ̶ handover of the emergency medical service ̶ exhaustion = if the rescuer is so exhausted that he cannot continue to do CPR ̶ there is a new danger for the rescuer Major BLS mistakes ̶ insufficient head tilt in adults ̶ insufficient chin lift ̶ long diagnosis of circulatory arrest ̶ failure to control the raising and lowering of the chest during rescue breaths ̶ blow of unnecessarily large volume of air ̶ failure to take turns early and regularly before exhaustion ̶ compression frequency too fast Learning outcomes ̶ The student is able to describe the basic BLS algorithm. ̶ The student knows how to technically perform compressions and artificial respiration. ̶ The student knows how to properly use an AED for CPR. Thank you for your attention!