Tuesday, July 28, 2015

Basic life support Guidelines to help people understand things in better way.

This information is taken from email sent by Dr.Pillai to IMA members and intended for general information only. 

No action should be taken on this basis only. The idea is to make information available vide spread and help people to understand things in better way.

For the awareness of the members I am adding a note on BLS, based on the latest international guidelines below

If a person gets a cardiac arrest

·  Ø  Immediate recognition of sudden cardiac arrest (SCA) is needed
o   Based on assessing unresponsiveness and absence of normal breathing (ie, the victim is not breathing or only gasping)
·  Ø  If not responding, be prepared to use automated external defibrillator if available
o   Bystanders (lay responders) should immediately call their local emergency number (like 108/102) to initiate a response anytime they find an unresponsive victim
·  Ø  If there is no breathing of gasping, check the central pulse for ONLY 5 seconds
o   The lay rescuer should not check for a pulse and should assume that cardiac arrest is present if an adult suddenly collapses or an unresponsive victim is not breathing normally.
o   The healthcare provider should take no more than 10 seconds to check for a pulse and, if the rescuer does not definitely feel a pulse within that time period, the rescuer should start chest compressions
·  Ø  If central pulse absent, start chest compression immediately
o   Chest compressions consist of forceful rhythmic applications of pressure over the lower half of the sternum. To provide effective chest compressions, push hard and push fast.
o   It is reasonable for laypersons and healthcare providers to compress the adult chest at a rate of at least 100 compressions per minute with a compression depth of at least 2 inches/5 cm
o   Rescuers should allow complete recoil of the chest after each compression, to allow the heart to fill completely before the next compression
o   Rescuers should attempt to minimize the frequency and duration of interruptions in compressions to maximize the number of compressions delivered per minute
·  Ø  Once chest compressions have been started, a trained rescuer should deliver rescue breaths by mouth-to-mouth or bag-mask to provide oxygenation and ventilation
o   Deliver each rescue breath over 1 second
o   Give a sufficient tidal volume to produce visible chest rise
o   Use compression to ventilation ratio of 30 chest compressions to 2 ventilations.
·  Ø  Use automated external defibrillator if available
o   Turn the AED on.
o   Follow the AED prompts.
o   Resume chest compressions immediately after the shock (minimize interruptions). 

Summary

·  Ø  Untrained Lay Rescuer: Should provide Hands-Only (chest compression only) CPR, with an emphasis on “push hard and fast,” until an AED arrives and is ready for use or healthcare providers take over care of the victim
·  Ø  Trained Lay Rescuer: All lay rescuers should, at a minimum, provide chest compressions and in addition, if the trained lay rescuer is able to perform rescue breaths, he or she should add rescue breaths in a ratio of 30 compressions to 2 breaths, until an AED arrives and is ready for use or healthcare providers take over care of the victim
·  Ø  Healthcare Provider: Optimally all healthcare providers should be trained in BLS and should provide chest compressions and rescue breathes for cardiac arrest victims. This should be performed in cycles of 30 compressions to 2 ventilations until an advanced airway is placed; then continuous chest compressions with ventilations at a rate of 1 breath every 6 to 8 seconds

Prof.Dr.A.Marthanda Pillai
National President,
Indian Medical Association.

special thanks to Dr.Pillai for this.

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