(bcls) programme - Singapore General Hospital
(bcls) programme - Singapore General Hospital (bcls) programme - Singapore General Hospital
ADULT FOREIGN-BODY AIRWAY OBSTRUCTION (CONSCIOUS – UNCONSCIOUS) STEPS Conscious victim Assessment Heimlich Manoeuvre Technique (Normal Size) Chest Thrust Technique (Pregnant & Obese) Unconscious victim ACTION Ask: “Are you choking?” Victim acknowledges by nodding. Rescuer replies: “I can help.” Stand behind the victim. Position one foot between the victim’s legs Locate the landmark : • Place your arms around the victim’s abdomen and locate the navel • With one hand place 2 fingers just above the navel • Make a fist with the other hand • Place thumb-side of the fist against the abdomen above the 2 fingers • Release the 2 fingers but maintain the fist on the abdomen • Lean the victim forward and grasp the fist with the other hand • Give successive inward-upward thrusts • Check if foreign body is expelled after every set of 5 abdominal thrusts • Repeat thrusts until the foreign body is dislodged or the victim becomes unconscious Stand behind the victim. Position one foot between the victim’s legs Locate the landmark : • Place arms under the victim’s armpits to encircle the chest • Make a fist with one hand • Place thumb-side of fist on the middle of the victim’s breastbone • Grasp the fist with the other hand and give successive quick backward thrusts • Check if foreign body is expelled after every set of 5 chest thrusts • Repeat thrusts until the foreign body is dislodged or the victim becomes unconscious When victim becomes unconscious. Proceed with the following steps : • Position the victim on a firm, flat surface • Call for ambulance 995 • Start 30 chest compressions (The landmark & technique is the same as for adult CPR) • Open airway : Head Tilt-Chin Lift • Check airway and remove any obvious foreign bodies • Check for normal breathing : Look, Listen, & Feel (up to 10 seconds) • If breathing is absent, attempt to ventilate (1st attempt) • If airway is still blocked, re-position the victim’s head and reattempt to ventilate • Attempt 2nd ventilation • If airway is still blocked, perform 30 chest compressions • Proceed to head tilt-chin tilt and check for foreign body • Repeat Step till help arrives or able to give 2 successful ventilations BCLS Programme • Check pulse (for healthcare providers only) and breathing once airway is cleared. • If pulse is absent (if unsure of pulse and victim has no breathing, assume cardiac arrest), continue CPR 30:2 Recovery Position Place victim in the recovery position if : • Pulse and breathing are present • Continue to monitor victim’s pulse and breathing every few minutes as this can stop suddenly 48
INFANT CPR STEPS D : Danger ACTION Look out for unsafe environment, e.g. Electrical current, Fire, Possible Explosion, Construction works, or Poisonous gas • Ensure that the scene is safe for you to help R : Response Establish unresponsiveness : • Call, tap or gently shake the infant’s shoulder to elicit response • If you are alone, immediately start CPR 30:2 for approx. 2 minutes S : Shout for Help • If a second rescuer is present, ask him or her to call for ambulance 995 A : Airway B : Breathing C : Circulation Open airway : Head Tilt-Chin Lift Check for normal breathing : Look, Listen, & Feel (up to 10 seconds) Look for the rise and fall of the chest Listen for air escaping during exhalation Feel for the flow of air from the infant’s mouth and nose moving past your cheeks Check for brachial pulse up to 10 seconds (only for Healthcare providers) If pulse is absent (if unsure of pulse and infant has no breathing, assume cardiac arrest), start 30:2 For laypersons, there is no need to check for pulse. If infant has no breathing, start CPR Locate landmark for chest compression: • Draw an imaginary line between nipples • Place index finger on the imaginary line • Place your middle and ring fingers next to the index finger • Move the 3 fingers to the centre of the sternum (breastbone) • Position the fingers upright • Lift off the index finger but maintain the middle and ring fingers contact on the sternum (breastbone) • Lean forward and place your cheek near the infant’s mouth and nose • Use your middle and ring fingers to compress the sternum (breastbone) by 4 cm Demonstrate correct technique of compression Keep fingers contact on the sternum during each upstroke Say mnemonic “1&2&3&4&5&1&2&3&4&10&1&2&3&4&15 1&2&3&4&20 1&2&3&4&25 1&2&3&4&30” Compression rate is at least 100 per minute CPR Cycle • Perform 5 cycles of 30 chest compressions followed by 2 breaths for approximately 2 minutes (For Healthcare providers only) • The duration for each breath is 1 second. • Ventilation volume is between 30 ml/breath • Allow lung deflation between each breath Reassessment • Assess for pulse and breathing after every 5 cycles of CPR 30:2 (for healthcare providers only) • If pulse is absent (if unsure of pulse and infant is not breathing, assume cardiac arrest), continue CPR 30:2 • For laypersons, continue performing CPR until help arrives or infant starts moving Recovery Position • Recovery Position Place the infant in the recovery position if : • Pulse and breathing are present • Infant is unconscious and has no evidence of trauma • Continue to monitor infant’s pulse & breathing every few minutes as this can stop suddenly BCLS Programme 49
- Page 1 and 2: BASIC CARDIAC LIFE SUPPORT (BCLS) P
- Page 3 and 4: C o n t e n t s Module 1 INTRODUCTI
- Page 5 and 6: Module 2 The Chain of Survival The
- Page 7 and 8: 3.2 Heart ATTACK Heart attack usual
- Page 9 and 10: • Major risk factors that can be
- Page 11 and 12: Module 4 ADULT CARDIO-PULMONARY RES
- Page 13 and 14: STEP 3 SHOUT FOR HELP & ACTIVATE EM
- Page 15 and 16: • Place one hand on the victim’
- Page 17 and 18: STEP 8 LOCATE HAND POSITION FOR CHE
- Page 19 and 20: GUIDELINES FOR PROPER COMPRESSION D
- Page 21 and 22: Module 5 ADULT RECOVERY POSITION Th
- Page 23 and 24: Module 6 ADULT FOREIGN BODY AIRWAY
- Page 25 and 26: STEP 3 • Place your arms around t
- Page 27 and 28: STEP 3 • Open victim’s airway b
- Page 29 and 30: Module 7 INFANT CARDIO-PULMONARY RE
- Page 31 and 32: STEP 5 OPEN THE AIRWAY Perform a he
- Page 33 and 34: STEP 8 LOCATE LANDMARK FOR CHEST CO
- Page 35 and 36: STEP 9A PERFORM CHEST COMPRESSION
- Page 37 and 38: Module 8 INFANT RECOVERY POSITION 8
- Page 39 and 40: Module 9 INFANT FOREIGN BODY AIRWAY
- Page 41 and 42: STEP 3 BACK BLOWS AND CHEST THRUSTS
- Page 43 and 44: 9.3 RELIEF OF FBAO IN THE UNCONSCIO
- Page 45 and 46: Module 10 APPLICATION OF POCKET MAS
- Page 47 and 48: STEP 4 • Apply the rim of the mas
- Page 49: Module 11 SUMMARY CHECKLIST ADULT O
- Page 53 and 54: Notes BCLS Programme 51
- Page 55 and 56: Notes BCLS Programme 53
ADULT FOREIGN-BODY AIRWAY OBSTRUCTION (CONSCIOUS – UNCONSCIOUS)<br />
STEPS<br />
Conscious victim<br />
Assessment<br />
Heimlich<br />
Manoeuvre<br />
Technique<br />
(Normal Size)<br />
Chest Thrust<br />
Technique<br />
(Pregnant &<br />
Obese)<br />
Unconscious<br />
victim<br />
ACTION<br />
Ask: “Are you choking?”<br />
Victim acknowledges by nodding. Rescuer replies: “I can help.”<br />
Stand behind the victim. Position one foot between the victim’s legs<br />
Locate the landmark :<br />
• Place your arms around the victim’s abdomen and locate the navel<br />
• With one hand place 2 fingers just above the navel<br />
• Make a fist with the other hand<br />
• Place thumb-side of the fist against the abdomen above the 2 fingers<br />
• Release the 2 fingers but maintain the fist on the abdomen<br />
• Lean the victim forward and grasp the fist with the other hand<br />
• Give successive inward-upward thrusts<br />
• Check if foreign body is expelled after every set of 5 abdominal thrusts<br />
• Repeat thrusts until the foreign body is dislodged or the victim becomes<br />
unconscious<br />
Stand behind the victim. Position one foot between the victim’s legs<br />
Locate the landmark :<br />
• Place arms under the victim’s armpits to encircle the chest<br />
• Make a fist with one hand<br />
• Place thumb-side of fist on the middle of the victim’s breastbone<br />
• Grasp the fist with the other hand and give successive quick backward thrusts<br />
• Check if foreign body is expelled after every set of 5 chest thrusts<br />
• Repeat thrusts until the foreign body is dislodged or the victim becomes<br />
unconscious<br />
When victim becomes unconscious. Proceed with the following steps :<br />
• Position the victim on a firm, flat surface<br />
• Call for ambulance 995<br />
• Start 30 chest compressions (The landmark & technique is the same as for adult<br />
CPR)<br />
• Open airway : Head Tilt-Chin Lift<br />
• Check airway and remove any obvious foreign bodies<br />
• Check for normal breathing : Look, Listen, & Feel (up to 10 seconds)<br />
• If breathing is absent, attempt to ventilate (1st attempt)<br />
• If airway is still blocked, re-position the victim’s head and reattempt to ventilate<br />
• Attempt 2nd ventilation<br />
• If airway is still blocked, perform 30 chest compressions<br />
• Proceed to head tilt-chin tilt and check for foreign body<br />
• Repeat Step till help arrives or able to give 2 successful ventilations<br />
BCLS Programme<br />
• Check pulse (for healthcare providers only) and breathing once airway is cleared.<br />
• If pulse is absent (if unsure of pulse and victim has no breathing, assume cardiac<br />
arrest),<br />
continue CPR 30:2<br />
Recovery Position Place victim in the recovery position if :<br />
• Pulse and breathing are present<br />
• Continue to monitor victim’s pulse and breathing every few minutes as this can<br />
stop suddenly<br />
48
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