BLS Flashcards
(29 cards)
how has DRSABC changed in the covid update
the airway section has been removed
DRS BC
What PPE should be worn for assessment / chest compressions / general contact with COVID-19 case
gloves
apron
mask
what PPE must be worn for aerosol generating procedures / airway interventions and ventilations
full face shield / eye protection
FFP face mask
gloves
long sleeved fluid repellant gown
is there any change to “danger”
no
still check before beginning
how do you check for response
- Gently shake
- Speak loudly
- “hello can you hear me”
• Cover the victim’s nose and mouth with a surgical mask or a cloth
• The person helping must also wear basic PPE now ○ Gloves ○ Apron ○ Mask ○ Visor
what is “s” and how do you do it
shout
same as before
shout for help
what has changed with checking the airway
DO NOT GO NEAR THE AIRWAY
Don’t do the head tilt chin lift / don’t open airway
Skip this step completely
what is the new way to check for breathing and circulation
• Stay clear of the airway • Palpate a carotid pulse ○ Circulation • Hand on the chest ○ Looking / feeling for movements of breathing • Simultaneously check for 10 seconds
Used to check this by doing look, listen, feel
Now you do not put your face near the victim’s face even if their nose and mouth is covered
what is agonal breathing
- Infrequent noisy gasps
- Not normal
- Ignore these - this is not breathing
when you dial 999 what should you say to the emergency services
• Cardiac arrest
• Not breathing
• Location
• Contact number
• COVID Status
○ This is the only difference when calling for help
○ If you know the victim is covid positive - tell them
○ If you do not know tell them the covid status is unknown
how should chest compressions be done
• Interlock fingers
• Straight elbows
• Compress the sternum 5-6cms
• 100-120 compressions per minute
○ This will equal around 2 compressions per second
• Continue compressions until help arrives
• Patients face should remain covered
You should be wearing basic PPE at least
how do you prepare the patient for the AED
• Scissors
○ Remove clothes on the chest
○ If there are no scissors available then pull the clothes up as high as you can to get access to the chest
• Dry
○ If the chest is wet, due to sweat or blood or something else it needs to be dried for the pads to stick
• Razor
○ Need to shave the chest if it is very hairy as the pads won’t stick properly / would be very painful to remove
○ Only need to shave the areas where the pads are
how do you use the defib
• Attach pads to the patients chest
○ One 10cm below the armpit (left hand side)
○ One just below the clavicle (right hand side)
• Listen to the voice prompts of the AED
• Early defibrillation is a key intervention associated with improved neurological outcomes
○ Early intervention is the best thing
○ Quicker it is done = better outcomes
Apply AED as soon as available, even if only wearing droplet-precaution PPE
- Stand clear
- Do not touch the patient
- Do not touch equipment
Move the oxygen a metre away
when can airway intervention / ventilation be done
only once full AGP PPE is put on
how much oxygen is given
15L of 100% oxygen per minute
what must be added to the bag valve mask
humidity moisture exchange filter (HME)
reduces the amount exhaled by the patient
how should venilations be done
• Use a 2 person technique
○ Very important to create the best possible seal
○ Don’t want any droplets to come out of the mouth
- AGP PPE must be worn
- FFP3 mask for all staff before airway interventions commence
• One person does the head tilt chin lift and holds the mask in place creating a good seal over the nose and mouth - fingers on mandible
Second person is squeezing the balloon
○ Squeeze very gently
○ Allow the bag time to fill up
○ Watch the chest rise and fall
• Give 2 rescue breaths via Bag-Mask Ventilation (100% Oxygen)
○ Should not be done via mouth-to-mouth or mouth-to-mask
what should be done if the chest does not rise and fall during the rescue breathes
check there is a good mask seal and that the head tile technique is correct
if these are good then use airway adjuncts / oropharyngeal airway (OPA)
[green usually female, male usually orange but always check first]
how to insert OPA
Insert upside down
180 degree twist
measure it first
what is ROSC
return of spontaneous circulation
what should be done in post resuscitation care / ROSC
- Reassess breathing and circulation
- Reassure casualty (even if unconscious)
- Maintain airway
• Deliver oxygen via BVM
○ Patients respirations per minute will be very low initially
○ Whenever the patient breathes in squeeze the bag to give them extra oxygen
○ When they cannot tolerate this any more remove the BVM and replace with an oxygen mask delivering 15L
- Do not remove AED pads - Patient could still rearrest
- Cover up to maintain dignity of the patient and keep the patient warm
- The casualty could rearrest - be prepared to deliver CPR again
- Keep all emergency equipment to hand
what is CPR
cardiopulmonary resuscitation
What is BLS
basic life support
what is AED
automated external defibrillator
