Healthcare BLS
41 videos, 3 hours and 6 minutes
Course Content
Welcome to the Course
- Welcome to ProCPR
- The Five Fears of CPR Rescue
- Cardiac Chain of Survival
- How to Access EMS Through Technology
Medical Emergencies
- Heart Attacks
- Stroke
Universal Precautions
- Universal Precautions in the Workplace
- Handwashing
Respiratory Arrest
- Adult Rescue Breathing
- Child Rescue Breathing
- Infant Rescue Breathing
- Opioid Overdose
Cardiac Arrest
- Agonal Respiration (Not Breathing Normally)
- Adult CPR
- Child CPR
- Infant Landmarks
- Infant CPR
- Neonatal BLS
- Adult AED
- Child AED
- Infant AED
- Spinal Injury - Jaw Thrust
- Hands-Only CPR
- When CPR Doesn't Work (optional)
Multiple Rescuer Skills
- Bag Valve Mask
- Adult CPR 2 Rescuer
- Child CPR 2 Rescuer
- Infant CPR 2 Rescuer
- 2-Person AED
- Adult CPR Team Approach
Choking
- Conscious Adult Choking
- Conscious Child Choking
- Conscious Infant Choking
- Unconscious Adult Choking
- Unconscious Child Choking
- Unconscious Infant Choking
Bleeding Control
- Arterial Bleeding
- Shock
Conclusion
- Pool Safety
- Conclusion
Video 14 of 41
4 min 3 sec
English, Español
English, Español
Transcript
- Now we're gonna cover adult CPR for the single rescuer forhealthcare professionals. We've ensured that our sceneis safe, our gloves are on, and our rescue mask isavailable with a one-way valve. And we're gonna call out to the victim to see if they're responsive. Sir, can you hear me? Are you okay? They don't respond. So I place a hand on the forehead, and I tap on the collarbone. Sir, sir, can you hear me? They didn't respond to my taps and shouts, so I'm gonna activate EMS,call 911 or call a code. If I have a bystander, I can tell them, Hey you in the plaid shirt, go call 911 and come back, and if you can find anAED, bring it with you. I might need your help. If I have a cellphone, Icould whip that out too, and actually call 911 andput it on speakerphone and allow for some help that way as well, or just access it through that technology. Now that I've gone ahead and done that, I can continue my assessment. I'm gonna look for signsof normal breathing as I check for a carotid pulse. How do we find that carotid pulse? It's located between the trachea and the sternocleidomastoid muscle, in the valley betweenthose two structures. We're gonna use the flatpart of our two fingers and press moderately in that valley. I check for no more than 10 seconds, and I note that the patientis not breathing normally, and they do not have a pulse. Now you might say also,well, what do you mean, breathing normally, what does that mean? Breathing normally issomeone who is breathing and oxygenating. Agonal respirations,which is basically like a fish out of water who'sgulping or gasping for a breath, does not equal regularbreathing or normal breathing. So, to me, agonal respirationsare no respirations, and there's no pulse,and they're unresponsive. So we're gonna go right into CPR. Now let's talk about the technique of CPR. Right between the breasts, on the sternum, lower third of the sternum. We wanna do a 2 to 2.4inch deep compression, and we wanna compress at a rate between 100 and 120compressions per minute. That's about two per second. The other thing to note is that, as you see me sitting on this bench, I would not stay here todo these compressions. It's, A, gonna be verydifficult and exhausting for me, and B, I'm gonna end uprolling over their chest, which does not adequately compress this hollow organ we call the heart. We want to compress that heartwhich is sandwiched between the sternum and the spine, so that we can maximizethat cardiac output. The second feature of that is that, once we do our 2 to 2.4inch deep compression, we want to allow forwhat we call full recoil. That full recoil means we come right backup to the neutral position before we do our next compression. And then, lastly, as westand over our patient, I want to come directlyover the top of them with my elbows locked, andusing my upper body weight to do my full 2 to 2.4inch deep compression, 100 to 120 times per minute. So here we go. One and two and threeand four and five and six and seven and eight andnine and 10, 11 and 12, 13, 14, 15, 16 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30. I grab my rescue mask, seal it over the patient's face and nose, give them a full aggressivehead-tilt/chin-lift, and try two breaths. (breathes) first breath goes in, chest rise and fall, (breathes) second breath goes in,chest rise and fall. Right back into the same location, and 30 more chest compressions. I'm gonna continue this30 chest compressions to two rescue breaths, until help arrives, AED arrives, or until my patient begins responding and breathing normally.
A patient who is unconscious, not breathing normally, and has no pulse is in cardiac arrest and needs CPR.
CPR is a combination of chest compressions and ventilations that circulates blood and oxygen to the brain and other vital organs for a person whose heart and breathing have stopped.
Remember the five links in the Adult Cardiac Chain of Survival:
- Recognize the cardiac emergency and call 911
- Early CPR
- Early defibrillation
- Advanced life support
- Integrated, post-cardiac arrest care
How to Provide Care
As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim to assess whether or not he or she is responsive.
Are you OK? Can you hear me?
If you don't get an initial response, place your hand on the victim's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps.
- Call 911 and activate EMS or call in a code if you're in a healthcare setting. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc. In the event that you do not know how to proceed, call 911 on your cell phone, put it on speaker, and follow their instructions.
- Continue to assess the victim's responsiveness and vital signs – signs of breathing normally, signs of a pulse, etc.
- Check for the carotid pulse, located between the trachea and sternocleidomastoid muscle, in the valley between these two structures. Use the flat parts of your index and middle fingers and press with moderate force in that valley. Spend no more than 10 seconds looking for a pulse.
- If you've determined at this point that the victim is unresponsive, not breathing normally (as you now know, agonal respiration is not breathing normally and should be considered the same as NO respirations), and has no pulse, continue immediately with CPR.
CPR Technique for Adults
Pro Tip #1: Make sure you're directly over the victim's chest to maximize cardiac output, and not off to one side. If you're not directly over the chest, you may not adequately compress the heart.
- Locate the area over the heart to begin chest compressions – between the breasts and on the lower third of the sternum.
- Stand or kneel directly over the patient's chest. Lock your elbows and use only your upper body weight to supply the force for the chest compressions, and count as you perform them.
- Conduct compressions that go 2-2.4 inches deep (or 1/3 the depth of the victim's chest) and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second.
- Perform 30 chest compressions.
- Grab the rescue mask and seal it over the victim's face and nose.
- Lift the victim's chin and tilt his or her head back slightly.
- Breathe into the rescue mask and wait for the chest to rise and fall before administering the next breath.
- Continue to perform 30 chest compressions to two rescue breaths until help arrives, an AED arrives, or the victim is responding positively and breathing normally.
Pro Tip #2: To maintain a steady rhythm, count out loud while performing chest compressions – one, as you press down, and, as you allow the chest to recoil. When you reach 13, drop the and to maintain a two-syllable cadence on the compressions and not disrupt the rhythm.
Warning: Once you perform a chest compression, make sure you allow for full recoil of the chest cavity. You want to allow the chest to come all the way back to the neutral position before performing another compression.
A Word About High-Quality CPR
It's important to understand what constitutes high-quality CPR, as performing CPR correctly will give the victim the best chance of survival.
High-Quality CPR
- Performing chest compressions at a rate of 100-120 per minute
- Compressing to a depth of at least 2 inches but not exceeding 2.4
- Allowing for full recoil after each compression
- Minimizing pauses in compressions
- Ventilating adequately – two breaths after 30 compressions, with each breath delivered over one second, and each causing the patient's chest to rise
Low-Quality CPR
- Compressing at a rate slower than 100 per minute or faster than 120 per minute
- Compressing to a depth less than two inches or greater than 2.4 inches
- Leaning on the chest between compressions or performing compressions while not directly over the victim's heart
- Interrupting compressions for greater than 10 seconds
- Providing excessive ventilation – too many breaths or breaths with excessive force
Warning: Once you begin CPR, it's important not to stop. If you must stop, do so for no more than 10 seconds. Reasons to discontinue CPR include more advanced medical personnel taking over for you, seeing obvious signs of life with the patient breathing normally again, an AED becomes available and ready to use or you getting too exhausted to continue.
