CPR Technique (BCLS Training Held at Singapure)


1.  ADULT ONE – MAN CPR

STEPS

ACTION

D : Danger Look out for unsafe environtment, 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 casualty
  • Call out loudly: “Hello! Hello! Are you OK?”
  • If no response, Call for help
A : Airway Open airway : Head Tilt – Chin Lift.

Check airway and remove any obvious foreign bodies

B : Breathing Check for breathing : Look, Listen, & Feel (10 seconds)

Look for the chest rise and fall

Listen for air escaping during exhalation

Feel for the flow of air from the casualty’s nose moving past your cheek

If no breathing,

Give 2 short breaths (1 sec/breath; Volume of air : 400 – 600 ml/breath)

Allow lung deflation between each breath

C : Circulation Check for pulse / *signs of circulation (6 to 10 seconds)

If no pulse or *signs of circulation, start CPR

  • Locate the landmark for chest compression
  • Proper body and hand position
  • Compress vertically 4-5 cm downwards with complete relaxation of pressure after each compression at rate of 100 per minute
  • 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

CPR Cycle Perform 30 chest compressions followed by 2 short breaths
Re-assesment Assess the casualty for pulse or ‘signs of circulation’ after every 5 cycles of CPR 30 : 2

If pulse or *signs of circulation is absent, resume CPR 30 : 2

If pulse or *signs of circulation is present, stop CPR and assess for breathing

Rescue Breathing If breathing is absent, perform rescue breathing by counting :

2-a-thousand, 3-a-thousand, 4-a-thousand, 5-a-thousand’ after each breath

Give 12 rescue breaths in 1 minute

Recovery Position Place the casualty in the recovery position if :

Pulse or *signs of circulation and breathing are present

Casualty is unconscious

Has no evidence of trauma

*signs of circulation – conscious, movement, breathing & coughing

 

2.  ADULT TWO – MAN CPR

STEPS

ACTION

Rescuer 1

Start one-man CPR 30 chest compressions followed by 2 short breaths

Rescuer 2

Appear and say :

“I know 2-man CPR, can I help?”

Rescuer 1

Acknowledge by nodding head and complete the cycle of 30 chest compressions followed by 2 short breaths and then reassess pulse or  *signs of circulation (6 to 10 seconds)

Rescuer 2

Locate the landmark for chest compressions while Rescuer 1 is assessing circulation

Rescuer 1

If pulse or *signs of circulation are absent, says : “No pulse, start CPR.”

Rescuer 2

Start chest compression by counting :

“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

Rescuer 1

Gives 2 short breaths after rescuer 2 has completed every 30 chest compression
Repeat the cycles :

Rescuer 1 : deliver 2 short breaths

Rescuer 2 : perform 30 chest compressions

Rescuer 2

Will initiate the switch of roles on the 5th cycle of 30 compressions, by counting:

“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& Switch&2&3&4&30

Rescuer 1

Will complete the 2 short breaths before moving to the chest to take up compression position

Rescuer 2

Moves to the head and assess for pulse (6 to 10 seconds) and say :

“No pulse, continue CPR.”

Re-assesment

Assess the casualty for pulse or ‘signs of circulation’ after every 5 cycles of CPR 30 : 2 or after every switching of roles

If pulse or *signs of circulation is absent, resume CPR 30 : 2

If pulse or *signs of circulation is present, stop CPR and assess for breathing

Rescue Breathing

If breathing is absent, perform rescue breathing by counting :

2-a-thousand, 3-a-thousand, 4-a-thousand, 5-a-thousand’ after each breath

Give 12 rescue breaths in 1 minute

Recovery Position

Place the casualty in the recovery position if :

Pulse or *signs of circulation and breathing are present

Casualty is unconscious

Has no evidence of trauma

*signs of circulation – conscious, movement, breathing & coughing

 

 

3.  ADULT FOREIGN-BODY AIRWAY OBSTRUCTION (Conscious – Unconscious)

STEPS

ACTION

Conscious casualty

Ask : “Are you choking?”

Casualty acknowledges by nodding. Rescuer replies : “I can help”

Assessment

Heimlich Manoeuver Technique

(Normal Size)

Stand behind the casualty. Position one foot between the casualty’s legs

Locate the landmark :

  • Put your arms around the casualty’s abdomen and locate for the navel
  • Place 2 fingers breath above the navel and well below the tip of the breastbone (xiphoid process)
  • Make a fist with one hand
  • Place thumb-side of the fist against the abdomen above the 2 fingers spacing
  • Release the 2 fingers spacing but maintain the fist on the abdomen
  • Lean the casualty 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 casualty becomes unconscious

Chest Thrust Technique

(Pregnant & Obese)

Stand behind the casualty. Position one foot between the casualty’s legs

Locate the landmark :

  • Place arms under the casualty’s armpits to encircle the chest
  • Make a fist with one hand
  • Place thumb-side of fist on the middle of casualty’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 casualty becomes unconscious

Unconscious casualty

When casualty becomes unconscious . Proceed with the following steps :

  • Position casualty on a firm, flat surface. Call for help
A : Airway Open airway : Head Tilt – Chin Lift.

Check airway and remove any obvious foreign bodies

B : Breathing Check for breathing : Look, Listen, & Feel (10 seconds)

Look for the chest rise and fall

Listen for air escaping during exhalation

Feel for the flow of air

If breathing is absent, attempt to ventilate (1st attempt)

If airway is blocked, re-position the casualty’s head and re-attempt to ventilate (2nd attempt)

If airway is still blocked, relieve obstruction by :

  • Perform 30 chest compressions  (hand position for chest compression is the same as for CPR)
Repeat steps A & B until able to give 2 successful ventilations
C : Circulation Check pulse or  *signs of circulation and if it is absent, resume CPR 30 : 2

If pulse or *signs of circulation is present, assess for breathing

Rescue Breathing If breathing is absent, perform rescue breathing by counting :

2-a-thousand, 3-a-thousand, 4-a-thousand, 5-a-thousand’ after each breath

Give 12 rescue breaths in 1 minute

Recovery Position Place the casualty in the recovery position if :

Pulse or *signs of circulation and breathing are present

Casualty is unconscious

Has no evidence of trauma

*signs of circulation – conscious, movement, breathing & coughing

 

4.  INFANT CPR

STEPS

ACTION

D : Danger Look out for unsafe environtment, 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
  • Activate Emergency Medical Service if second rescuer is available
A : Airway Open airway : Head Tilt – Chin Lift.

Check airway and remove any obvious foreign bodies

B : Breathing Check for breathing : Look, Listen, & Feel (10 seconds)

Look for the chest rise and fall

Listen for air escaping during exhalation

Feel for the flow of air from the casualty’s nose moving past your cheek

If no breathing,

Give 2 short breaths (1 sec/breath; Volume of air : 30 ml/breath)

Allow lung deflation between each breath

C : Circulation Check for brachial pulse / *signs of circulation (6 to 10 seconds)

If no pulse, start CPR

Locate the 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 up the index finger but maintain the middle and ring fingers 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 about 2 cm
Demonstrate correct technique of compression

Keep fingers on the sternum during 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 100 per minute

CPR Cycle Perform 5 cycles of 30 chest compressions followed by 2 short breaths for approximately 2 minutes

ActivateEMSif it is not done earlier

Assess for pulse or ‘signs of circulation’ after every 5 cycles of CPR 30 : 2

If pulse absent, continue CPR

Rescue Breathing If breathing is absent, perform rescue breathing by counting :

2-a-thousand, 3-a-thousand’ after each breath

Give 20 rescue breaths in 1 minute

Recovery Position Place the casualty in the recovery position if :

Pulse or *signs of circulation and breathing are present

Infant is unconscious

Has no evidence of trauma

*signs of circulation – conscious, movement, breathing & coughing

5.  INFANT FOREIGN-BODY AIRWAY OBSTRUCTION (Conscious – Unconscious)

STEPS

ACTION

Conscious casualty

Assess for signs of complete airway obstruction (choking)

If infant is choking, attempt to relieve the airway obstruction immediately

Assessment

Back Blows

&

Chest Thrust

Support the infant’s head and body between your hands and forearms using the “Sandwich Manoeuvre”

  • Hold the infant’s face down and rest your forearm on your thigh
  • Keep the head lower than the trunk
  • Deliver 5 back blows forcefully between the shoulder blades with the heel of your other hand
  • Support the infant’s head and body between your hands and forearms after delivering the 5 back blows
  • Turn the infant over on his/her back, resting on your thigh
  • Keep the head lower than the trunk
  • Deliver 5 chest thrusts over the lower half of the sternum (breastbone) by counting aloud ‘1,2,3,4,5’. (landmark for chest thrust is the same as for infant CPR)

Re – assessment

Check if foreign body is expelled after every set of 5 back blows and 5 chest thrusts and remove if it is visible

  • If the foreign body is expelled successfully, assess the infant for pulse and breathing
  • If the airway remains obstructed and the infant is conscious, repeat the sequence of 5 back blows and 5 chest thrust

Unconscious casualty

When infant becomes unconscious . Proceed with the following steps :

  • Position infant on a firm, flat surface.
  • Call for help

A : Airway

Open airway : Head Tilt – Chin Lift.

Check airway and remove any obvious foreign bodies

B : Breathing

Check for breathing : Look, Listen, & Feel (10 seconds)

Look for the chest rise and fall

Listen for air escaping during exhalation

Feel for the flow of air

If breathing is absent, attempt to ventilate (1st attempt)

If airway is blocked, re-position the infant’s head and re-attempt to ventilate (2nd attempt)

If airway is still blocked, relieve obstruction by :

  • Perform 30 chest compressions  (The landmark and technique for chest compression is the same as for CPR)
Repeat steps A & B until able to give 2 successful ventilations

C : Circulation

Check pulse or  *signs of circulation and if it is absent, resume CPR 30 : 2

If pulse or *signs of circulation is present, assess for breathing

Rescue Breathing

If breathing is absent, perform rescue breathing by counting :

2-a-thousand, 3-a-thousand’ after each breath

Give 20 rescue breaths in 1 minute

Recovery Position

Place the casualty in the recovery position if :

Pulse or *signs of circulation and breathing are present

Infant is unconscious

Has no evidence of trauma

*signs of circulation – conscious, movement, breathing & coughing

This articles is specialized training for medic/doctor who working in Rig/Offshored  as CPR technique that held in Singapure on BCLS Training.

We hope this article is very usefull to you that interesting and active in an emergency respon team or triage team in many conditions in berau county or other places.

 

 

Keep Your Medical Skill and Improve it ,

Your Safety and Healthy Partner,

Krist@2012 (Promkes Batu Putih)

Email ;     Bajaumundu@yahoo.com or puskesmas_batu_putih@yahoo.com 
Practitioner of Health and Educational Promotion Program in CHC of Batu Putih. 

 

 

 

 

 

Categories: Health and Safety Focus, Promosi Kesehatan | 2 Komentar

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2 thoughts on “CPR Technique (BCLS Training Held at Singapure)

  1. muhlis

    Thanks, sepertinya ini guideline 2005. sudah ada guidline 2010 yang diantara beberapa perubahannya adalah dari ABC ke CAB (untuk konsep cardiac), dan meniadakan look. liste and feel.

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