BLS (Primary survey, CPR, recovery position)

Report
Freddie Stevens
(Leeds LINKS SJA Training officer)
First things First
 Who?
 Tommaso (unit leader/president)
 Freddie and Chris (Training officers)
 What?
 First Aid
 Social side.
First things First
 Why?
 Everyone who needs it should receive first aid from
those around them. No one should suffer for the lack of
trained first aiders.
 Enough of this… Lets get on with business!
 Don’t hesitate to stop me if you don’t understand or if
you have a question 
Man down… What now?
 Danger
 Response
(Shout)
 Airway
 Breathing
Danger!
 To Who?
 1st) YOU!!! – you are there to help, not get injured
 2nd) Bystanders – you don’t want more patients
 3rd) The patient – you’re there to help them!
 Forms of Danger?
 Water, Electricity, Other People, Fire…
Response!
 Alert
 All of you… I hope!
 Voice
 Give a voice command in each ear… Why?
 Pain
 Firm pat on both shoulders
 Unresponsive
 If none of the above!
 This basic scale of responsiveness will be referred to a lot
through the year!
(Shout!)
 Shout for help!
 You may be good, but your not Wonder-woman!
 Tell your help to call an ambulance, you can update
them and the dispatcher as you learn more about the
condition of your patient!
Airway!
 What classes as airway??
 Neck, Throat, Jaw, Nose, Tongue, Teeth, Lips…
 Quick check that all of these things look normal and
unobstructed.
 If obstructed then clear obstruction IF SAFE to do so!
 Unconscious patients can’t maintain their own
airway… so you have to do it for them!
 Demonstration with the lovely Dennis!
Breathing!
 There are 3 things to do while checking breathing
 Look!
 Listen!
 Feel!
 Smell!
 How many breaths in how long?
 2-3 breaths in 10 seconds
 MUST check for the FULL 10 seconds
 Are they breathing?
 Yes – Recovery Position
 No – CPR
Play Time
 Everyone pair up and lets go through this series of
steps, this is your primary survey!
Danger?
Make area safe before
approaching
Yes
No
Response?
Yes
Talk to the
patient
No
Airway obstruction?
Yes
If safe, clear it
No
Are they Breathing?
NO!
Yes!
CPR!!
Recovery Position
Recovery Position
 So… We mentioned the recovery position earlier, what
is it?
 Safe position for an unconscious patient.
 Maintains airway
 Prevents patient choking if they vomit
We Know What, Now How?
 Straight off the SJA website Turn them onto their side
 Lift chin forward in open airway position and adjust
hand under the cheek as necessary
 Check they cannot roll forwards or backwards
 Monitor breathing continuously
 If injuries allow, turn them to the other side after 30
minutes.
Demo and practice
CPR!
 Cardiopulmonary Resuscitation
 Unlikely to return cardiac rhythm on its own
 If delivered effectively it can increase the window in
which defibrillation is effective!
CPR run down
 Compressions vs Compressions and Breaths?
 We do compressions and breaths
 NEJoM study has shown there is No Sig. Dif. (poor
investigation though)
 Compression to breaths ratio?
 30:2
 Compressions or Breaths First?
 Compressions – unconscious, not breathing adult
 Breaths – Unconscious, not breathing Child, Baby or
suspected Drowning (if breaths come first there should be 5
rescue breaths before normal 30:2 cycling)
 How fast should the compressions be?
 100 - 120 bpm
Is it really worth it?
 Watch this, then you decide…
 http://www.youtube.com/watch?v=hfrv7ZzLcJc
 http://www.youtube.com/watch?v=KXjEnTHMUow&f
eature=related
 Start at 8 mins
How to do Compressions!
 Interlock your fingers
 Place your hands in the middle of the patients chest, 1-
2 inches above the bottom of the sternum
 Lean over your patient
 “Lock-out” your elbows
 Begin compressions
After 30 compressions!
 Open their airway the same way as during the primary




survey
Pinch their nose
Make a full seal with your mouth to theirs
Attempt to deliver a breath
Take your face away from theirs before attempting to
deliver the next breath.
 Demonstration with Dennis 

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