RCP Advanced Life Support

RCP Advanced Life Support

Education for Life

720 N. Valley St. Ste. F, Anaheim, CA 92801

Tel. (714) 808-9036

New CPR Guidelines for the Healthcare Provider

Modern CPR was first described in 1960, and the first conference in CPR was held in 1966. Since the advent of those original guidelines, the American Heart association has published four major updates in 1974, 1980, 1986 and 1992. The International guidelines 2000 conference in September 2000 was the first international conference on Cardiopulmonary Resuscitation and Emergency Cardiac Care. The new guidelines strongly emphasize evidence as the basis for all new clinical recommendations. The highest potential survival rate from cardiac arrest can be achieved only when the following sequence of events occur as rapidly as possible: (1) recognition of early warning signs, (2) activation of the EMS system, (3) basic CPR, (4) defibrillation, (5)management of airway and ventilation, and (6) intravenous administration of medications.

BLS for the Healthcare Provider: New Course Objectives

The primary goal of the BLS for Healthcare Provider Course is to improve rates of survival from sudden cardiac arrest. It emphasizes the importance of early activation of EMS, CPR (with mouth-to-mask and bag-mask ventilation, with and without oxygen), and the use of an AED for victims 8 years of age. The course continues too include relief of foreign body airway obstruction (FBAO) and the prevention of death and disability due to heart attack and stroke. Teaching now includes methods to reduce death caused by sudden infant death syndrome in infants and injuries in children. At the end of the course, the participant will be able to demonstrate the following skills: (1) Phone 911, (2) Rescue breathing including bag-mask ventilation on adult, child, and infant victims, (3) One and Two Rescuer CPR for adult, child and infant, (4) Use of an AED, (5) Relief of FBAO in responsive and unresponsive victims of any age.

The HUNT for V-FIB

Early defibrillation is the single most important factor in determining the patients’ outcome in most adult patients. Some studies report a conversion rate (to a perfusing rhythm) of 80-95% in VF patients treated with early defibrillation (within the first minute). As each minute passes the window of opportunity slowly closes. In adult cardiac arrests, the hunt for V-FIB starts as soon as the code is called. The clock keeps ticking as we try to get the defibrillator to the patient’s room and attach the leads. According to the AHA, we should be able to deliver 3 stacked shocks to all patients with VF within 3 minutes. Any delay in defibrillation increases mortality. Evidence supports timely defibrillation in public places, in the homes of high-risk patients, and in commercial aircraft, airports, hospitals, doctor’s offices, and outpatient clinics. An AED can be used in children 8 years of age and older. Healthcare providers with a duty to perform CPR need to be trained, equipped, and authorized to use an AED.

Modification of the “Phone First vs. Phone Fast” Guidelines: Recognition of Special Situations

New for Adults – Guidelines now recognize 4 special resuscitation situations where airway compromise, rather than VT/VFib is the cause of the arrest. The new BLS guideline for these victims is “phone fast”. This means provide 1 minute of CPR before phoning the EMS. These situations are (1) Submersion/near drowning, (2) Poisoning, drug overdose, (3) Trauma, and (4) Respiratory arrest.

New for Pediatrics – The major exception to the “phone fast” rule is those children at risk for VT/VFib/Cardiac history, who experience sudden collapse. For that select group “phone first” is recommended.

Primary Survey

Establish Unresponsiveness – Activate EMS as delineated in “Phone First vs. Phone Fast” Guidelines

1. OPEN AIRWAY – Head tilt-chin lift (if trauma is present, use jaw thrust).
2. CHECK FOR BREATHING – Look, listen, and feel for no more than 10 seconds.
3. If victim is breathing or resumes effective breathing, place in the recovery position.
4. If victim is not breathing, give 2 slow breaths using [pocket mask or bag-mask or barrier device.
5. CHECK FOR SIGNS OF CIRCULATION – “Normal breathing, coughing, or movement” and pulse check.
6. DEFIBRILLATION – Using Automated External Defibrillator (AED) in victims over 8 years of age.