BASIC LIFE SUPPORT

·  You are likely to be presented with a resus mannequin and told that you have found the patient collapsed, either on a corridor in the hospital or somewhere outside. Either way, the algorithm to follow is fairly similar.

·  The basic train of though is “Dr. ABC”, or rather:

Danger, Response, Airway, Breathing, and Circulation.

·  Danger

Initially you should assess if there is any danger in the situation either for you or for the patient.

·  Response

You should check if there is any response from the patient. Do this by gently shaking the patient’s shoulders and loudly shouting into both ears, asking them “Can you hear me?”.

If there is no response you should shout for help.

Check for response

·  Airway

Check if the patient’s airway is patent. Perform the head tilt (unless there is any chance of cervical spine injury) and jaw thrust to open the airway. Ensure that there is no physical blockage by their tongue, vomit, or anything else.

Check patient's airway

·  Breathing and Circulation

Check the patient’s breathing and circulation simultaneously. Do this by maintaining the head tilt and jaw thrust, placing your face and ear over the mouth to feel for any respiratory effort, whilst observing the chest for any movement. At the same time you should place two fingers over the carotid pulse to assess circulation.

Check for breathing and circulation

·  If breathing and circulation are normal, place the patient in the recovery position and find help.

Recovery position

·  If breathing and/or circulation are absent you should call for the emergency services.

This number is 999 in the UK, or typically 911 or 112 internationally (check and know your local number). From within the hospital, call the crash call number (commonly 2222, but again check for local differences).

·  Once you have called for support, you should start chest compressions.

Place one hand over the sternum roughly in the middle, interlock your fingers and lock your elbows positioning yourself vertically above your hands. Depress the sternum 4-5 centimeters and release the pressure. Repeat this 30 times at a rate of 100 per minute.

Start chest compressions

·  Start to give a combination of 2 rescue breaths and 30 chest compressions. For the rescue breaths ensure the head tilt and jaw thrust are in place, pinch the soft part of the nose so that it is closed, open the mouth, seal your lips around theirs and blow steadily for 2 seconds. Watch the chest to check that it rises and falls with the breath. Once the breaths are given, return to giving 30 chest compressions.

Pinch nose and tilt head

Breathe into patient

·  If there is anyone who can assist, you should share out the work. One of you should perform the breaths and the other the compressions, swapping when tired.

·  You should continue this cycle of 2 rescue breaths and 30 chest compressions until either further help arrives, the patient regains consciousness, or you can no longer physically continue.