and Resuscitation Council (UK) Instructor for EPLS, ALS ...
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NHS FAST DEFLATE 3 3 FAST DEFLATE CPR 1 2 C P R NORMAL TRANSPORT 3 Page 1 of 3 Cardiopulmonary Resuscitation Children Part 7: Chest compressions for children Edited by Colin Pidgeon, Resuscitation Officer, Barnet and Chase Farm Hospitals NHS Trust, and Resuscitation Council (UK) Instructor for EPLS, ALS and GIC, Advanced Life Support Group Instructor for APLS ©2016 Clinical Skills Limited. All rights reserved Position the child (b) Prepare to carry out compressions (a) It is important for the child to be flat on his or her back on a firm surface to achieve the most effective chest compressions. If possible, adjust the height of the bed so that the child’s chest is on a level between your knee and mid-thigh (Resuscitation Council (UK), 2015b). Apply the brakes to the bed. For useful guidance on safe manual handling during CPR, including when carrying out chest compressions, refer to Guidance for Safer Handling during Resuscitation in Health Care Settings (Resuscitation Council (UK), 2015b). On some pressure-relieving beds, there is a switch, often labelled CPR, to allow you to rapidly deflate the mattress to achieve a firm surface (see inset). Do not undertake or attempt any procedure unless you are, or have supervision from, a properly trained, experienced and competent person. Always first explain the procedure to the patient and obtain his/her consent, in line with the policies of your employer or educational institution Put on gloves as soon as possible. In a child over 1 year old, locate the xiphisternum at the angle where the lower costal margins meet and compress one finger’s breadth above this point (Resuscitation Council (UK), 2015a). If using the two-hand technique in a child over 1 year old, place the heel of your other hand on top of the first hand; interlock the fingers of your hands and ensure that you do not apply pressure over the patient’s ribs (Resuscitation Council (UK), 2015a). Cardiopulmonary resuscitation is divided into basic life support procedures and advanced life support procedures. This procedure, which describes treatment of children, falls within the category of basic life support and can be carried out by anyone who has successfully completed the appropriate training. In cardiopulmonary resuscitation (CPR), it is vital to perform chest compressions effectively in order to maximise the critical flow of blood and oxygen to the brain and other vital organs. If the technique is not taught correctly and not practised periodically at an update session, the compressions may be ineffective. The Resuscitation Council (UK) (2015a) notes that chest compressions, both in hospital and outside, are often undertaken with insufficient depth and at the wrong rate. Chest compressions in children are delivered over the lower half of the sternum. In order to avoid compressing the upper abdomen, locate the xiphisternum at the angle where the lower costal margins meet and compress one finger’s breadth above this point (Resuscitation Council (UK), 2015a). It takes a lot of energy to perform chest compressions: if two or more rescuers are present, you should hand over to a colleague after each episode of 1 to 2 minutes, without interrupting compressions (Resuscitation Council (UK), 2015a). In addition, you must be above and over the patient so that all the energy is transmitted to the chest area, through your straight arms, with maximum ease. This procedure covers the method for performing chest compressions, as part of basic life support. For further information on other elements of basic life support, please refer to other parts of this series. For References and Key Reading please see html page. www.clinicalskills.net
Transcript of and Resuscitation Council (UK) Instructor for EPLS, ALS ...
NHS Great Ormond StreetHospital for Children
NHS Trust
FIONA HORROXLINK LECTURER LSBU
FAST DEFLATE
33
FAST DEFLATE
CPR12
CPR
NORMAL
TRANSPORT
3
Page 1 of 3
Cardiopulmonary ResuscitationChildren
Part 7: Chest compressions for childrenEdited by Colin Pidgeon, Resuscitation Officer, Barnet and Chase Farm Hospitals NHS Trust,
and Resuscitation Council (UK) Instructor for EPLS, ALS and GIC, Advanced Life Support Group Instructor for APLS
©2016 Clinical Skills Limited. All rights reserved
Position the child
(b)Prepare to carry out compressions (a)
It is important for the child to be flat on his or her back on a firm surface to achieve the most effective chest compressions. If possible, adjust the height of the bed so that the child’s chest is on a level between your knee and mid-thigh (Resuscitation Council (UK), 2015b). Apply the brakes to the bed. For useful guidance on safe manual handling during CPR, including when carrying out chest compressions, refer to Guidance for Safer Handling during Resuscitation in Health Care Settings (Resuscitation Council (UK), 2015b). On some pressure-relieving beds, there is a switch, often labelled CPR, to allow you to rapidly deflate the mattress to achieve a firm surface (see inset).
Do not undertake or attempt any procedure unless you are, or have supervision from, a properly trained, experienced and competent person.Always first explain the procedure to the patient and obtain his/her consent, in line with the policies of your employer or educational institution
Put on gloves as soon as possible. In a child over 1 year old, locate the xiphisternum at the angle where the lower costal margins meet and compress one finger’s breadth above this point (Resuscitation Council (UK), 2015a).
If using the two-hand technique in a child over 1 year old, place the heel of your other hand on top of the first hand; interlock the fingers of your hands and ensure that you do not apply pressure over the patient’s ribs (Resuscitation Council (UK), 2015a).
Cardiopulmonary resuscitation is divided into basic life support procedures and advanced life support procedures. This procedure, which describes treatment of children, falls within the category of basic life support and can be carried out by anyone who has successfully completed the appropriate training.
In cardiopulmonary resuscitation (CPR), it is vital to perform chest compressions effectively in order to maximise the critical flow of blood and oxygen to the brain and other vital organs. If the technique is not taught correctly and not practised periodically at an update session, the compressions may be ineffective. The Resuscitation Council (UK) (2015a) notes that chest compressions, both in hospital and outside, are often undertaken with insufficient depth and at the wrong rate.
Chest compressions in children are delivered over the lower half of the sternum. In order to avoid compressing the upper abdomen, locate the xiphisternum at the angle where the lower costal margins meet and compress one finger’s breadth above this point (Resuscitation Council (UK), 2015a).
It takes a lot of energy to perform chest compressions: if two or more rescuers are present, you should hand over to a colleague after each episode of 1 to 2 minutes, without interrupting compressions (Resuscitation Council (UK), 2015a). In addition, you must be above and over the patient so that all the energy is transmitted to the chest area, through your straight arms, with maximum ease.
This procedure covers the method for performing chest compressions, as part of basic life support. For further information on other elements of basic life support, please refer to other parts of this series.
For References and Key Reading please see html page. www.clinicalskills.net
At leastone-third
At leastone-third
Cardiopulmonary Resuscitation
Children
Part 7: Chest compressions for children Page 2
Compress the chest: (a) (b)
It is important not to apply pressure over the upper abdomen, or at the bottom of the sternum.
Position yourself vertically above the child’s chest. You must keep your arms straight to make compressions as effective as possible. Your shoulders should be directly over the child’s chest and the force for the compressions should derive from flexion of your hips (Resuscitation Council (UK), 2015a).
Compress the chest vertically downwards by at least one-third of the depth of the chest, which is approximately 5 cm. It is important that the depth of pressure is adequate and correct.
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Do not undertake or attempt any procedure unless you are, or have supervision from, a properly trained, experienced and competent person.Always first explain the procedure to the patient and obtain his/her consent, in line with the policies of your employer or educational institution
Release the pressure: (a)
After each compression, release all the pressure on the chest wall, allowing the chest to recoil fully, but without losing contact between your hands and the sternum (Resuscitation Council (UK), 2015a). Keeping your hands on the child’s sternum helps to maintain the correct rate of compressions and also conserves your own energy.
Compression and release should take an equal amount of time (Resuscitation Council (UK), 2015a).
(b)
(c)
x 15 x 2
Cardiopulmonary ResuscitationChildren
Part 7: Chest compressions for children Page 3
Continue chest compressions Deliver ventilations
(c)
The compressions should be given at a rate of 100 to 120 a minute. This is a fast rate but it is important to follow this guidance, in order to allow an adequate amount of blood and oxygen to reach the vital organs, such as the brain. It can be helpful to count aloud, “13, 14, 15,”, so that the person who is breathing for the child can be ready to deliver a breath via his or her own mouth or a device.
Deliver two breaths after each 15 compressions (Resuscitation Council (UK), 2015a). When breaths are delivered, leave your hands on the chest but do not press down. This allows the lungs to inflate more easily.
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Do not undertake or attempt any procedure unless you are, or have supervision from, a properly trained, experienced and competent person.Always first explain the procedure to the patient and obtain his/her consent, in line with the policies of your employer or educational institution
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16
SINGLEUSE
ID4.
0
S.S
OD
ORA
LN
ASAL
Once there is a secured airway, for example by endotracheal intubation, the lungs can be ventilated at a rate of about 10 to 12 breaths per minute (Resuscitation Council (UK), 2015a). Chest compressions should be continued without pausing while ventilation is maintained (Resuscitation Council (UK), 2015a). Note that asynchronous chest compression and ventilation is not appropriate with an oropharyngeal airway such as a Guedel device.
Barnet & Chase Farm HospitalsNHS Trust
RESUSCITATIONRESUSCITATION OFFICER
COLIN PIDGEON
NHS
NHSGreat Ormond StreetHospital for ChildrenNHS TrustFIONA HORROXLINK LECTURER LSBU
Guedel airway
An oropharyngeal airway such as a Guedel device may be inserted at this point if required.
Performing chest compressions is tiring: if two or more rescuers are present, hand over to a colleague after each episode of 1 to 2 minutes, without interrupting compressions (Resuscitation Council (UK), 2015a).
Perform compressions for no more than 2 minutes
Chest compressions and intubation
