BASIC LIFE SUPPORT SYSTEM SAVES LIFE
By Milin Maru
Rajkot: If someone collapses in front of us, what to do? Sudden outbreak of fire, natural calamities, etc. why are we afraid of these??? The reason is they all are associated with mortality. So what to do to save the lives? If someone collapses in front of us due to cardiac arrest , what next? The answer to all the above questions is cardio-pulmonary resuscitation i.e. Basic Life Support (BLS). Moreover every minute counts, because mortality increases by 10% every minute. So delay in initiation of CPR and activation of EMS ends up with increased mortality. Dr. Bhumi Dave [MD Medicine, IDCCM, FCCM] expressed her opinion in an exclusive interview to Asia Times.
Cardiopulmonary resuscitation (CPR) is a life saving technique useful in many emergencies including heart attack or near drowning in which breathing or heart has stopped. CPR is a technique of BLS for oxygenating the brain and heart until appropriate, definitive medical treatment is available to restore normal heart and ventilator function. The purpose of CPR is to maintain blood circulation by external cardiac massage and to open and clear the airway and to maintain breathing by external ventilation. The principle behind CPR is to prevent irreversible cerebral damage due to anoxia. The brain suffer irreversible damage if cerebral circulation is not present for approximately four minutes. So the emphasis is made to perform excellent chest compressions – only CPR , early access and use of automatic external defibrillator (AED) is encouraged. The EMS (emergency medical services) system should be activated as soon as possible once SCA (sudden cardiac death) is identified. Patient survival depends primarily upon excellent CPR and early defibrillation. During initial phase of SCA, the pulmonary vessels and heart likely contain sufficient oxygenated blood to meet markedly reduced demands, so the importance of compression supersedes the ventilation. The initiation of the chest compression remains the first step to improve oxygen delivery to the tissues, she said.
Before moving towards the resuscitation, safety of the scene, victim, rescuer and bystander should be maintained. Then check the response and if the victim is not responding or not breathing or only gasping, then activate the emergency system and ask for AED immediately and then proceed with chest compression. If within 10 seconds pulse is not felt, begin chest compressions. The chest compression should be high quality CPR with adequate rate atleast 100/min, adequate depth at least 5 cm (2 inches) in depth and should allow complete chest recoil. There should be minimum interruptions during CPR and continue for 5 cycles or for 2 minutes. Then give 2 rescue breaths in less than 10 seconds. Compression – ventilation ratio is 30:2, whether 1 or 2 rescuers. In children and infants, if 1 rescuer ration is 30:2 and with 2 rescuers ration is 15:2. Airway is opened by head tilt – chin lift and ventilation is given by mouth to mask or bag mask. If advanced airway is there, chest compressions should be continuous at least 100/min and 1 breath every 6-8 seconds asynchronous with chest compressions. Once AED arrives attach the AED pads and use as soon as possible. Minimize interruptions in chest compressions before and after shock and resume CPR with chest compressions immediately after each shock. For infants, a manual defibrillator is preferred to an AED for defibrillation.
Early activation of emergency system and initiation of chest compressions help for survival of the patients. In most of the cases, the cause of collapse is cardiac arrest due to ventricular tachycardia and ventricular fibrillation. So early and timely use of AED helps return of spontaneous circulation. Basic life support should be continued till Adavanced Cardiac Life support is available.[/vc_column_text][/vc_column][/vc_row]
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