Pro First Aid

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Now let's cover basic life support for the adult in team approach.

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Team approach is best known when we're talking about advanced cardiac life support

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with team leaders and running a mega code.

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In this case, we're going to apply some of those same principles, but at a basic life support level.

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It works extremely well. This is a situation where you're probably more in a clinical setting

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or with multiply trained rescuers. So, what's neat about this is that you have the ability

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to step back as a team leader, and usually take a role of rescue breathing while you direct

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the other team members to do specific jobs.

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It's efficient, it's effective, and it's a great way to provide this type of basic life support

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when you have extra help. So, we're going to walk through these steps.

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The same thing is going to apply. The scene is safe, gloves are on,

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CPR shield is available. Ideally, you would bring in an AED, bag valve mask, crash cart

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immediately with you if you knew this was happening.

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But let's just, for this scenario's sake, say that someone made you aware,

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or a couple of people were in the hallway, that someone is not responsive.

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The first rescuer comes in and is going to actually do the same thing.

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Tap and shout, are you alright are you okay? Look to see if the patient is breathing normally,

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or not breathing, or in agonal respirations, which qualify as not breathing.

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If that's the case, they're going to call a code or activate the emergency medical response team.

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And then, they're going to check for a pulse.

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No pulse found, patient non-responsive, no breathing, no moving, they're going to go right into 2-person

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CPR if there's two rescuers. If there's only one rescuer, they're going to call for help.

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The hallway is going to hear them, they're going to come in and now they're going to have at least

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a couple of rescuers. Now, keep in mind, the emergency medical response team has been activated.

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So, more help should be on the way. And, ideally, they're going to be coming back with gear --

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AED, crash cart, bag valve mask. When we go through the practice session, we're going to show

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what that looks like and how it works in a choreographed manner.

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While the person is doing CPR, if a person walks in with a bag valve mask, they can then come over

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and take team leadership and start the ventilations with the bag valve mask.

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The benefits of that is that with room air, you are giving the patient oxygen but no carbon dioxide.

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So, now, we're not adding more carbon dioxide to the person's bloodstream, causing that

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acidic problem that we were talking about before. This person can now be supportive role

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and exchange places with the initial compressor, which allows them to take a break

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and for us to consistently continue those deep, 2-inch plus compressions

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at least 100 times a minute in order to keep that circulation level up.

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Ideally, the AED is soon going to arrive, if it's not already on scene. They're going to go ahead

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and prepare the patient's chest. Remember what we talked about with wiping off excess sweat.

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Making sure the scene is safe to be able to use the AED, meaning there' s no combustibles,

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no liquids, no flammables. Then, they're going to go ahead and apply the AED.

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Compressions will stop, respirations will stop, AED is in place. We let it do its thing.

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Ideally, then, if the crash cart is not already there, we have an additional runner who begins to come

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in. They'll probably ask, "Is there anything I can do to help?"

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They could even be an administrative role. At this point, we say, "Yes, Janet.

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Could you please go and grab the advanced life support crash cart and return quickly?"

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They go ahead and do that, which is going to get us the medications, the intubation equipment,

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the suction equipment, everything else we need to turn this into a high-speed,

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life rescuing event, and it's going to work really well if you practice this from a team approach.

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Scene is safe. Gloves, mask. Are you alright, are you okay?

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Rex, go activate the emergency response team and come right back.

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1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16,

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17, 18, 19, 20, 21, 22, 23...

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Dan: I'm going to take over breaths now. Can you do compressions?

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Rex: Yes, I'm all ready.

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Roy: Hey guys, what's going on?

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Dan: We've got a guy down.

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Roy: Ok, no pulse?

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Dan: No pulse

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Roy: Okay, I'm going to go ahead and take over rescue breathing. Jody just got here with the AED.

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Janet: Hey, is there anything I can do to help?

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Roy: Yeah, Janet, could you go ahead and go get the advanced life support crash cart?

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And then come back as quickly as possible, please.

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Janet: Yup, I'm on it.

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Roy: Thanks.

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AED: * Remove clothing from person's chest *

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Roy: Looks like the scene is safe to use the AED. No combustibles, no standing liquids.

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AED: * Attach pads firmly to person's chest as shown *

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Roy: Does anybody know how long this person was down?

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Dan: Just walked up to it and the person was unresponsive.

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AED: * Plug in connector *

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Roy: Did they have a no-code status or anything like that?

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Could you tell Janet to bring in the no-code status and paperwork?

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AED: * Shock advised... Charging. Everyone stand clear. *

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AED: * BEEP *

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Roy: Clear

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AED: * Everyone stand clear. Push the shock button. *

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Jody: Clear

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AED: * Shock delivered. Begin 5 cycles of CPR *

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Roy: Okay, at this point we're going to continue 30 compressions to 2 rescue breaths,

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using the bag valve mask, if available.

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We're going to continue this until the AED interrupts or until the full advanced life support

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crash cart gets here and we bring it to the next level.