PART II

LESSON PLAN OF VIDEO ASSISTED

TEACHING PROGRAMME
REGARDING BASIC LIFE SUPPORT
Name of the student teacher: Harpreet kaur

Topic : Basic life support

Group: Under graduate students

A.V aids: Video and power point presentation

General objective: At the end of the video assisted teaching programme students will acquire adequate knowledge on basic life support.

Specific objectives: The students will be able to:

 Define BLS
 List out the indications of cardio pulmonary resuscitation.
 Elaborate the concepts of CPR
 Explain briefly about the steps of basic life support
 Describe about high quality CPR
S. SPECIFIC TIME CONTENT MATTER A.V TEACHING EVALUATION
NO OBJECTIVE AIDS LEARNING
ACTIVITY
1. Self 30 SELF INTRODUCTION
Introduction Sec I am Harpreet kaur student of Lala Lajpat Rai Institution of Nursing Education, Gulab Devi Verbally Students
Hospital, Jalandhar, Punjab. Maintains
Eye
2. Announcement 20 ANNOUCEMENT OF THE TOPIC Contact
Of the topic Sec Today we will learn about the Basic life support. With
Teacher
3. Assess the 30 PREVIOUS KNOWLEDGE
Previous Sec What do you know about BLS?
knowledge

4. Define BLS 1min DEFINITION

Sequences of procedures performed to restore the circulation of oxygenated blood after a
sudden pulmonary and cardiac arrest. Define
P BLS?
Chest compressions and pulmonary ventilation performed by anyone who knows how to do
it, anywhere, immediately, without any other equipment.

CPR (Cardio pulmonary resuscitation) is the part of BLS. It is the non-invasive assessment P
and intervention used to quickly identify and treat victims of respiratory, cardiovascular
emergencies. It is a combination of rescue breathing and chest compressions.

5. Describe the 2 min INDICATIONS T What are

Indications Cardiac Arrest The
Of BLS Sudden, unexpected loss of heart function, breathing and consciousness. Indications
In cardiac arrest, the heart abruptly stops beating without prompt intervention, it can result For BLS?
in persons’s death.
Heart attack
A blockage of the blood flow to the heart muscle. A heart attack is a medical emergency. A
 heart attack usually occurs when a blood clot blocks blood flow to the heart, without blood,
tissues loses oxygen and dies.
Respiratory arrest
It is the state in which a patient stops breathing but maintains a pulse. Respiratory arrest can
exist when breathing is ineffective , such as agonal gasping.
 Survival from sudden cardiac arrest is optimized when the event is witnessed and
CPR is initiated immediately
 Patient survival declines dramatically if basic CPR is not initiated within first four P
minutes
The Systematic Approach: The BLS Primary Survey The students
Goal of BLS : Clear the
 To support and restore effective Doubts from
 oxygenation teacher
 Circulation
 with return of intact neurologic function
 ROSC (return of spontaneous circulation)

6. Explain BLS 5 min BLS

Chain of survival ( Steps) P
 Recognize symptoms and activate EMS
 Perform early CPR Explain the
Steps of
 Defibrillate with AED
Chain of
 Advanced life support
Survival?
 Post cardiac arrest care

Important
Although BLS is taught as a sequence of distinct steps to enhance skills retention and T
clarify priorities, several actions should be accomplished simultaneously (begin CPR and
activate emergency response system) when multiple rescuers are present.
All adult arrest are cardiac in origin therefore 1st step i.e. call for help is important because
if AED is not available it can come on time.
BLS consists of……….
 Three main parts:
Chest compressions (C)
Airway (A)
Breathing (B)
Defibrillation (D)

7. Elaborate the 10 Steps of BLS

Steps of BLS Min There are basically 4 steps in BLS:
 Assessment and scene safety
 Activate Emergency response system and Get an AED P Enlist the
 Check pulse Steps of
 Begin cycles of 30 chest compressions and 2 breaths if you do not definitely feel a BLS?
pulse within 10sec and perform 5 cycles (30:2) with CAB sequence.
1. Scene safety The students
Ask yourself….. Take down
 Is it safe for me to approach the victim? The notes
I may suffocate /get burnt/get hypothermic/get electric shock
 Is it safe for the victim to be attended to where he has collapsed?
I need to take victim out of water / switch off the main switch to start CPR
 What other precautions should I take for my own safety?
P
I should use barriers like handkerchief, gloves
Assessment
 Tap the victim’s shoulder and shout,
“Are you all right?”
 Check to see if the victim is breathing.
 If not breathing or not breathing normally (gasping), activate emergency response
system.
2. Activate Emergency response system
If someone approaches to help…
 Ask him to call EMS (emergency medical services) T
 Ask him to tell EMS about the place and about collapsed victim?
  While he activates the EMS , the rescuer should start CPR
If no help available….
 Call yourself before starting the CPR
3. Pulse check P
 Palpate carotid pulse.
 Feel for a pulse for atleast 5sec but no more than 10 sec.
 If you do not feel pulse within 10 seconds, start chest compressions (in CAB The students
sequence) Maintains
4. Begin CPR Eye contact
The aim of cardio pulmonary resuscitation is restore heart and lung function. So, to With teacher
begin CPR we should follow:
1. Assess Circulation and providing chest compression
2. Opening Airway
3. Assess Breathing and providing breath P
Revision
4 main steps of BLS:
1. Scene safety and Assessment
2. Call EMS
3. Check pulse
4. Start CPR ( in CABD sequence)

CIRCULATION
 After palpating pulse for atleast 10sec start with CPR if no definite pulse is T
palpable.
 Mechanism: Increase of intrathoracic pressure and direct compression of the heart
 Recommended compression rate: atleast 100-120/min
 Depth of compression should be atleast 2-2.4 inches (5cm).
 Compression : ventilation
30 : 2 when one rescuer
30 : 2 when 2 rescuers
15 : 2 when 2 rescuers (infants and children)
8. Describe high 10 High quality CPR
Quality CPR Min Start compressions within 10 seconds of recognition of cardiac arrest. What is
 Push hard, push fast: Compress at a rate of atleast 100-120/min with depth of atleast High
2-2.4inches (5cm). Quality
 Allow complete chest recoil after each compression. CPR?
 Minimize interruptions in compression (try to limit interruptions to < 10 sec)
Process of CPR
 Position yourself at the victim’s side. P
 Make sure that victim lies on the firm, hard surface. Students
 Put the heel of the hand on the center of the victim’s chest on the lower half of the Clear
breastbone. Doubts from t
 Put the heel of your other hand on the top of first hand. Teacher
 Straighten your arm with knees locked and position your shoulder directly over the
hands.
 Push hard and fast
 Press down atleast 2-2.4 inches (5cm) with each compression. P
 Deliver compressions in a smooth fashion at a rate of atleast 100-120/min.
 At the end of each compression, make sure to allow complete chest recoil
after each compression.
 Adjust position that your shoulders are on top of the victim and in line with hands
 Provide cycles of compressions and breathing.
 30 compressions with 2 breaths is one cycle
 30 : 2 in adults (with one or two rescuer)
 Complete 5 cycles in 2 min and then check carotid pulse and switch roles T
 If untrained bystanders witness a cardiac emergency he should call for help
and perform hands only CPR.

AIRWAY
Open the airway for breaths
2 methods are there to open the airway:
• Jaw thrust
 • Head tilt- chin lift
*Jaw thrust is used with 2 rescuers as two persons are needed to provide breaths and
to open the airway when neck or spinal cord injury suspected.

*Head lilt-chin lift method is used when no injury is suspected but patient is
unresponsive.
P
Caution
 Do not press into the soft tissue under the chin because this might block the airway.
 Do not use thumb to lift the chin.
 Do not close the victim’s mouth completely.
 Management of obstructed airway: by removing the visible obstruction.
Signs of an obstructed airway are
 Poor gas exchange The students
 High pitched noise while inhaling Take down
 Inability to speak The notes
BREATHING
Provide breaths
 Mouth to mouth breaths P
 Mouth to mask breaths
 Bag to mask breaths
Mouth to mouth breaths
 Hold the victim’s airway open with a head tilt – chin lift.
 Pinch the nose closed with your thumb and index finger (using the hand on
forehead)
 Take a regular (not deep) breath and seal your lips around the victim’s mouth,
creating an airtight seal.
 Give 1 breath (blow for 1sec). Watch for the chest rise. T
 Give a second breath.
 If you are unable to ventilate the victim after 2 attempts, promptly return to chest
compressions.
Face mask
  Standard precautions include using face mask or a bag mask ventilation when
giving breaths.
 Mask usually have a 1-way valve that diverts exhaled air, blood or bodily fluids
away from the rescuer.
Mouth to mask breaths
 Position yourself at the victim’s side.
 Place the mask on the victim’s face, using the bridge of the nose as a guide
for correct position.
 Seal the mask against the face:
 Using the hand that is closer to the top of the victim’s head, place your P
index finger and thumb along the edge of the mask.
 Place the thumb of your second hand along the bottom edge of the mask.
 Place the remaining fingers of your second hand along the bony margin of
the jaw and lift the jaw
 While you lift the jaw, press firmly and completely around the outside edge of the
mask to seal the mask against the face.
 Deliver air over 1 second to make the victim’s chest rise.
Bag to mask breaths
 Position yourself directly above the victim’s head. P
 Place the mask on the victim’s face, using the bridge of the nose as a guide for
correct position.
 Use the E-C clamp technique to hold the mask in place while you lift the jaw to
hold the airway open
 Squeeze the bag to give breaths (1second each) while watching the chest rise.
E – C technique
The E-C clamp technique of bag – mask ventilations. Three fingers of one hand lift the jaw
(they form the “E” Shape) while the thumb and index finger hold the mask to the face
(making a “c”) Students
The rescuers will then give compressions and breaths but should switch roles after every 5 T Clear
cycles of CPR (about every 2min) Doubts from t
 Rescuer 1: At victim’s side Teacher
Rescuer 2: At victim’s head
  Maintain an open airway
 Give breaths watching for chest rise and avoiding excessive ventilation.
 Correct the rescuer 1 to perform adequate CPR
 Switch duties with the second rescuer every 5 cycles or about 2 minutes, taking less
than 5 second to switch.

DEFIBRILLATION
AED (Automated External Defibrillators)
 Automated external defibrillators (AEDs) are computerized devices that can
identify cardiac rhythms that need a shock and these can deliver shock. P
 When VT is present, the heart muscle fibres quiver and do not contract together to
pump blood.
 This delivers shock to stop the quivering of the heart fibres and allows the muscle
fibres of the heart to ‘reset’ so that they can begin to contract at same time. The students
 Once an organized rhythm occurs, the heart muscle may begin to contract Take down
effectively and begin to generate a pulse (called ROSC) The notes
Parts of AED
• Pads (self sticking)
• On/off switch
• Shock delivery button P
• Pad connector
• Battery
 Once the AED arrives, place it at the victim’s side
 If multiple rescuers are present, one rescuer should continue CPR while another
rescuer attaches AED pads.
Attempted Defibrillation
Current Recommendation
 One shock
 Biphasic 150-200J
 Monophasic 360J T
 Immediate CPR
 Rhythm check only after 5 cycles (2 mins) of CPR
Using AED
 Switch it on
 Act according to voice prompt
 Apply pads to bare chest of victim ( one to the side of the left nipple, with the top
edge of the pad a few inches below the armpit and other below right collar bone)
 Connect pads to AED (some are pre connected)
 Let AED Analyze heart rhythm: do not touch the victim (it will take 5 to 15 sec to
analyze)
 If the AED advices a shock; be sure no one is touching the victim. P
 Loudly state a “clear the victim” message, such as “Everybody clear” or simply
“clear”.
 Look to be sure no one is in contact with the victim.
 Press shock button
 Shock delivered: immediately resume with 5 cycles CPR begin with chest
compressions
 If “no shock advised”, immediately restart CPR.
AED in special situations
Age :
 Victim <1yr – AED not advised P
 Victim 1-8yrs – use child pads and child AED
Hairy chest:
 Press pads firmly, if not remove hairs by sticking pads and removing hair along
with them. Use other set of pads now
 Use razor
Wet chest:
 Clean victim’s chest dry
 If patient is in water, do not use AED but if patient is in snow; dry the chest first
and then AED can be used. The students
 Implanted device: Do not use AED T Maintains
AED with 2 rescuer Eye contact
 Check the response and check breathing With teacher
 o The first rescuer stays with the victim and performs the next steps until the
next rescuer returns with AED.
o The second rescuer activates the emergency response system and gets the
AED.
 Check for pulse
o The first rescuer removes or moves clothing covering the victim’s chest and
then start CPR.

Students
Clear
Doubts from t
teacher
P

T
P

The students
Take down
The notes

T
9. Summarize the 15 verbally
Topic sec SUMMARIZATION
Today we learn about the BLS:
 Definition of BLS
 Indications of BLS
 Steps of BLS
 High quality CPR
 Compressions
 Airway
 Breathing
 Defibrillation
10. Recaptulize 15 verbally
The topic sec
RECAPTULIZATION
1. What is bls?
2. What are the indications of BLS?
3. Describe the steps of BLS?
4. What is high quality CPR?