□ Basic life support includes: assessing safety of the environment, checking response, opening and clearing the airway, checking breathing, delivering breaths if needed, checking for circulation and delivering chest compressions if required.
□ In the hospital setting defibrillators may be employed.
□ It is important to call for emergency help after establishing the presence or absence of breathing.
□ The recovery position is vital in maintaining the support of the airway in the collapsed casualty.
Mr Coughlin, a 73 year old, is visiting his son in his new home. He has been digging the garden and comes into the house clutching his chest. He collapses to the floor and his wife and son are unable to rouse him. The son rushes across the street to find help. You are one of two rescuers who attend the house. You are both student nurses who have recently had BLS training. What should you do?
Before reading on, make a list of your actions.
Firstly you should check that the environment is safe to enter, then assess the casualty for a response. Next you should open and clear the airway and check for the presence of breathing and circulation. This reveals that Mr Coughlin is unresponsive and not breathing. You order the son to contact the emergency services. There are no signs of life and on checking the pulse, you find this is also absent. Your friend explains to Mr Coughlin's wife and son about the need to perform BLS.
In line with guidelines, you commence BLS as per two-person recommendations. One of you delivers the breaths and the other chest compressions at a ratio of 2:15.
You rotate roles to reduce exhaustion. After 20 minutes the emergency services arrive and are able to insert an oro-pharyngeal airway, administer oxygen via a mask and apply defibrillator pads whilst you continue BLS. This unfortunately reveals that Mr Coughlin has no cardiac output and an asystolic rhythm is seen on the monitor screen.
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