Basic Life Support Skills

Whether it’s the A to E assessment, or how to effectively perform chest compressions, Claire is here with the advice you need to brush up on your life support skills.

Disclaimer About This Training Video

This video will explain in detail what you can expect to do. It will also supplement any existing qualification and experience you have in this subject and procedures, refresh your memory and prepare you for a regulated training course. (Of course, it is not a substitute for a course.) You can also find regulated training courses on Nurses.co.uk. Our courses will build your CPD, provide you with a certificate, and enhance your CV when job hunting.

Topics Covered In This Article

Introduction

The A To E Assessment

Airway

Breathing

Circulation

Disability

Exposure

How To Utilise Life Support

Chest Compressions

Differences With Children

Remaining COVID Aware

Physical Demonstration (Featuring Annie)

Conclusion

Introduction

Hi everyone and welcome back to the blog.

So in today's blog, we're gonna be talking about basic life support and I just have to put a disclaimer here, this is not a teaching video, this is not like part of CPD or anything like that, I'm not a qualified trainer or anything like that.

This is just more about awareness and what we do in healthcare or anyone that's trained to do basic life support basically this is the run through of what we do.

So firstly, there are many, many reasons why a person may literally just drop down to the floor and lose consciousness.

There's many things.

Some people have just fainted.

There's some sort of reaction that's gone on, they've fainted, but they come round quite quickly, other people have some sort of anaphylaxis reactions or maybe they've had some sort of allergic reaction.

The A To E Assessment

It's really, really important that the first thing you do is go through your A to E assessment, which I'm going to go through to you now.

And then you can work out what's happened to this person and what your next steps are.

And also there are some differences between a child and adult.

So with an adult, if an adult is going into some form of cardiac arrest and need in life support, nine times out of 10, this is because it's a heart problem in adults, whereas with a child it's nine times out of 10, it's normally to do with their breathing, where they might need a different form of treatment.

So this is why the A to E assessment is important, no matter what the age.

So first letter of the alphabet, we're gonna go with airway, A to E.

Airway

So airway, is the airway obstructed?

So you want to have a look in their mouth, just make sure they haven't got anything stuck in there.

Also listen to the sounds that they're making as well.

That can give you a bit more of an idea as well.

If there's something stuck there, it's gonna make some sort of weird sounds like not a normal breathing sound if that makes sense, it might be like a whistling sound or rattly sound, something that's not right.

And common causes of airway obstruction could be physically their tongue for a start, some form of foreign body like I said, if they're out eating or something like that, or maybe they've snapped a lid off something and it's gone down their throat, I don't know.

Also things like vomit, blood or secretions as well.

And then things like local swelling as well.

So swelling around the throat area, which again can happen in things like anaphylactic shock if they've had some sort of reaction to something.

Breathing

Next up is B for breathing, is the patient breathing?

So normally when you're doing your assessment in life support, you'll put your cheek and ear to the person's mouth, and you will look down the chest to see that rise and fall of the chest as well, but also feeling the breath or hearing the breath on your face as well.

So that is the next step, just to see if the patient is actually breathing.

And if they are breathing, how is their breathing?

Is it really shallow?

Is it really fast, is it rapid, are they using all of the accessory muscles around the chest?

Is it like really laboured breathing?

Does it again does it sound peculiar, not like a normal breath?

Is it in the normal range, 12 to 20 respiratory rates a minute?

Also the rhythm and is the chest equal?

So is both sides of the chest rising and falling at the same time or is it doing this?

Because that could be a sign that something else is going on as well.

Circulation

C is for circulation.

Does the patient have a pulse?

Oh, in Nursing we have these amazing machines called defibrillators and they will tell you whether the patient or person has a shockable rhythm. As soon as you touch it to the person, it will come up and say rhythm identified, something like that. I've never actually personally been in that situation where I've needed one, thank God, but it does tell you that the person has a shockable rhythm.

So that tells you that they've got some sort of pulse that you can work with.

And what a defibrillator does is it doesn't restart the heart.

So it's not to be used on someone that has absolutely no heartbeat at all.

It's just to shock it back into rhythm because something's gone on with the rhythm of the heart and that's why someone's gone into some form of cardiac arrest.

And it just needs that shock to get it back in line and to keep it working, if that makes sense.

But if they've got nothing at all, it doesn't restart the heart.

And when we're checking circulation in any normal sort of person, we're checking things like the pulse rate as well.

So have they got a regular pulse rate and is it irregular?

Is it skipping beats, things like that?

What does the patient or person look like as well?

Are they sweaty, are they clammy, have they got like a blue tinge to the lips? What we call cyanosis.

Have they got blue tinges as well to the finger beds?

That shows you that there's some sort of circulation thing going on as well. Capillary refill times.

So this is where you press the skin like this for a few seconds, release.

And it's the amount of time it takes for that to change colour basically.

So it will be white initially and how long it takes to go back to pink like that.

And if this is prolonged, so if this is like over two, three seconds, then this could mean that there's something going on as well.

Disability

D is for disability.

So disability is normally what we call ACVPU or whatever it's called now.

They keep adding letters to this, which is alert, confused is the patient more confused than normal.

And we say that because sometimes patients maybe that have got some sort of impairment or some sort of maybe like dementia and stuff like that, that have some sort of confusion anyway, are they more confused than normal?

Voice so are they responding to your voice only?

Or are they awake and alert and orientated or are they sort of, they've got their eyes closed, they're lying there but when you speak to them, they sort of wake up startled like that sort of thing, are they responding to your voice alone?

Pain, do they respond to pain?

So you've got your person, they're lying there again, they've got their eyes closed, they're not responding to your voice, but if you press the finger or something like that, are they responding to it?

Or if you're giving them a shake are they responding to that sort of response like that touch response or are they completely unresponsive?

They're not responding at all.

Exposure

And lastly E is for exposure.

So this is anything else that doesn't tick any of the other boxes basically. So things like skin conditions, have they suddenly developed a rash, bleeding, excess loss, anything like that.

Also anything like abnormal swelling that you've noticed or anything that's not normal or doesn't look normal for you in a patient, if that makes sense.

However, it's hard to assess somebody if you don't know this person, say you're walking down the street and someone just drops down.

You don't know what their skin condition looks like or anything.

So it can be really hard to assess something like that.

But if you see anything like that on the skin that looks like it's suddenly developed, or it's a new thing for them, like a rash is suddenly spreading up the face or something like that, then that's where you sort of put that into that box.

So that is a quick run through of your A to E assessment.

How To Utilise Life Support

I hope that all made sense for you, but how do we use this in life support?

So the first thing you do, if you, again, I'm gonna use, if you're out there walking down the street, someone drops down in front of you.

So then you look around, you're looking at the person.

You're looking around, make sure there's no dangers cause you're not gonna put yourself in danger or anything like that.

The next thing you're gonna do is approach the person, shout hello, you okay? Like as loud as you can in the ear, give them a little sort of shake on the shoulders.

If there's no response, that's when you go to step two and this is where we're assessing the airway.

So we're going in, like I said, you're listening, you're feeling for the breath on your face, you're looking at the rise and fall of the chest and then you seeing it and you're like, no, this patient isn't breathing.

And then if there's really no signs of life there, you shout for help, if there's no help, you dial 999 on your phone, you put it on speakerphone, put it on the side and you start those chest compressions as quick as you can.

Because, research shows the sooner that that is started, the better chance of survival that the patient has.

And that's for adults.

Chest Compressions

So adults, you always go straight to the chest compressions because nine times out of 10, it's more of a cardiac problem.

Whereas in children, you would give the rescue breaths first and then you would go on to chest compressions just because in children, it's more lungs and breathing problems and things like that.

So that's why they do it the opposite way around.

And then for adults, you're given 30 chest compressions and then two rescue breaths.

So you'll do your 30 chest compressions, stop do your two rescue breaths.

And then you look for signs of life again in between each of these rounds.

So you're gonna give your 30 chest compressions, do your two rescue breaths, look for any signs of life again, so you listen, looking down the chest, feeling for the pulse again, nothing.

Then you go back to your chest compressions and you keep doing those cycles either until someone helps you, someone comes or you physically can't do anymore.

With children it's very, very different.

Differences With Children

So like I said, if you see a child, let's say you're out on the street again and they dropped down, again you're gonna do the same process.

You're gonna look for danger, make sure you're not putting yourself into danger. You're gonna approach the person, shout hello, you okay?

Give them a little shake, no response.

Then you go into the breathing, checking the airway, feeling for any breath, feeling for a pulse, looking for that rise and fall in the chest.

If there's nothing again, you're shouting for help, you're calling 999, you're putting it on speakerphone, you're putting it on the side and you start with the breaths for this one.

So you want to give five rescue breaths initially to this patient, and then you go on to chest compressions.

So then you're given your five rescue breaths.

You've done your 30 chest compressions on this child and then you go back to two rescue breaths to 30 chest compressions.

And you keep doing that cycle until help arrives or till you physically cannot do anymore.

Another thing to be more aware of is if you were doing chest compressions on somebody and there's a local defibrillator that you know of try and get someone to get that defibrillator, or if you're in the workplace or anything like that, the faster you can get a defib on somebody, the better cause the chances of survival are way higher.

Remaining COVID Aware

And lastly, with the Coronavirus, the pandemic right now, the Resource and Patient Council have put out guidelines on this, on COVID-19 and things like that and reducing your risk.

So what the advice is is if you suspect they might have COVID or you're not sure or anything like that, you can put a piece of cloth or something over their nose and mouth, just to make sure that there's no spread and just stick with the chest compressions that's from the Resource Council, 2021.

However, if you feel comfortable and you want to do that, then that's your choice and your decision at the end of the day, but there is guidance out there. So have a look at the guidance of what to do in the event of a pandemic.

Physical Demonstration (Featuring Annie)

So now just to end the video, I'm just gonna do a quick run through like really quick, basic run through of what you do out there.

Everything that I've explained in this video, I'm just gonna physically show you just so it's that more visual awareness of that makes sense.

I know I'm a visual learner, so I like to see things in action to be able to learn and help with my learning.

So hopefully that will just help you give a better understanding of the sort of things that we do in healthcare as Nurses as well.

And hopefully you'll never be in that situation where you have to sort of do this at all, but again, make sure that you're trained, make sure you're competent and make sure you're confident at doing something like this.

You know, this again isn't official training or anything like that.

You're not gonna be this expert suddenly, this is just an awareness video, just for your information, just to show you the types of things that you might have to deal with as a Nurse.

So check for danger, no danger, safe to approach, and then go up to the patient or person.

And then you're gonna give them a shake and say, hello, hello, can you hear me, hello.

No response.

So that's when we're checking for the breathing, you use the head, chin and tilt lift now. So forehead, two fingers underneath to lift, listen and look for any signs of life, no signs of life.

So I'm gonna get my mobile, can't use it in a minute cause I'm filming.

Get your mobile, going 999, hello I need help. I'm in such and such a place.

Tell them where you are, follow the protocol, put the phone on there and then follow the steps to start your chest compressions.

Heel, middle of the chest, somewhere between the nipple areas.

Heel of your palm down, lock those fingers in.

You're gonna position your body over the patient so that you've got that weight behind you.

You're gonna lock your arms so that they're straight and you're gonna go like that.

Once you've done 30, you're gonna go to your rescue breaths and you're gonna look at that rise and fall as you do the breaths to make sure that they're in there. And then you're gonna go straight back to chest compressions.

And then just keep going like I said, until someone comes with a defibrillator, until help arrives or until you're physically you're so exhausted, you physically can't do anymore or until the patient comes round and they're all right.

And then that's when you would put them into, but not like that.

That's when you put them into the recovery position.

If your patient comes round and they're okay, they're breathing, put them into recovery position and wait for help to arrive.

Conclusion

So I hope that was useful.

It's just a quick run through of what we do as Nurses, healthcare professionals, anyone that's first aid training; this is the sort of thing that we do out there in practice.

So that is it from me, if you need any more advice, if you want any more information, if there's any other videos you'd like me to do, put some comments below and I'll get them done for you.

But for now it's goodbye from me, goodbye from Annie.

Have you got anything else to add?

No, nothing you want to say to anyone?

Bit shy; see you next time.