As you know, it is the responsibility of all RNs to maintain three mandatory competencies of Basic Life Support (including CPR), Manual Handling and Infection Control. While there are many more nursing competencies required by individual employers, at their discretion, it is imperative that these three mandatory competencies are seen to and updated as required.
AHPRA stipulate that these competencies do not necessarily need to be attended by each employer or workplace, rather allowing them to be transferable across workplaces. We therefore are more than happy to accept certificates or evidences of your attendance to these competencies provided that they are current and within expiry dates.
Please indicate your completion and ability to provide evidence of having attended to these mandatory competencies by answering the questions in the quiz section.
If you are not able to provide these you will be asked by HHQ to attend to these three competencies and we will provide detail on how to do so.
Basic Life Support (CPR) – Adult eLearning Module
As a healthcare worker you must maintain your skills and knowledge in BLS. This module is an opportunity to do just that.
The aim of the module is to familarise participants with the Australian and New Zealand Committee on Resuscitation (ANZCOR) requirements for performing Basic Life Support for adults.
Performance Outcomes
On completion of this module, you will be able to.
- List the steps in the Australian and New Zealand Committee on Resuscitation (ANZCOR) flow chart to provide Basic Life Support (BLS);
- Outline the steps involved in the DRSABCD Basic Life Support flow chart; and
- Apply the BLS DRSABCD algorithm to a simulated scenario
This module provides the theoretical component of basic life support. Your role may require you to complete a mandatory yearly practical assessment. Complete this module and if necessary complete the practical assessment at your local facility.
No matter what your environment, BLS follows the same DRSABCD steps.
7 steps to Basic Life Support – DRSABCD
D DANGERS
In approaching any situation including helping a collapsed patient, you should check your surroundings for any potential DANGER.
R RESPONSE?
After assessing and managing any potential dangers, the next step is to check the RESPONSE of the patient.
S SEND FOR HELP
If the patient is unresponsive, it is vital you SEND or CALL for HELP immediately.
A OPEN AIRWAY
After sending for help, the next step is to open the patient’s AIRWAY. Do this to ensure that the patient’s airway is not blocked prior to assessing for breathing.
B NORMAL BREATHING
After opening the airway, the next step is to assess for normal BREATHING.
C START CPR
If the patient is NOT breathing normally, and is unresponsive, COMMENCE CHEST COMPRESSIONS.
D ATTACH DEFIBRILLATOR (AED)
A defibrillator should be attached as soon as possible (if available), after commencing chest compressions. Early defibrillation for shockable rhythms improves the patient’s chance of survival.
More detailed scenarios relating to the application of DRSABCD
D – DANGERS
You are walking down a corridor and a visitor urgently calls for your assistance with a patient. Upon entering the room, you see a collapsed patient lying on the floor of their room.
In approaching any situation, including helping a collapsed patient, you should check surroundings for any potential DANGER.
R – RESPONSE
After assessing and managing any potential dangers, the next step is to check the RESPONSE of the patient.
Talk to and touch the patient in an attempt for a response
S – SEND OR CALL FOR HELP
Once you have assessed there is no response, it is vital you SEND or CALL for HELP immediately.
3 methods in doing so (use all 3 if you need to)
– use the room call bell, use phone in the room, shout for help
A – AIRWAY
After sending for help your next step is to open the patient’s AIRWAY. Do this to ensure that the patients airway is not blocked prior to assessing for breathing.
If you open the patient’s mouth and notice that there is fluid or vomit, roll the patient on their side to allow the fluid to drain out.
Once you have cleared the mouth of fluid you need to tilt the head back to open the airway.
The most common technique is the head tilt/chin tilt, however if spinal injury is suspected, the jaw thrust technique can be used.
B – BREATHING
After opening the airway, your next step is to assess for normal BREATHING. Abnormal breathing is gasping, noisy, irregular, and/or very slow.
Assess for breathing: Look, Listen, Feel
Look – for movement of the chest and upper abdomen and for breath on the rescuer’s cheek
Listen – for movement of the lower chest and upper abdomen
Feel – for escape of air from the mouth and nose
Assess for breathing for up to 10 seconds.
If the patient is breathing normally and remains unresponsive, place in the recovery position
If the patient is not breathing normally and remains unresponsive, start compressions
C – COMPRESSIONS
If the patient is NOT breathing normally and is unresponsive, COMMENCE CHEST COMPRESSIONS.
In order to deliver effective CPR, follow these steps:
1. Place your hands on the lower half of the sternum, with the heel of your hand in the centre of the chest and the other hand on top.
2. Keep elbows straight and locked.
3. Compress sternum approximately one third of the depth of the chest with each compression.
NOTE: When performing compressions and if feasible, change rescuers every two minutes to prevent fatigue and deterioration in chest compression quality.
Perform 30 chest compressions to two breaths at a rate of 100-120 compressions per minute.
There are two options for how to deliver rescue breathing.
Pocket mask and anti-reflux valve
This equipment is the minimum protective equipment to provide safety to the rescuer. It is your responsibility to ensure you are able to locate appropriate equipment quickly in an emergency situation.
Bag and mask (air viva)
This equipment is commonly found in a healthcare setting, however it requires practical training for effedlive use. Two rescuers may be required in order to achieve an adequate seal around the mask
D – DEFIBRILLATOR
A defibrillator should be attached as soon as possible (if available). Early defibrillation for shockable rhythms improves the patient’s chance of survival.
The importance of defibrillation has been well established as part of overall resuscitation, along with effective CPR. You must keep the following in mind:
Automated External Defibrillators (ADs) must only be used for victims who are unresponsive and not breathing normally.
CPR must be continued until the AED is turned on and pads attached. The rescuer should then follow the AED’s prompts.
Do not wait for CPR cycle to be completed, as early defibrillation is vital.
Safety considerations – there are several safety considerations that need to be considered.
- ensure patient is dry prior to applying pads
- do not place pads over other objects (e.g. pacemakers, jewellery, clothes, ECG leads, medication patches
- oxygen to be away from patient prior to pressing the shock buttons
Visually re-check and ensure no one is touching the patient prior to pressing th that you announce clearly to everyone that you are about to deliver a shock.
