Mark: Hi, I'm Mark for CPR Certification Institute. In today's video, we're going to review healthcare provider BLS for the adult victim. Let's take a look and see what those skills look like, shall we?
First, establish unresponsiveness. Next, look for breathing. We're just looking at the patient's chest for about five seconds to see if they're breathing. If they're not breathing, call a code. Get some help coming. Next step, check for a carotid pulse, but remember, spend no more than 10 seconds checking for that pulse. Next, begin chest compressions. We're going to do our compressions at a rate of at least 100, at a compression to ventilation ratio of 30:2 and we're going to get the AED or the defibrillator on the patient as quickly as we can. So let's take a peek and see what that looks like, shall we?
Nurse: Doctor! Doctor!
Mark: Yes.
Nurse: They just dropped this man off outside the ER.
Mark: Well, let's see. He's unresponsive. Look for breathing for five seconds. This man is not breathing! Nurse, call the code.
Hi, welcome back.
Nurse: Thank you.
Mark: Next, we check for a pulse. How long do I check a pulse for?
Nurse: No more than 10 seconds.
Mark: This patient has no pulse. We must begin CPR.
Nurse, I've started chest compressions. Hey, get me a AED or a defibrillator right now. What is my compression to ventilation ratio?
Nurse: Doctor, we're going to give 30 compressions to 2 breaths.
Mark: 30 compressions to 2 breaths. How far into the chest should I be pushing on this guy?
Nurse: Two inches.
Mark: Two inches. What's my rate of compressions? I don't know what I'm doing.
Nurse: At least 100 a minute.
Mark: At least 100 a minute; and 30.
I'm getting tired. Somebody get over here. This is a lot of work.
Nurse: Yeah.
Mark: Now remember in the adult cardiac arrest, over 90% are in V-fib or pulseless V-tach when they hit the ground and the only thing that is going to fix them is rapid defibrillation. CPR in the adult cardiac arrest is a bide-time maneuver only. It helps to keep the patient in V-fib so we can shock them; but again, we need to shock them as quickly as we can, so get that AED and get it on the patient.
Nurse, where the hell is that AED?
Nurse: The AED is here now.
Mark: Hand me those shears, let me get this guy's shirt off.
Now remember, when applying the defibrillator pads on the adult chest, you're going to place them high right, low left. High right, low left, for a couple of reasons. One, most implanted devices, implanted defibrillator or pacemaker, are placed under the patient's left clavicle. You might be able to feel and appreciate that, but for that reason we place the pads high right, low left with the intent of making a heart sandwich. That's right, a heart sandwich. We need the heart in between the pads. If I put a pad here and a pad here, energy goes from one pad to the other, I'm going to defibrillate this guy's sternum. I need to get the heart in between the pads, so again, the pads go high right, low left, heart sandwich.
Speaker 3: Place electrodes.
Place electrodes.
Do not touch patient. Analyzing rhythm.
Stand clear. Push flashing buttons-
Nurse: I'm clear. You're clear. We're clear.
Mark: I'm clear.
Nurse: Three, two, one. Shock.
Mark: I'm Mark for CPR Certification Institute. This has been healthcare provider BLS for the adult victim. Remember, like us on Facebook and please become a subscriber to our YouTube channel. Thanks, see you in the next video.
Nurse: Doctor! Doctor!
Mark: Yes?
Nurse: They just wheeled this man back from the waiting room.
I was like where's he coming from? The field? The waiting room?