ASSIGNMENT OF NURSING IV

SURVEY THE SCENE

IN BASIC CARDIAC LIFE SUPPORT (BCLS)

BY:
A9-D
GROUP 1

BACHELOR OF NURSING DEGREE

WIRA MEDIKA PPNI BALI INSTITUTE OF HEALTH SCIENCES

2018/2019

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 PREFACE

Om Swastiastu,

Worship and praise our thanks to Ida Hyang Widhi Wasa, because for His
blessing the paper entitling " Basic Concept of Disease And Basic Concept of Nursing
Care on Patient with “Basic Cardiac life support (BCLS) Survey The Scene " can be
finished on time.

This handing out is compiled as a mean to deepen the knowledge and

understanding of student of concerning basic concept of “Basic Cardiac life support
(BCLS) Survey The Scene” . We realize full, that this handing out far from perfect word
and still a lot of insuffiencys remember our limitation in compilation. Therefore with the
limitation, we expect the criticism and suggestion to develop it, from various party for
the perfection of this handing out. Do not forget the us render thanks and appreciation
profusely to all party assisted and support the solving of this handing out.

Word hopefully this masterpiece be of benefit to all of us.

Om Shanti,Shanti,Shanti,Om

Denpasar, June 2017

Compiler

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 TABLE OF CONTENS

CHAPTER I INTRODUCTION

A. Background 1
B. The Problem 3
C. Benefit 3
D. Writing Methode 3

CHAPTER II DISCCUSION

A. The Concept of BCLS (Basic Cardia Life Support) 4

B. The Concept About BCLS With Principles Survey The Scene 6
C. Every Emergency Is Different, So The Amount To Be Done in Each of The
Steps That Will Follow May Vary 8

CHAPTER III CONCLUSION

A. Conclude 10
B. Advise 11

REFERENCE

CHAPTER I
INTRODUCTION

A. BACKGROUND
There are many circumstances that would cause death within a short time, but it all
ends up at one end of which is failure of oxygenation of cells, especially brain and heart. The
work done untu sustain life when people develop a life-threatening objec known as "Live
Aid" (Life Support). When Life Assistance business without using intra-venous fluids, drugs

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 or electric shock then known as Aid Hiudp Basic (Basic Life Support). Bcls training
purposes and competencies to provide basic understanding to the participants to be able to
provide basic life support in accordance with established standards of competence. This
training can be followed by health workers, especially nurses and midwives who have
worked in hospitals and healthcare companies and students who have not worked to be able
to handle emergency cases of cardiovascular disease including heart attack (acute
myocardial miocard) and arythmia lethal.Dalam this training participants will taught about
the use of Automatic External defibrillator which is the basic tool of international standards
ias training was also cited by students of nursing / midwifery to be more mature in entering
the workforce and compete in the job market.
Basic life support (BLS) is the level of medical care which is used for patients with
life-threatening illnesses or injuries until the patient can be given full medical care at a
hospital. It can be provided by trained medical personnel, including emergency medical
technicians, paramedics, and by laypersons who have received BLS training. BLS is
generally used in the pre-hospital setting, and can be provided without medical equipment.
Basic life support (BLS) is the provision of care to an unresponsive patient. The
mainstay of BLS is cardiopulmonary recuscitation, or CPR. Immediate bystander CPR given
to a witnessed cardiac arrest doubles the chances of survival.
Many countries have guidelines on how to provide basic life support (BLS) which are
formulated by professional medical bodies in those countries. The guidelines outline
algorithms for the management of a number of conditions, such as cardiac arrest, choking
and drowning. BLS generally does not include the use of drugs or invasive skills, and can be
contrasted with the provision of Advanced Life Support (ALS). Most laypersons can master
BLS skills after attending a short course. Firefighter, lifeguards, and police officers are often
required to be BLS certified. BLS is also immensely useful for many other professions, such
as daycare providers, teachers and security personnel and social workers especially working
in the hospitals and ambulance drivers.
CPR provided in the field increases the time available for higher medical responders to
arrive and provide ALS care. An important advance in providing BLS is the availability of
the automated external defibrillator or AED. This improves survival outcomes in cardiac
arrest cases.

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 Basic life support consists of a number of life-saving techniques focused on the
medicine "CAB"s (previously known as ABC. was recently changed by the American Heart
Association) of pre-hospital emergency care:
1. Circulation: providing an adequate blood supply to tissue, especially critical organs, so
as to deliver oxygen to all cells and remove metabolic waste, via the perfusion of
blood throughout the body.
2. Airway: the protection and maintenance of a clear passageway for gases (principally
oxygen and carbon dioxide) to pass between the lungs and the atmosphere.
3. Breathing: inflation and deflation of the lungs (respiration) via the airway.
Healthy people maintain the CABs by themselves. In an emergency situation, due to
illness (medical emergency) or trauma, BLS helps the patient ensure his or her own CABs,
or assists in maintaining for the patient who is unable to do so. For airways, this will include
manually opening the patients airway (Head tilt/Chin lift or jaw thrust) or possible insertion
of oral (Oropharyngeal airway) or nasal (Nasopharyngeal airway) adjuncts, to keep the
airway unblocked (patent). For breathing, this may include artificial respiration, often
assisted by emergency oxygen. For circulation, this may include bleeding control or
Cardiopulmonary Resuscitation (CPR) techniques to manually stimulate the heart and assist
its pumping action.
Developing First Aid, common sense is an important part of providing first aid care.
First Aid properly given can reduce the effect of injuries and medical emergencies can keep
a seriously ill or injured person alive and can mean the difference between life and death;
between rapid recovery and a long period of hospitalization, or between temporary disability
and permanent injury. Proper first aid must be given quickly and effectively or the victim's
condition may become more serious by the time further help arrives on the scene.
In the excitement of an emergency, it is important to stop for a moment to clear your
head and think before you act. When responding to any emergency situation, remain calm
and apply the four emergency action principles:
1. Survey the scene
2. Do a primary survey of the victim

3. Phone the emergency medical service or look for help

4. Do a secondary survey of the victim when appropriate

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 Survey The Scene - In responding to an emergency situation, make a quick survey of
the entire scene. Do not only look at the victim, look at the area around the victim. This
should take only a few seconds.
In this paper will discuss more about the survey the scene, and anything that includes
the survey the scene. For further understanding.

B. THE PROBLEM
1. How to concept about BCLS ?
2. How to concept about BCLS with principles survey the scene?
3. How to emergency is different, so the amount to be done in each of the steps that will
follow may vary.

C. BENEFIT
1. To recognize the concept about BCLS.
2. To recognize the concept about BCLS with survey the scene.
3. To recognize emergency is different, so the amount to be done in each of the steps
that will follow may vary.

D. WRITING METHODE
Writing method used in compiling this handing out is the descriptive method
qualitative, where data obtained from bibliography media by literature is supporter
supporting studied problem.
CHAPTER II
DISCCUSION

A. THE CONCEPT OF BCLS (BASIC CARDIA LIFE SUPPORT)

Basic cardiac life support is a combination of CPR, or cardiopulmonary resuscitation,

with Automated External Defibrilator (AED) training. Basic cardiac life support differs from

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 advanced cardiac life support, in that it may be taught to members of the public, because it
requires little to no specialized equipment and no administering of medications. Therefore,
you must always summon more advanced medical assistance prior to starting any rescue
attempt with basic cardiac life support.
1. Assessing
The first step in any rescue attempt is to assess the situation for danger. Look for
sources of electrocution, such as a downed power line, or for other dangers such as
traffic. Take action to remove any dangers prior to assessing the victim. Shake the
victim while calling out loud. If there is no response, place your ear right above the
mouth and nose and check for breathing. Respirations may be agonal, or slow and
nonrhythmic, or they may be absent in a cardiac emergency. Tilt the victim's head
back, pinch the nose and give two breaths, watching to make sure the chest rises. If
there is no response, begin CPR. A pulse check is not recommended for community
rescuers, only medical professionals.
2. Chest Compressions
In 2005, the American Heart Association changed its recommendations to place a
greater emphasis on chest compressions. To begin compressions, place your hands in
the middle of the chest, over the sternum. It is no longer recommended to find
placement markers, as the key to survival is immediate initiation of CPR. Place one
hand palm down in the center of the chest, between the nipples. Cover it with your
other hand and lace your fingers together. Rise up above the victim so that your arms
are straight and your weight rests over your hands. Using your entire body, compress
the chest wall approximately 2 inches. Always remember to allow the chest wall to
fully rise after each compression. The compressions should be given at a rate
approximate to 100 compressions a minute and should not be stopped for any length of
time. Immediately return to compressions after respirations, shocks or other
interruptions.
3. Respirations
As of 2005, the recommended American Heart Association ratio is 30 chest
compressions to two breaths. After administering 30 chest compressions, tilt the head
back to open the airway and give two breaths of approximately 1 second each. You
should see the chest wall rise with each breath. If not, retilt the head and attempt again,

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 making sure to get a good seal around the victim's mouth. Once the breaths have been
given, resume chest compressions.
4. AEDs

In most cases, the only way a person will survive a cardiac event is quick
intervention with a defibrillator which is why it is important to summon help before
initiating CPR. In many public buildings, such as airports, there are automated external
defibrillators (or AEDs). These machines are designed for community rescuers to use
and contain an on-board computer that directs the rescuer.
Once obtaining an AED, immediately turn on the device and follow
directions. Place the two pads on the chest wall, following the diagram. Back away
from the victim and insure no one else is touching the victim. Once connected to the
victim the machine will analyze the electrical rhythm of the victim's heart and
determine if defibrillation is appropriate. If so, recheck to make sure no one is
touching the victim and then push the button on the machine as directed. If the
machine advises against shock, return to CPR, leaving the machine hooked up.
Reassess the patient after every fifth cycle of chest compressions.

B. THE CONCEPT ABOUT BCLS WITH PRINCIPLES SURVEY THE SCENE

Once you recognized that an emergency has occurred and decide to act, you must
make sure that the scene of the emergency is safe for you, the victim/victims, and the
bystander/bystanders. In responding to an emergency situation, make a quick survey of the
entire scene. Do not only look at the victim, look at the area around the victim. This should
take only a few seconds.
First Aid Emergency Action Principles:
1. Decide what to do next, consider the following as you do your survey:
a. Is the scene safe?
Is the scene safe - You must first decide if the situation is safe for you? You can not
help a victim by becoming a victim yourself, know your abilities. If you cannot get to
the victim because of hazards such as fire, toxic fumes, heavy traffic, electrical wires

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 or deep swift moving river. Call emergency service or other services needed to
handle the specific life threatening hazard.
b. What happened?
What Happened - If the victim is conscious, ask questions to determine what
happened and the extent of the victim's illness or injury. If the victim is unconscious.
Ask by-standers to look for clues. The scene itself often gives the answer.
c. How many people are injured?
How Many People Are Injured - Look beyond the victim you see at first glance.
There may be other victims.
d. Are there bystanders who can help?
Are There By-standers Who Can Help - If there are by-standers, use them to help you
find out what happened. By-standers though may not be trained in first aid, but can
help you in other important ways such as calling medical attention, by offering
emotional support to the victims.
e. Identify your self as a person trained in first Aid.
Tel the victim and the by-standers who are there, and that you are trained in first Aid,
this may help to reassure the victim. It will also help you to take charge of the
situation.
2. Activate Medical Assistance
In some emergencies, you will have enough time to call for specific medical advice
before administering first aid. But in some situations, you will need to attend to the
victim first.
a. Call First : If the victim is not in a life threatening situation and there is plenty of
time to first aid.
b. First Aid First : If the victim is in a life threatening situation.
3. Initial Assesment of the Victim
In every emergency situation, you must first find out if there are conditions that are
immediate threat to the victim’s life. Check level of response :
a. Alert-The patient is fully awake (although not necessarily oriented). This patient
will have spontaneously open eyes, will respond to voice (although may be
confused) and will have bodily motor function.
b. Verbal-The patient makes some kind of response when you talk to them, which
could be in any of the three component measures of eyes, voice or motor - e.g.
patient's eyes open on being asked "Are you OK?". The response could be as little
as a grunt, moan, or slight move of a limb when prompted by the voice of the
rescuer.

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 c. Painful-The patient makes a response on any of the three component measures on
the application of pain stimulus, such as a central pain stimulus like a sternal rubor
a peripheral stimulus such as squeezing the fingers. A patient with some level of
consciousness (a fully conscious patient would not require a pain stimulus) may
respond by using their voice, moving their eyes, or moving part of their body
(including abnormal posturing).
d. Unresponsive- Sometimes seen noted as 'Unconscious', this outcome is recorded if
the patient does not give any eye, voice or motor response to voice or pain.

4. The first step of Emergency Action Principle is to Survey the Scene. As a trained
rescuer, it is imperative to assess the scene by observing for the following:
a. The Safety
Take a look around to ensure the surrounding area is safe for the rescuer as well as
the victim. Note: unless there is an imminent danger, the victim should not be
moved. Assess the surroundings for any people who can help.
b. The Type of Injury
This observation is extremely important in an effort to understand the reason for
sustained injury: automobile accident, electric shock, fall, fire, etc.
c. The Location
Make sure you are aware of your location (for ex. floor in the building, etc), to help
emergency responders locate you.

C. EVERY EMERGENCY IS DIFFERENT, SO THE AMOUNT TO BE DONE IN EACH

OF THE STEPS THAT WILL FOLLOW MAY VARY.
Assess hazards and make the area safe – Your safety comes first! If you cannot enter
the area without risking your safety, don’t do it, call Emergency Services immediately and
wait for them. If you think you can safely enter the area, look around the emergency scene
for anything that can be dangerous or hazardous to you, the casualty or anyone else at the
scene. Do whatever you can to make the area safe as long as the result will not be more
hazardous or more of a risk to people at the scene. Bystanders can help with making the area
safe.
Take charge of the situation – If you are the first aider on the scene act fast. If someone
is already in charge, briefly introduce yourself and see if that person needs any help. If there
is any chance the casualty could have a head or spinal injury, tell them not to move!
Get Consent. Always identify yourself as a first aider and offer to help. Always ask for
consent before touching a conscious adult casualty and always ask for consent from a parent

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 or guardian before touching an unconscious or conscious child or infant. With an
unconscious adult casualty consent is implied as it is generally accepted that most people
want to live.
Assess Responsiveness. Is the casualty is conscious or unconscious? Note their
response while you are asking them for their consent. If they respond continue with the
primary survey, and if they don’t respond, be aware that an unconscious casualty is or has
the potential of being a breathing emergency.
Call out for help – this will attract bystanders. Help is always useful in an emergency
situation. Anytime you need help just call out. Someone can be called over to phone for
medical help. Others can bring blankets if needed, get water etc. A bystander can help with
any of the following:
1. Make the area safe
2. Find all the casualties
3. Find a first aid kit, or any useful medical supplies
4. Control the crowd
5. Call for medical help
6. Help give first aid, under your direction
7. Gather and protect the casualty’s belongings
8. Take notes, gather information, be a witness
9. Reassure the casualty’s relatives
10. Lead the ambulance attendants to the scene of the emergency
You must always notify Emergency Services as soon as you can. Either send a
bystander or call yourself. Emergency professionals never get involved in an emergency
scene without back-up and neither should you.

CHAPTER III
CONCLUSION

A. CONCLUDE
Basic cardiac life support is a combination of CPR, or cardiopulmonary resuscitation,
with Automated External Defibrilator (AED) training. Basic cardiac life support differs from

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 advanced cardiac life support, in that it may be taught to members of the public, because it
requires little to no specialized equipment and no administering of medications. Therefore,
you must always summon more advanced medical assistance prior to starting any rescue
attempt with basic cardiac life support.
Developing First Aid, common sense is an important part of providing first aid care.
First Aid properly given can reduce the effect of injuries and medical emergencies can keep
a seriously ill or injured person alive and can mean the difference between life and death;
between rapid recovery and a long period of hospitalization, or between temporary disability
and permanent injury. Proper first aid must be given quickly and effectively or the victim's
condition may become more serious by the time further help arrives on the scene.
Survey the scene in responding to an emergency situation, make a quick survey of the
entire scene. Do not only look at the victim, look at the area around the victim. This should
take only a few seconds. Decide what to do next, consider the following as you do your
survey:Is the scene safe - You must first decide if the situation is safe for you? You can not
help a victim by becoming a victim yourself, know your abilities. If you cannot get to the
victim because of hazards such as fire, toxic fumes, heavy traffic, electrical wires or deep
swift moving river. Call emergency service or other services needed to handle the specific
life threatening hazard, What Happened - If the victim is conscious, ask questions to
determine what happened and the extent of the victim's illness or injury. If the victim is
unconscious. Ask by-standers to look for clues. The scene itself often gives the answer.How
Many People Are Injured - Look beyond the victim you see at first glance. There may be
other victims. Are There By-standers Who Can Help - If there are by-standers, use them to
help you find out what happened. By-standers though may not be trained in first aid, but can
help you in other important ways such as calling medical attention, by offering emotional
support to the victims. Identify yourself as a person trained in first Aid. Tel the victim and
the by-standers who are there, and that you are trained in first Aid, this may help to reassure
the victim. It will also help you to take charge of the situation.
Then, identify yourself as a trained first aider. Get consent to give care.

B. ADVISE
Nursing students as we are able to understand about BCLS so that latter we able to
provide proper handling emergency. That also can also able increase the knowledge nurses.

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 REFERENCE

Australia Seeks Skilled Nurses Work Permit Assessment Online.

http://madzmas.hubpages.com/hub/PRINCIPLES-OF-EMERGENCY-CARE. (accessed June 2nd
2017).
CPR-Pro.com Inc. 2011. Your first choice in CPR & Resuscitation supplies. Established in 2001
http://www.cpr-pro.com/fa_scene_survey.html (accessed June 2nd 2017).
Vicogon. 2011. Principle And Practice Of Emergency Management.
http://www.infobarrel.com/Principle_And_Practice_Of_Emergency_Management. (accessed
June 2nd 2017).

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 BCLS Demonstration with Survey The Scene

One day at Sumoboo café there are 2 women talking about their business. A few moments later
after a long talking, one of the ladies was named Ms lia her telephone is ranging.

Ms Lia : Hallo pipik how are you?

Ms Pipik : Hallo lia, I’m fine. How about you?
Ms Lia : I’m fine too. What about the business you are running now?
Ms Pipik : So far my business is running well, even progressing. How about your business
lia?
Ms Lia : Right now I’m doing business in culinary, are you interested to cooperate with
me pik?
Ms Pipik : hhhmmmmmmm
Ms Lia : Oh wait a minute pik, my phone is ringing.
(When receiving a call)
Hallo good morning. What ? Are you serious ? He canceled to cooperate with
our restaurant? How much damage do we receive from this?
After moments Ms Lia picked up the phone, she grabbed her chest and fell to the floor in shock
of receiving her call. Instantly everyone who saw the event came closer and tried to give first aid.
Ms Pipik : Oh she is my friend, what happened to her. Help me !
Anyone here who understands medical treatment please help my
Friend !
Nurse Okta : Oh yes I am a nurse, I have a BCLS certificate. I will help to save him. Please,

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 woman who is wearing a white shirt help me to call the ambulance 911, tell
them this time we are at Sumoboo café, that there is someone who is
unconscious and need help.
Ms Pradnya : Okay I will help to call an ambulance now.
(Good afternoon, this is an ambulance number? Please come to Sumoboo café
because someone is unconscious and need help soon)
Nurse Okta : Please for everyone who is here help me to secure the environment around the
patient. Please keep the chairs, tables and bags away so that I can more easily
provide help to patients. To keep patients and helpers safe.
Ms Pradnya : Please for everyone here to stay away 1 meter from patient.
(While removing bags, table and chairs from patients and helpers)
Nurse Okta : Please can anyone give me information what actually happened?
So this woman is unconscious?
Ms Pipik : He was talking with me then he received a call and was shocked and then fell
so unconscious.
Nurse Okta : Ms are you okay? Do you listen to my voice?
(While pressing the patient's finger to find out the response from the pressure
given to the patient)
Nurses take the airway and check the respiratory circulation and regulate the patient's position.
Uuuuuuiiiiiiiiiiuuuuuuuiuuuu .........
A few minutes later there was an ambulance to provide further primary help.

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Suatu hari di café Sumoboo ada 2 orang wanita sedang membicarakan tentang bisnis mereka.
Beberapa saat kemudian setelah berbincang-bincang cukup lama, salah 1 dari wanita tersebut
bernama Ms lia mendapatkan telfon.

Ms lia : hallo pipik apa kabar ?

Ms ppik : hallo lia, kabar baik bagaimana denganmu lia ?

Ms lia : baik juga. Bagaimana dengan bisnis yang sedang kamu jalankan sekarang ?

Ms ppik : sejauh ini bisnisku berjalan lancar, bahkan semakin maju. Apa bisnis yang
sedang kamu jalani lia ?

Ms lia : saat ini aku sedang berbisnis di bidang kuliner, apakah kamu berminat untuk
bekerjasama denganku pik ?

Ms ppik : hhhmmmmmmm

Ms lia : oh tunggu sebentar pik telfon saya berbunyi, saya angkat telfonnya sebentar ya.
(saat menerima telfon)

Apa ? Apakah kau serius ? dia membatalkan untuk bekerja sama dengan
restaurant kita ? berapa kerugian yang kita terima dari hal ini ?

Beberapa saat setelaha ms lia mengangkat telfon dia pun memegang dadanya dan terjatuh di
lantai karena terkejut menerima telfon tersebut.

Seketika semua orang yang melihat peristiwa itu datang untuk menghampiri dan mencoba untuk
memberikan pertolongan pertama.

Ms ppik : oh dia temanku, apa yang terjadi dengannya. Tolong aku ! Seseorang disini siapa
saja yang mengerti tindakan medis tolong bantu teman saya !

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Nurse : oh ya saya perawat, saya memiliki sertifikat BCLS. Saya akan bantu untuk
menyelamatkan dia. Tolong anda ibu yang memakai baju putih bantu saya untuk
menelfon ambulance 911 beritahu saat ini di café Sumoboo bawha ada seseorang
yang tidak sadarkan diri dan membutuhkan pertolongan.

Ms : baiklah saya akan membantu untuk menelfon ambulance sekarang.

(selamat sore, ini benar nomor ambulance? Tolong segera datang ke café
Sumoboo karena ada seseorang tidak sadarkan diri dan memerlukan pertolongan
segera)

Nurse : Tolong untuk semua orang yang ada disini bantu saya untuk mengamankan
lingkungan sekitar pasien. Tolong jauhkan kursi, meja dan tasnya silahkan di
jauhkan supaya saya dapat lebih mudah memberikan pertolongan kepada pasien.
Agar pasien dan penolong tetap aman.

Ms : tolong untuk semua orang disini agar menjauh 1 meter dari pasien. (sambil
menjauhkan tas, meja dan kursi dari pasien dan penolong)

Nurse : tolong ada yang bisa memberikan informasi apa yang sebenarnya terjadi ?
sehingga ibu ini tidak sadarkan diri ?

Ms ppik : dia tadi mengobrol bersama saya kemudian dia menerima telfon dan terkejut lalu
terjatuh sehingga tidak sadarkan diri.

Nurse : Ms apakah anda baik-baik saja ? apakah anda mendengarkan suara saya ?

(sambil menekan jari pasien untuk mengetahui respon dari tekanan yang di
berikan kepada pasien)

Perawat melakukan tindakan membuka jalan nafas dan mengecek sirkulasi pernafasan dan
mengatur posisi pasien.

Uuuuuuiiiiiiiiiiuuuuuuuiuuuu………

Beberapa menit kemudian datanglah mobil ambulance untuk memberikan pertolongan primer
lebih lanjut.

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