BLS

SAFETY ‘As i was passing by I saw the patient poorly. I will check for the sceen
safety - scene is safe to approach.’

PRIVACY ’I will draw the curtain or close the door to maintain dignity and
privacy.’

HAND WASHING ‘’Since this is an emergency, I will just be performing a quick hand
run.’

APPROACH ‘Hey, are you okay? Can you hear me?’

PATIENT - Shake patient and shout at both ears
‘The patient is unresponsive.’

SHOUT HELP ‘HELP1 I NEED HELP HERE!’

- PULL EMERGENCY CALL BELL

CHECK AIRWAY Position patient - FLAT on back

Adjust height comfortable to you
HEAD-TILT-CHIN MANEUVER
Check mouth for visible obstruction
‘I am going to check the mouth for any visible obstruction while doing a
head-tilt-chin maneuver. I see none.’

CHECK Listen for breath sounds

BREATHING & - Place your ear near mouth of patient
CIRCULATION Look for rise and fall of the chest
Feel carotid pulse
Maintain a head-tilt-chin-lift maneuver for 10
seconds
‘I am going to check for breathing by listening for breath sounds and
feeling the air coming from the nose and mouth of the patient and
observing the rise and fall of the chest. I will then check for circulation
by feeling for the carotid pulse for no more than 10 seconds while
maintaining the chin-lift maneuver. 10, 9, 8, 7, 6, 5, 4, 3, 2, 1.’
No pulse, no breathing, i declare cardiac arrest at __(time)__.

HELP ARRIVED ‘Please call 2222 and activate Adult Cardiac Resuscitation team at
__(time)__ here at __(location)__ and inform them to bring the crash
cart trolley. When you come back please bring the bag valve mask and
connect to 15L/min oxygen making a tight seal over the nose and mouth
while maintaining a head-tilt-chin-lift maneuver.

CPR 30:2 Rate - 100-120/min

Depth - 5-6 cm
 Ratio - 30:2

ARREST TEAM ‘Are you ready to take over?’

ARRIVED
HAND WASHING - Turn on tap, wet hands and wrist
then lather soap.
1. Rub palm to palm
2. Back of the hands with fingers interlaced
3. Palm to palm with fingers interlaced
4. Back of fingers with fingers interlocked
5. Tips of fingers with opposite palm in rotational movement
6. Rub each wrist in rotational movement
7. Rinse and dry with a paper towel for 30 seconds
8. Dispose paper towel to black bin

‘Are you ready for the hand over?’

HANDOVER ‘My name is _______, i am a nurse who saw and helped the patient.’
SITUATION
Reversible Causes - I was just passing by when i saw the patient collapsed/poorly
of Death: BACKGROUND
5Hs and 4Ts - I do not know anything about the patient since he is not within
Hypoxia my care but i can get you the nurse-in-charge for you to have a
Hypothermia detailed information.
Hypovolemia ASSESSMENT
Hypokalemia - ‘I checked for the scene safety and i provide privacy by drawing
Hyperkalemia the curtains. Since it was an emergency I just did a quick hand
Toxicity rub.
Tamponade - ‘I checked for consciousness by doing the ‘SHake and Shout’
Tension method to both ears by patient was unresponsive, so I called for
pneumothorax help and pulled the emergency call bell.
Thrombosis - ‘Checked airway, breathing and circulation.’
- ‘Checked for airway obstruction by doing the head-tilt-chin-lift
Chain of Survival: maneuver, there was none.’
Early detection - ‘Checked for breathing by listening for breath sounds and
Early CPR observed for chest rise and fall.’
Early Defibrillation - ‘Checked the carotid pulse for circulation for nor more than 10
Early ACLS minutes.
Early transfer to - ‘There was no breathing o declared arrest at ______.’
ITU/HDU - ‘I asked to call for 2222 activate Adult Cardiac Resuscitation
team at __(time)__ here at __(location)__. I also asked for the
Arrhythmias that bag valve mask and attach it to 15L/min oxygen making a tight
Cause Arrest: seal over the nose and mouth.’
Asystole - I did ___ cycles of compressions and ventilations with a ratio of
VF 30:2. Each cycle has 30 compressions and 2 ventilations. The
PVT rate of compressions was 100-120/min and the depth was 5-6
 PEA cm. Then you came, hence the handover.’
RECOMMENDATIONS
- ‘I recommend that quality, uninterrupted compressions should
be continued until signs of life is evident.’
- ‘And once the patient show signs of life, he should be put to
recovery position. I also recommend that he/she be transferred
to ICU/HDU and to be submitted for senior review.’
- ‘He should be attached to the cardiac monitor and high flow
oxygen.’
- ‘Also, check his oxygen saturation, ABG analysis, sets of bloods,
BP monitoring, ECG, CXR, insert urinary catheter and monitor
urine output and give prescribed IV fluids to hydrate the patient.
- ‘Also, call the next of kin to inform what happened to the
patient.’
HAND RUB

DOCUMENT ‘I will be documenting:

1. Name of patient
2. Date and time of arrest
3. People involved
4. Sequence of events
5. Any medications/drugs given
6. Response of patient
7. Affix name and signature
8. Inform family’
HAND WASHING