Analgesic Gases and Oxygen Provider Level 2 (VTQ)
Course Content
- Course Introduction
- Basic Life Support
- Oxygen and Why We Need It
- Pulse Oximetry
- Oxygen Equipment
- Standard oxygen cylinder
- BOC Oxygen cylinders
- Cylinder sizes
- Storage Of Oxygen
- Cylinder storage and maintenance
- Oxygen safety
- Transport of Cylinders
- Labelling and transport of oxygen
- PIN INDEX cylinder
- Oxygen Regulators
- BOC Oxygen Kit
- How long does an Oxygen cylinder last?
- Portable Suction Units
- Obtaining medical oxygen
- Manufacturing oxygen
- Providing Oxygen
- Providing Analgesic Gases
- What is Nitronox and Entonox
- Analgesic brands
- When would you use analgesic gas
- Problems with analgesic gas
- How much analgesic gas should be given
- The Analgesic Gas Cylinder
- Nitronox cylinders
- The Analgesic Gas Regulator
- Entonox kit assembly
- Entonox administration
- Entonox maintenance, transport and storage
- Medical gas storage
- Medical gases bag
- Course Summary
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In this scenario, we found somebody who's unconscious. And what we're going to do is we're going to go through the CPR process, cardiopulmonary resuscitation. What we're doing here is we're going to try and keep this person in a state with oxygen-rich blood flowing around their body until the paramedics arrive, or until an AED arrives. Let's just look at CPR and what we're actually doing. What we're doing with CPR is we are pushing down onto the chest, and what this is doing is it's squeezing the heart and forcing blood out. When we let go, it's releasing, it's sucking blood back into the heart. So we're forcing oxygen-rich blood around the body. We're also going to be delivering breaths. And what the breaths are doing is they're flushing out any carbon dioxide out through the lungs, and also putting new oxygen back in. Now, with this, this not a process which is going to make them come around, it's not going to get them into a state where they're just going to jump up and shake your hand, it's not going to happen. What we're dealing with here is purely a method of giving effective CPR so that when the paramedics do arrive, then they can use the drugs and the defibrillator they have to hopefully bring this person around. Now, survival rates within this are not that good. This person who is in need of CPR is in what we classify as clinical death. If we don't do anything to this patient, they will stay dead. We're not going to do anything to this person which is going to cause them any harm or any long-term effects. What we can do is we can increase the chance of survival. Don't be scared about doing CPR, don't be scared about pushing too hard or doing it wrong because anything you do is a bonus for this person. You can't be blamed if it's not going to work because the majority of the time, CPR will not work. However, I'm sure if you think about even a the small chance of survival, you would go for it. First thing we're going to do, we make sure the scene is safe. You look out for any potential dangers. It could be here with the door opening behind us, it could be any other dangers around us, a fuel, or a fire, or electricity, things like that. For this example here, we're looking at CPR, so let's just assume the scene is safe. Gloves on, we want to make sure we keep the barriers there. Face shield if you have it, you can get that ready. What we're doing is we're approaching the person and we would call for help, shout out, "Help! Will someone come up to help us?" We also want to introduce ourselves the same as we've done within the previous modules. "Hello, my name's Keith, with First Aid. May I help you?" Ask them a direct question. Tap on the collarbone, "Are you okay? Are you okay?" Looking around them trying to get any response from them. By giving this direct contact, we're trying to establish a response due to a mild pain type threshold of actually bashing onto their collarbone. We have no response here at all. The next thing we need to do is open the airway. Now, this is exactly the same as when we did the recovery position. We're going to place one hand onto the forehead, and the other hand onto the bony part of the chin, and we're going to tilt the head back. Once the airway's open, let's draw in the tongue away from the back of the throat and we can do a good assessment to see if the person is breathing. We do a breathing check for 10 seconds. Place your ear down close to their mouth, look down on their chest and then count one, two, three, four, five, six, seven, eight, nine, ten. During that time, what we're doing is we're looking, listening, and feeling for signs of normal breathing. If they're breathing, I've got hear it, I've also got to feel it on my ear and on my cheek. I'm looking down their body so I might be able to see their chest or their stomach rising or falling. In this example, this person is not breathing. Now, one thing you may detect is what's called agonal breathing. Agonal breathing is just a gasping sound. It's not like normal breathing, it's just a rough core sound. Now, this is a sign of death, not a sign of life. Be careful not to mistake it. It's obviously not normal breathing, it's more of a gasp type noise. Now we got this person here who's not breathing, we need to do CPR, but we need to get help. If someone is here, we can send them away to go call the emergency services. If somebody's here and they come upstairs say, "Can you go and dial 999? Ask for an ambulance. Tell them we've got an unconscious male in sudden cardiac arrest. We are doing CPR. We are at... " And then give them the name and the address of where you are, "And come back and tell me what they say." And ask that person is there an AED available because it may well be there is an AED on site and you need that as quick as possible. AED units are very, very easy to use. They talk to you, so they'll tell you what to do. Always ask if there is an AED available. If you're on your own and this person's not breathing, you must leave them and go for help. There's no point in doing CPR because we need to get the ambulance on its way. In this instance, maybe you get your mobile phone, dial 999 or 112, and you call the emergency services. Let's assume now that we've sent someone away, that person's gone for help. At some point, they'll come back and tell us that the emergency service are on their way. We now need to look at the next stage. The next thing we need to do is chest compressions. What we're going to be doing is we're going to be pushing down with the heel of the hand in this area here. To get pressure onto the chest, we need to interlock the fingers so the hands are in this position. We then need to put the hands in the center of the breastbone. Looking at somebody's roughly line, in this example with the male, we can look at the line between the nipples and the arm, in the center of this breastbone. It's worth just looking at yours. The breast bone's here, it's not difficult to get your hand into the middle. Interlock your fingers, hands straight in there, right on the center. We're pulling the fingers away from the chest because what we don't want to be doing is pushing down onto the ribs themselves because the heart is just underneath that breastbone. By pushing down on the breastbone, we're actually forcing the heart, which is then going to squeeze the blood out of the heart and when we release we're going to let the blood come back in. The other thing we want to do is make sure we push straight down. To do this, we need to position ourselves so that our shoulders are right above the person. With the arms nice and straight, we're pushing down onto the chest and we're pushing a depth of around about five to six centimetres. Five to six centimetres in depth should be enough to force the blood out of the heart. And we're doing that at a speed of 100 to 120 compressions a minute. And we're doing it a rate of 30 compressions. That's roughly every one second to doing two compressions. Arm straight, straight over and then 30 compressions. One, two, three, four, five, six, seven, eight, nine, 10, 11, 12, 13, 27, 28, 29, 30. With the compressions, we're doing it equally down as we are coming up. See, it's just as important that the heart fills up with blood as it does when we push down and squeeze the blood up out of the heart. Once we've done the compressions, we need to move to breaths. For this, we then hand on the forehead, under the chin, open the airway in the same way. We squeeze the nose, otherwise, we're going to blow air in here, and it's going to come back out in the nose and not carry it down into the lungs. We're giving two breaths around about one second. With the breaths, we're not trying to blow as much air into the lungs as possible because what will happen as we blow air into the lungs, the chest will rise. You're going to get so much air in the lungs that the next place it's going to go is into the stomach. You'll get the stomach will start extending. And at that point, the person's going to vomit or regurgitate the food from the stomach. All this air's going to be forced back out again. We're only giving breaths at around about one second or until you see the chest rise. By delivering the breaths, we're also doing them quickly. The 2015 guidelines have been amended to state that the maximum time you should break in the compressions to deliver the two breaths is 10 seconds. So it would be compression, airway, breath, breath, then compression in no more than 10 seconds. And if the person does vomit, you can turn them onto their side, allow the vomit to come out, put them back onto their back and then continue. Just to recap with that. We're doing 30 compressions, two breaths, 30, two, 30, two. And we continue that. Now, in an ideal world, we would continue that for two minutes and hand over to a second rescuer and then swap between the two of you. Or maybe every minute if you get very tired. If you're on your own, it's a little bit different. You continue it until the emergency services arrive, until someone relieves you until an AED arrives and you can deliver the shocks to the person, or until you get too tired to continue. Now, after as little as two minutes, you're going get very tired and you're not going be as effective. But what you need to do is try and deliver the compressions and carry on the CPR for as long as you can. Hopefully, the emergency services will be there in less than eight minutes. But if you're practising on the mannequin, eight minutes of practice on here, you'll be very, very tired. All you can do is do your best. When you're doing this for real, the adrenaline's going be pumping in your body. You're going have relatively superhuman-type strength to do it. But it's very, very upsetting. When the emergency services get there, don't stop. If you can, just carry on. Just give them a chance to get their equipment out and try and help them and tell them what's been going on. They will then guide you to when they want you to stop and what they want you to do. CPR is there, it's a very simple skill to learn. It's something that every first aid course has CPR on it and the reason for it is you can really make a difference in this person's life.
Adult CPR is performed by checking for patient responsiveness, contacting the emergency services, and checking for breathing for up to 10 seconds. Next, perform 30 compressions at a rate of 100 to 120 compressions per minute and a depth of 5 to 6 cm in the centre of the chest. Compressions should be the same speed on the push and the release and at a regular interval.
These 30 compressions should be followed by two rescue breaths, then the cycle of compressions to breaths should be repeated until an AED or the emergency services arrives. Do not waste time between the compressions and the breaths. It should just be a maximum of a 10-second break in giving the compression. It is vital to keep the oxygen-rich blood pumping around the body, which is why compressions are so important.
Rescue breaths are carried out by opening the airway with the head tilt, chin lift, squeezing the soft part of the nose, and sealing your mouth around the victim's, blow gently in for about one second or until you see the chest rise.
The latest CPR guidelines are the 2021 UK and European Resuscitation Council guidelines. The next scheduled update will be until October 2025.
- IPOSi Unit four LO3.1, 3.2 & 3.3
- IPOSi Unit two LO1.2, 1.3, 1.4, 2.1, 2.2 & 2.3