A Bls Team Is Bringing A 70

A BLS Team is Bringing a 70: A Comprehensive Guide to Managing a Critical Patient

Responding to a "70" – a code signifying a critical patient – is a high-stakes situation demanding precision, teamwork, and rapid decision-making from a Basic Life Support (BLS) team. This article delves into the multifaceted aspects of managing such a critical patient transport, encompassing pre-hospital care, efficient communication, and ethical considerations.

Understanding the "70" Code and its Implications

The designation "70" (or a similar code specific to your region) typically signals a patient experiencing a life-threatening condition requiring immediate advanced life support (ALS) intervention. This could stem from various causes, including:

Common Critical Conditions Triggering a "70" Code:

• Cardiac arrest: Absence of heartbeat and breathing, requiring immediate CPR and defibrillation.
• Severe trauma: Major injuries from accidents (MVA, falls, etc.) leading to significant blood loss, compromised airways, or spinal cord damage.
• Respiratory failure: Inability to adequately breathe, often requiring assisted ventilation or intubation.
• Stroke: Sudden blockage or bleeding in the brain, causing neurological deficits and potential permanent disability.
• Severe allergic reaction (anaphylaxis): Potentially fatal reaction to allergens, causing airway swelling, hypotension, and circulatory collapse.
• Septic shock: Life-threatening condition caused by overwhelming infection, leading to organ failure.

The "70" code initiates a rapid response protocol, ensuring a swift arrival of ALS support, typically a paramedic unit or mobile intensive care unit (MICU). However, the BLS team plays a crucial, time-sensitive role in stabilizing the patient before ALS arrival.

The BLS Team's Crucial Role Before ALS Arrival

The BLS team's actions during the initial moments are paramount. Their effectiveness directly impacts patient outcome. Key interventions include:

1. Scene Safety and Assessment:

Before approaching the patient, ensure the scene is safe. This involves assessing for hazards such as traffic, downed power lines, or aggressive bystanders. A thorough, rapid primary assessment follows, focusing on:

• Airway: Is the airway open and patent? Listen for breathing sounds. If obstructed, initiate airway maneuvers (head-tilt-chin-lift or jaw-thrust) and suction as needed.
• Breathing: Assess the rate, depth, and quality of breathing. Is the patient breathing adequately? Look for signs of respiratory distress (e.g., use of accessory muscles, cyanosis). Administer oxygen via a non-rebreather mask if available.
• Circulation: Check for a pulse (carotid or femoral). Assess skin color, temperature, and capillary refill time. If pulseless, immediately begin CPR according to established guidelines. Control any external bleeding with direct pressure.
• Disability: Briefly assess neurological status (e.g., level of consciousness, pupillary response). This provides crucial baseline information.
• Exposure: Completely expose the patient to assess for injuries (remove clothing as necessary while maintaining patient dignity).

2. Initiating BLS Interventions:

Based on the primary assessment, initiate appropriate BLS interventions:

• CPR: If pulseless and breathless, start chest compressions and rescue breaths at the correct compression-to-ventilation ratio. Use an AED if available and follow the device prompts.
• Oxygen administration: Provide supplemental oxygen to all patients with respiratory distress or suspected hypoxia.
• Bleeding control: Apply direct pressure to any significant bleeding sites.
• Shock management: If shock is suspected (e.g., hypotension, cool clammy skin), keep the patient warm and elevate their legs if no spinal injury is suspected.

3. Effective Communication:

Clear and concise communication is critical. The BLS team must:

• Relay accurate and concise information: Provide the dispatch center with vital details, including location, patient's condition, and interventions performed. Use standardized terminology to avoid ambiguity.
• Update ALS personnel: When ALS arrives, provide a detailed handover of the patient, including the history, assessment findings, interventions performed, and vital signs.
• Maintain teamwork: Effective communication between team members ensures coordinated care. Clearly assign roles and responsibilities.

4. Patient Monitoring and Documentation:

Continuously monitor the patient's vital signs (pulse, respiration, blood pressure, oxygen saturation if available) and document all interventions performed. Accurate documentation is crucial for legal and medical reasons. This forms the cornerstone of a comprehensive patient care record.

The Arrival of ALS and the Handover Process

The arrival of the ALS team marks a crucial transition. The BLS team's role shifts to assisting the ALS providers while maintaining clear and efficient communication. The handover process includes:

• Detailed patient report: A comprehensive and concise account of the patient's condition, history, assessment findings, and interventions undertaken.
• Documentation review: Ensuring all recorded information is accurate and reflects the care provided.
• Assisting ALS providers: Maintaining airway support, administering oxygen, and assisting with other tasks as directed by the ALS personnel.

This seamless transition of care ensures a continuity of high-quality patient management.

Ethical Considerations in Managing a "70" Code

Managing a "70" code involves significant ethical dimensions:

• Informed consent: While obtaining explicit consent is often impossible in a critical situation, the BLS team must act in the best interest of the patient, adhering to principles of beneficence (doing good) and non-maleficence (avoiding harm).
• Confidentiality: Maintaining patient privacy while providing care is crucial.
• Resource allocation: In situations with multiple critical patients, the BLS team must prioritize patients based on their immediate needs and likelihood of survival, following established triage protocols.
• End-of-life care: In cases where resuscitation efforts are unsuccessful, the BLS team plays a supportive role for the patient and their family, ensuring compassionate and dignified care.

Post-Incident Debriefing and Learning

After the incident, a debriefing session involving all involved personnel is essential. This process serves several important functions:

• Identifying areas for improvement: Analyzing the response, identifying areas where performance could be improved.
• Strengthening teamwork: Reinforcing communication and coordination among team members.
• Stress management: Providing a platform for team members to discuss their experiences and address any emotional impact.
• Continuous improvement: Using lessons learned to refine protocols and improve future responses.

Conclusion: A Collaborative Effort for Optimal Outcomes

Successfully managing a "70" code requires a coordinated effort from the entire healthcare team. The BLS team plays a pivotal role in the initial stages, providing crucial life support and facilitating a smooth transition to ALS care. Effective communication, meticulous documentation, ethical awareness, and continuous learning are vital components of ensuring optimal patient outcomes and enhancing the overall effectiveness of emergency medical services. By mastering these key elements, BLS teams can significantly contribute to saving lives and improving the quality of pre-hospital care. Remember, every second counts in these critical situations.