BASIC LIFE SUPPORT

(BLS)

BY- SANA ALi

BUMS 3rd proff
AMU, ALIGARH
Each year, over
500000 cardiac
arrests
Occur in india ,
statistics show if
more people
Knew CPR more
lives could be
saved. !!
Introduction

⦿ 63% of all cardiac deaths

were caused by
sudden
cardiac arrest (SCA)

⦿ SCA is the Leading cause

of death
Sudden Cardiac Arrest (SCA)
⦿ 5 Lakh die annually in the US, of which 64%
is out-of-hospital.

⦿ VF/VT (pulseless) most common initial

rhythms in SCA & other causes are asphyxia,
as in drowning, choking or drug overdose.
PERFORMED BY

⦿ Anyone who knows how to do it

⦿ Anywhere

⦿ Immediately

⦿ No Complex Device
Cardio Pulmonary Resuscitation
⦿ 1960 CPR program was started
according to
American Heart Association (AHA)

⦿ 1966, the first CPR guidelines

were developed by AHA.
⦿ International Liaison Committee on
Resuscitation (ILCOR), a resuscitation council
Published in 2000
Cardio Pulmonary Resuscitation (CPR) or
or CPCR

⦿ Series of life saving actions that

improve the chance of survival
after cardiac arrest.
Support and Restore:
Oxygenation
Ventilation and
Circulation with
return of intact
Neurological
function
What are the goals of CPR?

1. To restore flow of blood

to brain
& heart
2. To delay tissue death
3. To extend the brief window
of opportunity for
successful
resuscitation--
Approach Safely!
Scene
Rescuer

Victim

Survey the area, needs to ensure that he/she

will be safe while performing the procedure.
This may include looking for traffic, fires or
other potential dangers.
Step 1 Check Responsiveness/Breathing
and pulse.
 Face the victim & tap on
shoulder & shout Are you all right?
 Look for chest movement--
Absent or Abnormal Breathing

 If no Response ?
Pulse Check
Which?

Carotid

How?
Maintai
n head
tilt with
one
hand

Use 2-3
fingers
of other
hand to
Step 2 Activate EMS & get AED

⦿ Shout for Help ask to Activate EMS

⦿ If no help activate EMS –emergency

medical service(112) Yourself

⦿ Give full details

⦿ Ask for AED(automated external

defibrillator)
Activate EMS
Give the following information:
⚫ Location of the emergency
⚫ What happened
⚫ Victims’ specification
⚫ Aid being given
Step 3

Pulse Check

If no pulse?

Start CPR
 Sequence of AHA Algorithm for CPR
⦿ Assess

⦿ Activate

⦿ Perform: CAB

⦿ Defibrillate as soon as it arrives

CAB not ABC
Chest Compression
Chest Compression
⦿ Victim on firm flat surface

⦿ Rescuer to kneel by side of victim

⦿ Place heel of one hand on

middle of victims chest (lower half of sternum)

⦿ Place heel of other hand on top of 1st hand

⦿ Interlace fingers to keep them off the chest

⦿ Arms straight-shoulder above victim

Chest Compression
⦿ Push Hard (at least 2 inches or 5
cm)
⦿ Push Fast (at least 100/ min)
⦿ Minimize interruption
⦿ Allow Adequate Chest recoil
⦿ Rotate compressor at 2min
⦿ If no advanced airway 30:2
(compression-ventilation ratio)
Airway
Airway
Open Airway

⦿ Head tilt-Chin lift

⦿ Jaw thrust
Patent Airway
⦿ Tongue is the most common cause of airway obstruction
in unresponsive patient

⦿ Quickly remove food particles, or loose dentures, if any

⦿ HEAD TILT - CHIN LIFT

maneuver lifts the tongue and relieves obstruction

⦿ JAW THRUST
maneuver in cases of suspected neck injuries
TONGUE CAUSING AIRWAY OBSTRUCTION
HEAD TILT - CHIN LIFT lifts the tongue & relieves obstruction
Head tilt– Chin lift

Jaw Thrust
without head Extension
In suspects a cervical
spine
injury
Breathing
Breathing

⦿ mouth to mouth/nose

⦿ mouth to mask

⦿ bag mask ventilation (2 rescuers)

Breathing
⦿ Provide 2 rescue breaths

⦿ Each over 1 second

⦿ Small TV, sufficient for a visible chest rise

⦿ Compression ventilation ratio of 30:2

Mouth to mouth breathing
Single rescuer bag and mask

Two rescuer Bag and Mask

Breathing
⦿ 2 Breaths
⦿ Give each breath over 1second
⦿ Allow 1 second for expiration
⦿ See visible chest rise
⦿ If no chest rise, reposition and give 2nd breath
⦿ If no chest rise again go back to
chest compression
⦿ Compression : Ventilation ratio 30
:2
Step 4 Defibrillation
Defibrillation------- early
 Why early defibrillation is critical?

Survival rates after VF arrest decrease approx. 7% to 10% with every minute that
defibrillation is delayed

Larsen et al. Ann Emerg Med. 1993:222:1652-58

Step 4 Defibrillation

⦿ Get AED as soon as possible

⦿ Continue CPR till AED arrives

⦿ Immediately after defibrillation start CPR

⦿ Do not check pulse

Step 4 Defibrillation

⦿ Check rhythm with Defibrillator

⦿ If shockable – give shock as indicated

⦿ After shock start CPR with chest

compression
Automated External Defibrillator
1. Ease of use by untrained
rescuers

2. Automated detection of
shockable rhythms

3. Advises shock &

delivers it

4. Portable
Steps of AED

1) Power on the AED

2) Attach Electrode Pads to pt’s bare chest

3) Analyze rhythm (ALL CLEAR)

4) Deliver Shock if advisable

AED in Special Situation

Water

⦿ Do not use AED in water (conduct)

⦿ The patient chest is covered with water-

Wipe the chest quickly before attaching the
electrodes

⦿ The patient is lying on snow or ice: you can

use AED
AED in Special Situation

Trans-dermal medical patch

⦿ Do not place AED electrode pad directly on top

of trans-dermal patch( nitroglycerine, nicotine,
analgesic, hormone, anti HTN)

⦿ Block energy transfer and cause skin burns

⦿ Remove the patch and wipe the area clean

AED in Special Situation
Implanted Pacemaker

⦿ Hard lump beneath the skin of the

upper chest or abdomen with visible scar
mark.

⦿ Place the AED electrode pads to either side

and not directly on top of the device.

⦿ If implanted D. is delivering shock, wait for

30-60 sec
before giving shock with AED
ATTACH PADS TO VICTIMS BARE CHEST
ANALYSING RHYTHM DO NOT TOUCH
VICTIM
SHOCK DELIVERED
FOLLOW AED INSTRUCTIONS
Scenario-1
Pulse present but ineffective breathing

Rescue breaths, 10 to 12/min (every 5-6 sec)

⦿ Give breath over 1 second

⦿ Visible chest rise

⦿ Check pulse every 2 minutes

Scenario-2
Victim Unconscious but Breathing Normally

Recovery
Position
 Recovery position
⦿ Unresponsive victims, who have
normal breathing & effective circulation

⦿ It maintained the patent airway & reduced

the risk of aspiration & airway obstruction

⦿ Good observation & access to the airway is

possible
 BASIC LIFE SUPPORT- ADULT

Unresponsive
No breathing or no normal breathing Get Defibrillator / AED

Activate emergency response

Start
CPR Shock

Check rhythm /
shock if indicated
PUSH HARD Repeat every 2
PUSH FAST minutes
Basic life support Advanced Life Support
(BLS) (ALS)
⦿ Circulation by ⦿ Circulation by
cardiac Defibrillation,
compression Cardioversion and Pacing
⦿ Airway management by ⦿ Airway management
basic by
technique equipments
⦿ Breathing by ⦿ Breathing by
basic equipments advanced technique

⦿ Defibrillation by ⦿ Drugs
Automated
Electrical Defibrillator
(AED)
Return of spontaneous circulation

(ROSC)

Go to post cardiac arrest care

Defibrillation
Shockable rhythms --------- VF/VT
No guidelines for use of AED in infants

Manual Defibrillation ---------Energy selection

1st shock 2j/KG

Subsequent shocks 4j/KG

CPR
 Future in You
Survival from SCA
depends
on
presence of a
trained rescuer who
is
ready, able, willing and
equipped to act
 Chain of Survival - Adults

BLS ACLS
1. Immediate recognition & activation
2. Early CPR
3. Rapid defibrillation
4. Effective advanced life support
5. Integrated post cardiac arrest care
When pushing on the chest, you should
compress the chest approximately
inches at a rate of compressions per
minute.

A 2 to 2½ inches; 30
B 1 to 1½ inches; 30
C 2 to 2½ inches; 100
D 1 to 1½ inches; 100
Thank You