BASIC LIFE SUPPORT
By:
Hanif Ullah
Nursing Lecturer
CNM BKMC
OBJECTIVES
At the completion of this unit, learners will be able to:
1. Describe various conditions classified as cardiac and Pulmonary
Arrest.
2. Demonstrate a basic understanding of the management of cardiac
arrest.
3. Demonstrate the commonly used step used for the management of
cardiac & pulmonary arrest.
4. Describe the complications of Cardio Pulmonary Resuscitation CPR.
BASIC LIFE SUPPORT: introduction
The sequence of procedures performed to restore the
circulation of oxygenated blood after a sudden pulmonary
and or cardiac arrest
BASIC LIFE SUPPORT [BLS]
•A IRWAY
•B REATHING
•C IRCULATION (CAB)
CHAIN OF SURVIVAL
INDICATION of BLS/CPR:
1) Cardiac Arrest
• Ventricular fibrillation (VF)
• Ventricular tachycardia (VT)
• Asystole
• Pulse less electrical activity
2) Respiratory Arrest:
This may be the result of the following:
Drug overdose
Drowning
Accident, Smoke
injury
inhalation
Foreign body in
the throat
Coma Stroke
Principles of CPR
• To restore effective circulation and ventilation.
• To prevent irreversible cerebral damage due to hypoxia.
When the heart fails to maintain the cerebral circulation
for approximately four minutes the brain may suffer
irreversible damage.
New Updates in BLS:
CAB VS ABC???
New CPR Updates (2015) : No more Look,
Listen and Feel
• Should not delay activating EMS
• 2 things remain simultaneously :
1. Breathing
2. Pulse ( within 10 seconds)
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Emphasis on High-Quality CPR:
NEW Guidelines (2015) Old Guidelines (2010)
1) A Compression rate of 100/minute to Compression rate of Approximately
120 /minute atleast100 per minute.
2) Shock First vs. CPR First: CPR first:
For witnessed adult cardiac arrest when an When an AED is immediately available on-
AED is immediately available, it is site, the rescuer should start CPR with chest
reasonable that the defibrillator be used as compressions and use the AED as soon as
soon as possible possible
3) A compression depth of at least 2 inches A compression depth of 5 cm (2 inches) in
but no more than 2.4 inches in adults and at adults.
least one-third of the AP diameter of infants
and children.
4) More Emphasis on teamwork.
WHAT TO DO…
1) APPROACH SAFETY
2) CHECK RESPONSE
3) SHOUT FOR HELP (Activate the EMS)
4) CHECK PULSE (At the same time also Check Breathing)
5) 30 CHEST COMPRESSIONS
6) OPEN AIRWAY
7) 2 RESCUE BREATHS
1) APPROACH SAFETY 1) APPROACH SAFETY
2) CHECK RESPONSE
• Make sure that the scene is 3) SHOUT FOR HELP (Activate the EMS)
safe for you and the
victim. 4) CHECK PULSE (At the same time also
Check Breathing)
• Do not become a victim
yourself. 5) 30 CHEST COMPRESSIONS
6) OPEN AIRWAY
7) 2 RESCUE BREATHS
2) CHECK RESPONSE
1) APPROACH SAFETY
2) CHECK RESPONSE
3) SHOUT FOR HELP (Activate the EMS)
4) CHECK PULSE (At the same time also Check Breathing)
5) 30 CHEST COMPRESSIONS
6) OPEN AIRWAY
7) 2 RESCUE BREATHS
CHECK RESPONSE Cont.
• Tapp shoulders gently
• Ask “Are you all right?”
• Check if the victim is Responsive
or Unresponsive
3) SHOUT FOR HELP: Activate EMS
1) APPROACH SAFETY
2) CHECK RESPONSE
3) SHOUT FOR HELP (Activate the
EMS)
4) CHECK PULSE (At the same time also Check
Breathing)
5) 30 CHEST COMPRESSIONS
6) OPEN AIRWAY
7) 2 RESCUE BREATHS
3) SHOUT FOR HELP (Activate EMS):
• If the Victim is unresponsive.
• Shout for nearby help.
• Activate emergency response system via a mobile device (if appropriate).
• Get AED and emergency equipment (or send someone to do so).
• Use AED as soon as possible.
4) CHECK PULSE (At the same time also Check
Breathing)
1) APPROACH SAFETY
2) CHECK RESPONSE
3) SHOUT FOR HELP (Activate the EMS)
4) CHECK PULSE (At the same time also Check Breathing)
5) 30 CHEST COMPRESSIONS
6) OPEN AIRWAY
7) 2 RESCUE BREATHS
4) Pulse Check (and Breathing):
• To perform a pulse check in adults to palpate
carotid artery.
• Look for breathing Simultaneously (Look for NO
breathing or gasping)
• If you do not definitely feel a pulse within 10
seconds, start chest compression.
• (Check pulse for at least 5 seconds and not more
than 10 seconds)
5) 30 CHEST COMPRESSIONS
1) APPROACH SAFETY
2) CHECK RESPONSE
3) SHOUT FOR HELP (Activate the EMS)
4) CHECK PULSE (At the same time also Check Breathing)
5) 30 CHEST COMPRESSIONS
6) OPEN AIRWAY
7) 2 RESCUE BREATHS
5) Begin Cycles of 30 Chest Compressions and 2 Breaths
The lone rescuer should give the
compression-ventilation ratio of 30
compressions to 2 breaths when giving
CPR to the victims of any age.
• When you give chest compressions, it is important to push the
chest hard and fast at the rate of 100 to 120 compressions per
minute, allow the chest to recoil completely after each
compression: Do not lean on the chest after each compression.
• Minimize interruptions in the chest compression to less than 10
seconds
Compression: Ventilation
Components Adults Children (Age 1 year to Infants (Age less than 1
Puberty) Year)
Compression: 1 or 2 rescuers I rescuer 30:2
30:2 2 rescuer 15:2
Compression At least 2.5 inches At least one third AP At least one third AP
Depth (5-6 cm). diameter of the chest diameter of the chest (about
(about 2 inches) 1.5 inches or 4 cm)
Hands 2 hands on the 2 hands or one hand 1 rescuer: 2 fingers in the
placement lower half of the on the lower half of center of the chest, just
sternum the sternum below the nipple line
2 or more rescuers:
2 thumbs encircling hands in
the center of the chest, just
below the nipple line
Chest Compression Technique:
• The foundation of CPR is chest compressions. Follow these steps to perform chest
compressions in ad adults.
1) Position yourself at the victim’s side
2) Make sure the victim is lying on face up.
3) Put the heel of one hand on the center of the victim’s chest on the lower half of the
breastbone
4) Put the heel of your other hand on the top of the first hand
5) Straighten your arms and position your shoulders directly over your hands.
Cont.
6) Push Hard and Fast: Press down at least 5-6 cm with each compression.
Deliver compressions at a rate of 100 to 120 per minute.
7) At the end of each compression, make sure to allow the chest to recoil
(re-expand) completely.
8) Minimize interruptions.
9) Recheck Pulse and Breathing after 5 cycles of 3O compression and 2
breaths or after two minutes
6) OPEN AIRWAY
1) APPROACH SAFETY
2) CHECK RESPONSE
3) SHOUT FOR HELP (Activate the EMS)
4) CHECK PULSE (At the same time also Check Breathing)
5) 30 CHEST COMPRESSIONS
6) OPEN AIRWAY
7) 2 RESCUE BREATHS
AIRWAY OPENING BY NECK EXTENSION
OPEN AIRWAY: 1) Head
tilt and chin lift:
- Contraindicated for head and spinal
injury to avoid further deterioration
2) Jaw Thrust
• The jaw-thrust maneuver is a procedure used to
prevent the tongue from obstructing the upper
airways. The jaw thrust maneuver is a technique used
on patients with suspected spinal injury and is used on
a supine patient.
• The maneuver is performed by placing the index and
middle fingers to physically push the posterior aspects
of the mandible upwards while their thumbs push
down on the chin to open the mouth. When the
mandible is displaced forward, it pulls the tongue
forward and prevents it from obstructing the entrance
to the trachea.
6) OPEN AIRWAY
1) APPROACH SAFETY
2) CHECK RESPONSE
3) SHOUT FOR HELP (Activate the EMS)
4) CHECK PULSE (At the same time also Check Breathing)
5) 30 CHEST COMPRESSIONS
6) OPEN AIRWAY
7) 2 RESCUE BREATHS
RESCUE BREATHS: 1) Mouth to Mouth Rescue
Breathing
• Open the victim's airway
• Pinch the patient’s nose
• Take a normal/regular breath not deeper
• Place lips over the mouth and create an airtight
mouth-to-mouth seal
• Give 1 breath over 1 second
• Blow until the chest rises
• Allow the chest to fall
• Repeat and give the second rescue breath
Breathing devices:
• Bag-Mask
- Use the E-C clamp technique to hold the mask
in place while you lift up the jaw to open the
airway
- Squeeze the bag to give breath while watching
for chest rise
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Rescue Breathing:
• To perform when victim has a pulse but no breathing
• Give 1 breath every 6 seconds i.e. 10 breaths per minute
• Rescuer’s exhaled air contains approximately 16% oxygen and 4% carbon
dioxide
• Each breath should result in visible chest rise
• Check pulse and Breathing every 2 minute
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Rescue Breathing Cont.
• Avoid giving breaths too rapidly, too forcefully and with too much
volume as it will cause gastric inflation.
• Gastric inflation can resulting victim vomit, aspiration or pneumonia.
• To reduce risk of gastric inflation:
1. Take 1 second to deliver each breath
2. Deliver air until you make victim’s chest rise.
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RECOVERY POSITION
If a victim starts to breathe normally and there
is a pulse, place in the recovery position
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STEP 1:
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STEP 2
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NURSING - KDU COLLEGE
STEP 3
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NURSING - KDU COLLEGE
STEP 4
April 15, 2025
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Adult Foreign Body Airway Obstruction (FBAO)
UNIVERSAL CHOKING SIGN
\ 38
Assess
Severity
Severe Mild
(ineffective (effective
cough) cough)
Encourage cough
Continue to check for
Conscious deterioration to ineffective
Unconscious
5 abdominal cough or until obstruction
Start CPR
thrusts relieved.
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ADULT – FOREIGN BODY AIRWAY
OBSTRUCTION
• MILD (effective cough)
- Presence of Universal Choking Sign
- Ask: Are You Choking?
Can You Speak?
Can I Help You?
• Encourage cough
• Continue to check for deterioration to ineffective cough
or until obstruction relieved 40
SEVERE (ineffective cough)
• Conscious
5 back blows
5 Abdominal thrusts (Heimlich maneuver)
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Techniques to relieve FBAO in Adults:
1) Back Blow:
• Stand to the side and slightly behind the victim.
• Support the chest with one hand and lean the victim forward
• Give 5 blows between the shoulder blades with the heel of your hand.
• If fail then use abdominal thrust.
2) Abdominal Thrust (Heimlich Maneuver)
• Stand behind the victim and wrap both arms round the waist.
• Clench your fist with 1 hand
• Place thumb side of your fist against the victim’s abdomen,
in the midline, slightly above the navel and well below the
breastbone.
• Grasp your fist firmly with your other hand and press your
fist into victim’s abdomen with a quick, forceful upwards
thrust.
• Repeat thrusts until the object is expelled from airway or
victim become unconscious 43
• If the patient becomes
Unconscious:
• Start CPR
• Open the airway and remove the foreign
object with finger sweep if it is visible
or else DO NOT APPLY BLIND
FINGER SWEEP.
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3) CHEST THRUST:
should be applied for obese and pregnancy victim.
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Removing FBAO in Infants:
Give Five back blows & followed by Five Chest Thrust
Check the patient’s mouth, if the foreign body is visible, then
sweep your fingers and remove it.
If it is not visible then repeat the procedure until
EMS arrives or the baby becomes unconscious.
IF the baby becomes unconscious, then Start CPR
Abdominal Thurst is contraindicated in Infants
POSSIBLE COMPLICATIONS of CPR
Sternal fracture Rib fractures
Pneumothorax
Aspiration
References:
• American Heart Association (2015). BLS for
Health Care providers
• American Heart Association (2010). BLS for
Health Care providers
