BASIC LIFE SUPPORT
(BLS)
By: Dr.
WHAT IS BASIC LIFE
SUPPORT ?
Basic Life Support (BLS) defines
Sequences of procedures performed to
restore the circulation of oxygenated
blood after a sudden pulmonary or
cardiac arrest until they can be given full
medical care at a hospital.
BLS does not include the use of drugs or
invasive skills.
GLOBAL BURDEN OF SUDDEN CARDIAC ARREST
Approximately 700,000 cardiac arrests per year.
Bystander CPR before arrival of emergency
services –doubles survival from sudden cardiac
arrest.
Early resuscitation can result in >60 % survival.
BASIC LIFE SUPPORT
It can be provided by trained medical
personnel, including paramedics, and by
Anyone who knows, How To do it, anywhere,
immediately, without any other equipment.
PURPOSES OF
CPR circulation and
Maintaining
oxygenation in order to maintain
a cardiac output to keep vital
organs alive.
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INDICATIONS OF CPR
CARDIAC ARREST
RESPIRATORY ARREST
COMBINATION OF BOTH
AHA GUIDELINES
The American Heart Association (AHA) is
a non-profit organization in the United States.
They are known for publishing standards
on basic life support and advanced cardiac
life support (ACLS).
WHAT IS CAB
APPROACH ?
There is a common acronym in BLS
used to guide providers in the
appropriate steps to assess and
treat patients in respiratory and
cardiac distress. This is CAB-D
(Circulation, Airway, Breathing,
Defibrillate)
CAB –Circulation Airway
Breathing
CHAIN OF SURVIVAL
FIVE LINKS OF ADULT CHAIN OF SURVIVAL-
•Early recognition of cardiac arrest.
•Activation of the Emergency Response
System.
•Early CPR, to provide blood supply to vital
organs.
•Early defibrillation to restart the heart.
•Comprehensive post-cardiac arrest care
to restore quality of life.
ACTIONS FOR PERFORMING ADULT CPR
1 Assess scene safety.
2 Determine responsiveness
3 Check carotid pulse
4 Perform chest compressions
5 Open Airway
6 Check Breathing and deliver breathe.
SCENE 1- YOU FIND AN ADULT LYING ON GROUND
ASSESS SCENE SAFETY
Assess to make sure the scene is
safe for you to respond to the
ASSESS RESPONSIVENESS
Shake the shoulder and speak to the
adult asking ARE YOU ALLRIGHT? . Look
at the chest and torso for movement and
normal breathing simultaneously.
CHECK CIRCULATION
Check the patient for a palpable
carotid pulse for 5-10 seconds. (Do
not check for more than 10 seconds.)
SHOUT FOR HELP
IF THERE IS NO
PULSE AND
NO/ABNORMAL
BREATHING
START
CPR
CARDIO-PULMONARY RESUSCITATION
To start CPR, place patient in supine position on a
firm and flat surface.
Kneel down to the patient and locate the position
for chest compression on person’s chest.
LOCATION OF CHEST COMPRESSIONS
Locate the lower
1/3 of the
patient’s sternum
between the
nipples in the
midline of body.
HAND POSITIONING FOR CHEST
COMPRESSIONS
1. Lock your arms.
2. Place the heel of one
hand over the center
of the person's chest,
between the nipples.
Place your other hand
on top of the first
hand.
3. Keep your elbows
straight and position
your shoulders directly
above your hands.
CONTINUED…….
Use your upper body weight (not just your arms)
as you push straight down on the chest at least 2
inches (approximately 5 centimeters) but not
greater than 2.4 inches (approximately 6
centimeters).
GOOD QUALITY CHEST COMPRESSIONS
Press hard and fast.
Allow for full chest recoil with each compression.
Allow for only minimal interruptions to chest
compressions.
CHEST COMPRESSIONS
Deliver 30 chest compressions initially.
Push hard at a rate of 100 -120
compressions per minute.
AIRWAY
After initial 30 chest compressions ,assess
and establish airway.
Give 2 rescue breaths, each lasting for 1
seconds and assess for visible chest rise with
each breath
AIRWAY :OPEN THE AIRWAY
After giving 30 chest compressions open
victim’s airway.
There are two maneuvers to open the
airway-
HEAD- TILT CHIN-LIFT MANEUVER (Or
Jaw thrust maneuver if spinal cord injury
is suspected).
JAW THRUST MANEUVER
RESCUE BREATHING
A technique used to resuscitate a person wh
o has stopped
breathing, in which the rescuer forces air int
o the victim's
lungs at intervals of several seconds.
METHODS OF RESCUE BREATHS
Mouth-to-Mouth Rescue
Breathing
Mouth-to-Nose and Mouth-
to-Stoma Ventilation
Ventilation With Bag and
Mask
Ventilation With an
Advanced Airway 32
Mouth to Mouth Breathing
Use a barrier device if available.
pinch the nostrils for mouth-to-mouth
breathing.
Make a seal using your mouth over the
mouth of the patient or use a pocket mask
or bag mask.
Bag and mask Ventilation: The one-
hand E-C technique
Place the mask on the
patient’s face before
attaching the bag.
Using the non
dominant hand, create
a C-shape with the
thumb and index 33
finger over the top of
the mask, and apply
Hook the remaining gentle downward
fingers around the pressure.
mandible, and lift
it upward toward
the mask, creating
the E.
Cover the nose and the mouth
with the mask without extending
it over the chin. Change the size
of the mask, as appropriate, to
create a good seal.
RESCUE BREATHING
Each rescue breath should last approximately 1
second.
Watch for chest rise.
Allow time for the air to expel from the
patient.
Cardio-Pulmonary
Resuscitation
1 cycle of adult CPR is 30 chest
compressions to 2 rescue breaths.
Perform 5 cycles of CPR (lasts
approximately 2 minutes).
CONTINUE CPR
2
30
If two providers are present: switch rolls
between compressor and rescue
breather every 5 cycles.
High Quality
CPR
30 compressions to 2
breaths
100-120 compressions per
minute
RATE AND DEPTH OF CPR
Chest Compression
Fraction (CCF)
Chest compression fraction (CCF) is the cumulative time
spent providing chest compressions divided by the total
time taken for the entire resuscitation. Targeting a CCF of at
least 60% is intended to limit interruptions in compressions
and maximize coronary perfusion during resuscitation.
Compression fraction and Pauses
To better resuscitation outcomes, compression pauses for ventilation should be as
short as possible. In adult and child cardiac arrest, it may be reasonable to perform
CPR with a chest compression fraction of at least 60%. It is reasonable to pause
compressions for 10 seconds (≈60%), to deliver 2 breaths. High-performing EMS
systems target at least 60% (≈10 seconds), with 80% (≈5 seconds) or higher being a
frequent goal.
CONTINUE RESUSCITATION UNTIL
Qualified help arrives and takes over
The victim starts breathing normally
Rescuer becomes exhausted
AUTOMATED EXTERNAL
DEFIBRILLATOR
An AED, or automated
external defrillator, is a
device that has the ability to
detect irregular heart rhythm
and it automatically delivers a
defibrillation shock to stop
irregular heart beat and allow
a normal rhythm to resume.
AEDs are designed to be used
by any laypersons.
ATTACH PADS TO CASUALTY’S
BARE CHEST
DEFIBRILLATION
YOU
CLEAR I CLEAR
ALL CLEAR
IF VICTIM STARTS TO BREATHE
NORMALLY PLACE IN RECOVERY
POSITION
RECOVERY POSITION
COMPLICATIONS OF CPR
1. Rib Fracture
2. Internal injuries
to organs
3. Laceration related
to the tip of the
sternum
4. Vomiting and
aspiration
5. Gastric
distension.
HODS - November 2006 86
TAKE HOME MESSAGE
Taking the right action quickly and
confidently can make the difference between
life and death for a person dealing with
cardiac arrest.
