What is BLS?

§ refers to the care healthcare providers and public safety

professionals provide to patients who are experiencing
respiratory arrest, cardiac arrest or airway obstruction
§ refers to the first aid given if the victim’s breathing or heart
stops
- heart attack
- drowning
- choking
- other injuries or conditions that affect breathing or the heart
 What is BLS?
§ includes psychomotor skills
for performing high-quality
cardiopulmonary
resuscitation (CPR), using an
automated external
defibrillator (AED) and
relieving an obstructed airway
for patients of all ages.
 What is BLS?
§ life-saving skills: resuscitation
§ include:
o Rescue breathing – to get needed oxygen into the lungs
o Chest compression – to pump oxygenated blood to vital
organs
o use of an AED – to shock the heart to beat regularly
o chocking care – including chest compressions, to expel an
obstructing object from the airway
 What is BLS?
§ BLS skills are used with adults, children and infants
§ Standard age groups
o Infant – birth to 1 year
o Child – ages 1 to 8
o Adult – over age 8
Respiratory Arrest
§ if the patient is not breathing but has a definite pulse
§ to care for a patient: ventilations must be given
Cardiac Arrest
§ if there is no breathing, no pulse and the patient is
unresponsive
§ cardiac arrest is a life-threatening situation in which the
electrical and/or mechanical system of the heart
malfunctions resulting in complete cessation of the heart’s
ability to function and circulate blood efficiently
§ according to recent statistics, sudden cardiac arrest is
rapidly becoming the leading cause of death
Cardiac Arrest
§ sudden stop of the beating of the heart
§ causes of sudden arrest:
o heart attack
o certain medication
o drug abuse or overdose
o electrocution, drowning, choking, traumatic injury
Caring for an unconscious or
nonbreathing person
§ maintenance of tissue oxygen supply is vital for life
§ establishing and keeping an open airway is a critical first
step
§ Airway obstruction impedes or prevents oxygen delivery to the
lungs, which then prevents delivery to the blood and
subsequently to tissues.
§ when oxygen supplies are interrupted, organ will suffer and
eventually die
§ without oxygen, brain may start dying after 4-6 minutes
§ need for immediate action is therefore crucial
§ unfortunately, a typical EMS response may take 6, 8 or even 10
minutes
During BLS
§ rescuers provide and maintain oxygen supplies to ill persons
by using chest compressions to
- maintain blood circulation and ventilations
- maintain oxygen levels
Key steps in BLS include
1. Check for responsiveness, and activate emergency medical
services (EMS).
2. Quickly check for normal breathing.
3. If the person is not breathing normally, provide chest
compressions to temporarily take over the function of the
heart and circulate blood.
4. Open the airway, and provide ventilations to deliver air to
the lungs.
Goal of CPR
§ to provide critical blood flow to the heart and brain
§ to keep oxygenated blood circulating
§ delays damage to vital organs (brain) and improves the
chances of successful defibrillation
 Note:
§ The exhaled air used during rescue breathing contains about 16 percent oxygen
compared with 21 percent in room air
§ the difference between sudden cardiac arrest (SCA) and or heart attack
Sudden cardiac arrest
- happen without warning or may be preceded by brief generalized seizures
- the heart has either completely stopped or is in a dysrhythmia that
cannot support life
* Check for normal breathing once seizure activity has stopped and
* activate EMS
* Initiation of CPR and implementation of an AED, if available, is critical
Note:
Heart attacks
- are serious cardiac events
- may not result in unresponsiveness or the need for CPR
* activate EMS and monitor the person continuously.
* be prepared to initiate CPR if the individual loses
consciousness.
Duty of Care
§ The potential first responder has no legal obligation to
provide medical care
§ In some areas, they have an obligation to notify authorities
that someone is in need of medical assistance
§ if one engages in basic life support, provide care within the
scope of training
Duty of Care
§ ask an individual for permission before you provide
care
§ If responsive, the individual should give permission before care is
provided
§ Not asking for permission or forcing care against a person’s will
exposes you to potential legal action for involuntary assistance or
battery
§ If a person is unresponsive, permission to provide medical
assistance is implied.
CHAIN OF SURVIVAL
§ chest pain should be recognized as a symptom of myocardial
ischaemia (lack of blood flow getting to the heart muscle)
§ Cardiac arrest occurs in a quarter to a third of patients with
myocardial ischaemia within the first hour after the onset of
chest pain
§ Recognizing the cardiac origin of chest pain, and calling the
emergency services before a victim collapses, enables rapid
activation of Emergency Response System (ERS).
§ If a cardiac arrest has occurred, early recognition is critical to
enable rapid activation of the ERS and prompt initiation of
bystander CPR.
§ The key observations are unresponsiveness and not
breathing normally.
§ Recognition of a medical problem should be followed by
prompt action.
§ Once unresponsiveness is established, call EMS.
- either yourself
- as bystander or other rescuer
§ There are two scenarios when the solo rescuer may consider
initiating CPR prior to activating EMS:
• child or infant victim
• drowning victim
§ The use of a cell phone to activate EMS while initiating CPR
is still recommended to expedite the arrival of advanced
medical care.
§ If a cell phone is unavailable, the lone rescuer should
perform two minutes of CPR before calling for help.
§ Children and drowning victims may spontaneously recover if
CPR is initiated immediately.
§ acute coronary syndromes (heart attacks) often cause
unstable heart rhythms that respond best to rapid
defibrillation.
§ Activating EMS and getting a defibrillator on the scene as
soon as possible
§ CPR should not be delayed, however, if an AED is not
immediately available
§ Regardless of who calls EMS, the person relaying information to
them should state:
• caller's name • number of injured persons
• exact location • call-back phone number
• condition of the injured persons • what happened
• care provided
§ Do not hang up until the operator releases you. It is important to
answer all dispatcher questions to assure an appropriate
response team and resources are sent to the site.
§ The operator may repeat critical information before ending
the call, which ensures that the message was received and
key facts were conveyed.
§ If someone else calls EMS, be sure to have that person
return to the scene after making the call to verify that help is
on the way.
§Remember, the sooner you make the call, the sooner
advanced life support will arrive.
§ The immediate initiation of CPR can increase the survival
rate from cardiac arrest.
§ If able, bystanders with CPR training should give chest
compressions together with ventilations.
§ help keep the brain and other vital organs supplied with
oxygen until AED arrives.
§ is the single most important intervention in the case of an
unstable cardiac rhythm and provides the greatest chance
of survival.
§ Most cases of adult respiratory arrest are due to cardiac
arrest. Cardiac arrest often results from a non-life-sustaining
rhythm known as ventricular fibrillation (VF).
* VF is a type of arrhythmia or irregular heartbeat that
affects the heart’s ventricle
§ Defibrillation within 3–5 mins of collapse can produce
survival rates as high as 50–70%.
§ Each minute of delay to defibrillation reduces the
probability of survival to discharge by 10–12%.
§ Delays of as little as 7-10 minutes greatly reduce the
chance of survival.
ü AED can help the heart beating normally again after a
cardiac arrest
§ CPR and defibrillation may not restore a normal cardiac
rhythm.
§ Medical interventions such as advanced airway management
and the delivery of medications may increase resuscitation
success.
§ Should CPR and/or defibrillation be successful, advanced life
support will help stabilize the person and make the patient
ready for hospital transport.
Remember: Advanced cardiac life support will not arrive until
local EMS is activated.
§ If a spontaneous heart rhythm resumes and effective
circulation is restored, there is still work to do.
§ Maintain airway support, and continually monitor the
individual until help arrives.
§ Unstable heart rhythms that lead to unconsciousness or
death may recur without warning.
Emotional Stress and Fear of Doing
Something Wrong
§ When a person has an accident or is in sudden cardiac arrest,
bystanders commonly wait for someone to take charge and
provide aid.
§ Hesitation is often caused by:
• fear of doing something wrong, causing harm or not
being able to bring back life
• fear of being sued
• fear of infection
§ providing some care (even if not “perfect”) is a much more
effective approach than providing no care at all.
Emotional Stress and Fear of Doing
Something Wrong
§ Unsuccessful rescues may cause emotional distress.
§ A key point to remember if you ever have to perform CPR
is that a person in cardiac arrest (with no signs of life) is in
the worst possible condition. If no one initiates CPR,
someone in cardiac arrest is certain to die; you cannot make
them any worse.
Rescuer and Victim
§ Rescuer – all, regardless of training, should provide chest
compression
a. Untrained Lay Rescuer – Hands only CPR
b. Trained Lay Rescuer – CC rescue breaths
c. Healthcare Provider (HCP) – CC + rescue breaths,
coordinate teamwork