Basic Life Support
BASIC LIFE SUPPORT
(BLS)
Basic Life Support
OBJECTIVES
Students should be able to demonstrate:
How to assess the collapsed victim
How to perform chest compression and rescue breathing
How to place an unconscious breathing victim in the recovery position.
Basic Life Support
BACKGROUND
Approximately 700,000 cardiac arrests per
year in Europe
Survival to hospital discharge presently
approximately 5-10%
Bystander CPR vital intervention before
arrival of emergency services – double or
triple survival from SCA (sudden cardiac
arrest)
Early resuscitation and prompt defibrillation
(within 1-2 minutes) can result in >60%
survival
Basic Life Support
BASIC LIFE SUPPORT
(BLS)
Airway
B
reathing
C irculation (CAB)
Basic Life Support
CHAIN OF SURVIVAL
Basic Life Support
BASIC LIFE SUPPORT
SEQUENCES OF PROCEDURES PERFORMED TO
RESTORE THE CIRCULATION OF OXYGENATED
BLOOD AFTER A SUDDEN PULMONARY AND/OR
CARDIAC ARREST
CHEST COMPRESSIONS AND PULMONARY
VENTILATION PERFORMED BY ANYONE WHO
KNOWS HOW TO DO IT, ANYWHERE, IMMEDIATELY,
WITHOUT ANY OTHER EQUIPMENT
Protective devices
Basic Life Support
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 997
30 chest compressions
2 rescue breaths
Basic Life Support
APPROACH SAFELY!
Approach safely
Scene
Check response
Rescuer Shout for help
Open airway
Victim Check breathing
Call 112
Bystanders 30 chest compressions
2 rescue breaths
Basic Life Support
CHECK RESPONSE
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 977
30 chest compressions
2 rescue breaths
Basic Life Support
CHECK RESPONSE
Shake shoulders gently
Ask “Are you all right?”
If he responds
• Leave as you find him.
• Find out what is wrong.
• Reassess regularly.
Basic Life Support
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 977
30 chest compressions
2 rescue breaths
Basic Life Support
OPEN AIRWAY
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 977
30 chest compressions
2 rescue breaths
Basic Life Support
AIRWAY OPENING BY
NECK EXTENSION
Campbell
Basic Life Support
OPEN AIRWAY
Head tilt and chin lift
- lay rescuers
- non-healthcare rescuers
No need for finger sweep
unless solid material can be seen in the airway
Basic Life Support
OPEN AIRWAY
Head tilt, chin lift + jaw thrust
- healthcare professionals
Basic Life Support
CHECK BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 977
30 chest compressions
2 rescue breaths
Basic Life Support
CHECK BREATHING
Look, listen and feel
for NORMAL
breathing
Do not confuse
agonal breathing
with NORMAL
breathing
Basic Life Support
AGONAL BREATHING
Occurs shortly after the heart stops
in up to 40% of cardiac arrests
Described as barely, heavy, noisy or gasping
breathing
Recognise as a sign of cardiac arrest
Erroneous information can result in withholding CPR
from cardiac arrest victim
Basic Life Support
POTENTIALLY REVERSIBLE
CAUSES
(5 H’s & 5 T’s):
Hypoxia
• Tension
Hypovolemia
pneumothorax
Hypothermia
Hyper/hypoK+and • Tamponade
metabolic disorders
• Toxic/therap.
H+ ions (acidosis)
disturbances
• Thrombosis
coronary
• Thrombosis
pulmonary
Basic Life Support
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 977
30 chest compressions
2 rescue breaths
Basic Life Support
FOREIGN-BODY AIRWAY OBSTRUCTION
(FBAO)
Approximately 16 000 adults and children receive
treatment for FBAO in the UK yearly
SIGNS MILD obstruction SEVERE obstruction
“Are you choking?” “YES” Unable to speak,
may nod
Other signs Can speak, cough, Can not
breathe breathe/wheezy
breathing/silent
attempts to cough/
unconsciousness
Basic Life Support
ADULT FBAO TREATMENT
Basic Life Support
BACK BLOWS
Basic Life Support
ABDOMINAL THRUSTS
Basic Life Support
30 CHEST COMPRESSIONS
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 977
30 chest compressions
2 rescue breaths
Basic Life Support
CHEST COMPRESSIONS
• Place the heel of one hand in
the centre of the chest
• Place other hand on top
• Interlock fingers
• Compress the chest
– Rate 100 min-1
– Depth 4-5 cm
– Equal compression : relaxation
• When possible change CPR
operator every 2 min
Basic Life Support
RESCUE BREATHS
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 977
30 chest compressions
2 rescue breaths
Basic Life Support
RESCUE BREATHS
Pinch the nose
Take a normal breath
Place lips over mouth
Blow until the chest
rises
Take about 1 second
Allow chest to fall
Repeat
Basic Life Support
Breathing: Mouth To
Nose (when to use)
Can’t open mouth
Can’t make a good seal
Severely injured mouth
Stomach distension
Mouth to stoma (tracheotomy)
Basic Life Support
RESCUE BREATHS
RECOMMENDATIONS:
- Tidal volume
500 – 600 ml
- Respiratory rate
give each breaths over about 1s with enough
volume to make the victim’s chest rise
- Chest-compression-only
continuously at a rate of 100 min
Basic Life Support
30
2
CONTINUE CPR
Basic Life Support
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 977
30 chest compressions
2 rescue breaths
Basic Life Support
DEFIBRILLATION
Basic Life Support
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 977
Attach AED
Follow voice prompts
Basic Life Support
AUTOMATED EXTERNAL
DEFIBRILLATOR (AED)
Some AEDs will
automatically
switch themselves
on when the lid is
opened
Basic Life Support
ATTACH PADS TO
CASUALTY’S BARE CHEST
Basic Life Support
ANALYSING RHYTHM
DO NOT TOUCH VICTIM
Basic Life Support
SHOCK INDICATED
Stand clear
Deliver shock
Basic Life Support
SHOCK DELIVERED
FOLLOW AED INSTRUCTIONS
30 2
Basic Life Support
NO SHOCK ADVISED
FOLLOW AED INSTRUCTIONS
30 2
Basic Life Support
IF VICTIM STARTS TO BREATHE
NORMALLY PLACE IN
RECOVERY POSITION
Basic Life Support
Basic Life Support
Approach safely Approach safely
Check response Check response
Shout for help Shout for help
Open airway Open airway
Check breathing Check breathing
Call Emergency System Call Emergency System
30 chest compressions Attach AED
2 rescue breaths Follow voice prompts
Basic Life Support
CONTINUE RESUSCITATION UNTIL
Qualified help arrives and takes over
The victim starts breathing normally
Rescuer becomes exhausted
When Can I Stop CPR?
Basic Life Support
Victim revives
Trained help arrives
Too exhausted to continue
Unsafe scene
Physician directed (do not resuscitate orders)
Cardiac arrest of longer than 30 minutes
(controversial)
Basic Life Support
Why CPR May Fail
Delay in starting
Improper procedures (ex. Forget to pinch nose)
No ACLS follow-up and delay in defibrillation
Only 15% who receive CPR live to go home
Improper techniques
Terminal disease or unmanageable disease (massive
heart attack)
Basic Life Support
Injuries Related to
CPR
Rib fractures
Laceration related to the tip of
the sternum
Liver, lung, spleen
Basic Life Support
Complications of
CPR
Vomiting
Aspiration
Place victim on left side
Wipe vomit from mouth with
fingers wrapped in a cloth
Reposition and resume CPR
Basic Life Support
REPETITION
1. Name adult basic life support sequences of actions.
2. What is the manoeuvre for keeping the airway open
called?
3. What is the numeral combination of chest compression
and
rescue breaths in adult basic life support?
4. Where do you place your hands while performing chest
compressions?
5. How would you describe „agonal breathing“?
6. What is the telephone number of emergency response
system?
7. Name 2 techniques applied in severe airway
obstruction?
Basic Life Support
THANK YOU
