BLS Algorithm
BLS Algorithm
Immediate Recognition & Activation of Emergency Response System If a lone rescuer finds an unresponsive adult or witnesses an adult who suddenly collapses, after ensuring that the scene is safe, the rescuer should check for response by tapping the victim on the shoulder and shouting at the victim. If the victim also has absent or abnormal breathing, the rescuer should assume the victim is in cardiac arrest. Pulse Check Healthcare Provider should not take more than 10 seconds to check for a pulse. The lay rescuer should not check for pulse and should assume the victim is in cardiac arrest. If unable to definitely feel a pulse within 10 seconds, the rescuer should start chest compressions. Early CPR Chest Compressions consist of forceful rhythmic application of pressure over lower half of the sternum. By increasing intrathoracic pressure and directly compressing the heart, these compressions create blood flow and oxygen delivery to heart & brain. To provide this effectively, Push Hard and Push Fast. Compress the adult chest at a rate of at least 100 per minute with a compression depth of at least 2 inches/5 cm. Rescuers should allow complete recoil of the chest after each compression to allow the heart to fill completely before next compression. Minimise the frequency and duration of interruptions in chest compressions. To maximise the effectiveness of chest compressions Place the victim on a firm surface when possible, in a supine position, with the rescuer kneeling beside the victim's chest. Place the heel of one hand on the centre of the victim's chest (lower of sternum) and the heel of the other hand on top of the first such that hands are overlapped and parallel. To minimise rescuer fatigue and thereby ineffectiveness, rotate with another rescuer every 2 minutes (or after about 5 cycles of compressions and ventilations at a ratio of 30:2)
Airway If there is no evidence of head/neck trauma, use the Head TiltChin Lift manoeuvre to open the airway. If head/neck trauma is suspected, open the airway using a jaw thrust without head extension. Spinal injury should be suspected if victim has a craniofacial injury and/or a Glasgow Coma Scale score of < 8. Rescue Breaths Once chest compressions have been started, a trained rescuer should deliver rescue breaths by mouth-to-mouth or bag-mask to provide oxygenation and ventilation. Deliver each rescue breath over 1 second. Give a sufficient tidal volume to produce visible chest rise. Use a compression to ventilation ratio of 30 chest compressions to 2 ventilations. Once an advanced airway (Endotracheal Tube/Combitube/Laryngeal Mask Airway) is in place, 2 rescuers need no longer pause chest compressions for ventilations. The rescuer giving chest compressions does it at the rate of least 100 per minute, while the rescuer delivering ventilation can provide a breath every 6 to 8 seconds (i.e., 8 to 10 breaths per minute) Early Defibrillation with Defibrillator After activating the emergency response system, the lone rescuer should next retrieve an AED if nearby & accessible and return to the victim to attach & use it. If two or more rescuers are present, one rescuer should begin chest compressions while the second rescuer activates emergency alarm system and gets the AED. After turning on the AED, follow the prompts to use it. Resume chest compressions immediately after the shock (minimise interruptions). Recovery Position It is used for unresponsive adult victims who have normal breathing and effective circulation. The victim is place on his/her side with the lower arm in front of the body.
Compressions
Push hard and fast on the centre of the victim's chest
Airway
Tilt the victim's head back and lift the chin to open the airway
Breathing
Give mouth-to-mouth rescue breaths