Basic Life Support

ADULT
BASIC LIFE SUPPORT
(BLS)
Muhamad eL Jidin, S.K
ep Ns
Basic Life Support

OBJECTIVES

Students should be able to demonstrate:

– How to assess the collapsed victim

– How to perform chest compression and rescu
e breathing
– How to place an unconscious breathing victim
in the recovery position.
Basic Life Support

BACKGROUND

• Approximately 700,000 cardiac arrests per year i

n Europe
• Survival to hospital discharge presently approxim
ately 5-10%

• Bystander CPR vital intervention before arrival of

emergency services – double or triple survival f
rom SCA (sudden cardiac arrest)

• Early resuscitation and prompt defibrillation (withi

n 1-2 minutes) can result in >60% survival
 BASIC LIFE SUPPORT (BLS
Basic Life Support

A irway

B reathing

C irculation (CAB)
Basic Life Support

CHAIN OF SURVIVAL
Basic Life Support

BASIC LIFE SUPPORT

SEQUENCES OF PROCEDURES PERFORMED TO RESTORE T

HE CIRCULATION OF OXYGENATED BLOOD AFTER A SUDDEN
PULMONARY AND/OR CARDIAC ARREST

CHEST COMPRESSIONS AND PULMONARY VENTILATION PER

FORMED BY ANYONE WHO KNOWS HOW TO DO IT, ANYWHE
RE, 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
Shout for help
Rescuer
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
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OPEN AIRWAY

Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 977
30 chest compressions
2 rescue breaths
 AIRWAY OPENING BY
Basic Life Support

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
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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 f

or NORMAL breathin
g

• Do not confuse agona

l breathing with NOR
MAL 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 gaspi

ng breathing

• Recognise as a sign of cardiac arrest

Erroneous information can result in withholding CPR from cardiac arrest victim
 POTENTIALLY REVERSIBLE CAU
Basic Life Support

SES
(5 H’s & 5 T’s):

• Hypoxia •Tension pneumoth

• Hypovolemia orax
•Tamponade
• Hypothermia
•Toxic/therap. distur
• Hyper/hypoK+an bances
d metabolic disor •Thrombosis corona
ders ry
• H+ ions (acidosis •Thrombosis pulmo
) nary
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 FBA
O in the UK yearly

SIGNS MILD obstruction SEVERE obstruction

“Are you choking?” “YES” Unable to speak,

may nod
Other signs Can speak, cough, breath Can not breathe/wheezy
e breathing/silent attempts
to cough/ unconsciousne
ss
Basic Life Support
ADULT FBAO TREATMENT
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BACK BLOWS
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ABDOMINAL THRUSTS
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30 CHEST COMPRESSIONS

Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 977
30 chest compressions
2 rescue breaths
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CHEST COMPRESSIONS

•Place the heel of one hand i

n 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
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RESCUE BREATHS

• Pinch the nose

• Take a normal breath
• Place lips over mouth
• Blow until the chest ri
ses
• Take about 1 second
• Allow chest to fall
• Repeat
 Breathing: Mouth To Nose (
Basic Life Support

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
CONTINUE CPR

2
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
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AUTOMATED EXTERNAL DEFI

BRILLATOR (AED)

• Some AEDs will auto

matically switch them
selves on when the lid
is opened
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ATTACH PADS TO CASUAL

TY’S BARE CHEST
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ANALYSING RHYTHM
DO NOT TOUCH VICTIM
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SHOCK INDICATED

• Stand clear
• Deliver shock
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SHOCK DELIVERED
FOLLOW AED INSTRUCTIONS

30 2
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NO SHOCK ADVISED
FOLLOW AED INSTRUCTIONS

30 2
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IF VICTIM STARTS TO BREATH

E NORMALLY PLACE IN RECO
VERY 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 resuscitat
e orders)
• Cardiac arrest of longer than 30 minu
tes
– (controversial)
 Why CPR May Fail
Basic Life Support

• Delay in starting
• Improper procedures (ex. Forget to pin
ch nose)
• No ACLS follow-up and delay in defibril
lation
– Only 15% who receive CPR live to go home
– Improper techniques
• Terminal disease or unmanageable dise
ase (massive heart attack)
 Injuries Related to CPR
Basic Life Support

• Rib fractures

• Laceration related to the tip of th

e sternum
–Liver, lung, spleen
 Complications of CPR
Basic Life Support

• Vomiting
• Aspiration
• Place victim on left side
• Wipe vomit from mouth with fi
ngers 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