BASIC

LIFE
SUPPOR
T
Monalyn B. La-ao, RN

Glenn Ryan Palao-ay, RN

BASIC LIFE SUPPORT

An emergency procedure that

consists of recognizing respiratory or
cardiac arrest or both and the proper
application of CPR to maintain life
until a victim recovers or advanced
life support is available.
Basic Precautions and Practice

Personal Hygiene Protective Equipment

Equipment Cleaning
& Disinfecting
Review on breathing and circulation

Air that enters the lungs contains about _____%

oxygen and only a trace of carbon dioxide.

Air that is exhaled from the lungs contains about

______% oxygen and ______% carbon dioxide.
EMERGENCY

ACTION

PRINCIPLES
GUIDELINES
 The American Heart Association’s Guidelines for
CPR and ECC provide science-based
recommendations for treating cardiovascular
emergencies, particularly sudden cardiac arrest in
adults, children, infants and newborns.
 Every five years, hundreds of leading resuscitation
experts from around the world review all new and
existing research as part of an international
consensus process. This is the basis for any revisions
to the American Heart Association’s Guidelines for
CPR and ECC.
HISTORY OF CPR
 In 1960, researchers combined breaths and
compressions to create CPR as we know it today.
 CPR training has been recommended for
healthcare professionals and for the general
public for more than 40 years.
 2010 marks a change in the sequence of CPR
from Airway-Breaths-Compressions (A-B-C) to
Compressions-Airway-Breaths (C-A-B)
sequence.
SUDDEN CARDIAC ARREST
 EMS treats nearly 300,000 victims of out-of-
hospital cardiac arrest each year in the U.S.
 Less than eight percent of people who suffer
cardiac arrest outside the hospital survive to
make it home from the hospital.
 Sudden cardiac arrest can happen to anyone at
any time. Many victims appear healthy with no
known heart disease or other risk factors.
 Sudden cardiac arrest is not the same as a heart
attack.
STRENGTHENING
THE LINKS IN THE CHAIN OF
SURVIVAL
 Immediate recognition of cardiac arrest and activation
of the emergency response system
 Early CPR with an emphasis on chest compressions

 Rapid defibrillation

 Effective advanced life support

 Integrated post– cardiac arrest care

RESPIRATORY ARREST
the condition in which the breathing stops or
inadequate
Causes:
1. Obstruction
Anatomical
Mechanical
2. Diseases
Bronchitis
Pneumonia
COPD
RESPIRATORY ARREST
3. Other causes of Respiratory Arrest
Electrocution
Circulatory collapse
External strangulation
Chest compression (by physical
forces)
Drowning
Poisoning
Suffocation
RESCUE BREATHING
a technique of breathing air into a person’s lungs to
supply him / her with the oxygen needed to survive
CARDIOPULMONARY CEREBRO
RESUSCITATION (CPCR)
 Less than one-third of out-of-hospital sudden
cardiac arrest victims receive bystander CPR.
 Effective bystander CPR, provided immediately
after sudden cardiac arrest, can double or triple a
victim’s chance of survival.
 Chest compressions should be provided at a rate
of at least 100 compressions per minute – the
same rhythm as the beat of the Bee Gee’s song,
“Stayin’ Alive.”
CARDIOPULMONARY CEREBRO
RESUSCITATION (CPCR)
 Compressions of adequate rate and
depth
 allowing complete chest recoil between
compressions
 minimizing interruptions in compressions
 avoiding excessive ventilation
BUILDING BLOCKS OF CPR
SIMPLIFIED ADULT BLS
ALGORITHM.
 YOUR ROLE IN A CODE BLUE
PHASE I: Putting the code in motion

NURSE 1 NURSE2

- LOC
- make sure the code has
- Call for help been called according to
- Check circulation hospital
- Initiate CPCR procedure
- Obtain emergency
equipment (Crash cart)
- Begin 2-responder CPCR
with nurse 1
PHASE I: PUTTING THE CODE IN
MOTION

NURSE 3 / 4
- Connect the patient to a monitor
- Set up AED or defibrillator,
oxygen, and suction equipment
- Get intubation equipment ready
- Set up IV equipment
PHASE II: DRUGS AND DEFIBRILLATION

Initiate ACLS protocols and

evaluation of the patient’s
response to therapy
 CODE TEAM
Team Leader - Usually a physician directs and coordinates the
resuscitation effort, but a nurse who’s trained in
ACLS may direct the code until a physician arrives
- The team leader usually stands at the foot or head
of the bed: she needs a clear view of the patient to
ensure that procedures and patient assessments
are performed rapidly and correctly

Defibrillator - A physician or a specially prepared nurse actually

Operator delivers the shock
Rapid defibrillation is the key to survival from
ventricular fibrillation, so the team must be prepared
to defibrillate immediately.
 CODE TEAM
Recorder - At the start of the code, one nurse should begin
recording the events and interventions
- Document all events and interventions, including
the type and time of arrest, respiratory
management, procedures, medication
administration, Iv fluids, VS, cardiac rythms,
defibrillations, patient response to treatment,
patient outcome, and termination of code.
- The role of a recorder is vital. She should’nt be
asked to participate in any other way that distracts
her from this responsibility.
- An important duty of a recorder is to announce
when a medication maybe due
- Identify which clock should be the official code
clock and be precise about the timing on the
resuscitation record.
 CODE TEAM
Intubationist - A physician (anaesthesiologist), respiratory
therapist, nuse anesthetist, or other specially
prepared nurse may do so.
- Prepare: Laryngoscope
: endotracheal tube and a stylet
: 10 ml syringe
: Lubricating gel
: Suction to remove oral secretions
and improve visualization of
anatomical landmarks
: Stethoscope
- If patient can’t be intubated within 30 seconds,
stop and hyperventilate and hyperoxygenate
 CODE TEAM
IV nurse - Solutions typically used during
resuscitation efforts include .9% sodium
chloride and lactated ringers solution

Medication - Familiarize self with the drugs used during

nurse codes
- As you prepare a drug, repeat the drug
name and dosage order out loud, so no
one’s confused about what you’re drawing
up. Again, announce the drug and dosage
prior to administration

Floor nurse - Throughout the entire code, the other

patients in the unit must be cared for
PHASE III: WINDING DOWN
 Typically begins after initial ACLS
measures have been instituted and their
effectiveness evaluated.
 In this phase, the team leader continues to
coordinate all the medical therapies, vital
signs, cardiac rhythm, and patient
response must be assessed frequently
throughout the code.
PHASE III: WINDING DOWN
Efforts are now aimed at one of the
following:
Maintaining the patient in stable condition
until he can be transported to a critical
care bed
Attempting other strategies to restore
cardiac function
Deciding to terminate the code
. KEY CHALLENGES TO IMPROVE CPR QUALITY
FOR ADULTS,
CHILDREN, AND INFANTS

 Recognition ● Failure to recognize gasping

as sign of cardiac arrest
● Unreliable pulse detection
 Initiation of CPR ● Low bystander CPR
response rates
● Incorrect dispatch instructions
 Compression rate ● Slow compression rate

 Compression depth● Shallow compression depth

 Chest wall recoil ● Rescuer leaning on the chest

. KEY CHALLENGES TO IMPROVE CPR QUALITY
FOR ADULTS,
CHILDREN, AND INFANTS

 Compression Interruptions
● Excessive interruptions for
 – rhythm/pulse checks

 – ventilations

 – defibrillation

 – intubation

 – intravenous (IV) access

 – other
. KEY CHALLENGES TO IMPROVE CPR QUALITY
FOR ADULTS,
CHILDREN, AND INFANTS
 Ventilation ● Ineffective ventilations
● Prolonged interruptions in compressions to deliver
breaths
● Excessive ventilation (especially with advanced airway)
 Defibrillation ● Prolonged time to defibrillator availability

● Prolonged interruptions in chest compressions pre- and

post-shocks
 Team Performance ● Delayed rotation, leading to rescuer
fatigue and decay in compression quality
● Poor communication among rescuers, leading to
unnecessary interruptions in compressions
BEING PREPARED

Each code situation is unique.

Knowing that a code usually
progresses through three phases
will help you feel more confident
when the actual event occurs.
BEING PREPARED
Tips to fine-tune your skills
 Keep your CPCR skills up-to-date and review
hospital policy on code procedures and
documentation
 Know current BLS guidelines

 If rule permit, open your crash cart and

medication box every 1 to 2 months and review
where supplies and medications are located.
BEING PREPARED
 Review the drugs used most frequently during a
code and their indications, usual dosages,
dilutions, and administration times.
 Know how to operate the cardiac monitor and
AED in you unit.
 Make sure you know how to change batteries in
the laryngoscope handle and the lightbulb in the
blade. Practice connecting the handle to the
blade
BEING PREPARED

These preparations will help you

stay calm and focused during a
code – and may make the
difference between chaos annd a
smooth-running, well-organized
code.!!