SUPPORT (BLS)

Frisiana Mirashi, MD
Emergency
DEPARTMENT
American Hospital 3
WHAT IS BASIC LIFE SUPPORT ?

Basic Life Support (BLS) defines

Sequences of procedures performed to
restore the circulation of oxygenated blood
after a sudden pulmonary or cardiac arrest
until they can be given full medical care at a
hospital.
BLS does not include the use of drugs or
invasive skills.
GLOBAL BURDEN OF SUDDEN CARDIAC ARREST
Approximately 700,000 cardiac arrests per year.
Bystander CPR before arrival of emergency services –
doubles survival from sudden cardiac arrest.
Early resuscitation can result in >60 % survival.
 BASIC LIFE SUPPORT

It can be provided by trained medical personnel,

including paramedics, and by Anyone who knows,
How To do it, anywhere, immediately, without any
other equipment.
 PURPOSES OF CPR
 Maintaining circulation and
oxygenation in order to maintain
a cardiac output to keep vital organs
alive.

HODS - November 2006 27

INDICATIONS OF CPR
CARDIAC ARREST
RESPIRATORY ARREST
COMBINATION OF BOTH
WHAT IS CAB
APPROACH ?
There is a common acronym in BLS
used to guide providers in the
appropriate steps to assess and treat
patients in respiratory and cardiac
distress. This is CAB-D (Circulation,
Airway, Breathing, Defibrillate)
CAB –Circulation Airway
Breathing
 CHAIN OF SURVIVAL

FIVE LINKS OF ADULT CHAIN OF SURVIVAL-

•Early recognition of cardiac arrest.
•Activation of the Emergency Response System.
•Early CPR, to provide blood supply to vital organs.
•Early defibrillation to restart the heart.
•Comprehensive post-cardiac arrest care to restore
quality of life.
 ACTIONS FOR PERFORMING ADULT CPR
1 Assess scene safety.

2 Determine responsiveness

3 Check carotid pulse

4 Perform chest compressions

5 Open Airway

6 Check Breathing and deliver breathe.

SCENE 1- YOU FIND AN ADULT LYING ON GROUND
 ASSESS SCENE SAFETY

Assess to make sure the scene is safe for you

to respond to the down patient.
ASSESS RESPONSIVENESS

Shake the shoulder and speak to the adult

asking ARE YOU ALLRIGHT? . Look at the
chest and torso for movement and normal
breathing simultaneously.
CHECK CIRCULATION

Check the patient for a palpable carotid

pulse for 5-10 seconds. (Do not check for
more than 10 seconds.)
SHOUT FOR HELP
IF THERE IS NO PULSE
AND NO/ABNORMAL
BREATHING

START CPR
 CARDIO-PULMONARY RESUSCITATION
To start CPR, place patient in supine position on a firm
and flat surface.
Kneel down to the patient and locate the position for
chest compression on person’s chest.
 LOCATION OF CHEST COMPRESSIONS

Locate the lower 1/3

of the patient’s
sternum between the
nipples in the midline
of body.
HAND POSITIONING FOR CHEST
COMPRESSIONS
1. Lock your arms.

2. Place the heel of one

hand over the center of
the person's chest,
between the nipples.
Place your other hand on
top of the first hand.

3. Keep your elbows

straight and position
your shoulders directly
above your hands.
CONTINUED…….

Use your upper body weight (not just your arms) as

you push straight down on the chest at least 2 inches
(approximately 5 centimeters) but not greater than
2.4 inches (approximately 6 centimeters).
GOOD QUALITY CHEST COMPRESSIONS

Press hard and fast.

Allow for full chest recoil with each compression.
Allow for only minimal interruptions to chest
compressions.
CHEST COMPRESSIONS

Deliver 30 chest compressions initially.

Push hard at a rate of 100 -120 compressions
per minute.
 AIRWAY

After initial 30 chest compressions ,assess and

establish airway.
Give 2 rescue breaths, each lasting for 1 seconds
and assess for visible chest rise with each breath
AIRWAY :OPEN THE AIRWAY

After giving 30 chest compressions open

victim’s airway.
There are two maneuvers to open the airway-

HEAD- TILT CHIN-LIFT MANEUVER (Or

Jaw thrust maneuver if spinal cord injury is
suspected).

JAW THRUST MANEUVER

 RESCUE BREATHING

A technique used to resuscitate a person who has

stopped
breathing, in which the rescuer forces air into the
victim's lungs at intervals of several seconds.
METHODS OF RESCUE BREATHS
 Mouth-to-Mouth Rescue
Breathing
 Mouth-to-Nose and Mouth-to-
Stoma Ventilation
 Ventilation With Bag and Mask
 Ventilation With an Advanced
Airway
32
Mouth to Mouth Breathing
 Use a barrier device if available.
 Pinch the nostrils for mouth-to-mouth
breathing.
 Make a seal using your mouth over the mouth
of the patient or use a pocket mask or bag mask.
Bag and mask Ventilation: The one-hand
E-C technique
Place the mask on the
patient’s face before attaching
the bag.
Using the non dominant hand,
create a C-shape with the
thumb and index finger over
the top of the mask, and apply
33

gentle downward pressure.

Hook the remaining

fingers around the
mandible, and lift it
upward toward the mask,
creating the E.
Cover the nose and the mouth with the mask
without extending it over the chin. Change
the size of the mask, as appropriate, to create
a good seal.
RESCUE BREATHING

Each rescue breath should last approximately 1

second.
Watch for chest rise.
Allow time for the air to expel from the
patient.
Cardio-Pulmonary
Resuscitation
1 cycle of adult CPR is 30 chest compressions
to 2 rescue breaths.
Perform 5 cycles of CPR (lasts approximately
2 minutes).
 CONTINUE CPR

2
30
If two providers are present: switch rolls
between compressor and rescue breather every
5 cycles.
High Quality CPR
30 compressions to 2 breaths

100-120 compressions per minute

RATE AND DEPTH OF CPR
 CONTINUE RESUSCITATION UNTIL

 Qualified help arrives and takes over

 The victim starts breathing normally

 Rescuer becomes exhausted

 AUTOMATED EXTERNAL
DEFIBRILLATOR

An AED, or automated external

defrillator, is a device that has
the ability to detect irregular
heart rhythm and it automatically
delivers a defibrillation shock to
stop irregular heart beat and allow
a normal rhythm to resume.

AEDs are designed to be used by

any laypersons.
ATTACH PADS TO CASUALTY’S BARE
CHEST
 DEFIBRILLATION

YOU
CLEAR I CLEAR

ALL CLEAR
IF VICTIM STARTS TO BREATHE
NORMALLY PLACE IN RECOVERY
POSITION
RECOVERY POSITION
 COMPLICATIONS OF CPR

1. Rib Fracture
2. Internal injuries to
organs
3. Laceration related to
the tip of the
sternum
4. Vomiting and
aspiration
5. Gastric distension.

HODS - November 2006 86

TAKE HOME MESSAGE
Taking the right action quickly and confidently can
make the difference between life and death for a
person dealing with cardiac arrest.