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Basic Life Support
for Health Care Providers
The AGA KHAN UNIVERSITY
SCHOOL OF NURSING and
MIDWIFERY (SONAM)
12/31/2013 1
12/31/2013 2
Prepared by:
ADULT HEALTH NURSING
INTEREST GROUP (AHNIG)
Revised on August , 2012
Presenter: Ms. Zulekha Saleem
Ms. Fatima Jawad
Basic Life Support (BLS)
12/31/2013 3
Objectives
By the end of the session participants will be able to:
Define Basic Life Support (BLS).
Identify the purposes of BLS.
Review the structure and functions of Heart, lungs and brain.
Discuss the difference between biological and clinical death.
Describe the indications of BLS.
Define and discuss steps of AED.
Discuss the chain of survival for adults, child and infant.
Discuss the general care for casualty
Explain the steps of BLS including adult, child and infant.
Identify various complications of BLS.
Define Foreign Body Airway Obstruction (FBAO).
Differentiate between Partial and Complete airway obstruction.
Explain the steps to relieve FBAO.
12/31/2013 4
Definition:
BLS is an attempt to restore spontaneous
circulation by using chest compressions
and artificial ventilation.
Purpose :
To keep the victim’s brain and heart
supplied with blood and oxygen until the
medical help arrives.
Basic Life Support (BLS)
12/31/2013 5
Review, Anatomy & Physiology
HEART
LUNGS
BRAIN
12/31/2013 6
Functioning Of Brain Cells
‘0’ Minute
 Breathing stops. Heart will soon stop beating.
‘4-6’ Minutes
 Brain damage possible.
12/31/2013 7
Biological and Clinical Death
Biological Death:
 Death of brain cells because of no
blood supply for more than 4-6
minutes.
 Irreversible condition.
Clinical Death:
 When heart beat and respiration stops.
 Reversible condition.
12/31/2013 8
Indications Of BLS
Cardiac Arrest
 Pulmonary Artery Diseases
(Arteriosclerosis, Arthrosclerosis).
 Coronary Artery Diseases.
(Angina, MI).
 If the child's heart rate is less than 60beats/min with
signs of poor perfusion.
Stroke
Respiratory Arrest
 Drowning.
 Poisoning.
 Suffocation.
 Sudden Infant Death Syndrome, Drug overdose.
12/31/2013 9
Chain Of Survival
For Adults
Chain Of Survival
For Adults are as follows:
 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
12/31/2013 10
12/31/2013 11
Chain Of Survival
For Adults (cont’d---)
 Check the patient for responsiveness and
presence/absence of normal breathing or gasping.
 Call for help.
 Check the carotid pulse for no more than 10 seconds.
 Give 30 compressions with minimum 2 inches of depth.
 Open the airway and give 2 breaths.
 Resume compressions. Minimum 100 per minute
12/31/2013 12
Flow Chart (Adult)
Check responsiveness
12/31/2013 13
12/31/2013 14
Correct location & Hand Position
for Chest Compression
At Mid Sternum
12/31/2013 15
Head Tilt Chin Lift Method
Jaw Thrust Method
12/31/2013 16
12/31/2013 17
Recovery Position
12/31/2013 18
Chain Of Survival for Child And
Infant
12/31/2013 19
Chain of Survival Of Child And Infant
If you are alone with the child/infant give
2 minutes of CPR before Calling 911.
It consist of following actions:
Prevention of sudden infant death syndrome, injuries, arrest and
choking.
Provide CPR ,Starting with Chest Compression.
30:2 (1 rescuer).Continue till two minutes.
Call EMS.
Advanced medical care.
12/31/2013 20
General Sequence Of BLS for Child/
Infant (Cont’d…)
 Check the child/infant for responsiveness and
presence/absence of normal breathing or gasping.
 Check the Brachial /Femoral pulse (Infant) for no more
than 10 seconds.
 Children: at least one third the depth of the chest,
approximately 2 inches (5 cm)
 Infants: at least one third the depth of the chest,
approximately 1½ inches (4 cm)
12/31/2013 21
CPR for Infant & Child
If you are alone with the child give 2 minute of CPR before Calling 911
Infant (under 1 year)
 Use 2 fingers of one hand for chest
compressions.
 Press the sternum 1/3rd to ½
depth of chest.(approximately 1½
inches).
 Give 2 full breath followed by 30
chest compressions. 5 cycles one
man
 Continue 10 cycles (100
compressions/min). Two men
 Rescue breathing 1 breath every 3-
5 sec. (12-20b/min).
 Brachial/ Femoral Pulse to be
Child (1 year to puberty)
 Use the heel of one hand for
chest compressions.
 Press the sternum 1/3rd to ½
depth of chest. Approximately 2
inches (5 cm)
 Give 2 full breath followed by 30
chest compressions. 5 cycles 1
man
 Continue 10 cycles (100
compressions/min). Two men
 Rescue breathing 1 breath every
3-5 sec. (12-20b/min).
 Carotid Pulse would be check for
the circulation.
12/31/2013 22
Difference Between Adult, Child, Infant CPR : A Summary
CHARACTERISTICS INFANT CHILD ADULT
AGE 1 month to 1 Yr. 1 yr. -Puberty
DEPTH OF
COMPRESSION
Approximate
1½ inches.
(4cm)
Approximate
2 inches (5 cm)
Minimum
2 inches
USE OF HANDS
HANDS PLACEMENT
1 Rescuer
Two fingers
2 Rescuer
2 thumbs encircling
technique
Heel of one or two
hands
Center of breast bone
(between nipple
line)
Heel of two hands
Center of breast
bone (between
nipple line)
RATE OF RESCUE
BREATHING
1 breath after
3 -5counts
1 breath after
3-5counts
1 breath after
5-6 counts
COMPRESSION
VERSUS BREATH
RATIO
One Man : 30 : 2
Two Man : 15 : 2
One Man :30 : 2
Two Man :15 : 2
One Man: 30:2
Two Man: 30:2
12/31/2013 23
Complications Of BLS
Fractured Ribs and Sternum (First & most
common).
Gastric distension.
Punctured Lungs.
Lacerated Liver.
Injury to kidneys.
12/31/2013 24
When to Stop BLS ??
When pulse returns.
When EMS arrives.
When rescuer gets exhausted.
When doctor announces death.
12/31/2013 25
FOREIGN - BODY AIRWAY
OBSTRUCTION
(FBAO)
12/31/2013 26
Causes Of FBAO
Adults:
Impacted food chocked while eating.
Infant and Children:
Choking during eating or play.
Unconsciousness Person:
Tongue Fall.
12/31/2013 27
Types Of FBAO
Airway Obstructions Redefined as Mild and
Severe:
 Mild Obstruction
 Severe Obstruction
12/31/2013 28
S/S of Mild Obstruction
· Good air exchange
· Responsive and can cough forcefully
· May wheeze between coughs
FBAO : Mild Obstruction
12/31/2013 29
FBAO : Severe Obstruction
S/S of Severe Obstruction
 Poor or no air exchange
 Weak, ineffective cough or no cough at
all
 High-pitched noise while inhaling or no
noise at all
 Increased respiratory difficulty
 Possible cyanosis (turning blue)
 Unable to speak
 Clutching the neck with the thumb and
fingers, making the universal choking
sign
 Unable to move air
12/31/2013 30
Sign and Symptoms of FBAO
Mild to Severe
Weak, ineffective or no cough.
Loss of sound, not able to speak or cry.
Increased Respiratory difficulty.
Color of lips and fingernails becomes blue.
Victims becomes unresponsive. (Complete
airway obstruction)
12/31/2013 31
THREE MANEUVERS TO
REMOVE FOREIGN BODIES
Heimlich Maneuver
(For responsive adults and child with partial airway
Obstruction)
Back blows & Chest Thrust
(For responsive Infants with partial airway Obstruction)
Remember: NO ABDOMINAL THRUST IN ADULTS
BLS
(Start immediately for adult, child and infants with un-
responsiveness and complete airway obstruction).
12/31/2013 32
Correct Position for Heimlich
Maneuver/ Thrust for Conscious
Adult and Child
12/31/2013 33
Airway Obstruction in
Pregnant/ Obese Victims
Chest Thrust
12/31/2013 34
Partial FBAO with
Poor Gas Exchange in Adults and
Child
Heimlich Maneuver
12/31/2013 35
Partial FBAO in Infants
with Good Gas Exchange
Hold the baby in Upright position
12/31/2013 36
Partial FBAO in Infants
with Poor Gas Exchange
5 Back blows 5 Chest Thrust
If the rescuer is alone then after 2 minute activate
EMS
12/31/2013 37
Complete FBAO in Infants
5 Back blows 5 Chest Thrust
Repeat above till the object comes out
If the rescuer is alone then after 1 minute activate EMS
2 Breaths followed by 5 Back Blows and 5 Chest Thrust
12/31/2013 38
12/31/2013 39
Automated External
Defibrillators (AED)
Operate AED with the help of the following basic steps:
POWER ON
Attachment
Analysis
Shock.
12/31/2013 40
References
BLS for health Care providers: Fighting heart disease
and stroke (2001), American Heart Association.
CPR for family and friends: Fighting heart disease and
stroke (2001), American Heart Association.
Fundamentals of BLS for health care providers: Fighting
heart disease and stroke (2001), American Heart
Association.
Guidelines summary for BLS Healthcare Providers-
American Heart Association. (2006). Retrieved on
July 31, 2007 from www.onlinetrainingplace.
com/demo/elp2.html.
12/31/2013 41
 Thank you 

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Basic Life Support (BLS).pdf

  • 1. Basic Life Support for Health Care Providers The AGA KHAN UNIVERSITY SCHOOL OF NURSING and MIDWIFERY (SONAM) 12/31/2013 1
  • 2. 12/31/2013 2 Prepared by: ADULT HEALTH NURSING INTEREST GROUP (AHNIG) Revised on August , 2012 Presenter: Ms. Zulekha Saleem Ms. Fatima Jawad Basic Life Support (BLS)
  • 3. 12/31/2013 3 Objectives By the end of the session participants will be able to: Define Basic Life Support (BLS). Identify the purposes of BLS. Review the structure and functions of Heart, lungs and brain. Discuss the difference between biological and clinical death. Describe the indications of BLS. Define and discuss steps of AED. Discuss the chain of survival for adults, child and infant. Discuss the general care for casualty Explain the steps of BLS including adult, child and infant. Identify various complications of BLS. Define Foreign Body Airway Obstruction (FBAO). Differentiate between Partial and Complete airway obstruction. Explain the steps to relieve FBAO.
  • 4. 12/31/2013 4 Definition: BLS is an attempt to restore spontaneous circulation by using chest compressions and artificial ventilation. Purpose : To keep the victim’s brain and heart supplied with blood and oxygen until the medical help arrives. Basic Life Support (BLS)
  • 5. 12/31/2013 5 Review, Anatomy & Physiology HEART LUNGS BRAIN
  • 6. 12/31/2013 6 Functioning Of Brain Cells ‘0’ Minute  Breathing stops. Heart will soon stop beating. ‘4-6’ Minutes  Brain damage possible.
  • 7. 12/31/2013 7 Biological and Clinical Death Biological Death:  Death of brain cells because of no blood supply for more than 4-6 minutes.  Irreversible condition. Clinical Death:  When heart beat and respiration stops.  Reversible condition.
  • 8. 12/31/2013 8 Indications Of BLS Cardiac Arrest  Pulmonary Artery Diseases (Arteriosclerosis, Arthrosclerosis).  Coronary Artery Diseases. (Angina, MI).  If the child's heart rate is less than 60beats/min with signs of poor perfusion. Stroke Respiratory Arrest  Drowning.  Poisoning.  Suffocation.  Sudden Infant Death Syndrome, Drug overdose.
  • 9. 12/31/2013 9 Chain Of Survival For Adults
  • 10. Chain Of Survival For Adults are as follows:  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 12/31/2013 10
  • 11. 12/31/2013 11 Chain Of Survival For Adults (cont’d---)  Check the patient for responsiveness and presence/absence of normal breathing or gasping.  Call for help.  Check the carotid pulse for no more than 10 seconds.  Give 30 compressions with minimum 2 inches of depth.  Open the airway and give 2 breaths.  Resume compressions. Minimum 100 per minute
  • 13. Flow Chart (Adult) Check responsiveness 12/31/2013 13
  • 14. 12/31/2013 14 Correct location & Hand Position for Chest Compression At Mid Sternum
  • 15. 12/31/2013 15 Head Tilt Chin Lift Method
  • 18. 12/31/2013 18 Chain Of Survival for Child And Infant
  • 19. 12/31/2013 19 Chain of Survival Of Child And Infant If you are alone with the child/infant give 2 minutes of CPR before Calling 911. It consist of following actions: Prevention of sudden infant death syndrome, injuries, arrest and choking. Provide CPR ,Starting with Chest Compression. 30:2 (1 rescuer).Continue till two minutes. Call EMS. Advanced medical care.
  • 20. 12/31/2013 20 General Sequence Of BLS for Child/ Infant (Cont’d…)  Check the child/infant for responsiveness and presence/absence of normal breathing or gasping.  Check the Brachial /Femoral pulse (Infant) for no more than 10 seconds.  Children: at least one third the depth of the chest, approximately 2 inches (5 cm)  Infants: at least one third the depth of the chest, approximately 1½ inches (4 cm)
  • 21. 12/31/2013 21 CPR for Infant & Child If you are alone with the child give 2 minute of CPR before Calling 911 Infant (under 1 year)  Use 2 fingers of one hand for chest compressions.  Press the sternum 1/3rd to ½ depth of chest.(approximately 1½ inches).  Give 2 full breath followed by 30 chest compressions. 5 cycles one man  Continue 10 cycles (100 compressions/min). Two men  Rescue breathing 1 breath every 3- 5 sec. (12-20b/min).  Brachial/ Femoral Pulse to be Child (1 year to puberty)  Use the heel of one hand for chest compressions.  Press the sternum 1/3rd to ½ depth of chest. Approximately 2 inches (5 cm)  Give 2 full breath followed by 30 chest compressions. 5 cycles 1 man  Continue 10 cycles (100 compressions/min). Two men  Rescue breathing 1 breath every 3-5 sec. (12-20b/min).  Carotid Pulse would be check for the circulation.
  • 22. 12/31/2013 22 Difference Between Adult, Child, Infant CPR : A Summary CHARACTERISTICS INFANT CHILD ADULT AGE 1 month to 1 Yr. 1 yr. -Puberty DEPTH OF COMPRESSION Approximate 1½ inches. (4cm) Approximate 2 inches (5 cm) Minimum 2 inches USE OF HANDS HANDS PLACEMENT 1 Rescuer Two fingers 2 Rescuer 2 thumbs encircling technique Heel of one or two hands Center of breast bone (between nipple line) Heel of two hands Center of breast bone (between nipple line) RATE OF RESCUE BREATHING 1 breath after 3 -5counts 1 breath after 3-5counts 1 breath after 5-6 counts COMPRESSION VERSUS BREATH RATIO One Man : 30 : 2 Two Man : 15 : 2 One Man :30 : 2 Two Man :15 : 2 One Man: 30:2 Two Man: 30:2
  • 23. 12/31/2013 23 Complications Of BLS Fractured Ribs and Sternum (First & most common). Gastric distension. Punctured Lungs. Lacerated Liver. Injury to kidneys.
  • 24. 12/31/2013 24 When to Stop BLS ?? When pulse returns. When EMS arrives. When rescuer gets exhausted. When doctor announces death.
  • 25. 12/31/2013 25 FOREIGN - BODY AIRWAY OBSTRUCTION (FBAO)
  • 26. 12/31/2013 26 Causes Of FBAO Adults: Impacted food chocked while eating. Infant and Children: Choking during eating or play. Unconsciousness Person: Tongue Fall.
  • 27. 12/31/2013 27 Types Of FBAO Airway Obstructions Redefined as Mild and Severe:  Mild Obstruction  Severe Obstruction
  • 28. 12/31/2013 28 S/S of Mild Obstruction · Good air exchange · Responsive and can cough forcefully · May wheeze between coughs FBAO : Mild Obstruction
  • 29. 12/31/2013 29 FBAO : Severe Obstruction S/S of Severe Obstruction  Poor or no air exchange  Weak, ineffective cough or no cough at all  High-pitched noise while inhaling or no noise at all  Increased respiratory difficulty  Possible cyanosis (turning blue)  Unable to speak  Clutching the neck with the thumb and fingers, making the universal choking sign  Unable to move air
  • 30. 12/31/2013 30 Sign and Symptoms of FBAO Mild to Severe Weak, ineffective or no cough. Loss of sound, not able to speak or cry. Increased Respiratory difficulty. Color of lips and fingernails becomes blue. Victims becomes unresponsive. (Complete airway obstruction)
  • 31. 12/31/2013 31 THREE MANEUVERS TO REMOVE FOREIGN BODIES Heimlich Maneuver (For responsive adults and child with partial airway Obstruction) Back blows & Chest Thrust (For responsive Infants with partial airway Obstruction) Remember: NO ABDOMINAL THRUST IN ADULTS BLS (Start immediately for adult, child and infants with un- responsiveness and complete airway obstruction).
  • 32. 12/31/2013 32 Correct Position for Heimlich Maneuver/ Thrust for Conscious Adult and Child
  • 33. 12/31/2013 33 Airway Obstruction in Pregnant/ Obese Victims Chest Thrust
  • 34. 12/31/2013 34 Partial FBAO with Poor Gas Exchange in Adults and Child Heimlich Maneuver
  • 35. 12/31/2013 35 Partial FBAO in Infants with Good Gas Exchange Hold the baby in Upright position
  • 36. 12/31/2013 36 Partial FBAO in Infants with Poor Gas Exchange 5 Back blows 5 Chest Thrust If the rescuer is alone then after 2 minute activate EMS
  • 37. 12/31/2013 37 Complete FBAO in Infants 5 Back blows 5 Chest Thrust Repeat above till the object comes out If the rescuer is alone then after 1 minute activate EMS 2 Breaths followed by 5 Back Blows and 5 Chest Thrust
  • 39. 12/31/2013 39 Automated External Defibrillators (AED) Operate AED with the help of the following basic steps: POWER ON Attachment Analysis Shock.
  • 40. 12/31/2013 40 References BLS for health Care providers: Fighting heart disease and stroke (2001), American Heart Association. CPR for family and friends: Fighting heart disease and stroke (2001), American Heart Association. Fundamentals of BLS for health care providers: Fighting heart disease and stroke (2001), American Heart Association. Guidelines summary for BLS Healthcare Providers- American Heart Association. (2006). Retrieved on July 31, 2007 from www.onlinetrainingplace. com/demo/elp2.html.