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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)
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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.
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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)
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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.
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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.
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
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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
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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.
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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)
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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.
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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
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Complications Of BLS
Fractured Ribs and Sternum (First & most
common).
Gastric distension.
Punctured Lungs.
Lacerated Liver.
Injury to kidneys.
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When to Stop BLS ??
When pulse returns.
When EMS arrives.
When rescuer gets exhausted.
When doctor announces death.
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Causes Of FBAO
Adults:
Impacted food chocked while eating.
Infant and Children:
Choking during eating or play.
Unconsciousness Person:
Tongue Fall.
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Types Of FBAO
Airway Obstructions Redefined as Mild and
Severe:
Mild Obstruction
Severe Obstruction
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S/S of Mild Obstruction
· Good air exchange
· Responsive and can cough forcefully
· May wheeze between coughs
FBAO : Mild Obstruction
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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
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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)
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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).
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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
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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
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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.