Three sentence summary: Basic life support (BLS) training outlines the steps to take when responding to life-threatening medical emergencies, including assessing the scene, checking responsiveness, calling for help, providing chest compressions, opening the airway, and using an AED if available. BLS focuses on maintaining circulation and breathing through CPR until more advanced medical help arrives. The goal of BLS is to buy time by maintaining CAB (circulation, airway, breathing) until definitive medical treatment can be provided.

1. BASIC LIFE SUPPORT TRAINING
CMCC
NASIK
OCT 2014

2. CPR

3. What is BLS
• Basic life support (BLS) is the level of medical
care which is used for victims of life-threatening
illnesses or injuries until they can be given full
medical care at a hospital. It can be provided by
trained medical personnel, including emergency
medical technicians, paramedics, and
by laypersons who have received BLS training.
BLS is generally used in thepre-hospital setting,
and can be provided without medical equipment.

5. GUIDELINES
• The guidelines outline algorithms for the
management of a number of conditions, such
as cardiac arrest, choking and drowning.
• BLS generally does not include the use of drugs or
invasive skills, and can be contrasted with the
provision of Advanced Life Support (ALS).
• Most laypersons can master BLS skills after
attending a short course. Firefighter, lifeguards,
and police officers are often required to be BLS
certified. BLS is also immensely useful for many
other professions, such
as daycare providers, teachers and security
personnel and social workers especially working in
the hospitals and ambulance drivers.

6. BLS

7. CPR AND AED’S
• CPR provided in the field increases the time
available for higher medical responders to
arrive and provide ALS care.
• An important advance in providing BLS is the
availability of the automated external
defibrillator or AED.
• This improves survival outcomes in cardiac
arrest cases.[1]

9. WHAT IS CAB
• Basic life support promotes adequate blood
circulation in addition to breathing through a
clear airway:
• Circulation: providing an adequate blood supply to
tissue, especially critical organs, so as to deliver
oxygen to all cells and remove metabolic waste, via
the perfusion of blood throughout the body.
• Airway: the protection and maintenance of a clear
passageway for gases (principally oxygen and carbon
dioxide) to pass between the lungs and the
atmosphere.
• Breathing: inflation and deflation of the lungs
(respiration) via the airway

10. Pneumonic
• These goals are codified in mnemonics such
as ABC and CAB. The American Heart
Association (AHA) endorses CAB in order to
emphasize the primary importance of chest
compressions in cardiopulmonary
resuscitation.[2]

11. •CAB’S
• Healthy people maintain the CABs by themselves.
• In an emergency situation, due to illness (medical
emergency) or trauma, BLS helps the patient
ensure his or her own CABs, or assists in
maintaining for the patient who is unable to do
so.
• For airways, this will include manually opening
the patients airway (Head tilt/Chin lift or jaw
thrust) or
• possible insertion of oral (Oropharyngeal airway)
or nasal (Nasopharyngeal airway) adjuncts, to
keep the airway unblocked (patent).

12. CHIN LIFT

13. CAB’S
• For breathing, this may include artificial
respiration, often assisted by
• emergency oxygen
• For circulation, this may include
• bleeding control or
• cardiopulmonary resuscitation (CPR)
techniques to manually stimulate the heart
and assist its pumping action.

14. Chain of survival
• The medical algorithm for providing basic life
support to adults in the USA was published in 2005
in the journal Circulation by the American Heart
Association.[3]
• The AHA uses a four-link "chain of survival" to
illustrate the steps needed to resuscitate a
collapsed victim:
• Early recognition of the emergency and activation
of emergency medical services
• Early bystander CPR, so as not to delay treatment
until arrival of EMS
• Early use of a defibrillator
• Early advanced life support and post-resuscitation
care

15. CHAIN OF SURVIVAL

16. • Bystanders with training in BLS can perform the
first three of the four steps.[4]
• The AHA-recommended steps for resuscitation
are known as DRS CAB:
• Check for Danger
• Check for a Response
• Send for help
• C directs rescuers to perform 30 Compressions to
patients who are unresponsive and not breathing
normally, followed by 2 rescue breaths
• A directs rescuers to open the Airway
• B directs rescuers to check Breathing but no need
to deliver rescue breaths
• D directs rescuers to attach an AED as soon as it is
available and follow prompts

17. WHAT A 1ST RESPONDER SHOULD DO?
• If the patient is unresponsive and not breathing,
the responder begins CPR with chest
compressions.
• Previously, the AHA recommended beginning
CPR with rescue breaths.
• If responders are unwilling or unable to perform
rescue breathing, they are to perform
compression-only CPR, because any attempt at
resuscitation is better than no attempt.

19. Adult BLS sequence
• C-A-B is recommended in the new AHA EU
guidelines.
• Keeping these facts as such follow the sequence
introduced by AHA guidelines 2010
recommendations C-A-B should be followed in
learning and teaching BLS.
• Ensure that the scene is safe.
• Assess the victim's level of consciousness by asking
loudly and shaking at the shoulders "Are you okay?"
and scan chest for breathing movement visually.
• If no response call for help by shouting for
ambulance or EMS and ask for an AED( which is
available in offices and building floors).

20. 2 RESPONDER

21. ASSESS
• If the patient is breathing normally, and pulse is
present then the patient should be placed in
the recovery position and monitored.
• Transport if required, or wait for the EMS to
arrive and take over.
• If patient is not breathing assess pulse at the
carotid on your side for an adult, at the brachial
for a child and infant for 5 seconds and not more
than 10 seconds;
• Begin immediately with chest compressions at a
rate of 30 chest compressions in 18 seconds
followed by two rescue breaths in 5 seconds
each lasting for 1 second.

22. WHAT TO DO IN NECK TRAUMA?
• If the victim has no suspected cervical
spine trauma, open the airway using the head-
tilt/chin-lift maneuver;
• if the victim has suspected neck trauma, the airway
should be opened with the jaw-thrust technique.
• If the jaw-thrust is ineffective at
opening/maintaining the airway, a very careful
head-tilt/chin-lift should be performed.

23. HOW TO DO?
• Blind finger-sweeps
should never be
performed, as they may
push foreign objects
deeper into the airway.
• This procedure has
been discarded as this
may push the foreign
body down the airway
and increase chances of
an obstruction.
• Continue chest
compression at a rate of
100 compressions per
minute for all age
groups, allowing chest
to recoil in between.
• For adults push up to
5 cm and for child up to
4 cm.
• For infants up to 3 cm or
1/3 of the chest
diameter antero-
posteriorly.

24. CONT’D
• Keep counting aloud.
• Press hard and fast maintaining the rate
of at about 100/minute.
• Allow recoil of chest fully between each
compression.
• After every 30 chest compressions give two
rescue breaths in adult and child victim,
• Continue for five cycles or two minutes
before re-assessing pulse.

25. ARTIFICIAL VENTILATIONS
• Attempt to administer
two artificial
ventilations using
the mouth-to-
mouth technique, or
a bag-valve-
mask (BVM).
• The mouth-to-
mouth technique is no
longer recommended,
unless a face shield is
present.
• Verify that the chest
rises and falls; if it
does not, reposition
(i.e. re-open) the
airway using the
appropriate technique
and try again.

26. CONT’D
• If ventilation is still unsuccessful,
• and the victim is unconscious,
• it is possible that they have a foreign body in
their airway.
• Begin chest compressions,
• stopping every 30 compressions,
• re-checking the airway for obstructions,
• removing any found, and re-attempting
ventilation.

27. How to check pulsations
• If the ventilations are successful, assess for the
presence of a pulse at the carotid artery.
• If a pulse is detected, then the patient should
continue to receive artificial ventilations at an
appropriate rate and transported immediately.
• Otherwise, begin CPR at a ratio of 30:2
compressions to ventilation's at 100
compressions/minute for 5 cycles.

28. Progress
• After 5 cycles of CPR, the BLS protocol should
be repeated from the beginning,
• assessing the patient's airway,
• checking for spontaneous breathing,
• and checking for a spontaneous pulse as per
new protocol sequence C-A-B.
• Laypersons are commonly instructed not to
perform re-assessment,
• but this step is always performed by
healthcare professionals (HCPs).

29. AED’s
• If an AED is available it
should be
• activated immediately and
• its directives followed and
(if indicated),
• call for clearance before
defibrillation/shock should
be performed.
• If defibrillation is
performed,
• begin chest compression
immediately after shock.

30. HOW LONG TO CONTINUE
• BLS protocols continue until
• (1) the patient regains a pulse,
• (2) the rescuer is relieved by another rescuer
of equivalent or higher training (see patient
abandonment),
• (3) the rescuer is too physically tired to
continue CPR, or (
• 4) the patient is pronounced dead by
a medical doctor.[3]

31. AFTER 5 CYCLES OF CPR?
• At the end of five cycles of CPR,
• always perform assessment via the AED for a
shockable rhythm,
• and if indicated,
• defibrillate, and
• repeat assessment before doing another five
cycles

32. CPR CONT’D
• The CPR cycle is often
abbreviated as 30:2 (30
compressions, 2 ventilations or
breaths).
• CPR for infants and children
uses a 15:2 cycle when two
rescuers are performing CPR,
• but still uses a 30:2 ,if there is
only one rescuer.
• Two person CPR for an infant
also requires the "two hands
encircling thumbs" technique
for the rescuer performing
compressions.

33. • Adult BLS sequence
• Ensure the safety of the victim, the rescuer, and any
bystanders.
• Check the victim for a response by gently shaking the
victim's shoulders and asking loudly "Are you all right?"
• If the victim responds, leave him in the position in which
he was found provided there is no further danger, try to
find out what is wrong with him and get help if needed,
and reassess him regularly.
• If the victim does not respond, turn him on to his back
and open the airway using the head-tilt/chin-lift. Shout
for help.
• Look, listen and feel for normal breathing for no more
than 10 seconds. If the victim is breathing normally, turn
him into the recovery position and get help. Continue to
check for breathing.
• If the victim is not breathing normally, call for
an ambulance.

34. • Adult choking
sequence
• Assess the severity of
airway obstruction. If
the victim is able to
speak and cough
effectively, the
obstruction is mild. If
the victim is unable to
speak or cough
effectively, or is unable
to breathe or is
breathing with a
wheezy sound, the
airway obstruction is
severe.
• If the victim has signs
of mild airway
obstruction, encourage
him to continue
coughing; do nothing
else.
• If the victim has signs
of severe airway
obstruction, and is
conscious, give up to 5
back blows (sharp
blows between the
shoulder blades with
the victim leaning well
forwards).

35. CHOKING
• Check to see if the obstruction has cleared after
each blow. If 5 back blows fail to relieve the
obstruction, give up to 5 abdominal thrusts,
again checking if each attempt has relieved the
obstruction.
• If the obstruction is still present, and the victim
still conscious, continue alternating 5 back blows
and 5 abdominal thrusts.
• If the victim becomes unconscious, lower him to
the ground, call an ambulance, and begin CPR.

37. PICTURES