adult BLS

1. Basic Life support
BY
DR. SAYED A. ABDELLAH
ANAESTHESIA CONSULTANT
HEAD OF AND OPERATION
DEPARTMENTS.

2. First Aid Measures
EVERY YEAR, MILLIONS OF PEOPLE DIE OR ARE
SERIOUSLY INJURED IN INCIDENTS. MANY
DEATHS COULD BE PREVENTED IF FIRST AID
WAS GIVEN BEFORE EMERGENCY SERVICES
ARRIVE.

3. What to do
If someone is seriously
injured, you should:
• FIRST CHECK SAFETY.
• SECOND CALL FOR HELP.
• THIRD BEGIN FIRST AID MEASURES

4. Call for help.
Do first Aid
measures

5. If someone is unconscious
and breathing:
If someone is unconscious but
breathing and has no other injuries
that would stop them being moved,
place them in the recovery position
until help arrives.
Keep them under observation to
ensure they continue to breathe
normally.

6. If unconscious and
not breathing:
call for help
cardiopulmonary
resuscitation (CPR) straight
away

7. Common accidents and emergencies
 Anaphylaxis:
 Bleeding: main aim is to prevent further blood loss
• Don’t remove the embedded object. Use a clean dressing or any clean, soft material
to bandage the wound firmly. Try to replace blood loss by inserting 2 large bore
canulae.
• Call for help
• Burns and scalds:
• cool the burn cool running water for at least 20 minutes. remove any clothing or
jewelry. Use dry dressing ut not wrap the burn tightly.
• Call for help.

8.  Chemical burns:
wear protective gloves, remove any affected clothing, and wash the burn with cool
running water for at least 20 minutes. If possible, determine the cause of the injury.
Use specific chemical antidote if possible.
Call for help.
Drowning:
ensure safety, call for help, check breathing if the patient isn’t breathing open
airway and give five rescue breathes and start CPR immediately.
If the person is breathing and unconscious put him in recovery position and watch
that breath normally.
Electric shock: ensure safety, don’t touch the person, switch off the electrical
current at the mains to break the contact between the person and the electrical
supply. Check for breathing if not start CPR and call for help.

9. Heart attack
If you think someone is having or has had a heart attack, call 999 and then move them
into a comfortable sitting position.
Typical chest pain – the pain is usually located in the center or left side of the chest and
can feel like a sensation of pressure, tightness or squeezing
Radiating to chest down left or both arms, or into the jaw, neck, back or abdomen.
If they're conscious, reassure them and ask them to take a 300mg aspirin tablet to
chew slowly. if the person has any medication for angina, help them to take it. Monitor
vitals and call for help.
If the person deteriorates and becomes unconscious, open their airway, check their
breathing and, if necessary, start CPR.

10. Heart attack

11. Choking
 Mild choking: if the airway is only partly blocked, the person will usually be
able to speak, cry, cough or breathe.
 In situations like this, a person will usually be able to clear the blockage
themselves.
 Encourage the person to cough to try to clear the blockage.
 Ask them to try to spit out the object if it's in their mouth.
 Do not put your fingers in their mouth if you can't see the object, as you
risk pushing it further down their mouth.
 If coughing doesn't work, start back blows.

12. Severe choking
If choking is severe, the person won't be able to speak, cry,
cough or breathe, and without help they'll eventually become
unconscious. If coughing doesn't work start back blows.
How to do back blows
To help an adult or child over 1 year old:
Stand behind the person and slightly to one side. Support their
chest with 1 hand. Lean the person forward so the object
blocking their airway will come out of their mouth, rather than
moving further down.
Give up to 5 sharp blows between the person's shoulder blades
with the heel of your hand.
Check if the blockage has cleared.
If not, give up to 5 abdominal thrusts.

13. abdominal thrusts(The Heimlich maneuver):
STAND BEHIND THE PERSON WHO IS CHOKING.
PLACE YOUR ARMS AROUND THEIR WAIST AND BEND THEM
WELL FORWARD.
CLENCH 1 FIST AND PLACE IT JUST ABOVE THE PERSON'S
MIDWAY BETWEEN XIPHISTERNUM AND UMBILICUS.
PLACE YOUR OTHER HAND ON TOP OF YOUR FIST AND PULL
SHARPLY INWARDS AND UPWARDS.
REPEAT THIS UP TO 5 TIMES. IF THE PERSON'S AIRWAY IS
STILL BLOCKED AFTER TRYING BACK BLOWS AND ABDOMINAL
THRUSTS CALL FOR HELP AND CONTINUE WITH THE CYCLES
OF 5 BACK BLOWS AND 5 ABDOMINAL THRUSTS UNTIL HELP
ARRIVES.
STARTS CPR IMMEDIATELY IF LOST CONSCIOUS.

14. N.B. Abdominal thrust is not done in pregnant and infant
less than 1 year.

15. BASIC LIFE SUPPORT

16. Cardiac arrest
 According to the Centers for Disease Control
(CDC) heart disease continues to be the leading
cause of death in the United States and is
responsible for over 600,000 deaths every year.
Early resuscitation and prompt
defibrillation(within 1-2 minutes) can result in
>60% survival.
 Cardiac arrest: Abrupt cessation of cardiac
pump function which may be reversible by a
rapid intervention but will lead to DEATH in its
absence.
 Death: Irreversible cessation of all biologic
functions.

17. BLS
 Is chest compressions and
pulmonary ventilation performed
by anyone who knows how to do
it anywhere, immediately,
without any other equipment.
 Effective CPR provides 1/4
to 1/3 normal blood flow.
 Rescue breaths contain
16% oxygen (exhaled).

18. Chain of survival

19. Basic Life Support ( BLS )
 Taking the right action quickly and confidently can make the difference between life
and death for a person dealing with cardiac arrest.
 Keys for Successful BLS:
• Quickly start the Chain of Survival(brain survival starts in 4-6 minutes).
• Deliver high-quality chest compressions to circulate oxygen to the brain and
vital organs.
• Know when and how to use an Automated External Defibrillator (AED).
• Provide rescue breathing.
• Understand how to work with other rescuers as part of a team.
• Know how to treat choking.

20. BLS For Adults

21. BLS For Adult: one rescuer
scenario
Be Safe
• Make sure the scene is safe before
proceeding.
• Move the person out of traffic.
• Move the person out of water and dry
the person.
• Be sure you do not become injured
yourself.

22. Check Response
Shake shoulders gently
- Ask "Are you all right?"
- If he responds
- Leave as you find him.
- Find out what is wrong.
- Reassess regularly.
- if not breathing or agonal
breathing(gasping).

23. Call for help.
call for help while assessing for
breathing and pulse. (Call for help
without leaving the person
speakerphone).

24. CPR
• Begin sets of compressions and
rescue breaths.
Defibrillate
• Attach the AED pads when available.

25. CPR
Begin sets of compressions and rescue breaths.
CPR steps:
Check for the carotid pulse on the side of the neck no more than 10 seconds. If you are not sure you feel a
pulse, begin CPR with a cycle of 30 chest compressions and two breaths.
•Kneel by the side of the victim
•Place the heel of one hand in the center of the
victim’s chest - this is the lower half of the victim’s
breastbone (sternum)
•Place the heel of your other hand on top of the first
hand and interlock your fingers
•Keep your arms straight
•Position yourself vertically above the victim’s chest
and press down on the sternum at least 5 cm (but
not more than 6 cm)
•After each compression, release all the pressure
on the chest without losing contact between your
hands and the sternum
•Repeat at a rate of 100-120 min-1

26. Steps of CPR
After 30 compressions, stop compressions and open the airway by tilting the head and lifting the chin.
 Put your hand on the person’s forehead and tilt the head back.
 Lift the person’s jaw by placing your index and middle fingers on the lower jaw; lift up.
 Do not perform the head-tilt/chin-lift maneuver if you suspect the person may have a neck injury. In
that case, the jaw-thrust is used.
 For the jaw-thrust maneuver, grasp the angles of the lower jaw and lift it with both hands, one on each
side, moving the jaw forward. If their lips are closed, open the lower lip using
your thumb.
 Give a breath while watching the chest rise. Repeat while giving a second breath. Breaths should be
delivered over one second.
 Resume chest compressions. Switch quickly between compressions and rescue breaths to
 minimize interruptions in chest compressions

28. TWO-RESCUER BLS/CPR FOR ADULTS
1. The second rescuer prepares the AED for use.
2. You begin chest compressions and count the compressions out loud.
3. The second rescuer applies the AED pads.
4. The second rescuer opens the person’s airway and gives rescue breaths.
5. Switch roles after every five cycles of compressions and breaths. One cycle consists of 30
compressions and two breaths.
6. Be sure that between each compression you completely stop pressing on the chest and allow
the chest wall to return to its natural position. Leaning or resting on the chest between
compressions can keep the heart from refilling in between each compression and make CPR
less effective. Rescuers who become tired may tend to lean on the chest more during
compressions; switching roles helps rescuers perform high-quality compressions.
7. Quickly switch between roles to minimize interruptions in delivering chest compressions.
8. When the AED is connected, minimize interruptions of CPR by switching rescuers while the AED analyzes the
heart rhythm. If a shock is indicated, minimize interruptions in CPR.
 Resume CPR as soon as possible

29. TWO-RESCUER BLS/CPR FOR ADULTS

30. ADULT MOUTH-TO-MASK VENTILATION
In one-rescuer CPR, breaths should be supplied using a pocket mask, if
available.
1. Give 30 high-quality chest compressions.
2. Seal the mask against the person’s face by placing four fingers of one hand across the
top of the mask and the thumb of the other hand along the bottom edge of the mask
(Figure 5a).
3. Using the fingers of your hand on the bottom of the mask, open the airway using the
head-tilt/chin-lift maneuver. (Do not do this if you suspect the person may have a neck
injury.
4. Press firmly around the edges of the mask and ventilate by delivering a breath over
one second as you watch the person’s chest rise.

31. ADULT MOUTH-TO-MASK VENTILATION

32. ADULT BAG-MASK VENTILATION IN TWO-RESCUER CPR
If two people are present and a bag-mask device is available, the second rescuer is positioned
at the victim’s head while the other rescuer performs high-quality chest compressions. Give 30
high-quality chest compressions.
1. Deliver 30 high-quality chest compressions while counting out loud.
2. The second rescuer holds the bag-mask with one hand using the thumb and index finger
in the shape of a “C” on one side of the mask to form a seal between the mask and the face,
while the other fingers open the airway by lifting the person’s lower jaw.
3. The second rescuer gives two breaths over one second each as you watch the person’s chest
rise.
4. Practice using the bag-valve-mask; it is essential to forming a tight seal and delivering
effective breaths.

33. ADULT BAG-MASK VENTILATION IN TWO-RESCUER CPR

34. SELF-ASSESSMENT FOR ADULT BLS
1. A 65-year-old male is on a short ladder changing a light and
collapses. He is unresponsive. What is the next step?
a. Call 911/EMS. b. Begin CPR.
c. Begin mouth-to-mouth ventilation. d. Check pulse.
2. What method should be used to open his airway in the case above.
a. Chin-lift. b. Jaw thrust.
c. Head-tilt/chin-lift. d. Head-tilt.
3. CPR is initiated and the person’s pulse returns, but he is not
What ventilation rate should be used for this person?
a. 6-8 breaths per minute. b. 10-12 breaths per minute.
c. 18-20 breaths per minute. d. Depends on his colour.