Basic Life Support

1. BASIC LIFE SUPPORT
References:
1. Advanced Life Support Training Manual by NCORT
2. American Heart Association 2015 Guidelines on CPR

2. OUTLINE
• Adult basic life support
• Paediatric life support
• Adult choking
• Paediatric choking

3. BLS : WHAT IS IT?
• Sequences of procedures performed to restore the
circulation of oxygenated blood after a sudden
pulmonary and/or cardiac arrest
• Chest compression and pulmonary ventilation
performed by anyone who knows how to do it,
anywhere, immediately without any other
equipment

7. CHAINS OF SURVIVAL

8. ADULT BLS

9. STEPS TO FOLLOW IN BLS
STEP 1 : SAFETY
• Make sure you, the victim and bystanders are
safe

10. STEP 2 : RESPONSE
• Check the victim for response
• Gently shake the shoulders and ask loudly : ‘Are you
all right?’
• If he responds, leave the victim in the position that he
was found
• Try to find out what is wrong with him and get help if
needed
• Reassess regularly

11. STEP 3 : CALL FOR HELP AND
AED
Call an ambulance - 999
• Ask a helper to call if possible otherwise call
them yourself
• Stay with the victim when making the call if
possible send for AED
• Send someone to get an AED if available
• If you are alone, do not leave the victim, start
CPR

12. STEP 4 : ASSESS BREATHING AND
CHECK PULSE SIMULTANEOUSLY
• Look for no breathing or gasping
• Check for definite pulse within 10 secs

13. CONDITION 1 : No breathing or
gasping, no pulse -- CPR
• Start chest compression
• Compress the chest to a depth of
5-6cm
• Rate of compression 100-120
per minute
• Minimize interruption during
chest compression
• Allow full chest recoil

14. • After 30 compressions, open the airway again using
head tilt and chin lift
• Give 2 rescue breaths
• Continue with chest compression and rescue breath in
a ratio of 30:2
• If untrained or unable to do rescue breath, give
compression only CPR
CONDITION 1 : No breathing or
gasping, no pulse

15. • Switch it on, follow the spoken / visual
instructions
• If a shock is indicated, deliver shock
• If no shock is indicated, continue CPR
CONDITION 1 : No breathing or
gasping, no pulse -- AED

16. CONDITION 2 : No normal breathing,
has pulse
• Provide rescue breathing
• 1 breath every 5-6 seconds, 10-12 breaths per
minute
• Pulse check every 2 minutes
• If no pulse, begin CPR

17. CONDITION 3 : Normal breathing, has
pulse
• Closely observe until emergency response
arrive

18. Do not interrupt resuscitation until :
• More healthcare workers arrive and can either
assist or take over
• You became exhausted
• The victim is definitely waking up, moving,
opening eyes and breathing normally
• If so, put the patient in recovery position and
assess regularly
When to stop CPR?

20. ADULT BLS
ALGORITHM
(AHA)

21. PAEDIATRIC BASIC LIFE SUPPORT

22. DEFINITIONS
• A newborn : a child just after birth
• A neonate : a child in the first 28 days of life
• An infant : a child under 1 year
• A child : between 1 year and puberty

23. INFANT AND CHILD BLS
Rescuers who have been thought adult BLS and have no knowledge of
paediatric resuscitation, should use the adult sequence
The following modifications to the adult sequence will make it more
suitable for use in children
- Give 5 rescue breaths before starting chest compressions (1 breath 1s)
- If alone, perform CPR for 1 min before going for help
- Pulse check or look for signs of life (any movement, coughing or
normal breathing)
- Compression 4cm for infant, 5cm for an older child
- 2 fingers technique for infant <1 year, one or 2 hands for a child >1
year
- Compression rate 100-120/min
- Rescue breathing once victim had a definite pulse, once rescue
breathing every 3 – 5 secs

24. PAEDIATRIC BLS
ALGORITHM

25. PHONE FIRST OR CPR FIRST ?
• When 2 rescuer is available, one starts resuscitation while
another rescuer goes for assistance
• If only 1 rescuer is present, undertake resuscitation for about
1 min or 5 cycles of CPR before going for assistance (to
minimise interruption in CPR, it may be possible to carry an
infant or small child whilst summoning help)
• If alone, witness a child suddenly collapse and you suspect a
primary cardiac arrest, call for help first and then start CPR as
the child will likely need urgent defibrillation (Uncommon
situation)

26. OPEN AIRWAY – HEAD TILT CHIN
LIFT

27. OPEN AIRWAY – JAW THRUST

28. LOOK, LISTEN, FEEL

29. 5 RESCUE BREATHS

30. CHECK FOR SIGNS OF LIFE / CHECK
FOR PULSE

31. CHEST COMPRESSION – INFANT
2-FINGERS TECHNIQUE vs
HANDS-ENCIRCLING TECHNIQUE

32. CHEST COMPRESSION – CHILDREN
1 HAND TECHNIQUE vs
2 HANDS TECHNIQUE

33. INFANT VS CHILD

34. RECOVERY POSITION

35. PAEDIATRIC BLS
ALGORITHM

36. SUMMARY : DIFFERENCES IN PAEDIATRIC AND ADULT BLS
Adult Child (>12 months) Infant (1-12 months)
Breathing rate 8-10 breaths per
minute
20 breaths per min
Pulse check Carotid Carotid Brachial
Compression rate 100-120 per minute
Compression method Heel of both hands Heel of one hand or 2
hands
2 fingers technique or
hands-encircling
technique
Compression depth 5-6cm At least 1/3rd AP
diameter
(about 5cm, 2 inches)
At least 1/3rd AP
diameter
(about 4cm, 1.5 inches)
Compression :
ventilation ratio
30:2 15:2
FB obstruction Heimlich manoeuvre Back blow and chest
thrust

37. CHOKING

38. ADULT CHOKING

39. UNIVERSAL SIGN OF CHOKING
Universal Sign :
Hands clutched
to the throat

41. CHOKING – SYMPTOMS AND SIGNS

43. 1) CHOKING – CONSCIOUS,
CAN BREATH, COUGH AND SPEAK

44. 2) CHOKING – CONSCIOUS, CANNOT
BREATH, COUGH OR SPEAK

45. 3) CHOKING - UNCONSCIOUS

46. PAEDIATRIC CHOKING

47. GENERAL SIGNS OF CHOKING
• Witnessed episode
• Coughing or choking
• Sudden onset
• Recent history of playing with or eating small objects

48. PAEDIATRIC CHOKING ALGORITHM

49. BACK BLOWS & CHEST THRUSTS
(INFANTS)

50. BACK BLOWS & ABDOMINAL THRUSTS
(CHILD >1 YEAR OLD)

51. HEIMLICH IN SUPINE CHILD

52. UNCONSCIOUS INFANT OR CHILD
WITH FBAO
• Call for help
• Place the child supine on a flat surface
• Open the mouth and attempt to remove any visible object
• Open the airway and attempt five rescue breaths,
repositioning the airway with each breath if the chest does
not rise
• Start chest compressions even if the rescue breaths were
ineffective
• Continue the sequence for single‐rescuer CPR for about a
minute then summon help again if none is forthcoming

53. THANK YOU ……