For sharing of slides on BLS and CPR. Hope it will benefit all who read the slides.

1. Date:28th March2023
Presenter: AnisHafizah

2.  Includes :
 Recognition of signs of sudden cardiac arrest (SCA), heart attack, stroke and foreign
body airway obstruction (FBAO)
 Cardiopulmonary resuscitation (CPR)
 Defibrillation with an automated external defibrillator (AED)
 CPR combines chest compressions with rescue breaths in an appropriate and
effective manner.
 It has to be initiated promptly to improve chance of survival before advance medical care
is available.
 CPR is associated with successful return of spontaneous circulation and neurologically
intact survival rates of >70%.

3. 2010 AHA Guidelines for CPR Updates
1) A- B- Cs to C- A- B sequence
 Argument: C (Circulation/cardiac compression) is the crucial process of delivering blood to vital
organs has often been delayed as rescuers took too long to manage the A (airway) and the B
(breathing).
 Immediate cardiopulmonary resuscitation (CPR) can double or triple the victim’s chance of
survival.
 CPR provides small but critical amount of blood flow to the heart and brain.
 In the absence of blood flow to brain, damage to brain cells begins in 4 minutes.
 Brain death is said to occur when a significant proportions of the neurons have undergone irreversible
damage due to lack of oxygen.
 If no CPR is carried out, brain death is almost certain in 10 minutes.
2) Emphasis on high-quality chest compressions (also re-emphasized in 2015 Updates)
3) ‘Look, Listen, Feel’ is removed from algorithm (mistook agonal gasps as normal breaths)
4) Emphasis on teamwork CPR

4.  Re- emphasized on early initiation of CPR by lay rescuers (for presumed cardiac arrest)
 Enhanced algorithms for BLS and ACLS resuscitation scenarios
 A sixth link, Recovery, was added to the IHCA (in- hospital cardiac arrest) and OHCA (out-
of- hospital cardiac arrest) chains of survival.

5. FOR LAY- RESCUERS
D
R
C
A
B
Assess for Danger
Check for Response
Commence CPR
Open the Airway
Check for Breathing
Before approaching the victim, ensure scene is safe
for yourself, the victim and any bystanders.
Gently tap the victim’s shoulders and shout loudly at victim’s ear,
“Hello…Hello…Sir, are you alright?”. Also scan for chest rise and
feel carotid pulse in <10s (if trained).
If you are alone, shout for help. If nobody responds, call
999 and get AED if available, then return immediately. If
there is bystander, recruit him to activate EMS.
Commence CPR immediately within 4 minutes of
victim’s collapse (presumed for cardiac arrest) at
30:2 compressions- ventilation ratio for 5 cycles.
Open the airway using head tilt- chin lift method
(sniffing/hyperextended position) or jaw thrust (if
cervical spine injury is suspected in trauma patient).
Deliver 2 rescue breaths via mouth- to- mouth/
pocket mask/ bag- valve- filter mask (BVFM) by
forming a C-E combination for good seal.
*AED (Automated External Defibrillator), EMS (Emergency Medical Services)
Reassess the every 2 minutes. Check for
breathing and present of pulse (at carotid). If no
signs of breathing, continue CPR until help
arrives.

6.  Push hard (at least 2 inches [5cm]) and fast (rate of
100-120 compressions/min)
 Allow complete chest recoil after each compression
(allow blood flow into the heart in between
compressions)
 Minimize interruptions in compressions (keep
interruptions <10s)
 Avoid excessive ventilation (can cause barotrauma)
 Change compressor every 2 minute, or sooner if
fatiqued.
 If no advanced airway, 30:2 compression-
ventilation ratio for each cycle.
Correct hand technique of
chest compressions:
o Use your dominant hand
o Place hands at lower half of
sternum (between nipples)
o Interlock the fingers of
your hand
o Keep your arms straight

7. HEALTHCARE
PROVIDER

8. Head tilt- chin lift Jaw thrust

10. Mouth- to- Mouth Pocket Mask Bag- valve- filter mask
(BVFM)

11. High quality CPR should be continues until 1 of the following occurs:
 There is spontaneous breath or the victim moves (return of
spontaneous circulation / ROSC)
o Reassessment is required to confirm these changes
o Consider placing the victim in recovery position
 More qualified help arrives and takes over the resuscitation process
 Rescuer becomes too exhausted to continue.

12.  Utilised for unresponsive adult victims who have normal breathing and
effective circulation.
 Aim:
 To maintain a patent airway
 Reduce the risk of airway obstruction and aspiration
 Position should be stable, near a true lateral position with the head
dependent and no pressure on chest that can impair the victim’s
breathing.

14. Any questions?
(without using a defibrillator)
The optimal time to use defibrillator is at the 3rd minute of the event.