Breakdown of BLS CPR as per AHA guidelines.

1. Presented By:
Louis van Rensburg
PARAMEDIC

2. Adult
Basic Life
Support

6. What Is
The
Fundamental
Aspects Of
BLS ?

7.  Immediate recognition of sudden
cardiac arrest (SCA)
 Activation of the emergency
response system
 Early cardiopulmonary
resuscitation (CPR)
 Rapid defibrillation With an
automated external defibrillator
(AED)
 Initial recognition and response
to heart attack and stroke are
also considered part of BLS.

9. Adult
BLS
Sequence

10.  Pulse Check
 Early CPR
Chest compressions
Rescue Breaths
 Early Defibrillation
With an AED

11.  The lay rescuer should not check for a pulse and
should assume that cardiac arrest is present
 Healthcare providers also may take too long to check
for a pulse
 The healthcare provider should take no more than
10 seconds to check for a pulse and, if the rescuer
does not definitely feel a pulse within that time
period, the rescuer should start chest compressions .

12. Early CPR
 Chest compressions
 Rescue Breaths

13.  Effective chest
compressions are essential
for providing blood flow
during CPR.
 For this reason all patients
in cardiac arrest should
receive chest compressions
(Class I).
 To provide effective chest
compressions, push hard and
push fast.

14.  Compress the adult chest
at a rate of at least 100
compressions per minute
(Class IIa) with a
compression depth of at
least 2 inches/5 cm
(Class IIa).
 Allow complete chest
recoil after each
compression.(Class IIa).

15.  The rescuer should place the
heel of one hand on the center
(middle) of the victim’s chest
(which is the lower half of the
sternum) and the heel of the
other hand on top of the first so
that the hands are overlapped
and parallel (Class IIa).
 Chest compression and chest
recoil/relaxation times
approximately equal (Class IIb).

17.  Minimize the frequency
and duration of
interruptions in
compressions (Class IIa).
 Once chest compressions
have been started, a
trained rescuer should
deliver rescue breaths by
mouth-to-mouth or bag-
mask to provide
oxygenation and
ventilation.

18.  Rescuer fatigue may lead to inadequate
compression rates or depth.
 When 2 or more rescuers are available it is
reasonable to switch chest compressors
approximately every 2 minutes (or after about 5
cycles of compressions and ventilations at a ratio
of 30:2) to prevent decreases in the quality of
compressions (Class IIa).
 Every effort should be made to accomplish this
switch in 5 seconds.

19. How can CPR be
effective
without rescue
breathing/bvmr?
(Can it Be ????)

20. 1. Initially during SCA with VF, rescue breaths
are not as important as chest compressions
because the oxygen level in the blood
remains adequate for the first several
minutes after cardiac arrest.
2. In addition, many cardiac arrest victims
exhibit gasping or Agonal breaths, and gas
exchange allows for some oxygenation and
carbon dioxide (CO2) elimination.
3. If the airway is open, passive chest recoil
during the relaxation phase of chest
compressions can also provide some air
exchange.

21. Managing the Airway
 A significant change in these guidelines is to
recommend the initiation of chest compressions
before ventilations (CAB rather than ABC).
 A healthcare provider should use the head tilt–
chin lift maneuver to open the airway of a victim
with no evidence of head or neck trauma .
 If healthcare providers suspect a cervical spine
injury, they should open the airway using a jaw
thrust without head extension (Class IIb).

23. Rescue Breathing
● Deliver each rescue breath
over 1 second (Class IIa).
● Give a sufficient tidal volume
to produce visible chest rise
(Class IIa)
● Use a compression to
ventilation ratio of 30 chest
compressions to 2 ventilations
(Class IIa).

24. Population
Group
Ventilation Ratio
(I:E)
BVMR Size Tidal Volume
(6 – 8 ml/kg)
Adult
1 Breath every
6-8 secs
Adult -/+ 600ml
Child
1 Breath every
5-6 secs
Child Weight
Dependant
Paed
1 Breath every
3-4 secs
Neonatal Weight
Dependant

25. Ventilation With Bag and Mask
 Rescuers can provide bag-mask ventilation with
room air or oxygen.
 This amount is usually sufficient to produce
visible chest rise and maintain oxygenation and
normocarbia in apneic patients (Class IIa).
 If the airway is open and a good, tight seal is
established between face and mask.

26.  As long as the patient does not have an
advanced airway in place, the rescuers
should deliver cycles of 30 compressions
and 2 breaths during CPR.
 The rescuer delivers ventilations during
pauses in compressions and delivers each
breath over 1 second (Class IIa).
 The healthcare provider should use
supplementary oxygen (O2 concentration
40%, at a minimum flow rate of 10 to 12
L/min) when available.

27. Ventilation With an Advanced Airway
 When an advanced airway (ie, endotracheal tube,
Combitube, or laryngeal mask airway [LMA]) is in
place during 2-person CPR, give 1 breath every 6 to
8 seconds without attempting to synchronize
breaths between compressions (this will result in
delivery of 8 to 10 breaths/minute).
 There should be no pause in chest compressions
for delivery of ventilations (Class IIb).
 Indicative of good proper CPR ? ETCO 2?
 Normal Ranges?
 CPR Range
 Shoot up?
 Drop Down?

28.  Excessive ventilation is
unnecessary and can cause gastric
inflation and its resultant
complications, such as
regurgitation and aspiration (Class
III).
 Rescuers should avoid excessive
ventilation (too many breaths or
too large a volume) during CPR
(Class III).

29. Cricoid Pressure
 Cricoid pressure might be used in a
few special circumstances (eg, to
aid in viewing the vocal cords
during tracheal intubation).
 Routine use of cricoid pressure in
adult cardiac arrest is not
recommended (Class III).

30. Early
Defibrillation
With an AED

31.  All BLS providers should be trained to
provide defibrillation because VF is a
common and treatable initial rhythm in
adults with witnessed cardiac arrest.
 For victims with VF, survival rates are
highest when immediate bystander CPR
is provided and defibrillation occurs
within 3 to 5 minutes of collapse.