basic life support

1. Basic Life
Support
Umar Aftab
Bsc Honc
Emergency & ICU

2. 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.

3. BLS is generally used in the pre-hospital setting,
and can be provided without medical
equipment.
Many countries have guidelines on how to
provide basic life support (BLS) which are
formulated by professional medical bodies in
those countries. The guidelines outline
algorithms for the management of a number of
conditions, such as cardiac arrest,
choking and drowning.

4. 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.

5. 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.

6. 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.

7. 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

8. 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
compression in cardiopulmonary resuscitation.
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.

9. . 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).
. 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.

10. Adult BLS sequence
C-A-B is recommended in the new AHA 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.

11. 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).

12. 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.

13. 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.

14. 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.

15. 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.

16. 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.

17. 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.
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.

18. 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 ventilation's 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.

19. 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.

20. 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.

21. BLS protocols continue until (1) the patient
regains a pulse, (2) the rescuer is relieved by
another rescuer of equivalent or higher
training (3) the rescuer is too physically
tired to continue CPR, or (4) the patient is
pronounced dead by a medical doctor.

22. 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.

23. The CPR cycle is often abbreviated as 30:2
(30 compressions, 2 ventilation's 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.