The document provides information about basic life support (BLS) training. It discusses the importance of immediately starting chest compressions (C) and airway (A) management before rescue breaths (B), known as C-A-B. Proper BLS techniques including chest compression rate, depth, open airway methods, and rescue breathing are explained. It also covers automated external defibrillator use, recovery position, and complications of CPR. The goal is to teach healthcare professionals current guidelines for emergency cardiac care.

1. GAJE SINGH
American Heart Association
Instructor

2. Course Objective
► The purpose of this course is to inform
healthcare professionals about current
guidelines for emergency cardiac care.

3. Approach
► BLS ( Basic Life Support) Primary survey.
► ACLS (Advanced Cardiovascular Life Support)
Secondary survey

4. Cardiopulmonary
Resuscitation
A - Airway
B - Breathing
D- Defibrillation
C - Circulation

5. C-A-B Rather than A-B-C
Steps
► Change in the BLS sequence of steps from A-
B-C (Airway, Breathing, Chest compressions)
to C-A-B (Chest compressions, Airway,
Breathing).
► Initiate chest compressions before giving
rescue breaths (C-A-B rather than A-B-C).
► Why: Highest survival rates from cardiac
arrest due to sooner starts of chest
compression.

6. What is CPR?
► CPR stands for Cardio Pulmonary
Resuscitation, i.e. to help restart the heart
(pulse) and lungs (breathing).
► CPR is performed when a person stops
breathing and/or the heart stops.

7. Why is timing important?
► When the heart (pulse) and lungs (breathing)
stops, the victim has 5 minutes before
(gradual) brain death starts to occur, if no
CPR is performed.
► Brain damage is certain after 5 - 10 minutes
without CPR
► Therefore, it is very important to start CPR as
soon as possible for better chance of survival.

8. Learning Objectives
► Use the principles of patient assessment to
guide treatment decisions.
► Describe the appropriate care of a patient in a
pulseless arrest.
► Relate factors to consider when evaluating a
patient with an arrhythmia.
► Justify the emphasis on rapid evaluation and
treatment of a patient with acute coronary
syndromes.
► Discuss how the physiological differences in
the phases of cardiac arrest drive the
appropriate treatments for each phase.

9. Why is it required to learn
Basic Life Support ?

10. What is Cardiac Arrest ?
► Sudden cardiac arrest occurs when electrical
impulses in the heart become rapid or
chaotic, which causes the heart to suddenly
stop beating.
► Cardiac arrests are more common than you
think, and they can happen to anyone at
any time even in healthy looking person.
► Nearly 383,000 out-of-hospital and 209,000
in hospital sudden cardiac arrests occur
annually.

11. Cardiac Arrest (contd..)
► Associated with very poor survival rate,
● 9.5 % for out of hospital cardiac arrest and
● 23.9% for in hospital cardiac arrest.
► Early resuscitation and prompt defibrillation
(within 1-2 minutes) can result in >60%
survival.
► Basic life support - one of the most important
skills you will learn here in this session.

12. BASIC LIFE SUPPORT
(BLS)

13. Objectives
► At the end of this session, participants should be
able to demonstrate:
● How to assess the collapsed victim.
● How to perform chest compression and rescue
breathing.
● How to operate an automated external defibrillator
safely.
● How to place an unconscious breathing victim in the
recovery position.

14. Basic Life Support (BLS)
► BLS is the foundation for saving lives
following cardiac arrest.
► Fundamental aspects of adult BLS include
five links called Adult Chain of Survival.

15. Chain of Survival
The 5 links in adult chain of survival are:
► Immediate recognition of cardiac arrest and activation
of the emergency response system.
► Early CPR with an emphasis on chest compressions.
► Rapid defibrillation.
► Effective advance life support.
► Integrated post-cardiac arrest care.

16. Approach safely
Open Airway
Check response
Shout for help
2 rescue Breaths
Call for emergency
Chest Compression
Defibrillation
Basic Life Support (BLS)

17. APPROACH SAFELY!
Scene
Rescuer
Victim
Bystanders
Approach safely
Open airway
2 rescue breaths
Defibrillation
Check response
Shout for help
Call for emergency
Chest compression

18. CHECK RESPONSE
Approach safely
Check response
Shout for help
Call for emergency
Chest compression
Open airway
2 rescue breaths
Defibrillation

19. Shake shoulders gently
Ask “Are you all right?”
If he responds
• Leave as you find him.
• Find out what is wrong.
• Reassess regularly.
If doesn't respond,
• Scan the chest & Check
pulse
CHECK RESPONSE
By Shake & Shout Method

20. SHOUT FOR HELP
Approach safely
Check response
Shout for help
Call for emergency
Chest compression
Open airway
2 rescue breaths
Defibrillation
For Unresponsive Cardiac Arrest Patient

21. Approach safely
Defibrillation
Check response
Shout for help
Call for emergency
Chest compression
2 rescue breaths
Open airway
CALL FOR EMERGENCY
For Unresponsive Cardiac Arrest Patient

23. CHEST COMPRESSION
Approach safely
Defibrillation
Check response
Shout for help
Call for emergency
Chest compression
Open airway
2 rescue breaths

24. • Place the heel of one hand in the
centre of the chest on the lower
sternum.
• Place other hand on top
• Interlock fingers
• Compress the chest
– Rate - At least 100 min-1 100-120
compression /min
– Depth - At least 2 inches.(5-6 cm)
– Equal compression : relaxation
• When possible change CPR
operator every 2 min
CHEST COMPRESSION
By Good Hand Position

25. COMPRESSIONS
► Quality: PUSH HARD, PUSH FAST, ALLOW
COMPLETE RECOIL AND MINIMIZE INTERRUPTIONS
► Site: Lower half of the sternum between nipples for
adult and child; Just below nipple line for infants
► Depth: at least 2 inches(5 cm) for adults; 5 cm for
children and 4 cm for infant
► Technique : two hand in adult and children, two
thumb, or two finger in infant

26. OPEN AIRWAY
Approach safely
Defibrillation
Check response
Shout for help
Chest compression
Open airway
2 rescue breaths
Call for emergency
By Head Tilt Chin Lift Method

27. Open The Airway
► Opening the airway by
head tilt chin lift
method.
► Placing one hand on
the victim’s forehead
with the other hand
on the chin and tilting
the head back.

28. RESCUE BREATHS
Approach safely
Check response
Shout for help
Call for emergency
Chest compression
Open airway
Defibrillation
2 rescue breaths

29. BREATHING
► Give two rescue breaths 1 breath in
one sec.
► Three methods to give breathing
► mouth-to-mouth breathing
► mouth-to-mask breathing
► bag-valve-mask ventilation

30. ► Pinch the nose
► Take a normal breath
► Place lips over mouth
► Blow until the chest
rises
► Take about 1 second
► Allow chest to fall
► Repeat
► For infant cover nose
and Mouth by lip &
give rescue breath
RESCUE BREATHS

31. Rescue Breathing
► 2 rescue breaths after
30 compressions.
► Each breath should be
delivered over 1
second with any
delivery method
available.
► A good breath will
cause the chest to
rise.
Mouth to Mouth Method
Mouth to Mask Method
Bag-Mask Method

32. CONTINUE CPR
30 2
Compression To Ventilation Ratio
Five cycles of the 30:2 compressions/ventilations should be
delivered, which should take approximately 2 minutes. Only then
is the pulse check repeated.

33. COMPRESSION VENTILATION RATIO
► For Adults its 30:2 (1 or 2 rescuers)
► For Children and Infants 30:2 (1
rescuer) and 15:2 (2 rescuers)
► One set of compressions and
ventilations form one cycle
► Five cycles of compression and
ventilation over 2 minutes
► Check pulse after five cycle if no pulse
start same at least 20 min

34. How CPR Works?
► Compression of the chest during CPR raises
the intrathoracic pressure which forces the
blood out of the heart chambers.
► When the chest recoils, a negative
intrathoracic pressure is produced which
allows blood to return to the heart, feeding
the coronary arteries and filling the heart
chambers so that the next compression will be
even more effective - A cumulative effect.
► Successive compressions will continue to
increase coronary artery pressure and organ
perfusion.

35. How CPR Works? (contd...)
► Effective CPR provides ¼ to 1/3 normal blood
flow.
► Rescue breaths contain 16 % Oxygen (out of
21 %)
► Tidal volume approx. 450 ml for effective
vantilation

36. Approach safely
Check response
Shout for help
Call for emergency
Chest compression
Open airway
2 rescue breaths
AUTOMATED EXTERNAL DEFIBRILLATORS
Defibrillation

37. Attach pads to casualty’s bare chest
Another pad on the upper-right
side of the patient’s bare chest
One pad - Left of the left nipple a
few inches below the left armpit.
AUTOMATED EXTERNAL DEFIBRILLATORS

38. Analysing rhythm
Do not touch victim
Shock indicated
Deliver shock
AUTOMATED EXTERNAL DEFIBRILLATORS

39. Chest Compression - Shock Delivery (With in
5 seconds) - Chest compression Again
30 2
DEFIBRILLATION

40. If he is breathing normally
• Turn him into the recovery position
• Send or go for help, or call for an ambulance.
• Check for continued breathing.
Recovery Position

41. If victim starts to breath normally
place in recovery position
RECOVERY POSITION

42. When CPR Should Stop?
► Victim revives
► Trained help arrives
► To exhausted to continue
► Unsafe scene
► Physician directed
► Cardiac arrest for more than 20
minutes

43. Complications of CPR
► Rib fractures (Most common)
► Vomiting and Aspiration
► Internal Injuries to vital organs like
lung & liver.
► Body Fluid Exposure - Risk of AIDS &
hepatitis like communicable diseases.
► Gastric Distention

44. Basic Life Support Algorithm