The document provides information on basic life support (BLS) training. It begins with an introduction stating that BLS skills are vital for healthcare providers to learn and re-learn. The document then defines BLS and its key components, including cardiopulmonary resuscitation (CPR), maintaining an open airway, and chest compressions. It provides guidance on performing CPR for adults, children, and infants. The document emphasizes the importance of early recognition of emergencies and prompt treatment, as well as following the proper techniques and timing for chest compressions. It concludes by noting some key points to remember when performing BLS, such as positioning oneself at the victim's side and avoiding obstructing the airway during

1. BASIC LIFE SUPPORT
(AHA)
A Key to Saving Life
Ward Level Presentation By:
Gina B. Magaway (45021)
Ward 7

2. INTRODUCTION:
Basic Life Support or BLS as we know it is as vital as all the other
skills that we have to learn and re-learn as healthcare providers. It is
important that we constantly enhance our BLS skills because the life we
save may be our own. Knowledge of BLS skills will make us more
confident to face the challenges of life-threatening situations as cardiac
arrest in the workplace, at home, or anywhere. How we responds to
health emergencies such as Cardiac Arrest, Stroke and Choking will
surely test our competencies amidst pressure. Early recognition and
prompt action is the key to a successful outcome especially in children
and infants in cases of sudden choking and respiratory or cardiac arrest.
We can make a difference and save many lives if we know CPR and
administer it properly when and if it is needed. According to the American
Heart Association, we can save an average of about 100 to 200
thousand lives per year if proper CPR timing and techniques are
followed. So timing and technique are the skills we should learn to better
equip us in administering BLS until the full medical team arrives. Until
such time, the life of an unresponsive patient is in our hands...
With proper training and practice, I believe that someday we can
confidently tell the person next to us, "Don't worry, you are safe with me!"

3. DEFINITION:
 BLS Basic Life Support (BLS) is a specific level
of pre-hospital medical care provided by
trained responders, including emergency
medical technicians, in the absence of
advanced medical care
 BLS Fundamental emergency treatment
consisting of cardiopulmonary resuscitation
(CPR) or emergency cardiac care (ECC) that is
... Basic life support (BLS) is a level of medical
care which is used for patients with life-
threatening illness or injury until the patient
can be given full medical care.
 Sequences of procedure performed to restore
the circulation of oxygenated blood after a
sudden pulmonary and/or cardiac arrest
 Basic Life Support (BLS) certification is a
relatively short training course required of
many health professionals to help revive,
resuscitate, or sustain a person who is
experiencing cardiac arrest or respiratory
failure of some sort. This could include a
drowning victim, heart attack or stroke patient,
or any scenario where breathing or heartbeat
have been compromised.
 CPR it is a combination of rescue breathing
and chest compression delivered to victims in
cardiac arrest, the blood flows to the heart
stops pumping blood. Compression is the most
important part of CPR which keep blood
flowing to the heart, brain, and other vital
organs.
 Approximately 700,000 cardiac arrests
per year in Europe
 Survival to hospital discharge presently
approximately 5-10%
 Bystander CPR vital intervention before
arrival of emergency services – double
or triple survival from SCA (sudden
cardiac arrest)
 Early resuscitation and prompt
defibrillation (within 1-2 minutes) can
result in >60% survival
 Sudden cardiac arrest (SCA) is the
leading cause of deaths in the Unites
States and Canada.
Background:

4. OBJECTIVES:
 Performing the method
of CPR with good
quality of chest
compression with
minimal interruption
 Healthcare providers
are taught to look for
“adequate breathing”
and distinguish
between agonal gasp.

5. ANATOMY & PHYSIOLOGY OF THE HEART
 Heart is a muscle about a size of a fist
 Located in the center of the chest behind the breastbone
(sternum) and in front of the spine
 It pumps oxygenated blood to all parts of the body via
coronary artery
Upper Respiratory System
• nose
• mouth
• throat
Lower
• Larynx
• Trachea
• Bronchi
• Alveoli
Anatomy & Physiology of the Respiratory System

6. START CPR IMMEDIATELY
 Better chance of survival
 Brain damage starts in 4 to 6 minutes
 Brain damage is certain after 10
minutes without CPR
 Effective CPR provides ¼ to 1/3
normal blood flow
 Rescue breaths contains 16%
 Oxygen 21%
Rule of Thumb for a Good quality of CPR
•Push hard, push fast: compress at a rate of 100
compressions per minute
•Allow full chest recoil after each compression
•Minimize interruption in chest compression: try to
keep in less than 10 seconds
•Avoid hyperventilation

7. BLS consist of 4 main
Life Saving Technique:
Airway
Breathing
Circulation
Defibrillation
A – Airway
Open the airway
Head tilt chin lift
Jaw thrust: without head tilt. The
Jaw is lifted without tilting the head.
Victim with a suspected spine
injury.
Checking Vital Signs

8. OPENING OF AIRWAY:
 Head tilt chin lift (no need to finger sweep unless solid material can be seen)
Head tilt chin lift +Jaw thrust
Things to avoid with Head Tilt
Chin Lift
Do not press deeply into soft tissue under
the chin because this might obstruct the
airway.
Do not use the thumb to lift the chin
Do not close the victims mouth completely
( unless mouth to nose breathing is the
technique of choice for the victim)

9. CPR TRAINING PRECAUTIONS
 Do not practice in person
 Clean faces properly after each use
* alcohol
* bleach wash
(do not use a MANIKIN if you have
cold or sore throat, known positive
hepatitis B or C, Infected HIV or
AIDS, You have an infection)
Masks
Shields
MOUTH to MOUTH Barrier DEVICE:

10. BREATHING ASSESSMENT:
•Look for the chest to rise
•Listen for the air escaping during exhalation
•Feel for the flow of air against your cheek
1. Place one hand on the
victim’s forehead and push
with your palm to tilt the
head back
2. Place the fingers of the
other hand under the bony
part of the lower jaw near
the chin
3. Lift the jaw to bring the
chin forward
N
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11. CHEST COMPRESSION TECHNIQUE
1. Position yourself at the side of the victims side
2. Make sure the victim is lying on his back on a firm , flat
surface. If the victim is lying facedown, carefully roll him
onto his back.
3. Move or remove all the clothing covering the victims chest.
You need to be able to see the skin
4. Put the heel of one hand on the center of the victims bare
chest between the nipples
5. Put the heel of your other hand on the top of the first hand
6. Straighten your arm and position your shoulder directly over
your hands
7. Push hard and fast. Press down 1 ½ to 2 inches with each
compression. For each chest compression ,make sure you
push straight down on the victims breastbone
8. At the end of each compression, make sure you allow more
the chest to recoil or re-expand completely. Full chest recoil
allows more blood to refill the heart between chest
compression. Incomplete chest recoil will reduce the blood
flow created by the chest compressions
9. Deliver compressions in a smooth fashion at a rate of 100
compressions per minute.
Place your hands on the
breastbone at the nipple line
Position of the rescuer during chest
compression
*place the heel of one hand in the center of
the chest
*Place other hand on top
*Interlock fingers
*Compress the chest
- rate 100 min
- depth 4-5
* When possible shift CPR every 2 minutes.

12. CPR FOR CHILDREN (1 YEAR OF AGE AND
PUBERTY)
 Assess the victim for a response. If no
response, shout for help.
 If someone responds, send that person
to activate the emergency response
system and get an AED ( if Available)
 Open the victim’s airway and assess
the victim’s breathing ( take at least 5
seconds and no more than 10
seconds).
 If no breathing, give 2 breaths (you
may need to try a couple of times to
open the airway and give a total of 2
breaths that make the chest to rise).
 Check the victim’s pulse ( take at least
5 seconds and no more than10
seconds). If there is no pulse or if the
heart rate is less than 60 beats per
minute with signs of poor perfusion (
poor color)
 Perform cycles of compressions and
ventilations( 30:2 ration) at a rate of
100 compressions per minute.
 After 5 cycles of CPR:
if someone has not done this activate the
emergency response system and get
an AED if Available.
 USE the AED.
Rescuers may need to try a couple of times to give a total of 2
breaths that
Make the victim’s chest to rise.
It is very important to give effective breaths for infants and
children during CPR.
Press down 1/3 to ½ the depth of the chest with each
compression.
For very small children you may use 1 to 2 hands for chest
compressions ( make sure you compress the chest 1/3 to ½ of
the chest with each compression.
If child heart rate is less than 60 beats per minute with signs of
poor perfusion, start CPR.
Rescuers in the out-of-hospital setting should provide about 5
cycles of CPR for a child before using an AED.
For 2 rescuer , should use 15:2 compression ventilation ration
CPR for a child victims.

13. Steps Actions
1. Power on the AED
Open the carrying case or the top of the AED
Turn the power on ( some device will power on automatically
when you open the lid or case)
2. ATTACH electrode pads to the victim’s bare chest
Choose correct pads for size /age of victim. Use child pad or
child system for children less than 8 years of age if available.
Do not use child pads or child system for victims 8 years and
older
*peel the backing away from from the electrode pads.
•Quickly wipe the victims chest if it is covered with water or
sweat.
•*Attach the adhesive electrode pad to the victim’s bare chest
• -- place one electrode on the upper-right side of the bare
chest to the right of the breastbone, directly below the
collarbone.
-- place the other pad to the left of the nipple, few inches
below the left arm pit
Attach the AED connecting cables to the AED.
3. Clear the victim and analyze the rhythm ( 5 to 15 seconds to
analyze)
4. If AED advises a shock it will tell you to be sure to clear the
victim. State loudly “ clear the patient” “ I’m Clear” You’re
clear, everybody’s clear or simply “clear”
Press shock button.
Shock will produce a sudden contraction of the victim’s
muscles.
5. As soon as AED gives the shock , begin CPR starting with
the chest compressions.
6. After 2 minutes of CPR, the AED will prompt you to repeat the
steps.
Some AED’s will
automatically switch
themselves on when the
lid is opened
ATTACH PADS TO
CASUALTY’S BARE
CHEST
ANALYSING RHYTHM
DO NOT TOUCH VICTIM
• Stand clear
• Deliver shock
SHOCK DELIVERED
FOLLOW AED
INSTRUCTIONS

14. CPR Adult and Older Children Child( 1 year old to
puberty)
Infant( less than 1 year
old)
Establish that the victim does
not respond Activate your
emergency response system
Activate your emergency
response system as soon as the
victim is found
Activate your emergency
response system after giving 5
cycles of CPR
Activate your emergency
response system after giving 5
cycles of CPR
Open the airway use head tilt
chin lift
Head tilt chin lift (suspected
trauma: jaw thrust)
Head tilt chin lift (suspected
trauma: jaw thrust)
Head tilt chin lift (suspected
:trauma jaw thrust)
Check breathing
If the victim is not breathing,
give 2 breaths that make the
chest rise
Open airway ,look,listen and
feel
Take at least 5 seconds and no
more than 10 seconds
same same
First 2 breaths Give 2 breaths( 1 second each) same same
Check pulse
At least 5 seconds and no more
than 10 seconds
Carotid (if no pulse, start CPR) Carotid pulse (if no pulse or
pulse <60 bpm with signs of
poor perfusion, start CPR)
Brachial pulse( if no pulse or
pulse is < 60 bpm with signs of
poor perfusion, start CPR)
START CPR
Compression location Center of the breastbone
between the nipples
Center of the breastbone
between the nipple
Just below the nipple line on
breastbone
Compression method Heel of 1 hand, other hand on
top( or 1 hand for small victims)
Heel of 1 hand, other hand on
top( or 1 hand for small victims)
2 fingers(2 thumbs-encircling
hand for 2-rescuer CPR)
Compression depth 1 ½ to 2 inches 1/3 to ½ depth of chest 1/3 to ½ depth of chest
Compression rate 100 per minute 100 per minute 100 per minute
Compression-Ventilation ratio 30:2 (1- or 2-rescuer CPR) 30:2 for 1-rescuer CPR
(15:2 for 2-rescuer CPR)
30:2 for 1-rescuer CPR
(15:2 for 2-rescuer CPR)

15. CPR FOR INFANT
• Give CPR press sternum ½ to 1/3
depth of the chest
•Use middle finger and ring finger
•30 compression to 2
•If alone, resuscitate for 2 minutes then
call 911
•Seal the nose and mouth or nose only (
infant under 1 year of age)
•Give shallow puffs

16. RECOGNIZING CHOKING
 The tongue is the most common obstruction in the unconscious
victim (head tilt- chin lift)
 Vomit
 Foreign body
 Balloons
 Foods
 Swelling (allergic reactions/ irritants)
 Spasm (water is inhaled suddenly)
How To Recognize Choking
•Can you hear breathing or coughing sounds
•High pitched breathing sounds?
•Is the cough strong or weak?
• Can’t speak, breathe or cough
•Universal distress signal (clutches neck)
•Turning blue
A partial airway obstruction with poor air exchange
should be treated as if it were a complete airway
blockage.
If victim is coughing strongly, do not intervene

17. CONSCIOUS CHOKING IN ADULT
(FOREIGN AIRWAY OBSTRUCTION )
 Give 5 abdominal Thrust (
Heimlich Maneuver)
 Place fist just above the
umbilicus ( normal size)
 Give 5 upward and inward
thrust
 Pregnant or obese 5 chest
thrust ( fist on sternum, if
unsuccessful, support chest
with one hand and give back
blows with the other
 Continue until successful or
victim becomes unconscious

18. CHOKING
 Conscious infant
 Position with head down
ward
 5 backblows ( check for
expelled object)
 5 chest thrust ( check for
expelled object)
 repeat
 Unconscious Infant
 Check for responsiveness,
activate , Position the infant
 When the first breath don’t
go in, check for object in
thraot then try 2 more
breaths If neither set of
breaths goes in , suspect of
choking
 Begin 30 compressions
 Checking for object in throat
( no blind finger sweep)
 Give 2 breaths

19. PEDIATRIC BASIC LIFE SUPPORT
 Sudden primary cardiac arrest is not
common usually brought about by
Respiratory arrest
 Major causes during infancy are
intentional or unintentional injury,
apparent life-threatening events
(SIDS), respiratory arrest, airway
obstruction, submersion, sepsis and
neurological diseases.
SIDS
5000 per year
Affects more males than females
No know cause
No indication of problem
Usually occurs during the sleep
during first 6 months of life
Place baby on back (now, side)
Avoid “fluffy” blankets etc.

20. VIDEO CLIPS :

21. POINTS TO REMEMBER:
 Position yourself at the victims side so that you are ready to open the
airway and giving breaths
 When doing head tilt chin lift do not press deeply into the soft tissue
under the chin because this might obstruct the airway
 Do not use the thumb to lift the chin
 Do not give breaths too quickly or with too much force, air is likely to
enter the stomach rather than the lungs which can cause gastric
inflation.
 Rescuer should use a universal compression-ventilation of 30 is to 2
breaths when giving CPR to victims of all ages except for the
neonates.
 Two rescuer should use a compression-ventilation ration of 15 is to 2
breaths when giving CPR to children and infants.
 Assessing for breathing should take 5 seconds but no more than 10
seconds.
 The correct rate for giving compression is 100 compressions a minute.
 Rescuers should try to minimize interruptions to less than 10 seconds
 continue resuscitation until qualified help arrives and takes over, the
victim starts breathing normally and rescuer becomes exhausted.
 When checking for breathing , do not confuse Agonal breathing with
normal breathing.
 Look, Listen and Feel for normal breathing.
 Do not move the victim while in CPR
 If you have difficulty pushing the breastbone deep during
compression, put one hand on the breastbone to push on the chest.
Grasp the wrist of that hand with your other hand to support the hand
as it pushes the chest. This technique may be helpful for rescuers
whose hands and wrist are arthritic.
 The correct compression-ventilation ration for and adult is 30
compression and 2 breaths
 Rescuers should try to minimize interruptions to less than 10 seconds
 Minimize interruption in chest compressions; try to keep interruptions
to 10 seconds or less
 Tongue is the most common structure causing airway obstruction in
the unresponsive infant or child.
 If patient starts to breath
normally place in recovery
position

22. CPR
Chain of Survival :
• CPR alone is not
enough to save lives
• CPR is a vital link in the
chain of survival that
must be initiated until
advanced life support is
available
Early Access
Early CPR
Early Defibrillation
Early Advanced care

23. Practice
makes
perfect…
24/11/2010
Bibliography
1. Michael.R. Sayre, MD(2006)American Heart Association
BLS for Healthcare Provider ,3-65.
2. www.american heart.org/cpr
3. Baas,L.S.(1992).Nursing responsibilities during
CPR.Med-Surg Nursing Quarterly,1(1),1-26.