Basic Life Support

Obtained from the American Heart Association

 Basic Life Support
“… the preservation or restoration of life by
the establishment and/or the maintenance
of airway, breathing and circulation, and
related emergency care. It’s a temporary
measure to maintain ventilation and
circulation.”
 Basic Life Support
AIM:
To provide adequate myocardial and
cerebral oxygenation until defibrillation,
persons trained in ACLS and equipment
are available
Importance
• Sudden cardiac arrest
– Leading cause of death in United States
• Presents as ventricular fibrillation (VF)

• Victims can survive if bystanders act

immediately while VF is still present,
but once the rhythm deteriorates to
asystole, successful resuscitation is
unlikely
Chain of survival
 Chain of survival

Early recognition of the emergency and activation of

the emergency medical services (EMS) or local
emergency response system
Chain of survival

Early bystander CPR

 Chain of survival

Early delivery of a shock with a defibrillator

 Chain of survival

Early advanced life support followed by post-

resuscitation care delivered by healthcare providers
Check for response

• Ensure that the scene is

safe
• Tap the victim on the
shoulder
• “hey, hey, hey
are you okey?”
Activate the EMS System

• Lone rescuer: activate

the EMS system and
return to the victim to
provide CPR
• 2 or more rescuers:
one should begin the
steps of CPR while a
second rescuer
activates the EMS
system
Open AIRWAY

• Supine position
• Head tilt or chin lift
method
• Jaw thrust: suspected
victims of cervical spine
injury
Check BREATHING
• Maintain an open airway
• look, listen, and feel for
breathing for less than 10
seconds
• Give 2 RESCUE
BREATHS
– Each over 1 second
– Enough volume to
produce visible chest
rise
Check BREATHING
Mouth-to-mouth breathing:
• open the victim’s airway
• pinch the victim’s nose
• create an airtight mouth-
to-mouth seal
• Give 1 breath over 1
second
• Take a “regular” breath
• Give a second rescue
breath over 1 second
 Check CIRCULATION
(Pulse check)
• Maintain head WITH PULSE:
tilt with one • Give rescue breaths
hand on at a rate of 10 to 12
forehead breaths per minute
• Feel for carotid or about 1 breath
pulse for less every 5 to 6 seconds
than 10 seconds • reassess the pulse
approximately every
2 minutes
Chest Compression
• Place the heel of the hand
on the sternum in the
center of the chest
between the nipples
• Then place the heel of the
second hand on top of
the first
• Position shoulder over
hands with elbows
locked and arms straight
• Give 30 compressions
Chest Compression
 Compress at a rate of
about 100 compressions
per minute
 Compression depth of 1
1⁄2 to 2 inches
(approximately 4 to 5 cm)
 Allow the chest to recoil
completely after each
compression
 Minimize interruptions
in chest compressions
 Compression-Ventilation Ratio

• Adults: 30:2
• Infants and children: 15:2
If advanced airway is present…

• Chest compressions: give continuously

at a rate of 100 per minute
• Ventilation: provides 8 to 10 breaths per
minute
• Change compressor and ventilator roles
approximately every 2 minutes
– To prevent compressor fatigue and
deterioration in quality and rate of chest
compressions
Defibrillator

 Ventricular fibrillation

 Pulseless ventricular
tachycardia
If shockable …

• Give 1 shock
• Resume CPR immediately for five cycles
 If not shockable …

• Resume CPR immediately for five cycles

• Check rhythm every 5 cycles
• Continue until ALS providers take over
Defibrillator
 Place the patient in a safe
environment, away from
pooled water or metal
surface
 Turn on defibrillator
 Select energy level:
 200J (biphasic)
 360J (monophasic)
 Charge the capacitator
 Ensure proper placement
of electrodes on the chest
Defibrillation

• Paddle position:
– Apex: left midaxillary
line to the left of the
nipple
– Right parasternal
infraclavicular area
Defibrillation
• Make sure no personnel
are directly or indirectly
in contact with the
patient
• “1 - I’m clear, 2 – you’re
clear, 3 – everybody’s
clear!!!”
• Deliver the electric shock
by depressing both
discharge buttons
simultaneously
 Recovery Position
• For unresponsive adult victims who have
normal breathing and effective circulation
• To maintain a patent airway and reduce the
risk of airway obstruction and aspiration
• Victim is placed on his or her side with the
lower arm in front of the body
When to stop CPR?
• More than 30 minutes of CPR without
return to spontaneous circulation
• Asystole more than 10 minutes
• Principle of patient autonomy, advance
directive, living with DNR