Basic Life Support

Ryan Budiyanto
Intensive and Acute Cardiac Care
National Cardiovascular Center
Harapan Kita, Indonesia
 Objectives
• Define BLS
• Explains steps & component of BLS
• Explains Chain of survival
• AED/electrical therapy
 Introduction
• According to recent statistics sudden cardiac arrest is rapidly becoming the
leading cause of death
• Once the heart ceases to function, a healthy human brain may survive for up
to 4 minutes without suffering any permanent damage
 What is BLS?
• Basic Life support refers to the care healthcare providers and public safety
professionals provide to patients who experiencing respiratory arrest, cardiac
arrest or airway obstruction.
• BLS includes psychomotor skills for performing high quality CPR, using an
AED.
 Respiratory arrest
• If the patient not breathing but has definitive pulse, then the patient is in
respiratory arrest
• Breathing support is the best treatment to care this patient
 Cardiac arrest
• When the patient no breathing, no pulse, and unresponsive, then the patient
is in cardiac arrest
• Cardiopulmonary resuscitation is recommended to care this victim,
according to AHA guideline 2015
 Causes
• Cardiac causes
• MI, cardiac tamponade, Arrhythmia VF/pVT
• Pulmonary causes
• Respiratory failure, ARDS, pneumothorax, pulmonary emboly
• Electrolyte imbalance
• Hypo-Hyperkalemia,
• Other
• drugs toxicity
Cardiac arrest is Time Sensitive

• Phase 1 : electrical
• 0-4 min
• Defib is Key
• Phase 2 : Circulatory
• 4-10 min
• CPR gains importance

• Phase 3 Metabolic
• >10 min
• Global ischemia
• Sepsis like syndrome
• Hypothermia may be beneficial
Chains of survival
DANGER

RESPOND
 STEPS OF BLS
• ENSURE SAFETY SCENE
• RESCUER
• PATIENT
• ENVIRONTMENT
• Assess response
• Verbal, Tactile, Pain
• CALL FOR HELP
• Activating emergency code (In-hospital setting)
• Call ambulance
 Circulation
• Check pulse within 10 second, if pulse is absence, start CPR
• Patient must be supine,
• Adult A. carotis, Neonatal, Infant A.Brachial
 Chest Compression
• Rhythmic application of pressure in the middle of chest
• Use dominant hand
• Firm surface (backboard of floor)
• Push hard & fast. Rate of 100-120 bpm
• Compression depth 5 cm- 6 cm
• Allow chest to fully recoil
• Compression-ventilation ratio 30:2
 Airway
• Open airway
• Jaw thrust maneuver
• Head tilt & chin lift
• No blind finer sweep
 Airway obstruction
• Adult conscious
 Breathing
• Check breathing
• No look, listen, feel in a new guideline
• Use a barrier device
• Deliver each rescue breath over 1
second
• Give sufficient tidal volume to visible
chest rise
• Avoid rapid or forceful breath
 Rapid Defibrillation
• AED – Automated external
defibrillator
• A battery operated device
• On applying to victim detects
and assesses cardiac rhythm
and prompts the user for
further action
• Attach its pad of AED
• Ensure everyone is clear
• Give one shock
• Continue CPR for 2 minutes
 AED
• After giving one shock – continue CPR for 2
minutes
• AED will automatically check the rhythm each
2 minutes
• If rhythm is non shockable, AED will inform
you to check sign of circulation, now check
pulse
• Non shockable : PEA and Asystole
 Recovery position
• The victim respond, place in a recovery position, monitor breathing until
help arrives
CPR Steps