DEPARTMENT OF HEALTH

Health Emergency Management Bureau

BASIC LIFE SUPPORT

TRAINING
(Didactic)

COURSE GUIDE
 DEPARTMENT OF HEALTH
Health Emergency Management Bureau

Course Description

Basic Life Support (BLS) Training aims to provide the competency for the initial response measures to
save lives being the foundation of all resuscitative efforts. It consists of life-saving competencies that
a person must achieve to help revive, resuscitate, or sustain a person who is experiencing cardiac
arrest or a respiratory failure.

Its goal is to train all health workers and as many members of the community “at least one member
of each household” in CPR and BLS because timely and effective response will ultimately save more
lives. In support to all BLS initiatives, the following policies were issued: (1) Department
Memorandum (DM) 2005-0056 “Basic Life Support Training for DOH Employees” which provides that
BLS is mandatory to DOH Employees; (2) Administrative Order (AO) 2004-155 “Implementing
Guidelines for Managing Mass Casualty Incidents during Emergencies and Disasters” prescribing BLS
Training as mandatory to all health personnel as part of capability building; and AO 2018-0001
“Revised Rules and Regulations Governing the Licensure Ambulances and Ambulance Service
Providers” which requires BLS as a minimum competency requirement for Type 1 & Type II
Ambulance Service Providers.

The BLS Healthcare Provider’s and Lay Rescuer’s both of which are BLS Basic Courses are designed for
the staff of the Central Office, Centers for Health Development, DOH Hospital, Local Health Facilities,
and for the general population.

Considering the global pandemic due to COVID-19, the continuous provision of BLS Training to health
workers shall not be interrupted and is deemed essential to ensure that they are equipped with the
right competencies to aid them in the delivery of health services with emphasis on the safety and
protection measures as well as for continuous professional development. To provide guidance in the
conduct of BLS Training in the pandemic situation and continue disseminating new policies and
standards, DM 2021-0134 “Updated Consensus Guidelines on Basic Life Support based on the 2020
Guidelines for Cardiopulmonary Resuscitation (CPR)” and DM 2020-0290 “Interim Consensus
Guidelines on Basic Life Support During COVID-19 Pandemic” were issued.
 DEPARTMENT OF HEALTH
Health Emergency Management Bureau

Course Description

To prepare the training system in adopting to the challenges of the new normal, the following
updates were integrated in the existing guidelines and materials:

On BLS Content Areas

 Consensus Guidelines by the DOH and its BLS Training Partners: Philippine Red Cross, Philippine
Heart Association, and American Heart Association on the following areas:

a. Use of Safety Standards and Transmission-based Precautions

b. When to Initiate and Continue BLS

c. Out of Hospital and In-hospital Cardiopulmonary Arrest

d. Management of Foreign Body Airway Obstruction (FBAO)

e. Maternal Considerations

f. Ethical and Miscellaneous BLS Considerations

 Training Memorandum based on the World Health Organization (WHO) and Center for Disease
Control and prevention (CDCP) Websites, DOH Policies and Issuances

 Adult BLS Algorithm

 Pediatric BLS Algorithm (Single and Two Rescuer)

On BLS Procedures – No PPE, No BLS

 Wearing of full Personal Protective Equipment (PPE) based on the Alert Level; follow donning
and doffing instructions

 Limit personnel; physical distancing

 Limit patient contact; DO NOT listen and feel for breathing; avoid providing ventilation and/or
rescue breathing

 Do standard chest compression only; avoid exposure to aerosol generating procedures

 DEPARTMENT OF HEALTH
Health Emergency Management Bureau

On Training Management

 Admission to training based on criteria/checklist with monitoring- temperature check and no

signs and symptoms.

 Practice of good hygiene and follow minimum health standards based on the Administrative
Order 2020-0015 “Guidelines on the Risk-based Public Health Standards for COVID- 19
Mitigation”, wearing of gloves and face masks.
 Decontamination of BVM and manikins after each use.

 1:1 ratio of manikin, pocket mask and one-way valve (for demo purposes); physical distancing.

 Observance of quarantine protocols, as necessary.

 Use of on-line or virtual platform for the didactic part.

 Demonstration and return demonstration to be conducted in-house.

 Screening of high risk participants.

 No PPE No BLS: Minimum PPEs – face mask, face shield, and gloves; and barrier, as available.

 CPR Manikins at least 6 feet apart.

 No listen and No Feel.

 Equipment disinfection using 10% Na Hypochlorite or alcohol based solution.

 Proper handwashing done before and after BLS Techniques.

 No food, meals, and drinks in the training venue.

Time Allotment for Each Topic

40 Minutes Recorded Presentation followed by a half day demonstration and return demonstration.

Teaching Methodology

Online Learning through the use of Audiovisual Presentations (Course Guide, Skills Video, Workbook)

Practice Demonstration and Return Demonstration shall be done face to face in-house in respective
facilities evaluated by the Lead Facilitator using the BLS Skills Sheets.
 DEPARTMENT OF HEALTH
Health Emergency Management Bureau

Evaluation Method

1. Online pre-test and post-test

2. Mini Quizzes

3. On-site Return Demonstration

Evaluation by the CPD Provider

With the course offered requiring skills training, a skill sheet of the procedure shall be used with the
listing of the steps and columns for done properly or not done. The passing rate combines the
percentage score for the written examination which is 30%, rating for the skill examination which is
60% and 10% for the attitude.

A Remedial Sessions is to be offered so that the participant who fails can eventually complete and
pass the evaluation and thereby receive a certificate of completion for the course offering.

Purpose of the Evaluation by the CPD Provider

Facilitator can provide feedback if the participants achieved the learning outcomes intended. CPD
Provider has to ensure confidence in the program that it designed. The increase in the pre to post
test score is one way of evaluating the outcomes of the didactic part of the training. In addition, self-
evaluation by the participant (Did you learn from this particular program?) can be a measure but not
an objective proof of having achieved learning outcomes.

While the CPD Provider needs to evaluate its own program for future planning through the client
satisfactory survey, this is not the evaluation tool for the learning outcomes intended.
 DEPARTMENT OF HEALTH
Health Emergency Management Bureau

UNIT OF COMPETENCY I. Principles of Emergency Care and Introduction to Basic Life Support
This unit of competency includes the initial steps in responding immediately upon arrival at the scene
to a victim. It provides an understanding on the level of life support that can be done to preserve life,
prevent further injury, and promote recovery.

At the end of this unit of competency, the participants should be able to accurately:

1. Demonstrate the Five Emergency Action Principles in a given emergency scenario.

2. Discuss Basic Life Support and its importance in saving unnecessary loss of lives due to lack or
inappropriate response to victims of cardiac arrest.

Session 1 Principles of Emergency Care

Learning Outcome 1: The participants should be able to perform the Five Emergency Action
Principles in a given emergency scenario.

Topics to be Discussed: Five Emergency Action Principles

1. Survey the Scene

2. Activate Medical Assistance (AMA)

3. Initial/Primary Assessment of the Victim

4. Secondary Assessment of the Victim

5. Referral for Further Evaluation and Management

At the end of the session on Principles of Emergency Care, the participants should be able to describe
the Five Emergency Action Principles with emphasis on the following:

1. Enumerate the elements of scene survey with emphasis on Infection Prevention and Control
(IPC) Protocol;

2. Appreciate the different ways in Activating Medical Assistance (AMA);

 DEPARTMENT OF HEALTH
Health Emergency Management Bureau

UNIT OF COMPETENCY I. Principles of Emergency Care and Introduction to Basic Life Support

3. Describe initial assessment;

4. Analyze the components of secondary assessment; and

5. Value the importance on the victim referral as the primary route for further evaluation and
management.

Session 2 Introduction to Basic Life Support

Learning Outcome 2: The participants should be able to explain Basic Life Support as one of the life-
saving skills given to a patient who is having cardiac arrest.

Topics to be Discussed:

1. Three Kinds of Life Support

a. Basic Life Support

b. Advance Cardiac Life Support

c. Prolonged Life Support

2. In-Hospital Cardiac Arrest (IHCA) and Out of Hospital Cardiac Arrest (OHCA) Chain of Survival
for Adult and Pediatric Patients

3. Respiratory, Circulatory and Nervous System

At the end of the session on Introduction to Basic Life Support, the participants should be able to:

1. Differentiate the three kinds of Life Support;

2. Describe the Chain of Survival for Adult and Pediatric Patients; and

3. Explain the importance of the Respiratory, Circulatory, and Nervous Systems in relation to BLS.
 DEPARTMENT OF HEALTH
Health Emergency Management Bureau

UNIT OF COMPETENCY II. Cardiopulmonary Resuscitation (CPR) & Automated External

Defibrillator (AED)

This unit of competency covers the procedure for responding to person in cardiac arrest through
performing high quality CPR and the advantage derived from the operations of an AED.

At the end of this unit of competency, the participants should be able to properly:

1. Execute CPR in a patient during cardiac arrest.

2. Use an AED to complement the CPR procedures.

Session 3 Cardiopulmonary Resuscitation

Learning Outcome 3: The participants should be able to discuss the CPR principles and execute
procedures in a cardiac arrest patient during an emergency.

Topics to be Discussed:

1. Definition of CPR

2. Criteria When to Start, When Not to Start, and When to Stop performing CPR

3. CPR Sequence

a. Circulation

b. Airway (Head-Tilt Chin-Lift Maneuver and Jaw Thrust Maneuver)

c. Breathing

4. Components of High Quality CPR

5. BLS Cardiac Arrest Algorithm for Adult and Pediatric Patients

6. CPR with Advanced Airway

 DEPARTMENT OF HEALTH
Health Emergency Management Bureau

UNIT OF COMPETENCY II. Cardiopulmonary Resuscitation (CPR) & Automated External

Defibrillator (AED)

At the end of the session on CPR, the participants should be able to:

1. Explain CPR;

2. Recognize the criteria for when to start, not to start, and when to stop CPR;

3. Illustrate the CPR sequence;

4. Enumerate the components of High Quality CPR;

5. Outline the BLS Cardiac Arrest Algorithm;

6. Discuss CPR with Advance Airway; and

7. Perform correct CPR techniques to an Adult, Child, and Infant who are in cardiac arrest.

Session 4 Automated External Defibrillator

Learning Outcome 4: The participants should be able to demonstrate the use of an AED in a cardiac
arrest patient during an emergency.

Topics to be Discussed:

1. Definition and Use of an AED

2. Parts of an AED

3. Definition of Defibrillation

4. Indications and Importance of Early Defibrillation

5. Shockable and non-shockable rhythms

6. Causes of Sudden Cardiac Arrest

7. Universal Steps in Using an AED

8. Special conditions that affect the use of an AED

 DEPARTMENT OF HEALTH
Health Emergency Management Bureau

UNIT OF COMPETENCY II. Cardiopulmonary Resuscitation (CPR) & Automated External

Defibrillator (AED)

At the end of the session on AED, the participants should be able to:

1. Define AED and identify its parts;

2. Define defibrillation;

3. Explain the indications and importance of early defibrillation;

4. Differentiate between the shockable and non-shockable rhythms;

5. Identify the causes of sudden Cardiac Arrest;

6. Enumerate the 4 universal steps of an AED operation;

7. Explain the special conditions that affect the use of an AED; and

8. Demonstrate how to properly use AED to an adult, child and infant who are in cardiac arrest.
 DEPARTMENT OF HEALTH
Health Emergency Management Bureau

UNIT OF COMPETENCY 3. Rescue Breathing due to Respiratory Arrest & Foreign Body Airway
Obstruction Management

This unit of competency comprises the procedure in bringing in air through rescue breathing and the
management of airway in case of obstruction in various cases.

At the end of this competency unit, the participants should be able to correctly:

1. Execute Rescue Breathing to a patient with respiratory arrest, when necessary.

2. Perform appropriate FBAO Management Techniques to a patient who is choking.

Session 5 Rescue Breathing due to Respiratory Arrest

Learning Outcome 5: The participants should be able to illustrate the techniques of Rescue
Breathing to a patient with respiratory arrest when necessary.

Topics to be Discussed:

1. Respiratory Arrest and its Causes

2. Rescue Breathing

3. Ways to ventilate the lungs

a. Mouth to Mouth

b. Mouth to Nose

c. Mouth to Mouth and Nose

d. Mouth to Stoma

e. Mouth to Face Shield

f. Mouth to Mask

g. Bag valve mask device

 DEPARTMENT OF HEALTH
Health Emergency Management Bureau

UNIT OF COMPETENCY 3. Rescue Breathing due to Respiratory Arrest & Foreign Body Airway
Obstruction Management

4. Special Considerations in Providing Rescue Breaths

5. Rescue Breathing Techniques for Adult, Child, and Infant

At the end of the session on Rescue Breathing due to Respiratory Arrest, the participants should be
able to:

1. Describe what Respiratory Arrest is and its causes;

2. Discuss the significance of Rescue Breathing in respiratory arrest;

3. Enumerate the different ways in Rescue Breathing;

4. Discuss the special considerations in providing rescue breaths;

5. Compare the Rescue Breathing techniques for Adult, Child, and Infant; and

6. Demonstrate correct Rescue Breathing techniques for Adult, Child, and Infant.

Session 6 Foreign Body Airway Obstruction Management

Learning Outcome 6: The participants should be able to exhibit FBAO Management Techniques to a
patient who is choking.

Topics to be Discussed:

1. Definition of FBAO

2. Causes of Airway Obstruction

3. Types of Airway Obstruction

a. Anatomical
b. Mechanical
 DEPARTMENT OF HEALTH
Health Emergency Management Bureau

UNIT OF COMPETENCY 3. Rescue Breathing due to Respiratory Arrest & Foreign Body Airway
Obstruction Management

4. Classification of Airway Obstruction

a. Mild
b. Severe
5. Universal Sign of Choking

6. FBAO Management

a. Abdominal Thrust
b. Chest Thrust
c. Back Slaps and Chest Thrust
7. FBAO Management Algorithm for Adult, Child, and Infant

At the end of the session on Foreign Body Airway Obstruction Management, the participants should
be able to:

1. Define FBAO;
2. Discuss the causes, types and classification of airway obstruction;
3. Differentiate the following FBAO Management: Abdominal Thrust, Chest Thrust, Back Slaps and
Chest Thrust; and
4. Explain the theory behind Abdominal Thrust and its possible complications.