BLS for HCP

BASIC LIFE SUPPORT

SL.ppt/TR/FC 1 1
Dear God, we offer everything to you
today. May we ask for your blessing and
divine providence that the activities set
for this undertaking be successful and
effective.
.

May we also retain the invaluable

knowledge and learning experiences that
we derive from this activity, for actual
application when we leave this venue.

We pray that you bless the committee in

charge that they fulfill their tasks
responsibly, that the objectives set may
be achieved.

Your generous blessing would mean the

success of this training. We know that
without you, we can do nothing.

This we ask in Jesus name. Amen.

Philippine National Anthem
 NKTI HYMN
With one voice
And with one heart
NKTI we sing our joyful song

You’ve chosen us
To serve and care
For anyone who comes in need… of your
comforting hand

Lord, use our hands, our minds and

hearts!
Lord, Fill us up with Your love and
healing power
For it’s our joy! When wonders work
Your people know oh Lord that You are
there!
 BLS for HCP
BASIC LIFE SUPPORT

SL.ppt/TR/FC 1 5
Legal Bases

• Policy: A.O. 155 s. 2004

“Basic Life Support Training is mandatory
to all health workers”

• HEMB Goal:
“At least one member of each household
shall be trained in BLS”

DOH - HEMS Basic Life Support Training of Trainers

Certificate of Attendance

At least 90% attendance

Certificate of Completion
Those issued a Certificate of
Republic of the Philippines
Attendance and DEPARTMENT OF HEALTH
Health Emergency Management Staff

pass the skill examinations a This certifies that

BLS Card will be issued;
LIEZL L. ALOOT
renewable after 2 years is a DOH-HEMS Basic Life Support

HEALTH CARE PROVIDER

BLSHP-10-HEMS-003

DOH - HEMS Basic Life Support Training of Trainers

 Duration
This training is 4 hours in duration, intended for
DOH-BLS renewal for Doctors

The first 2 hours is dedicated for the lecture

discussion of CPR for adult, child and infant and
demonstration of BLS techniques. Discussion
includes 2015 AHA BLS Update.

DOH - HEMS Basic Life Support Training of Trainers

 Duration

The next 2 hours is dedicated for the skills

enhancement and skills evaluation

DOH - HEMS Basic Life Support Training of

INTRODUCTION TO BASIC LIFE SUPPORT
• Basic life support (BLS) is the foundation for
saving lives following cardiac arrest

• Fundamental aspects of BLS

- immediate recognition of sudden cardiac arrest (SCA) and

activation of the emergency response system

- early cardiopulmonary resuscitation (CPR)

- and rapid defibrillation with an automated external

defibrillator (AED).

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Cardiopulmonary Resuscitation
 BLS for HCP
FOUNDATIONS OF BLS

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 Adult Chain of Survival

Recognition Early Rapid Effective Integrated

Activation CPR Defibrillation ACLS Post-cardiac
Care

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1. The First Link: IMMEDIATE RECOGNITION & ACTIVATION OF EMS

It is the event initiated after the patient’s collapse until the arrival of
Emergency Medical Services personnel prepared to provide care.

2. The Second Link: EARLY CPR

It is most effective when started immediately after the victim’s collapse. The
probability of survival approximately doubles when it is initiated before the
arrival of EMS.

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3. The Third Link: RAPID DEFIBRILLATION
It is the cornerstone therapy for patients who have just suddenly
collapsed probably due to ventricular fibrillation and pulse-less
ventricular tachycardia.

4. The Fourth Link: EFFECTIVE ACLS

Provided by highly trained personnel like paramedics.

5. The Fifth Link: INTEGRATED POST-CARDIAC ARREST CARE

Post cardiac arrest care after return of spontaneous circulation (ROSC)
can improve the likelihood of patient survival with good quality of life.

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 Pediatric Chain of Survival

Prevention Early Rapid access Rapid PALS Integrated

of Arrest CPR to EMS Support Post-cardiac
Arrest Care

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Each link in the PEDIATRIC CHAIN OF SURVIVAL must be strong to maximize survival
and a neurologically intact outcome after life threatening cardiovascular emergencies

1. The First Link: PREVENTION OF ARREST

In children, the leading cause of death is injury, and vehicular

accidents are the most common causes of fatal childhood injuries
and child passengers’ safety seats can reduce the risk of death.

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2. The Second Link: EARLY AND EFFECTIVE BYSTANDER CPR

It is most effective when started immediately after the victim’s collapse.

The probability of survival approximately doubles when it is initiated before
the arrival of EMS. It is associated with successful return of spontaneous
circulation and neurologically intact survival in children.

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3. The Third Link: RAPID ACTIVATION OF THE EMS
(OR OTHER EMERGENCY RESPONSE) SYSTEM
It is the event initiated after the baby collapse until the arrival of Emergency
Medical Services personnel prepared to provide care.

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4. The Fourth Link: EARLY AND EFFECTIVE ADVANCED LIFE
SUPPORT (INCLUDING RAPID STABILIZATION AND TRANSPORT
TO DEFINITIVE CARE &REHABILITATION)

Initial steps in stabilization (provide warmth by placing baby under a radiant

heat source, position head in a “sniffing” position to open the airway, clear
airway w/ bulb syringe or suction catheter, dry baby and stimulate breathing.

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5. The Fifth Link: INTEGRATED POST-CARDIAC ARREST CARE

Post cardiac arrest care after return of spontaneous circulation (ROSC)

can improve the likelihood of patient survival with good quality of life.

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CARDIOPULMONARY
BLS for HCP
RESUSCITATION
(ADULT)

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 ADULT BLS SEQUENCE
• Immediate recognition and
Activation of the
Emergency Response
Sytem (EMS)
– Establish scene safety first
– Check for a response by
tapping the victim on the
shoulder and shouting at
the victim
• Simultaneously look for no
breathing or gasping
– Activate EMS
 ADULT BLS SEQUENCE
• Pulse Check
– Check pulse no
more than 10
seconds
– If there is no
pulse start CPR
 ADULT BLS SEQUENCE
• Early CPR
– Chest Compressions
• Push Hard Push Fast
• Rate: at least 100-
120/min
– should take 15-18 sec
• Depth: at least 2 inches
or 5cm for Adults
• Depth: at least 1/3 of the
AP diameter of the chest
– Infants: 1 ½ inches(4cm)
– Chilldren: 2 inches(5cm)
• Allow complete chest
recoil
• Minimize interruptions

Basic Life Support ebec 33

2009
 ADULT BLS SEQUENCE
• Early CPR
– Rescue Breaths
• Deliver rescue
breath over 1 second
• Allow visible chest
rise
• Compression:Ventila
tion ratio of 30:2
• 5 cycles or 2 minutes

34
 CPR
• Continue CPR until
– AED arrives and is ready for use
– EMS providers take over the care of the
victim
• Cycles of 30 compressions:2 ventilations
should be continued until an advanced airway
is placed
– Continuous compressions
– Ventilation rate of 1 breath every 6 to 8
seconds
35
 Key Changes on the 2015 AHA
Guidelines for BLS
1. Rate of Compressions
– Keep the rate of chest compressions between 100-
120 per minute
– Avoid leaning on the chest
 Key Changes on the 2015 AHA
Guidelines for BLS

2. Depth of compressions
– Compress to a depth of a least 2 inches but avoid
compressing too deeply beyond 2.4 inches (6 cm)
in adult patients
 BLS Guidelines
1. Quick Assessment
2. 30 compression to 2 ventilations
 BLS Guidelines
3. Hand position
 BLS Guidelines

4. Chest Recoil
 BLS Guidelines
5. Higher chest compression rate fraction
(Minimize Interruptions in Chest Compressions)
 BLS Guidelines
6. Suspected opioid overdose
Naloxone
Video for Hands Only CPR
Return Demo – Partner
CARDIOPULMONARY
BLS for HCP
RESUSCITATION
(INFANT)

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 Pediatric CPR
Child CPR
 Lower half of the sternum, between the
nipples.
 Depth: 1/3 of the AP Diameter of the
chest
 2 inches (5 cm) depth
 One hand only/ two hands
 30:2 for single rescuer, 15:2 for 2-man
rescuer (optional for HCP).
51
 Pediatric CPR
Infant CPR
 Just below the nipple line, lower half of
sternum
 Depth: 1/3 of the AP Diameter of the
chest
 1 1/2 inches (4 cm) depth
 Two fingers, flexing at the wrist (lone rescuer)
 2-thumbs hand encircling technique (two
rescuers)

52
 1 – Rescuer Pediatric CPR
1. Survey the scene.

2. Introduce Self

3. Check for responsiveness

4. IF unresponsive and not breathing or gasping,

call for HELP! Activate EMS and get the AED.
If you are a lone rescuer do 5 cycles of CPR
before calling for help
SL.ppt/TR/FC 20 53
 1 – Rescuer Pediatric CPR
5. Perform 30 Compressions on the chest

6. Open Airway -Head/Tilt chin lift and perform 2

Rescue Breaths

7. Do this for 5 cycles or approx. 2 minutes.

8. Do this until AED/Defibrillator arrives, ALS

provider takes over, or victim starts to move.

SL.ppt/TR/FC 20 54
 2- Rescuer Pediatric CPR
1. Survey the scene.

2. Introduce Self

3. Check for responsiveness

4. IF unresponsive and not breathing or gasping,

call for HELP! Activate EMS and get the AED.

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 2- Rescuer Pediatric CPR
5. 1st Rescuer performs 15 chest Compressions (
for infant victims do two thumbs CPR)

6. 2nd Rescuer opens the Airway- Head/Tilt chin

lift and delivers 2 Rescue Breaths

7. Do CPR 15:2 for 10 cycles or approx. 2 mins.

8. Reassess for less than 10 secs. Rescuers may

switch roles
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 2- Rescuer Pediatric CPR

9. Do this until AED/Defibrillator arrives, ALS

provider takes over, or victim starts to move.

10. If patient becomes conscious, place patient in

recovery position

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Infant Demo
BLS for HCP
Automated External
Defibrillator (AED)

59
 Basic Life Support Visual Aids
DOH-HEMS Automated External Defibrillator (AED)

Definition

AEDs are sophisticated, computerized devices that can

analyze heart rhythms and generate high voltage
electric shocks.
 Basic Life Support Visual Aids
DOH-HEMS Automated External Defibrillator (AED)

Evidence
100

For every minute

Survival Rate

80
defibrillation is delayed
the victim’s survival rate
(%)

60
decreases by 10%

40

20

0
5 10 15 20 25 30
Time to Defibrillation
(minutes)
 Basic Life Support Visual Aids
DOH-HEMS Automated External Defibrillator (AED)

Parts of an AED
Example: AED Trainer
Pads connector port
On button

Analyze
button

Shock
button
Pads
Defibrillator
 Basic Life Support Visual Aids
DOH-HEMS Automated External Defibrillator (AED)

PAAS
Return Demo on AED
BLS for Doctors
 BLS for HCP
BASIC LIFE SUPPORT
2015 AHA Guidelines
(Based on DOH Dept Memo No.2015-0419 dtd Dec. 29, 2015)

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 Key Changes on the 2015 AHA
Guidelines for BLS
1. Rate of Compressions
– Keep the rate of chest compressions between 100-
120 per minute
– Avoid leaning on the chest
 Key Changes on the 2015 AHA
Guidelines for BLS

2. Depth of compressions
– Compress to a depth of a least 2 inches but avoid
compressing too deeply beyond 2.4 inches (6 cm)
in adult patients
 BLS Guidelines
1. Quick Assessment
2. 30 compression to 2 ventilations
 BLS Guidelines
3. Hand position
 BLS Guidelines

4. Chest Recoil
 BLS Guidelines
5. Higher chest compression rate fraction
(Minimize Interruptions in Chest Compressions)
 BLS Guidelines
6. Suspected opioid overdose
Naloxone
Con’t of Conditions in applying BLS

Other causes may be treated by doing either

rescue breathing, cardio-pulmonary
Resuscitation, abdominal thrust, or chest thrust
and back slap depending on the situation.

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BLS for HCP
Introduction to
Basic Life Support

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THREE KINDS OF LIFE SUPPORT

1. BASIC LIFE SUPPORT (BLS)

2. ADVANCED CARDIAC LIFE SUPPORT
3. PROLONG LIFE SUPPORT

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THREE KINDS OF LIFE SUPPORT

2. ADVANCED CARDIAC LIFE SUPPORT (ACLS)

A set of clinical interventions for the urgent treatment of
cardiac arrest and other life threatening emergencies, as well
as the knowledge and skills to deploy those interventions.

3. PROLONGED LIFE SUPPORT (PLS)

For post resuscitative and long term resuscitation with the
use of adjunctive equipment such as ventilator, cardiac
monitor, pulse oximeter etc.

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 ANATOMY AND PHYSIOLOGY

*Clinical death
0 - 1 min. - cardiac irritability
1 - 4 min. - brain damaged not likely
4 - 6 min. - brain damage possible

*Biological death
6 - 10 min. - brain damaged very likely
over 10 min. - irreversible brain damaged

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BLS for HCP
Cardiopulmonary
Resuscitation

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 1 and 2 Rescuer Adult CPR
1. Establish scene safety.

2. Introduce self to establish authority.

3. Determine unresponsiveness (movement &

breathing)

4. IF unresponsive and not breathing or gasping,

call for HELP! Activate EMS and get the AED.

184
 1 and 2 Rescuer Adult CPR
5. Pulse check within 10 seconds (for HCP).

6. Perform 30 Compressions on the chest

7. Open Airway- Head/Tilt chin lift and perform

2 Rescue Breaths

8. Do this for 5 cycles or approx. 2 minutes.

Rescuer may switch roles.

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 1 and 2 Rescuer Adult CPR

9. Do this until AED/Defibrillator arrives, ALS

provider takes over, or victim starts to move.

10. If patient becomes conscious, place patient in

recovery position

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 Table of Comparison on Cardiopulmonary Resuscitation
ADULT CHILD INFANT
Compression Lower half of sternum, between the nipples Just below the nipple
Landmark line (lower half of
sternum)
Location for Pulse Carotid Pulse Carotid Pulse or Brachial Pulse or
Check (HCP only) Femoral Pulse Femoral Pulse
Compression Depth At least 2 inches At least 1/3 of the AP Diameter of the chest
(5 cm) About 2 in (5 cm) About 1 1/2 in (4 cm)
Compression method Heel of one hand Heel of one hand Lone Rescuer: 2
(Push hard and fast, with hand of the with hand of the finger technique
Allow Complete recoil) other on top other on top or one 2 HCP rescuers: 2-
hand technique thumbs hand
encircling technique
Compression rate At least100 Compressions per minute
Counting for 1-29, 1 up to 5 cycles
Standardization (30 compressions within 18 seconds)
Purpose 1-14, 1 up to 10 cycles for 2-rescuer Pedia
CPR
(15 compressions within 9 seconds)
Compression- 1 or 2 - Rescuer 1-rescuer (30:2)
Ventilation Ratio (30:2) 2-rescuer (15:2)
 Recovery Position in CPR
• Adult and Child
 Table of Comparison on Rescue Breathing
ADULT CHILD INFANT

Opening of airway Head Tilt-Chin Lift

(Head-Tilt_ Chin-Lift (HCP: If suspected spine injury perform Jaw thrust maneuver)
Maneuver)
Mouth-to-mouth or mouth-to-nose Mouth-to-mouth and
Method
nose
Normal breath enough to make the chest rise
Amount of Breath

1 breath every 5 – 6
1 breath every 3 - 5 seconds then reassess
seconds then
Rate every 2 minutes
reassess every 2
minutes

Breathe 1001,1002,
Counting for
1003, 1004, 1005,
Standardization Breathe 1001,1002, 1003, breathe
breathe
Purposes

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