BASIC LIFE SUPPORT

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 OVERVIEW
• Cardiovascular diseases is the
leading cause of death in the US for
both men and women.

• Sudden cardiac death is the major

complication of cardiovascular
diseases.
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 VENTRICULAR FIBRILLATION
O The most frequent
initial rhythm
documented in
witnessed sudden
cardiac arrest.

O The useless quivering of

the heart that results in
no blood flow to the
body.
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 Early Defibrillation
• The most effective treatment
of Ventricular Fibrillation is
Defibrillation.

• Defibrillation, however, is
another intervention with
time limited access.

• The probability of successful

defibrillation decreases by
AED (Automated External approximately 7-10% for
Defibrillator) every minute defibrillation
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 OVERVIEW
O Many victims of other emergencies may also be
saved by prompt initiation of access to the EMS
system, CPR and use of AED.
*Trauma *Electrocution
*Drowning * Drug Intoxication
*Pediatric and Neonatal resuscitation

O Prompt intervention with BLS and ACLS not only

save lives but also help avoid devastating brain
damage that may result in long term suffering and
economic hardship!
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 The Community as the “Ultimate Coronary
Care Unit”

• Because the majority of sudden death caused by

cardiac arrest occur outside the hospital, it is then
clear that the community must be recognized as the
“ultimate coronary care unit”.

• Public education and training are crucial aspects to

reduce sudden cardiac death.

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EMERGENCY CARDIOVASCULAR CARE
(ECC)

O ECC includes all responses (pre-hospital or in-

hospital) needed to stabilize the victim or patient
who develops sudden and often life threatening
events affecting the cardiovascular,
cerebrovascular and pulmonary systems.

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 ECC
O Emergency transportation
without life support is not
Emergency Cardiovascular
Care (ECC).

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 COMPONENTS OF ECC
1. BLS
– It includes recognition of respiratory arrest or
cardiac arrest, access to EMS system and
application of basic CPR.
2. ACLS
– Refers to the attempts to restore spontaneous
circulation with basic CPR plus advance airway
management, tracheal intubation, defibrillation,
and intravenous medications.

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 The Expanding Role of BLS

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Critical Time

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 IMPORTANCE OF BLS

OPrevent cardiac arrest

ORestore cardio respiratory
function.
OMaintain brain viability

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 GETTING STARTED
O Plan of Action
O Gathering of Needed Materials
O Remember the Initial Response as
Follows:
O A – Ask for help
O I – Intervene
O D – Do not Further Harm

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Philippine Red Cross

 EMERGENCY ACTION
PRINCIPLES
O Survey the Scene
O Activate Medical Assistance (AMA)
or Transfer Facility
O Do a Primary Survey of the Victim
O Do a Secondary Survey of the Victim

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Philippine Red Cross

 SURVEY THE SCENE
Take time to survey the scene and ask these
questions:
1. Is the scene safe?
2. What happened?
3. How many people are injured?
4. Are there bystanders who can help?
5. Then, identify yourself as a trained first Aider

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Philippine Red Cross

 ACTIVATE MEDICAL ASSISTANCE
(AMA) OR TRANSFER FACILITY
Call First
– First aider is alone
– 8 yrs old/older
– Unconscious, infant or child known to be at high risk for
heart problem

Care First
– Unconscious victim less than 8 years old
– Victim of submersion or near drowning
– Victim of arrest associated with trauma
– Victim of Drug overdose

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Philippine Red Cross

ACTIVATE MEDICAL ASSISTANCE
(AMA) OR TRANSFER FACILITY
Information to be Remembered in AMA

1. What happened?
2. Location
3. Number of persons injured
4. Extent of injury and first aid given
5. The telephone number from where you are calling
6. Person who activated the Medical Assistance must
identify him/herself and drop the phone last

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Philippine Red Cross

DO A PRIMARY SURVEY OF THE
VICTIM

O Check for consciousness

O Check for circulation
O Check for airway
O Check for breathing

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Philippine Red Cross

 DO A SECONDARY
SURVEY OF THE VICTIM
1. Interview the victim
 Ask the victim’s name
 Ask what happened
 Ask the SAMPLE history
2. Check the Vital Signs
3. Do head to toe examination

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Philippine Red Cross

 CHAIN OF SURVIVAL
O A metaphor to communicate the
interdependence of a community’s
emergency response to cardiac arrest.

O This response is composed of Four Links. If

a link is weak or missing, the result will be
poor despite excellence in the rest of ECC
system.

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Philippine Red Cross

 Chain of Survival

Early Early Early Early

Access CPR Defibrillation Advanced
Care

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Philippine Red Cross

 CHAIN OF SURVIVAL
• The First Link: Early Access
– Encompasses the events initiated after the
patient’s collapse until the arrival of EMS
personnel prepared to provide care.

– Recognition of early warning signs, such

as chest pain and shortness of breath.

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Philippine Red Cross

 CHAIN OF SURVIVAL
• The Second Link: Early CPR

– CPR is most effective when started

immediately after the victim collapse.

– Bystander CPR

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Philippine Red Cross

 CHAIN OF SURVIVAL

O The Third Link:

Early Defibrillation

O Most likely to improve survival

rates.

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Philippine Red Cross

 CHAIN OF SURVIVAL
• The Fourth Link:
Early Advance care
– Another critical link in the
management of cardiac arrest.
– ACLS brings equipment to
support ventilation, establish IV
access, administers drugs,
controls arrhythmias and
stabilizes the victim for
transport.
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Philippine Red Cross

 DENIAL ! THE DEADLY
RESPONSE TO A HEART
ATTACK!
O Denial on the part of the patient but insists on
taking prompt action
1. “Call First”- call EMS
2. Be prepared to provide CPR if necessary.

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 CARDIAC ARREST
O Occurs when the heart stops beating and
breathing ceases abruptly or unexpectedly.
O May occur as the initial and only symptom of
CAD.
O Commonly occurs within the first hour after the
onset of symptoms.

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 Causes of Cardiac arrest
1. CAD – most common
2. Primary respiratory arrest
3. Direct injury to the heart
4. Use of drugs
5. Disturbance in heart rhythm

SIGNS AND SYMPTOMS

6. No response
7. No adequate breathing
8. No signs of circulation, no pulse

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 Cardiopulmonary Resuscitation
(CPR)
Is a series of assessments and
interventions using techniques
and
maneuvers made to bring victims
of cardiac and respiratory arrest
back to life.

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American Heart Association

 The C-A-B Method

• Core concept: Oxygen to the

brain

• In order: Compression-Airway-
Breathing
These build on each other

• “You cannot breathe for a patient

or
assess breathing without first
opening
the airway”.
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American Heart Association

 AHA 2010 Guidelines
• Early CPR improves the likelihood of
survival.
• Chest compressions are the foundations of
CPR.
• Compressions create blood flow
by
increasing the intra-thoracic
pressure
and directly compress the heart;
generate blood flow and oxygen
delivery to the myocardium and
brain.
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American Heart Association

 CPR Sequence
1. Establish scene safety.
2. Introduce self to establish authority.

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American Heart Association

CPR Sequence
3. Assess or check for Responsiveness
(movement & breathing)
• Tap or shout:
Hey, hey… Are you
OK?

• Scan the chest for

movement

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American Heart Association

4. Activate Emergency Response (EMS) and get AED

• If not moving and

NO signs of circulation,
go get HELP!

Activate EMS

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American Heart Association

5. Check the carotid pulse (5-10 seconds)

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American Heart Association

6. Perform 30 Compressions
if you can’t feel the pulse within 10 seconds,

Location: Sternum
2 fingers above the Xiphoid Process
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American Heart Association

 Compression

Immediately give 30 Chest

Compressions
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American Heart Association

 Push Hard (Firm)

Push fast to the

beat
Of “Staying Alive”

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American Heart Association

 7. AIRWAY
O Position the Victim
O Open the airway

Obstruction by the
tongue and
epiglottis.

When a victim is
unresponsive, the
tongue and
epiglottis can block
the upper airway.
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American Heart Association

 Head Tilt – Chin Lift (HTCL)

Obstruction
of
the airway is
relieved by
Head Tilt-
Chin Lift

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American Heart Association

 Jaw-thrust maneuver
Jaw thrust without
head tilt. The jaw is
lifted without lifting
the head.

This is the airway

Maneuver of choice
for a victim with
suspected cervical
spine injury.
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American Heart Association

 8. BREATHING

 Determine absent
or inadequate
breathing by (LLF)
1.LOOK
2.LISTEN
3.FEEL

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American Heart Association

O If there is no breathing, give 2 Rescue breaths

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American Heart Association

 9. Continue CPR
30 Compressions : 2 breath (5 Cycles)

Do this until AED arrives,

ALS provider takes over,
or victim starts to move.

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American Heart Association

DEFIBRILLATION

 As soon as possible
connect the victim
with an AED or
defibrillator and if
indicated deliver
a shock

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 AED
 Turn on the AED
 Attach pad to the
victim’s
bare chest
 Clear the victim
 Listen to the prompt if
shock is needed
 Press button to deliver
shock
 Start CPR, begin with
compression
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Recovery position

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 Methods of Rescue Breathing
Mouth to Mouth

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 Mouth to Stoma

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 Mouth to mask

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 Mouth to face shield

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 Bag Mask Device

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 CPR SEQUENCE
• The scene is safe.
• There is one victim lying on the floor/ground.
• I am _____, a trained First Aider.
• Hey, hey … are you OK? (2X)
• Shout for HELP!!! Call 117 and get AED
• Using CAB Method: Check for pulse (5-10 sec.)
• (thousand 1, thousand 2, thousand 3…thousand 10)
• Perform 30 Compressions (Locate landmark)
• Open Airway (HTCL), (LLF)
• Perform 2 Rescue Breathing
• Continue CPR until EMS/AED arrives
30 compression : 2 breaths X 5 cycles
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 O Adult CPR
Airway opening Maximum HTCL
Rate of compression 100/ min
Depth of compression 1 ½ to 2 inches
Ratio 30 compressions: 2 ventilations
Cycles/min 5 cycles
Rescue breaths Full, slow breaths
Location for Lower sternum: 2 fingers above
compression xiphoid
Pulse check Carotid pulse
1,2,3,4,5,6,7,8,9,10,11,12,…….29,1, 2 Breaths
Counting for 1,2,3,4,5,6,7,8,9,10,11,12,…….29,2, 2 Breaths
standardization 1,2,3,4,5,6,7,8,9,10,11,12,…….29,3, 2 Breaths
1,2,3,4,5,6,7,8,9,10,11,12,…….29,4, 2 Breaths
1,2,3,4,5,6,7,8,9,10,11,12,…….29,5, 2 Breaths
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 FOREIGN BODY
AIRWAY
OBSTRUCTION
(FBAO)

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 RELIEF OF FBAO
• Severe or complete airway obstruction is an
emergency that will result in death within minutes if
not treated.
– Intrinsic (tongue)
– Extrinsic (Foreign body)

• Classification of FBAO
– Partial Obstruction
• Good air exchange
• Poor air exchange
– Complete Obstruction

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 Signs of Severe or Complete
Airway Obstruction

1. Universal choking sign

2. Inability to speak
3. Weak ineffective coughs
4. High-pitched sounds or no
sounds while inhaling
5. Increased difficulty of
breathing
6. Bluish skin color (cyanosis)

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Relief of FBAO: Conscious Victim

O Heimlich
Maneuver
with a
standing/sitting
victim

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OHeimlich maneuver with the
victim lying.

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OChest thrust
for responsive
pregnant
woman

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Responsive Victim of FBAO Becomes Unresponsive

1. Activate EMS
2. Perform a TONGUE-JAW LIFT, then a finger
sweep to remove the object.
3. Open the airway and try to give 2 rescue
breaths.
4. Perform Heimlich maneuver up to 5 times.
5. Repeat the sequence of tongue-jaw lift, finger
sweep, attempt to ventilate, and Heimlich
maneuver.

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 Tongue-jaw Lift and
Finger Sweep
O Used to remove a foreign body from the
back of the pharynx

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 Actions After Relief of FBAO
After the obstruction is removed, the rescuer
should:
1. Provide 2 slow breaths
2. Check for signs of circulation. If no signs of
circulation, perform CPR.
3. If signs of circulation are present but the
victim is not breathing, continue with
RESCUE BREATHING.
4. Place the victim in a RECOVERY POSITION

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 Common Questions Asked

O What happens if I break a rib?

O What happens if a female is pregnant?
O What do I do if the patient vomits?
O Can I get AIDS doing CPR?
O What do I do if the patient is wearing
dentures?
O What do I do if I am alone and I am
choking?

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 RELIEF OF FOREIGN BODY
AIRWAY OBSTRUCTION
O Responsive Infant
O Recognize presence of choking
O Deliver 5 back blows and 5 chest thrust
O Repeat until object is removed or victim becomes
unresponsive.

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 O Unresponsive infant
O Open the airway, finger sweep if visible
O Attempt to ventilate
O Reposition the head and reattempt to
ventilate
O Give 5 back blows and 5 chest thrusts

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 O Responsive child
O Heimlich maneuver

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 O Unresponsive child
O Open the airway, finger sweep if visible
O Attempt to ventilate
O Reposition and reattempt to ventilate
O Give 5 abdominal thrusts

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 Pediatric CPR

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 COMMON LIFE THREATENING
EMERGENCIES IN INFANTS AND CHILDREN

O Respiratory Arrest
O Cardiac Arrest
O Choking

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 RESPIRATORY ARREST
• Causes
– Submersion
– Foreign body airway obstruction
– Poisoning
– Suffocation
– Electrocution
– Head injuries
• Signs and symptoms
– No response
– No adequate breathing

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 CARDIAC ARREST
O Causes
O Most often develop as a complication of
breathing difficulties, shock or injuries.
O Signs and symptoms
O No response
O No adequate breathing
O No signs of circulation including pulse

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 CHOKING
O Types of Airway Obstruction
O Partial airway obstruction
O Poor air exchange
O Good air exchange
O Complete/ severe airway obstruction

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 O Signs of Poor air exchange
O Weak cry
O Weak or no voice
O Decreasing responsiveness
O Blue or pale lips
O Signs of Complete Obstruction
O Universal choking sign
O No voice
O Weak, ineffective cough
O High pitched sounds while inhaling
O Increased difficulty of breathing
O Bluish skin color

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 PEDIATRIC CHAIN OF
SURVIVAL
1. Early Prevention (cardiac arrest & respiratory arrest)
2. Early CPR
3. Early Access
4. Early Advance Care

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 FIRST LINK:
Prevent Causes of Cardiac Arrest
O SIDS
O Leading cause of death in infants 1-6 months
old.
O Injuries
O The leading cause of death in children, teens
and young adults.
O Choking
O A very preventable cause of cardiac arrest in
infants and children.
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 AIRWAY
INFANT CHILD

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 BREATHING
INFANT CHILD

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 CIRCULATION
O Checking for signs of circulation

INFANT
CHILD

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 O Location for Compression (Child)

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 THANK YOU!

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