BASIC LIFE
SUPPORT
( BLS)
Dr.RASHMI
It is a systematic approach to
assess and treat cardiac arrest
WHAT IS and acutely ill or injured patients
BASIC LIFE for optimum care.
SUPPORT
(BLS)?
GOAL : To support and restore
effective oxygenation, ventilation,
and circulation with return of
intact neurologic function.
• Cardio-pulmonary Resuscitation(CPR) can be performed
• By ANYONE
• ANYWHERE
• IMMEDIATELY
• without any other equipment
OBJECTIVES
How to perform chest
How to assess an compression and rescue
unconscious individual? breathing until the arrival
of Advanced Life Support?
WHAT ARE THE STEPS IN
BLS?
Scene Safety
Check Responsiveness
Call for HELP!
Check breathing
Check pulse
30 chest compressions
open airway
2 breaths
WHAT ARE THE STEPS IN
BLS?
Continue for 2 minutes
Check pulse
Shock
Continue CPR
ROSC/ Termination
SCENE SAFETY
Scene Safety
Safety of :
Check responsiveness
• Rescuer/s
Call for HELP
• Victim
Check breathing
Check pulse
30 chest compressions
open airway
2 breaths
CHECK RESPONSE
Scene safety
Check responsiveness
Call for HELP
Check breathing
Check pulse
30 chest compressions
open airway
20 breaths
CHECK
RESPONSE
1. Tap shoulders gently
2. Ask “Are you all right?”
3. If he responds
• Leave him as you find
him
• Find out what is wrong
• Reassess regularly
4. If he does not respond, go
to next step
CALL FOR HELP!
Scene safety
Check responsiveness
Call for HELP!
Check for breathing
Check pulse
30 chest compressions
Open Airway
2 Breaths
CALL FOR HELP!
Activate Emergency Response System
Or
Ask them to get an AED send someone to activate the ERS and
get an AED
• Out of hospital --> Call 108
CALL FOR • Inside hospital --> CODE BLUE 2020
HELP!
• DO NOT FORGET!!
Ask for AED/
Defibrillator
CHECK BREATHING
Scene safety
Check Responsiveness
Call for HELP!
Check breathing
Check pulse
30 chest compressions
open airway
20 breaths
CHECK BREATHING
Check for absent breathing
Assessment of the type of respiration need not be done (agonal breathing
, gasping )
GOAL = Early delivery of chest compression
Looking at or scanning the chest for
movement
About 5-10 seconds
CHECK PULSE
Scene safety
Check responsiveness
Call for HELP!
Check Breathing
CHECK Pulse
30 chest compressions
open airway
2 Breaths
For not more than
10 seconds .
CHECK
PULSE
SITE : Over the
Carotids
• How to check?
• While maintaining the head tilt with
one hand on the forehead, locate the
victim's trachea with 2 or 3 fingers -->
slide the fingers between the trachea
and the muscles of the neck where the
carotid pulse can be felt
CHEST COMPRESSIONS
Scene safety
Check responsiveness
Call for HELP!
Check Breathing
Check Pulse
30 chest compressions
Open Airway
2 Breaths
PUSH HARD, PUSH FAST!!
• Place the heel of the dominating hand
on the lower half of the sternum
• Place other hand on top
• Interlock fingers
• Compress the chest
• Rate 100 per min
• Depth 2-2.4 inches for adults, not greater
than 2.5 inches or 6cm
• Depth of 1.5 inches of infants
• When possible change Operator every
2 min.
HIGH QUALITY CPR
• Compress the center of the chest HARD and FAST
• Allow complete chest recoil after each compression
• Minimize interruptions in compressions (10 seconds or
less)
• Switch providers about every 2 minutes to avoid fatigue
• Avoid excessive ventilation
OPEN AIRWAY
Scene safety
Check responsiveness
Call for HELP!
Check breathing
Check pulse
30 chest compressions
Open airway
2 breaths
AIRWAY OPENING BY
NECK EXTENSION
Campbell
OPEN AIRWAY
HEAD TILT, CHIN LIFT + JAW
THRUST
RESCUE BREATHS
Scene safety
Check responsiveness
Call for HELP!
Check breathing
Check pulse
30 chest compressions
open airway
2 breaths
RESCUE BREATHS
Pinch the nose
Take a deep breath
Make a seal over victim's mouth
Blow until the chest rises
Take about 1 second
Allow chest to fall
Repeat
BREATHS
RECOMMENDATIONS:
Give each breaths over about 1 second with enough volume to make
the victim’s chest rise
BREATHING : MOUTH TO
NOSE (WHEN TO USE)
• Can’t open mouth
• Can’t make a good seal
• Severe injury to mouth
C AND E MANEUVER TO HOLD
FACE MASK
HOW LONG BEFORE CHECKING
FOR PULSE AGAIN?
• Compressions : breaths at ratio
Continue CPR for 2
of 30:2
mins
• five cycles of 30:2 --> 2 minutes Check pulse again
OR Shock
• Rate of 100-120 compressions
Continue CPR
per minute for 2 minutes
ROSC/ Termination
• Check pulse after 2 minutes of
CPR
• If there is a pulse, start RESCUE BREATHING at
1 breath every 5-6 seconds
(10-12 breaths per minute)
CONTINUE CPR TILL
HELP ARRIVES
30 2
2017 AHA GUIDELINES FOR
BLS
A irway C ompressions
B reathing A irway
C irculation B reathing
AUTOMATED EXTERNAL
DEFIBRILLATOR (AED)
Some AEDs will
automatically
switch themselves
on when the lid is
opened
STEPS FOR DEFIBRILLATION
1. Gain access to the patient's chest by cutting off their upper clothing
2. Position the defibrillation pads correctly on the patient.
3. Use the anterior-lateral position
• One paddle or pad is placed on the midaxillary line over the 6th left
intercostal space on the left side of the body
• Other on the right parasternal area over the 2nd intercostal space
ATTACH PADS TO
VICTIMS’S BARE CHEST
DEFIBRILLATION
• Check for a shockable rhythm with an AED/ defibrillator as soon as it
arrives
• Provide shocks if indicated as shockable rhythm
• Follow each shock immediately with CPR, beginning with
compressions for 2minutes i.e., 5 cycles of 30:2 and then check the
rhythm again
ANALYSING RHYTHM -
DO NOT TOUCH VICTIM
WHEN TO DELIVER SHOCK?
SHOCKABLE RHYTHMS Non- shockable rhythms
• Ventricular Fibrillation (VF) Asystole
• Pulseless Ventricular • Pulseless Electrical Activity
Tachycardia (VT) (PEA)
SHOCKABLE RHYTHMS
VENTRICULAR TACHYCARDIA
VENTRICULAR FIBRILLATION
SHOCK INDICATED
• Stand clear
• Deliver shock
CONTINUE CPR
with chest compressions and
intermittent breaths 30:2
• When the defibrillator is fully charged, it will alarm. This is your cue to say the
following in a clear and loud voice:
• - Compressions cease
• - Compressor stand clear
• If the heart rhythm is VF or VT:
• 1. SAY in a loud, clear voice:
• - All clear, shocking
• 2. PRESS the shock button (double check that everyone is still clear prior to
pressing the button).
• When shock is delivered due to a heart rhythm of VF or VT: Immediately
resume CPR
RECOVERY POSITION
• If victim has palpable pulse and starts to breathe
normally, place him/her in
RECOVERY POSITION
RECOVERY POSITION
TECHNIQUE
COMPLICATIONS OF CPR
• Rib fractures
• Laceration related to the tip of the sternum
- Liver, lung, spleen.
• Aspiration
WHY CPR MAY FAIL?
• Delay in starting CPR is the most important cause of death in such cases
• Failure of high quality CPR
• Improper procedures (ex. Forget to pinch nose)
• Delay in defibrillation
• No follow-up with ACLS
• Only 15% who receive CPR live to go home.
• This is primarily attributed to improper techniques.
• Terminal disease or unmanageable disease (massive heart attack)
THANK YOU
