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
SL.ppt/TR/FC 1 17
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.
SL.ppt/TR/FC 10 22
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.
SL.ppt/TR/FC 10 23
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)
SL.ppt/TR/FC 1 50
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.
SL.ppt/TR/FC 20 55
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
SL.ppt/TR/FC 20 56
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
SL.ppt/TR/FC 20 57
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)
SL.ppt/TR/FC 1 92
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.
SL.ppt/TR/FC 34 110
BLS for HCP
Introduction to
Basic Life Support
SL.ppt/TR/FC 20 143
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.
SL.ppt/TR/FC 6 145
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.
185
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
186
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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