BASIC LIFE SUPPORT
BY
HIMANSHU RATHORE
M.SC. NURSING
1ST YEAR
INTRODUCTION
• According to recent statistics sudden cardiac arrest is rapidly becoming the leading cause
of death.
• Once the heart ceases to function, a healthy human brain may survive without oxygen for
up to 4 minutes without suffering any permanent damage.
• Unfortunately, a typical EMS response may take 6, 8 or even 10 minutes
• It is during those critical minutes that CPR (Cardio Pulmonary Resuscitation) can provide
oxygenated blood to the victim's brain and the heart, dramatically increasing his chance
of survival.
• And if properly instructed, almost anyone can learn and perform CPR
WHAT IS BLS ??
• Basic Life Support (BLS) refers to the care healthcare providers and public safety
professionals provide to patients who are experiencing respiratory arrest, cardiac arrest or
airway obstruction.
• BLS includes psychomotor skills for performing high-quality cardiopulmonary
resuscitation (CPR), using an automated external defibrillator (AED) and relieving an
obstructed airway for patients of all ages
RESPIRATORY ARREST
• If the patient is not breathing but has a definitive pulse, the patient is in respiratory arrest.
• To care for a patient experiencing respiratory arrest, ventilations must be given.
CARDIAC ARREST
• If there is no breathing, no pulse and the patient is unresponsive, the patient is in cardiac
arrest.
• Cardiac arrest is a life-threatening situation in which the electrical and/or mechanical
system of the heart malfunctions resulting in complete cessation of the heart’s ability to
function and circulate blood efficiently.
CHAIN OF SURVIVAL
COMPONENTS OF BLS
• Ensure safety
• Check for response
• Activate EMS
• Chest compressions
• Check airway and ventilate
• Defibrillate
ENSURE SAFETY
• Safety Of Self
• Safety Of Patient
• Movement of a trauma victim – only when absolutely necessary
ASSESS RESPONSE
• Ask the person “Are you ok ?”
• Tap and shout If the client responds
• Leave the client and call for help.
• Return as quick as possible and reassess the condition of the person
ACTIVATE EMS
• Call 108 / 102
• Describe the emergency to the operator-includes where you are (address and location)
-condition of patient
CHANGE FROM A-B-C TO C-A-B
• The vast majority of cardiac arrests occur in adults, and the highest survival rates from
cardiac arrest are reported among patients of all ages who have a witnessed arrest and an
initial rhythm of VF or pulseless VT.
• In these patients, the critical initial elements of BLS are chest compressions and early
defibrillation.
• In the A-B-C sequence, chest compressions are often delayed while the responder opens
the airway to give mouth-to-mouth breaths, retrieves a barrier device, or gathers and
assembles ventilation equipment.
CIRCULATION
• Check pulse. If pulse is not definitely felt within 10 seconds, proceed with chest
compressions.
Position of victim
• Must be supine on a firm flat surface for CPR to be effective
• Victim lying facing down – logroll the victim
PRONE CPR
• Standard CPR is performed with the person in supine position.
• Prone CPR or reverse CPR is CPR performed on a person lying on their chest, by turning
the head to the side and compressing the back. Due to the head's being turned, the risk of
vomiting and complications caused by aspiration pneumonia may be reduced.
• The American Heart Association's current guideline recommends to perform CPR in the
supine position, and limits prone CPR to situations where the patient cannot be turned
PREGNANCY
• During pregnancy when a woman is lying on her back, the uterus may compress the
inferior vena cava and thus decrease venous return. It is therefore recommended that the
uterus be pushed to the woman's left; if this is not effective, either roll the woman 30° or
healthcare professionals should consider emergency resuscitative hysterotomy.
CERVICAL SPINE STABILIZATTION
• Use cervical collar if available
• Any hard objects that restrict neck movement
• Firm surface(backboard or floor)
POSITION OF RESCUER
• Firm surface(backboard or floor)
• Kneel beside victim’s chest or stand beside bed
• Heel of one hand on inter-mammary line (which is the lower half of the sternum)
• Heel of other hand on top of the first so that the hands are overlapped and parallel
• Lock elbows
CHEST COMPRESSION
• Rhythmic applications of pressure over the lower half of the sternum.
• It Increase intrathoracic pressure and directly compress hear
CHARACTERISTICS OF GOOD COMPRESSION
• “Push hard push fast”. Push at a rate of 100-120 min.
• Compression depth- at least 2 inches(5cm) not more than 2.5 inches
• Release completely to allow the chest to fully recoil.
• A compression-ventilation ratio of 30:2 .
• Do not bounce your hands up and down on the victim's chest.
• Never use the palm of your hand, use the heel of your hand.
When 2 or more rescuers available,
• Switch the compressor about every 2 minutes (or after 5 cycles of compressions and
ventilations at a ratio of 30:2).
• Accomplish this switch in ≤5 seconds.
Advanced airway and 2 rescuers
• Continuous chest compressions at a rate of 100-120 /min without pauses for ventilation.
• The rescuer delivering ventilation provides 8 to 10 breaths per minute.
• Rescuers should continue CPR until an AED arrives
AIRWAY
Open Airway
• Jaw thrust maneuver
• Head tilt and chin lift
• No blind finger sweep
BREATHING
• Check breathing.
• No “look, listen, feel” for signs of breathing in new guidelines.
• After the first set of chest compressions, the airway is opened and the rescuer delivers 2
breaths
GIVING RESCUE BREATH
• Use a barrier device of some type while giving breaths.
• Deliver each rescue breath over 1 second.
• Give a sufficient tidal volume to produce visible chest rise (500600ml).
• Avoid rapid or forceful breaths.
• When an advanced airway is in place during 2-person CPR, ventilate at a rate of 8 to 10
breaths per min.
METHODS OF RESCUE BREATH
• Mouth-to-Mouth Rescue Breathing
• Mouth-to–Barrier Device Breathing
• Mouth-to-Nose and Mouth-to-Stoma Ventilation
• Ventilation With Bag and Mask
• Ventilation With an Advanced Airway
CONTINUE RESUSCITATION UNTIL
• Qualified help arrives and takes over
• Victim revives: The victim starts breathing normally
• Rescuer becomes exhausted
CONCLUSION
• CPR is responsibility of a team of personnel.
• For patients with cardiac arrest, early appropriate resuscitation, involving CPR, early
defibrillation, and appropriate implementation of post–cardiac arrest care, leads to
improved survival and neurologic outcomes.
BIBLIOGRAPHY
• Lakhwunder kaur, sukhminder kaur, ‘textbook of medical surgical nursing’ 3 rd edition PP-
505-513.
• Brunners and suddarths, ‘textbook of medical surgical nursing’ 13 th edition, volume-1 PP-
985-988.
• Javed Ansari ‘textbook of medical surgical nursing’ pee vee regd. PP. 485-490.
• BT Basavanthapa ‘ essential for ‘medical surgical nursing ‘ jaypee publication, 2 nd edition
pp. 289-292.
• EMMESS ‘Textbook of medical surgical nursing’ first edition pp. 689-691.
