BLS

Basic Life Support

Quick Reference

C-A-B

Compressions Airway Breaths

  Critical Concepts

High-quality CPR improves a victim’s chances of survival. The critical

characteristics of high-quality CPR include the following:
  • Start compressions within 10 seconds of recognition of
cardiac arrest.
  •  Push hard, push fast: Compress at a rate of 100 to 120/min
with a depth of
   –  At least 2 inches (5 cm) for adults
   – At least one third the depth of the chest, about 2 inches (5 cm),
for children
   – At least one third the depth of the chest, about 1½ inches
(4 cm), for infants
  • Allow complete chest recoil after each compression.
  •  Minimize interruptions in compressions (try to limit
interruptions to less than 10 seconds).
  •  Give effective breaths that make the chest rise.
  • Avoid excessive ventilation.

KJ1173  2/16  © 2016 American Heart Association  Printed in the USA

BLS Healthcare Provider Adult Cardiac Arrest
Algorithm—2015 Update

Verify scene safety.

Victim is unresponsive.
Shout for nearby help. Provide rescue breathing:
Activate emergency response system 1 breath every
via mobile device (if appropriate). 5-6 seconds, or about
Get AED and emergency equipment 10-12 breaths/min.
(or send someone to do so). • Activate emergency
response system
(if not already done)
Normal No normal after 2 minutes.
breathing, breathing, • Continue rescue
has pulse has pulse breathing; check pulse
Look for no breathing about every 2 minutes.
Monitor
or only gasping and check If no pulse, begin CPR
until
pulse (simultaneously). (go to “CPR” box).
emergency
Is pulse definitely felt • If possible opioid
responders
within 10 seconds? overdose, administer
arrive.
naloxone if available
per protocol.
No breathing
or only gasping,
no pulse By this time in all scenarios,
emergency response system or
backup is activated, and AED and
emergency equipment are retrieved
or someone is retrieving them.

CPR
Begin cycles of
30 compressions and 2 breaths.
Use AED as soon as it is available.

AED arrives.

Check rhythm.
Yes, Shockable rhythm?
No,
shockable nonshockable

Give 1 shock. Resume CPR Resume CPR immediately for about

immediately for about 2 minutes
(until prompted by AED to allow
rhythm check).
Continue until ALS providers take
over or victim starts to move.
2 minutes (until prompted by AED
to allow rhythm check).
Continue until ALS providers take
over or victim starts to move.
Summary of High-Quality CPR Components

Children Infants
Adults and
Component (Age 1 Year to (Age Less Than 1 Year,
Adolescents Puberty) Excluding Newborns)

Scene safety Make sure the environment is safe for rescuers and victim
Recognition of Check for responsiveness
cardiac arrest No breathing or only gasping (ie, no normal breathing)
No definite pulse felt within 10 seconds
(Breathing and pulse check can be performed simultaneously in less
than 10 seconds)
Activation of If you are alone Witnessed collapse
emergency with no mobile Follow steps for adults and adolescents
response system phone, leave the on the left
victim to activate the Unwitnessed collapse
emergency response Give 2 minutes of CPR
system and get
the AED before Leave the victim to activate the emergency
beginning CPR response system and get the AED
Otherwise, send Return to the child or infant and resume CPR;
someone and begin use the AED as soon as it is available
CPR immediately;
use the AED as soon
as it is available
Compression- 1 or 2 rescuers 1 rescuer
ventilation 30:2 30:2
ratio without 2 or more rescuers
advanced airway 15:2
Compression- Continuous compressions at a rate of 100-120/min
ventilation Give 1 breath every 6 seconds (10 breaths/min)
ratio with advanced
airway
Compression rate 100-120/min

Compression depth At least 2 inches At least one third AP  At least one third AP
(5 cm)* diameter of chest diameter of chest
About 2 inches (5 cm) About 1½ inches (4 cm)
Hand placement 2 hands on the 2 hands or 1 hand 1 rescuer
lower half of the (optional for very 2 fingers in the center
breastbone (sternum) small child) on the of the chest, just below
lower half of the the nipple line
breastbone (sternum)
2 or more rescuers
2 thumb–encircling
hands in the center of
the chest, just below
the nipple line
Chest recoil Allow full recoil of chest after each compression;
do not lean on the chest after each compression
Minimizing Limit interruptions in chest compressions to less than 10 seconds
interruptions

*Compression depth should be no more than 2.4 inches (6 cm).

Abbreviations: AED, automated external defibrillator; AP, anteroposterior; CPR, cardiopulmonary
resuscitation.
BLS Healthcare Provider Pediatric Cardiac Arrest
Algorithm for the Single Rescuer—2015 Update

Verify scene safety. Provide rescue

breathing:
1 breath every
Victim is unresponsive. 3-5 seconds, or about
Shout for nearby help. 12-20 breaths/min.
Activate emergency response system • Add compressions
via mobile device (if appropriate). if pulse remains
≤60/min with signs
Normal No normal of poor perfusion.*
breathing, breathing, • Activate emergency
has pulse has pulse response system
Look for no breathing
(if not already done)
or only gasping and check
after 2 minutes.
pulse (simultaneously).
• Continue rescue
Is pulse definitely felt
breathing; check
within 10 seconds?
pulse about every
Activate
No breathing 2 minutes. If no
emergency
or only gasping, pulse, begin CPR
response
no pulse (go to “CPR” box).
system
(if not already Witnessed sudden Yes
done). Return collapse? Activate emergency
to victim and
response system
monitor until No (if not already
emergency done), and retrieve
responders CPR
AED/defibrillator.
arrive. 1 rescuer: Begin cycles of
30 compressions and 2 breaths.
(Use 15:2 ratio if
second rescuer arrives.)
Use AED as soon as it is available.

After about 2 minutes, if still alone, activate emergency

response system and retrieve AED (if not already done).

AED analyzes rhythm.

Yes, Shockable rhythm? No,
shockable nonshockable

Give 1 shock. Resume CPR Resume CPR immediately for

immediately for about 2 minutes
(until prompted by AED to allow
rhythm check).
Continue until ALS providers take
over or victim starts to move.
about 2 minutes (until prompted
by AED to allow rhythm check).
Continue until ALS providers take
over or victim starts to move.

*Signs of poor perfusion may include cool extremities, decrease in responsiveness,

weak pulses, paleness, mottling (patchy skin appearance), and cyanosis (turning blue).
BLS Healthcare Provider Pediatric Cardiac Arrest
Algorithm for 2 or More Rescuers—2015 Update

Verify scene safety.

Victim is unresponsive.
Shout for nearby help.
First rescuer remains with victim. Provide rescue
Second rescuer activates emergency breathing:
response system and retrieves AED 1 breath every
and emergency equipment. 3-5 seconds, or about
12-20 breaths/min.
• Add compressions
Normal No normal if pulse remains
breathing, breathing, ≤60/min with signs
has pulse has pulse of poor perfusion.*
Look for no breathing
or only gasping and check • Activate emergency
pulse (simultaneously). response system
Is pulse definitely felt (if not already done)
within 10 seconds? after 2 minutes.
• Continue rescue
Monitor until breathing; check
emergency pulse about every
responders No breathing
2 minutes. If no
arrive. or only gasping,
pulse, begin CPR
no pulse
(go to “CPR” box).

CPR
First rescuer begins CPR with 30:2
ratio (compressions to breaths).
When second rescuer returns, use
15:2 ratio (compressions to breaths).
Use AED as soon as it is available.

AED analyzes rhythm.

Shockable rhythm?
Yes, No,
shockable nonshockable

Give 1 shock. Resume CPR Resume CPR immediately for

immediately for about 2 minutes
(until prompted by AED to allow
rhythm check).
Continue until ALS providers take
over or victim starts to move.
about 2 minutes (until prompted
by AED to allow rhythm check).
Continue until ALS providers take
over or victim starts to move.

*Signs of poor perfusion may include cool extremities, decrease in responsiveness,

weak pulses, paleness, mottling (patchy skin appearance), and cyanosis (turning blue).
Relief of Foreign-Body Airway Obstruction

Adults and Infants

Children (Age Less Than
Adolescents (Age 1 Year to Puberty)
1 Year)

1. Ask “Are you 1. Ask “Are you 1. If the victim cannot
choking?” choking?” make any sounds or
  If the victim nods   If the victim nods breathe, severe airway
“yes” and cannot “yes” and cannot obstruction is present.
talk, severe airway talk, severe airway
obstruction is present. obstruction is present.
  Take steps   Take steps
immediately to relieve immediately to relieve
the obstruction. the obstruction.
2. Give abdominal 2. Give abdominal 2. Give up to 5 back
thrusts/Heimlich thrusts/Heimlich slaps and up to 5
maneuver or chest maneuver. chest thrusts.
thrusts for pregnant or
obese victims.
3. Repeat abdominal 3. Repeat abdominal 3. Repeat step 2 until
thrusts (or chest thrusts until effective effective or the
thrusts if the victim or the victim becomes victim becomes
is pregnant or obese) unresponsive. unresponsive.
until effective or
the victim becomes
unresponsive.

Victim becomes unresponsive

4. Activate the emergency response system via mobile device (if appropriate) or
send someone to do so. After about 2 minutes of CPR, if you are alone with no
mobile device, leave the victim to activate the emergency response system (if no
one has already done so).
5. Lower the victim to the floor. Begin CPR, starting with chest compressions. Do
not check for a pulse.
6. Before you deliver breaths, look into the mouth. If you see a foreign body that
can be easily removed, remove it.
7. Continue CPR until advanced providers arrive.