BASIC LIFE SUPPORT

(BLS)
 Basic life support (BLS)
is a level of medical care which is used for
patients with life-threatening illness or injury
until the patient can be given full medical
care.
It can be provided by trained medical
personnel, including emergency medical
technicians, and by laypersons who have
received BLS training.
 Basic life support (BLS)
BLS is generally used in the pre-hospital
setting, and can be provided without medical
equipment.
Many countries have guidelines on how to
provide basic life support (BLS) which are
formulated by professional medical bodies in
those countries.
 Basic life support (BLS)
BLS generally does not include the use of
drugs or invasive skills, and can be
contrasted with the provision of Advanced
Life Support (ALS).
Most laypersons can master BLS skills after
attending a short course.
 Basic life support (BLS)
Firefighters and police officers are often
required to be BLS certified.
BLS is also immensely useful for many other
professions, such as daycare providers,
teachers and security personnel.
The BLS Proper Training
Providing first-aid basics, nothing can
replace the hands-on learning you get
from formal training in a classroom
setting.
Anyone can learn first aid, and by
learning new lifesaving skills and
updating past knowledge, you will feel
and act more confident at home and
work and while traveling.
The BLS Proper Training
Many organizations offer first-aid
classes, such as the American Red
Cross, the American Heart Association,
and the National Safety Association;
and other local organizations offer Basic
Life Support (BLS) classes.
Some occasionally offer free one-day
classes to the community; most charge
a small fee for a one- to two-day course
in CPR and basic first aid.
Emergency Response
Its well known that in order to save
lives, CPR needs to begin immediately
after a person collapses or witnessed
arrest occurs (when someone sees the
event occur).
But only approximately one-third or less
of people respond in witnessed arrest
situations, and even when CPR is
begun immediately it is often done
incorrectly.
Emergency Response
Thats why its important to become
certified in CPR and Automated
External Defibrillators (AED) and to take
the recommended renewal certification
classes.
By learning CPR, you can help preserve
life, limit disability, restore health, and
even reverse clinical death in
emergency situations.
History of CPR
The origins of cardiopulmonary resuscitation
(CPR) can be traced back to 1740, when the
Paris Academy of Sciences first formally
recommended mouth-to-mouth resuscitation
for near-drowning victims.
History of CPR
Over a hundred years later in 1891, the first
documented and effective chest compression
in humans was performed by Dr. Friedrich
Maass.
History of CPR
Through the years the use of external
chest compressions in human
resuscitation was attempted and
analyzed, and it was proven that
expired air by a rescuer is sufficient to
oxygenate an unresponsive person.
History of CPR
CPR was then officially developed and
instituted in 1960, and a program by the
American Heart Association (AHA)
provided CPR training and encouraged
the use of CPR by the general public.
 History of CPR

The American Red Cross and other agencies

came on board to institute performance
standards, standardized training, and
certification for CPR for intervention of
sudden cardiac arrest and acute life-
threatening cardiopulmonary problems.
 History of CPR

Every five years the AHA guidelines for CPR

and emergency cardiac care are reviewed,
improved, and updated to improve survival
rates of life threatening events.
 History of CPR

AHA establishes these guidelines with the

cooperation of other organizations, peer-
reviewed studies, and other systematic
evidence-based study and review.
The ABCs of First Aid
There are three critical steps in
emergency first aid.
A person needs all three common
denominators to live, and basic life
support or CPR, together with early
defibrillation, is proven to improve long-
term survival after a cardiac arrest.
The ABCs of First Aid
The ABCs of first aid is a mnemonic
that stands for airway, breathing, and
circulation:
Airway: Is the airway unobstructed?
Use measures to clear the airway.
Breathing: Is the person breathing?
Start rescue breathing.
Circulation: Is the persons heart
beating? Start chest compressions.
 Indications for CPR

Cardiac arrest
Ventricular fibrillation
Ventricular tachycardia
Asystole
Pulseless electrical activity
 Indications for CPR
Respiratory arrest
Drowning
Stroke
Foreign-body airway obstruction
Smoke inhalation
Drug overdose
Electrocution/injury by lightning
Suffocation
Accident/injury
Coma
Epiglottitis
If not treated immediately(Complications):
Post resuscitation distress syndrome
(secondary derangements in multiple
organs)
Neurologic impairment
Brain damage
 Time rules!
Chances for survival decrease by 7-10 % per minute!

AHA UPDATE 23
 Take the following steps when you witness anyone
over the age of one year old collapse:

1. Assess that it is safe to approach the fallen

person.
2. Use protective equipment and follow
universal precautions. If you are able to, use
common sense, and stay away from any
obvious hazards.
Take the following steps when you witness
anyone over the age of one year old collapse:
3. Attempt to wake the person by
rubbing your knuckles firmly against the
sternum (breastbone) and shouting,
Are you okay?
4. If the person fails to rouse,
immediately call 911 or shout for help,
depending on your situation. If there is
an AED available, also shout for
someone to bring it.
Take the following steps when you witness
anyone over the age of one year old collapse:
5. If the person becomes conscious, is
moaning, or moves, do not start CPR.
6. Call 911 if the person is not able to
speak or appears confused. If the
person does not wake, begin CPR and
use an AED if available.
AED
is a small, portable electronic device
that is used to deliver an electric shock
in an attempt to disrupt or stop
abnormal electrical activity in the heart.
Abnormal electrical activity correlates
with an abnormal heart rhythm, and a
continual abnormal rhythm is not
sufficient to pump blood and deliver
oxygen through the body.
AED
An AED shock cannot restart a dead
heart; the heart must have a rhythm (even
though the rhythm is abnormal).
The AED will automatically diagnose any
cardiac arrhythmia when attached by
leads to an unconscious person.
When you see one of these lethal
rhythms, you can then treat the person
with the AED electrical therapy or a
shock (defibrillation) that may interrupt
the arrhythmia and allow the heart to re-
establish a normal and effective rhythm.
You can learn how to use an AED in
many first-aid, firstresponder, and CPR
classes (ACLS).
Alert:

The AHA recommends that rescuers push

hard, push fast (100 compressions per
minute), and allow complete chest recoil
between compressions, with minimal
interruptions in compressions, for all
persons.
The steps for performing
CPR
1. Open the airway using the head-tilt,
chin-lift method
one hand on the forehead, fingers of the
other hand under the bony part of the
lower jaw, near the chin.
Tilt the head back, gently lift the jaw,
making sure not to close the mouth or
push on soft parts beneath the chin.
Avoid lifting the neck in the case of
spinal injury.
Head tilt-chin lift maneuver
2. Check for normal breathing
by putting your ear to the persons
mouth and turning your head to look for
chest movement, while listening for air
flowing through the mouth or nose and
trying to detect breath on your cheek.
A person with periodic gasping is most
likely in cardiac arrest and needs CPR.
3. If there are no signs of breathing
pinch the nose; make a seal over the
mouth with yours and give the person a
breath strong enough for you to see the
chest rise.
When the chest falls, repeat the rescue
breath once more for a total of two
breaths.
3. If there are no signs of breathing

If available, use a CPR mask as a

barrier between your mouth and the
persons mouth that you are rescuing.
These first three steps are called
rescue breathing.
4. Begin chest compressions
by placing the heel of your
hand in the middle of the
chest, over the lower half of
the breastbone at the nipple
line.
Place your other hand on top
and lace your fingers
together (heel of one hand
on chest, heel of the other
hand on top of that hand)
and compress the chest
about one to two inches.
4. Begin chest compressions
Allow the chest to recoil completely, and
then perform thirty compressions, at a
rate of 100 compressions per minute.
5. After thirty chest compressions
immediately repeat the two rescue
breaths.
Open the airway with headtilt, chin-lift
again.
This time, go directly to rescue breaths
without checking for breathing again.
Give one breath, making sure the chest
rises and falls, then give another.
6. Perform the cycle of
thirty compressions followed by two
breaths for about two minutes.
Then stop and recheck for breathing.
If the person is not breathing, continue
chest compressions and rescue
breaths.
Recovery Position
is a technique used in first aid for all
unconscious people who are breathing.
Recovery Position
This includes:
1. anyone over the age of one year old who
has started breathing after being given
CPR
2. those who may be unconscious or nearly
unconscious but are still breathing
3. those who are too inebriated to assure
their continued breathing
4. persons of near drowning
5. in cases of suspected poisoning.
Recovery Position
An unconscious person who is lying
face up is in a position that may result in
obstruction to the airway.
When a person is laying face up, the
tongue may relax to the back of the
throat and fluids such as blood or vomit
can pool in the back of the throat and
obstruct the airway.
Recovery Position
Also, in the face-up position, the
esophagus is tilting down slightly from
the stomach toward the throat, and
when combined with loss of muscular
control that occurs when someone is
unconscious, this can lead to what is
called passive regurgitationwhen
the stomach contents flow up into the
throat.
Recovery Position
Aside from airway obstruction, any fluid
collecting in the back of the throat can
flow down into the lungs and the acid
from the stomach that is in that fluid can
damage the lungs, a condition known as
aspiration pneumonia.
Recovery Position
While in the recovery position, the force
of gravity keeps the tongue from
obstructing the airway and prevents
fluids from flowing the wrong way.
This, coupled with raising the chest
above the ground, protects the person
while aiding breathing.
WHEN TO STOP CPR?
S = Spontaneous breathing &
circulation was established.
T = Turnover of the patient to a facility.
O = Operator (rescuer) becomes
exhausted.
P = Physician (doctor) takes over.
 ADULT AR ARTIFICIAL
RESUSCITATION/RESCUE
BREATHING:

1. Survey the scene.

15 meters away from the victim.
The scene is safe, I am safe.
2. Introduce your self
I am Mr./Ms._______, a Nursing/
Caregiving student from NCF & a
trained first aider. May I help?
3. Check for consciousness
Kneel between head and shoulder
of victim (Kneel first with knee near
the head part).
Tap the shoulders and say Hey,
hey, are you ok? 2 times.
Victim is unresponsive.
4. AMA
HELP activate medical
assistance I have a patient who is
unconscious, please be back
immediately while I do first aid.
5. Check ABCs.
LLF (Look, Listen, & Feel):
A- Airway head tilt, chin lift maneuver (Look: for the
rise & fall of the victims chest)
B- Breathing 5 seconds (Listen: Place your ear near
the victims nose. Count 1, 1002, 1003, 1004, 1005)
C- Circulation 10 seconds carotid (Feel: the
pulsations of the victims carotid artery using your 2nd,
3rd, and/or 4th fingers. Count 1, 1002, 1003, 1004,
1005, 1006, 1007, 1008, 1009, 1010).
6. Observation :
() breathing, (+) pulse.
7. AMA
HELP, activate medical
assistance, I have a victim who is
under respiratory arrest, please be
back immediately while I do rescue
breathing or AR.
Ratio 1 blow, 5 sec. 24 cycles.
8. Pinch blow 1, 1002, 1003,
1001.. Pinch blow 1, 1002,
1003, 1002.ending in 24 cycles.
9. End with a blow
10. Check ABC
Breathing :5 sec.
Circulation: 10 sec, carotid.
(+) Breathing, (+) Pulse,
victim/patient has been revived.
11. Put victim/patient in a
recovery position
Lateral recovery position
12. Do secondary survey head
to feet
13. Record and endorse.
 INFANT AND CHILD AR - ARTIFICIAL
RESUSCITATION/RESCUE
BREATHING:

1. Survey the scene.

15 meters away from the victim.
The scene is safe, I am safe.
2. Introduce your self
I am Mr./Ms._______, a Nursing/
Caregiving student from NCF & a
trained first aider. May I help?
3. Check for consciousness
Kneel between head and shoulder
of victim (Kneel first with knee near
the head part).
Infant: Tap the feet
Child: Tap the shoulder and say
Hey, hey baby, are you ok? 2
times.
Victim is unresponsive.
4. AMA
HELP activate medical
assistance
I have a patient who is
unconscious, please be back
immediately while I do first aid.
 5. Check ABCs.
LLF (Look, Listen, & Feel):
A- Airway head tilt, chin lift maneuver (Look: for
the rise & fall of the victims chest)
B- Breathing 5 seconds (Listen: Place your ear
near the victims nose. Count 1, 1002, 1003, 1004,
1005)
C- Circulation 10 seconds carotid (Feel: the
pulsations of the victims brachial[infant] artery
using your 2nd and 3rd fingers and carotid artery
[child].
Count 1, 1002, 1003, 1004, 1005, 1006, 1007,
1008, 1009, 1010).
6. Observation
() breathing, (+) pulse.
7. AMA
HELP, activate medical assistance, I
have a victim who is under respiratory
arrest, please be back immediately
while I do rescue breathing or AR.
Ratio 1 blow, 3 sec. 40 cycles Infant
nose & mouth/Child mouth.
8. AR
blow 1, 1001; blow- 1, 1002; blow 1,
1003 ending in 40 cycles.
9. End with a blow.
10. Check ABC
Breathing :5 sec.
Circulation: 10 sec, carotid.
(+) Breathing, (+) Pulse, victim/patient
has been revived.
11. Put victim/patient in a
recovery position
Lateral recovery position
(child)/Shoulder hold (baby).
12. Do secondary survey
head to feet
13. Record and endorse.
 CARDIOPULMUNARY
RESUSCITATION:
Hand & finger use Depth of
for compression: Compression:

Adult 2 hands 1 - 2 inches

Child 1 hand 1 1 inches

Infant Index, middle, -1 inches

and/or ring finger
Infant Ratio:
2 blows, 30 thrust, 5 cycle for 2
minutes
Adult/ Child:
2 blows, 30 compression, 5 cycle
CPR Guidelines:
1. Do not overexert pressure during
compression.
2. Do not bend your elbows.
3. Do not bend your back.
4. Pressure of exertion comes from the
shoulder towards the hands.
 CPR PROCEDURE:

1. Survey the scene.

15 meters away from the victim.
The scene is safe, I am safe.
2. Introduce your self
I am Mr./Ms._______, a nursing
student from NCF & a trained first
aider. May I help?
3. Check for consciousness
Kneel between head and shoulder of
victim (Kneel first with knee near the
head part).
If the victim is an adult or Child: Tap
the shoulders and say Hey, hey, are
you ok? 2 times.
If the victim is an infant: Tap the feet
and say Hey, hey baby are you ok?) 2
times. Victim is unresponsive.
4. AMA
HELP activate medical
assistance, I have a patient who is
unconscious, please be back
immediately while I do first aid.
 5. Check ABCs.
LLF (Look, Listen, & Feel):
A- Airway head tilt, chin lift maneuver (Look: for
the rise & fall of the victims chest)
B- Breathing 5 seconds (Listen: Place your ear
near the victims nose. Count 1, 1002, 1003, 1004,
1005)
C- Circulation 10 seconds carotid (Feel: the
pulsations of the victims carotid artery using your
2nd, 3rd, and/or 4th fingers, brachial artery for infant
use 2nd & 3rd fingers.
Count 1, 1002, 1003, 1004, 1005, 1006, 1007,
1008, 1009, 1010).
6. Observation :
() breathing, (-) pulse.
7. AMA
HELP, activate medical assistance, I
have a victim who is under cardiac
arrest, please be back immediately
while I do CPR.
Ratio 2 blows, 30 compressions, 5
cycles.
8. Give 2 blows and start
compression (follow the
following sequence).
Count
1,2,3,4,5,6,7,8,9,10,11,12,13,14,
15,16,17,18,19,20,1,2,3,4,5,6,7,8
,9, & 1 blow, blow
1,2,3,4,5,6,7,8,9,10,11,12,13,14,
15,16,17,17,18,19,20,1,2,3,4,5,6,
7,8,9,& 2,blow, blow, repeat
comp.
Ending in 5 cycles.
9. End in 2 blows.
10. Check ABC
Breathing :5 sec.
Circulation: 10 sec, carotid.
11. Assess the victim.
Victim with (+) Breathing, (+) Pulse,
victim/patient has been revived.
12. Put victim/patient in a recovery
position
Lateral recovery position (adult &
child)/Shoulder hold (baby).
13. Do secondary survey
head to feet
14. Record and endorse.
Foreign Body Airway
Obstruction (FBAO)
Choking
Choking occurs when an object gets
stuck in the throat and partly or
completely blocks the airway.
If the airway is completely obstructed,
permanent brain damage or death will
occur within 3 to 5 minutes secondary to
hypoxia.
Partial obstruction of the airway can
lead to progressive hypoxia, and
respiratory and cardiac arrest.
Causes:
In adults, aspiration of a bolus of meat is
the most common cause of airway
obstruction.
In children, small toys, buttons, coins, and
other objects are commonly aspirated in
addition to food.
Signs of choking include:
1. Pointing to throat, hands crossed on
throat (universal sign of choking)
2. Gasping or coughing
3. Signs of panic
4. Difficulty speaking
5. Red face that steadily turns blue
6. Loss of consciousness
Alert!
Never slap any person on the back you
think might be choking.
A baby who is crying, has a strong
cough, and appears to be breathing well
should be placed in a sitting position
and allowed to finish coughing.
Never stick your fingers down a babys
throat, or anyone elses, in an attempt to
remove an object while they are
coughing.
 Heimlich Maneuver

The Heimlich maneuver

(pronounced Hi-mlick) is a technique
whereby you administer abdominal
thrusts to yourself or to a person
who is choking.
 Heimlich Maneuver

The Heimlich maneuver is recommended for

use in clearing a blocked airway in conscious
adults and children over the age of one; it is not
meant to be used for choking infants under age
one.
The act of abdominal thrust lifts the diaphragm
and forces air from the lungs, similar to a
coughing action, so that the foreign body in an
airway may be moved and expelled.
 The steps to perform the Heimlich maneuver
on a choking person are:
Observe victim if
choking. Ask are you
choking? Determine if the
victim can cough or speak
1. Stand behind the
person, wrap your arms
around the waist, and tip
the person slightly
forward.
2. Make a fist with one
hand and place it slightly
above the navel.
The steps to perform the Heimlich
maneuver on a choking person are:

3. Grasp your fist with your other

hand and press forcefully into the
abdomen with quick, upward
thrusts, using force as if you were
attempting to lift the person up.
4. Continue the thrusts until the
foreign body is dislodged.
The steps to perform the Heimlich
maneuver on yourself if you are
choking are:
1. Place your fist just slightly above
your navel.
2. Grasp your fist with your other
hand, bend over a hard surface like a
chair or countertop, and thrust your
fist inward and upward.
On An Obese Person & Pregnant?

1. Place your fists closer to the chest,

right above the joining of the ribs at
the base of the breastbone
2. Follow the Heimlich maneuver
steps.
 ADULT/CHILD AIRWAY OBSTRUCTION
MANAGEMENT (UNCONSCIOUS)
1. If victim is Unconscious,
check for object with a
tongue-jaw lift. If you see
the object, remove it. (finger
sweep)
2. Open the airway (head
tilt-chin lift or jaw thrust) and
look, listen, feel for adequate
breathing.
 ADULT/CHILD AIRWAY OBSTRUCTION
MANAGEMENT (UNCONSCIOUS)

3. If the victim is not breathing adequately,

give 1 or 2 rescue breaths.
4. If the victims chest does not rise with
breaths, reposition the head and give 1 or 2
more rescue breaths.
5. If ventilation is unsuccessful. Perform
airway obstruction management
(abdominal/chest thrust for adult/child).
(30 chest compression)
 ADULT/CHILD AIRWAY OBSTRUCTION
MANAGEMENT (UNCONSCIOUS)
6. Repeat the sequences of tongue-jaw lift,
finger sweep, ventilate, and airway
obstruction management.
7. If ventilation is effective, check for signs
of circulation for at least 10 seconds
8. Place victim on recovery position.
 Infant FBAO (Concious)
1. Observe baby for some signs of
difficulty in breathing, choking, or
cyanosis.
2. Introduce yourself I am Mr/Ms.
____ a student nurse of NCF and a
trained first aider, can I help
3. Get baby & sandwich baby in your
arm upside down, head lower than
extremities.
4. Give 5 back blows, then reverse or
turn baby to supine pos. in arms give 5
chest thrust using the 2 fingers.
5. Check mouth for any object.
6. Repeat no. 4 until object is seen,
finger sweep object & place in a clean
container for laboratory exam.
7. Baby has been revive, baby is okay.
8. Put baby in recovery position
shoulder hold
9. Do secondary survey head to
feet, if no bleeding, no bruises, no
swelling, no contusions, no injury,
baby is okay.
10. Record and endorse.
 INFANT AIRWAY OBSTRUCTION - UNCONSCIOUS

1. Survey the scene 15 meters away from

the victim. The scene is safe, I am safe.
2. Introduce yourself I am Mr./Ms.__ a
nursing student of NCF and a trained first
aider, May I help.
3. Check for consciousness (Place the
baby on a table & tickle feet by saying; Hey,
hey baby are you okay? 2x). Baby is
unresponsive.
4. AMA HELP activate medical
assistance, I have a victim who is
unconscious, please be back
immediately while I do the first aid.
 5. Check ABCs.
LLF (Look, Listen, & Feel):
A- Airway head neutral (Look: for the rise & fall
of the victims chest)
B- Breathing 5 seconds (Listen: Place your ear
near the victims nose. Count 1, 1002, 1003, 1004,
1005)
C- Circulation 10 seconds Feel: the pulsations of
the victims brachial artery use 2nd & 3rd fingers.
Count 1, 1002, 1003, 1004, 1005, 1006, 1007,
1008, 1009, 1010).
6. Give two blows air bounces back.
7. AMA HELP activate medical
assistance, I have a baby who is
suffering from airway obstruction, please
be back immediately, while I do
obstruction management.
8. Give 30 chest thrust, using 2 fingers.
9. Check for presence of object.
10. Repeat 30 chest thrust until object
is seen. Do finger sweep with small
finger using the hand on the head part.
Place object in a clean container for lab.
Exam.
11. Give another 2 blows air enters.
12. Check ABC breathing 5 sec.
circulation 10 sec.
13. Baby with (+) breathing, (+) pulse,
baby has been revived.
14. Put baby in recovery position
shoulder hold.
15. Do secondary survey head
to feet.
16. Record and endorse.