basic life support algorithm

Basic Life SupportObtained from the American Heart Association

Basic Life Support

“… the preservation or restoration of life by the establishment and/or the

maintenance of airway, breathing and circulation, and related emergency care. It’s a temporary measure to

maintain ventilation and circulation.”

Basic Life Support

AIM:To provide adequate myocardial and

cerebral oxygenation until defibrillation, persons trained in

ACLS and equipment are available

Importance• Sudden cardiac arrest

– Leading cause of death in United States

• Presents as ventricular fibrillation (VF)

• Victims can survive if bystanders act immediately while VF is still present, but once the rhythm deteriorates to asystole, successful resuscitation is unlikely

Chain of survival

Chain of survival

Early recognition of the emergency and activation of the emergency medical services (EMS) or local emergency

response system

Chain of survival

Early bystander CPR

Chain of survival

Early delivery of a shock with a defibrillator

Chain of survival

Early advanced life support followed by post-resuscitation care delivered by healthcare providers

• Ensure that the scene is safe

• Tap the victim on the shoulder

• “hey, hey, hey are you okey?”

Check for response

• Lone rescuer: activate the EMS system and return to the victim to provide CPR

• 2 or more rescuers: one should begin the steps of CPR while a second rescuer activates the EMS system

Activate the EMS System

• Supine position• Head tilt or chin lift

method• Jaw thrust: suspected

victims of cervical spine injury

Open AIRWAY

• Maintain an open airway

• look, listen, and feel for breathing for less than 10 seconds

• Give 2 RESCUE BREATHS– Each over 1 second– Enough volume to

produce visible chest rise

Check BREATHING

Mouth-to-mouth breathing:• open the victim’s

airway• pinch the victim’s

nose• create an airtight

mouth-to-mouth seal • Give 1 breath over 1

second• Take a “regular”

breath• Give a second rescue

breath over 1 second

Check BREATHING

• Maintain head tilt with one hand on forehead

• Feel for carotid pulse for less than 10 seconds

Check CIRCULATION (Pulse check)

WITH PULSE:• Give rescue

breaths at a rate of 10 to 12 breaths per minute or about 1 breath every 5 to 6 seconds

• reassess the pulse approximately every 2 minutes

• Place the heel of the hand on the sternum in the center of the chest between the nipples

• Then place the heel of the second hand on top of the first

• Position shoulder over hands with elbows locked and arms straight

• Give 30 compressions

Chest Compression

Compress at a rate of about 100 compressions per minute

Compression depth of 1 1⁄2 to 2 inches (approximately 4 to 5 cm)

Allow the chest to recoil completely after each compression

Minimize interruptions in chest compressions

Chest Compression

• Adults: 30:2• Infants and children: 15:2

Compression-Ventilation Ratio

• Chest compressions: give continuously at a rate of 100 per minute

• Ventilation: provides 8 to 10 breaths per minute

• Change compressor and ventilator roles approximately every 2 minutes – To prevent compressor fatigue and

deterioration in quality and rate of chest compressions

If advanced airway is present…

Ventricular fibrillation

Pulseless ventricular tachycardia

Defibrillator

If shockable …

• Give 1 shock• Resume CPR immediately for five cycles

If not shockable …

• Resume CPR immediately for five cycles• Check rhythm every 5 cycles• Continue until ALS providers take over

Place the patient in a safe environment, away from pooled water or metal surface

Turn on defibrillator Select energy level:

200J (biphasic)360J (monophasic)

Charge the capacitator Ensure proper

placement of electrodes on the chest

Defibrillator

• Paddle position:– Apex: left

midaxillary line to the left of the nipple

– Right parasternal infraclavicular area

Defibrillation

• Make sure no personnel are directly or indirectly in contact with the patient

• “1 - I’m clear, 2 – you’re clear, 3 – everybody’s clear!!!”

• Deliver the electric shock by depressing both discharge buttons simultaneously

Defibrillation

• For unresponsive adult victims who have normal breathing and effective circulation

• To maintain a patent airway and reduce the risk of airway obstruction and aspiration

• Victim is placed on his or her side with the lower arm in front of the body

Recovery Position

When to stop CPR?

• More than 30 minutes of CPR without return to spontaneous circulation

• Asystole more than 10 minutes• Principle of patient autonomy,

advance directive, living with DNR