BASIC LIFE SUPPORT(BLS)

Dr. Ahmad Aqel

The University of Jordan

• Cardiac arrest (CA) occurs when the heart ceases to produce an effective pulse and circulate blood

• It includes four conditions:

1. Ventricular fibrillation

2. Pulseless ventricular tachycardia

3. Pulseless electrical activity.

4. Asystole

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Dr. Ahmad Aqel

AGONAL GASPS▪ May happen in the first minutes after cardiac arrest▪ Not breathing or only gasping

The characteristics of the victim with cardiac arrest ▪ Unresponsive ▪ NO breathing activity or abnormal breathing (gasping)▪ Absent carotid pulse

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Consists of important skills

C: chest compressions A: Opening the airway

B: Providing ventilation D: Defibrillation.

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1) Verify scene safety

2) Assess responsiveness:

– Tapping on the victim shoulders

– Victim is unresponsive: shout for help, activate EMS by calling 911 (get AED)

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3) Look for no breathing or gasping and check for carotid pulse in adult victim (simultaneously) within 10 s

▪ If normal breathing and have a pulse: ▪ monitor until emergency responders arrive

▪ If no breathing but has a pulse: ▪ provide rescue breathing (I breath every 5-6

seconds about 10-12 breaths/m)▪ Activate EMS if not done after 2 minutes▪ Continue rescue breathing: check pulse every 2 min

If possible opioid over dose, administer naloxone if available

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Dr. Ahmad Aqel

IF NO PULSE:

▪ Begin cycles of 30 compressions and 2 breaths

▪ Place the heel of your hand on the center of the person's chest.

▪ Place the heel of your other hand on top of your first hand.

▪ Keep arms straight and your shoulders directly over your hands.

▪ Push hard and fast, compressing chest at least 2 inches.

▪ Let chest rise completely before pushing down again.

▪ Compress at least 100-120 times /m

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Dr. Ahmad Aqel

Open the airway first: 1- head tilt chin lift

a) place one hand on the patient’s forehead and push with your palm to tilt the head.

b) Place the finger of the other hand under the bony part of the lower jaw near the chin

c) Lift the jaw to bring the chin forward

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Dr. Ahmad Aqel

2. Jaw thrust دفع الفك للامام)a) Place one hand on each side of

the victim’s headb) Place your fingers under the

angles of the victim’s lower jaw and lift with both hands, displacing the jaw forward

c) If the lips close, push the lower lip with your thumb to open the lips.

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Dr. Ahmad Aqel

PROVIDE 2 RESCUE BREATHS▪ Remember open the airway

first before providing rescue breathing

▪ Use pocket mask to deliver rescue breaths if available, or Use mouth to mouth breathing

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Dr. Ahmad Aqel

▪ Open airway, connect the bag to oxygen ▪ Hold Mask to face and tight seal, ▪ Use E-C technique and squeeze the bag ▪ Each breath over 1 sec, observe chest rise

▪ Switching Rolls: every 5 cycles switch roll, taking less than 5 seconds to switch

Avoid hyperventilation▪ Giving breaths too quickly or with too

much force lead to gastric inflation may lead to vomiting, aspiration or pneumonia

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1) Turn on the AED. It will give you step-by-step instructions.

▪ Wipe chest dry.

2) Attach the pads.

▪ Make sure no one is touching the person. Say "Clear" so that people know to stay back and not touch the person.

3) Push the "Analyze" button if necessary.

▪ If a shock is advised,

4) push the "Shock" button.

5) Resume compressions and follow AED prompts.

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Dr. Ahmad Aqel

1. Scene safety2. Check responsiveness (Foot tap)3. 2 minutes of CPR, then call 911.

• Two- finger chest compression • Depth is at least 1/3 AP diameter of the chest. This is about

1 ½ inches• Compression rate: 100/m

4. Check airway (Sniffing position)5. Give 2 rescue breaths, Ensure chest rise with each breath,

Allow chest to recoil completely 6. Continue 30 compression and 2 rescue breaths

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Dr. Ahmad Aqel

Two thumb-encircling hands techniqueChest compression

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Adult Child Infant

Scene safety ▪ Make sure the environment is safe for rescuer and victim

Recognition of cardiac arrest

▪ Check for responsiveness▪ No breathing, no pulse felt within 10 s

Activation of emergency response system

▪ Call 911 and then begin CPR

▪ Use AED as soon as it is available

▪ Witnessed collapse: Call 911 then do CPR

▪ Unwitnessed collapse: give 2 minutes of CPR then call 911 if you are alone

Compression-ventilation ratio

▪ 1 and 2 rescuer 30:2

▪ 1 rescuer: 30:2▪ 2 rescuer: 15:2

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Adult Child Infant

Compression rate 100 – 120 /min

Compression depth

At least 2 inches (5cm) but no more than 6cm

About 2 inches (5cm)

About 11/2 inches (4cm)

Hand placement 2 hands on the lower half of the sternum

2 hands or 1 hand for very small child on the lower half of the sternum

1 rescuer: 2 fingers in the center of the chest just below the nipple line

Compression ventilation ratio with advanced airway

Continue compression at a rate of 100-12/mGive 1 breath every 6 seconds (10 breaths)

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