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Basic Life Support

2010 Guidelines

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Signs of life =A – Check airway for signs or risk of any

airway obstructionB – Check for normal breathing pattern, rate

>8 AND <30.C – Check pulse, assess general colour, and

perfusion D – Monitor for changes in conscious levelE – Can you see any obvious major injuries

that require prompt treatment

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DR SCAB PACED

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Danger

Ensure safety of both

victim AND rescuer

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Response

Shake gently, stabilising the head, to see if the

person responds

Shout “Are you alright”

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Shout

Shout for help

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Clear airway Remove any visible

obstruction or loose fitting dentures

Leave well fitting dentures

Do not under any circumstances do a blind finger sweep (only remove visible objects)

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Open Airway Open airway with head

tilt - chin lift Try to avoid head tilt if

neck injury suspected

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Are They Breathing Normally Maintain head tilt chin lift and

Look, Listen, Feel For no more than 10

seconds If in any doubt breathing is

normal, act as if patient is not breathing

If (s)he is breathing normally

place in recovery position check for continued

breathing send for or go for help

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Carotid Pulse

Look for any movement (signs of life)

Check for the carotid pulse FOR NO MORE THAN 10 SECONDS

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If no pulse call Arrest team Send someone for help or if alone go

yourself If available ask them to bring the Automated External Defibrillator (AED) with them

At this point you need qualified help, pre hospital this would be a paramedic,

call 999 or the Pan European number 112 America is 911.

In hospital the cardiac arrest team is usually on 2222.

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Apply Compressions x 30 Kneel/stand beside the casualty Place the heel of one hand in the

centre of the victim’s chest Place the heel of your other hand on

top of the first hand Interlock the fingers of your hands

and ensure that pressure is not applied over the victim’s ribs.

Keeping arms straight aim to depress sternum to a depth of 5 cm (no more than 6 cm)

Release pressure and repeat 30 times

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Minute rateCompressions should be

applied at a rate of between 100 to 120 per

minute

Compression and release should take an equal

amount of timeAvoid applying pressure over the

upper abdomen or the bottom end of the sternum

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Two ventilations Re-establish head tilt –

chin lift Pinch soft part of nose with

thumb and forefinger Open mouth a little Take a good breath and

place lips round mouth Give two effective

ventilations

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Effective ventilation Blow steadily over 1

second Watch for chest to rise Maintain head tilt - chin lift Avoid inhaling patient’s

expired breath Watch chest fall Repeat Continue at ratio of 30

compressions to 2 ventilations

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Using a Pocket-mask A pocket face mask allows easier

ventilation with a head tilt - chin lift Non-return valve prevents rescuer

from re-breathing victim’s expired air

Removes need for mouth to mouth ventilation, but administers only 16% O2 concentration

Adding high flow (10-15 litres/min) oxygen can improve oxygenation markedly (45-50% concentration) but must not delay BLS

Setting up a pocket Mask

1. Remove the mask and valve from the case2. Push out the soft dome with your fingers3. Ensure that the one way valve is in place05/01/2023 © Clinical Skills Resource Centre, University of Liverpool, UK 17

1 2 3

Your positionA pocket mask is best

managed if you position yourself in line with the top of the patient’s head

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Technique of using pocket-mask Place the mask over the patients

mouth and nose Use the rim of the mask to retract

the lower lip so that the patient’s mouth remains open under the mask

Use thumbs to hold the mask and your fingers to grasp the lower jaw in front of the earlobes

Pull upward to open the airway and seal the mask.

Blow slowly into the air valve and watch as the patients chest rises

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DON’T STOP UNLESS Shows signs of life

(if so, reassess patient) Help arrives You are overcome by

exhaustion If patient begins to show

signs of recovery place in the recovery position and monitor A,B,C,D and E

Be prepared to recommence resuscitation

DO NOT STOPOnce basic life support has commenced do

not stop unless the victim shows signs of regaining consciousness: Coughing Opening eyes Speaking Moving purposefully Starts breathing

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Problems with respirations If ventilations are not effective – then continue on to 30

compressions. Before you give your next breaths - Check victim’s mouth and remove any visible obstruction- Recheck you have adequate head tilt chin lift- Do not attempt more than two breaths before returning

to compressions

If you are unable to do mouth to mouth ventilation (e.g. massive facial trauma) then continuous compressions are advised at a rate of 100 a minute

Mouth to nose or mouth to tracheostomy ventilations may also be effective

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Respiratory arrest Respiratory arrest is when there is a pulse present

but no breathing Commence ventilating the patient at a rate of 10-12

breaths per minute, at the end of the minute reassess breathing and circulation (see slide 13 & 14)

If circulation ceases then seek help and commence full basic life support at 30 compressions to 2 ventilations.

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DR SCAB PACED D – DANGER R – RESPONSE

S – SHOUT FOR HELP C – CLEAR AIRWAY A – OPEN AIRWAY B – BREATHING ASSESSMENT

P – PULSE CHECK A – ARREST TEAM (CALL 999 OR 112) HOSPITAL 2222 C – COMPRESSIONS X 30 E – EFFECTIVE VENTILATION X 2 D – DON’T STOP