Download - 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