basic life support (BLS)
Last edited 04/2018 and last reviewed 04/2018
Basic life support refers to the maintaining of airway patency and supporting breathing and the circulation without the use of equipment other than a protective device (1).
With respect to Basic Life Support in an Adult:
- The following guidance is based on a situation where the rescuer is alone and without access to medical equipment such as an electrocardiograph or a defibrillator. The guidance is for lay people and medical personnel alike. It is based on the guidance from the European Resuscitation Council (Resuscitation 2005;67:181-341) which has been accepted by the Resuscitation Council (UK).
Basic Life Support (BLS) in an adult consists of the following sequence of actions (1):
sure you, the victim and any bystanders are safe
listen and feel for normal breathing for no more than 10 seconds
In the first few minutes after cardiac arrest, a victim may be barely breathing, or taking infrequent, slow and noisy gasps. Do not confuse this with normal breathing. If you have any doubt whether breathing is normal, act as if it is they are not breathing normally and prepare to start CPR
Call an ambulance (999)
|SEND FOR AED||
Send someone to get an AED if available
|GIVE RESCUE BREATHS||After
30 compressions open the airway again using head tilt and chin lift and
give 2 rescue breaths
If you are untrained or unable to do rescue breaths, give chest compression only CPR (i.e. continuous compressions at a rate of at least 100–120 min-1)
AN AED ARRIVES
on the AED
not interrupt resuscitation until:
you are certain the victim is breathing normally but is still unresponsive,
place in the recovery position
- suspected spinal injuries: Spinal injuries may occur in a variety of situations, for example, if the victim has sustained a fall, been struck on the head or neck, or has been rescued after diving into shallow water. In a situation where there is a suspected spinal injury then particular care must then be taken during handling and resuscitation to maintain alignment of the head, neck, and chest in the neutral position. When establishing an airway, jaw thrust is preferable to chin lift. During resuscitation, assistance from others may be required to maintain head, back, and chest alignment if adequate splinting is not available. It is important to remember that successful resuscitation that results in paralysis is a tragedy, but failure to carry out adequate ventilation in cases of respiratory arrest will result in death
- barrier Devices:
- health care professionals may prefer to use these. A pocket face mask is especially suitable since the technique is easily learned and a good tidal volume can be achieved - care is needed to avoid gastric distension.
- considerable training is required to use a bag-valve-mask. This device should preferably incorporate an oxygen reservoir facility and generally requires two people
- there is no evidence of the transmission of the HIV or Hepatitis B virus during mouth-to-mouth ventilation
- There have been no human studies to address the effectiveness of barrier devices during CPR; however, laboratory studies have shown that certain filters, or barrier devices with one-way valves, prevent transmission of oral bacteria from the victim to the rescuer during mouth-to-mouth ventilation.
- two rescuer CPR:
- the ratio of ventilations to compressions remains 2:30 irrespective of the number of rescuer
- compression-only CPR (1)
- studies have shown that compression-only CPR may be as effective as combined ventilation and compression in the first few minutes after non-asphyxial arrest.
- however, chest compression combined with rescue breaths is the method of choice for CPR by trained lay rescuers and professionals and should be the basis for lay-rescuer education
- lay rescuers who are unable or unwilling to provide rescue breaths, should be encouraged to give chest compressions alone. When advising untrained laypeople by telephone, ambulance dispatchers should give instruction on compression-only CPR
- mouth to nose ventilation can be effectively preformed on patients if the patients mouth is seriously injured or cannot be opened, if the rescuer is assisting a victim in the water, or if a mouth-to-mouth seal is difficult to achieve (1).
- regurgitation during CPR (1)
- turn the victim away from you.
- keep him on his side and prevent him from toppling on to his front.
- ensure that his head is turned towards the floor and his mouth is open and at the lowest point, thus allowing vomit to drain away.
- clear any residual debris from his mouth with your fingers; and immediately turn him on to his back, re-establish an airway, and continue rescue breathing and chest compressions at the recommended rate.
- (1) Resuscitation Council (UK). Resuscitation Guidelines 2015.
- (2) Resuscitation Council (UK). Resuscitation Guidelines 2010.
- (3) Resuscitation 2001;48:191-309.