BLS

 

BLS

Basic Life Support Quick Reference

C-A-B

 Compressions

  A irway irway

 

Breaths

  Critical Concepts

High-quality CPR improves a victim’s victim’s chances of survival. The critical characteristics of high-quality CPR include the following: compressions within 10 seconds of recognition of   •  Start cardiac arrest.   •  Push hard, push fast: Compress at a rate of 100 to 120/min with a depth of   – At least 2 inches (5 cm) for adults   – At least one third the depth of the chest, about 2 inches (5 cm), for children   – At least one third the depth of the chest, about 1½ inches (4 cm), for infants  Allow ow comple complete te chest chest re recoi coill after each compression.   •  All   •  Minimize interruptions in compressions (try to limit interruptions to less than 10 seconds).   •  Give effective breaths that make the chest rise.   •  Avoid excessive excessive ventilation. ventilation. KJ1173

2/16

© 2016 American Heart Association

Printed in the USA 

 

BLS Healthcare Provider Adult Cardiac Arrest  Algorithm—2015 Update  Verify  V erify scene safety. safety.

 Victim is unresponsive. Shout for nearby help.  Activate emergency response response system via mobile device (if appropriate). Get AED and emergency equipment (or send someone to do so). No normal breathing, has pulse

Normal breathing, has pulse

Look for no breathing or only gasping and check pulse (simultaneously). Is pulse definitely  felt  felt

Monitor until emergency responders arrive.

5-6 seconds, or about 10-12 breaths/min. breaths/min. •  Ac  Activ tivate ate eme emerrgen gency cy response respons e system (if not already done) after 2 minutes. • Continue rescue breathing; breath ing; check pulse about every 2 minutes. If no pulse, begin CPR (go to “CPR” box). • If possible opioid overdose, administer overdose, naloxone if available per protocol.

within 10 seconds? No breathing or only gasping, no pulse

Provide rescue breathing: 1 breath every

By this time in all scenarios, emergency response system or backup is activated, and AED and emergency equipment are retrieved or someone is retrieving them.

CPR Begin cycles of

30 compressions and 2 available. breaths. Use AED as soon as it is

 AED arrives.

 Yes,  Yes, shockable

Check rhythm. Shockable rhythm?

Give 1 shock. Resume CPR immediately for about 2 minutes (until prompted by AED to allow rhythm check). Continue until ALS providers take over or victim starts to move.

No, nonshockable

Resume CPR immediately for about 2 minutes (until prompted by AED to allow rhythm check). Continue until ALS providers take over or victim starts to move.

 

Summary of High-Quality CPR Components

Component Scene safety  Recognition of cardiac arrest

 Adults and  Adolescents

Children

Infants

(Age 1 Year to Puberty)

(Age Less L ess Than Tha n 1 Year, Year, Excluding Newborns)

Make sure the environment is safe for rescuers and victim Check for responsiveness No breathing or only gasping (ie, no normal breathing) No definite pulse felt within 10 seconds (Breathing and pulse check can be performed simultaneously in less than 10 seconds)

 Activation of  Activation emergency response system

Compressionventilation ratio without  advanced  advan ced airway  airway  Compressionventilation ratio with advanced  airway   airwa y 

If you are alone with no mobile phone, leave the victim to activate the emergency response system and get the AED before beginning CPR

Hand placement

Unwitnessed collapse Give 2 minutes of CPR

Leave the victim to activate the emergency response system and get the AED

Otherwise, send someone and begin CPR immediately; use the AED as soon as it is available

Return to the child or infant and resume CPR; use the AED as soon as it is available

1 or 2 rescuers 30:2

1 rescuer  30:2  2 or more rescuers 15:2

Continuous compressions compressions at a rate of 100-120/m 100-120/min in Give 1 breath every 6 seconds (10 breaths/min)

Compression Compressio n rate Compression Compressio n depth

Witnessed collapse Follow steps for adults and adolescents on the left

100-120/min  At least 2 inches (5 cm)*

 At least one third AP diameter of chest  About   2 in inches ches (5 cm cm))

  At least one third AP diameter of chest  About About 1½ inches (4 cm)

2 hands on the lower half of the breastbone (sternum)

2 hands or 1 hand (optional for very small child) on the lower half of the breastbone (sternum)

1 rescuer  2 fingers in the center of the chest, just below the nipple line  2 or more rescuers 2 thumb–encircling hands in the center of the chest, just below the nipple line

Chest recoil

 Allow full recoil of chest chest after each com compression; pression; do not lean on the chest after each compression

Minimizing interruptions

Limit interruptions in chest compressions to less than 10 seconds

*Compression depth should be no more than 2.4 inches (6 cm).  Abbreviations: AED, AED, automated external de defibrillator; fibrillator; AP, anteroposterior; CPR, ca cardiopulmonary rdiopulmonary resuscitation.

 

BLS Healthcare Provider Pediatric Cardiac Arrest  Algorithm for the Single Rescuer—2015 Update  Verify  V erify scene safety. safety.

 Victim is unresponsive. Shout for nearby help.  Activate emergency response response system via mobile device (if appropriate). Normal breathing, has pulse

Look for no breathing or only gasping and check pulse (simultaneously). Is pulse definitely  felt  felt within 10 seconds?

 Activate emergency response system (if not already done). Return to victim and monitor until emergency responders arrive.

No normal breathing, has pulse

No breathing or only gasping, no pulse

Witnessed sudden collapse?

Provide rescue breathing: 1 breath every 3-5 seconds, or about 12-20 breaths/min. •  Ad  Add d comp compre ressi ssions ons if pulse remains ≤60/min with signs of poor perfusion.* •  Ac  Activ tivate ate eme emerrgen gency cy response respons e system (if not already done) after 2 minutes. • Continue rescue breathing; breath ing; check pulse about every 2 minutes. If no pulse, begin CPR (go to “CPR” box).

 Yes es  Y

No CPR 1 rescuer: Begin cycles of 30 compressions and 2 breaths. (Use 15:2 ratio if second rescuer arrives.) Use AED as soon as it is available.

 Activate  Activ ate eme emerrgen gency cy response respons e system (if not already done), and retrieve  AED/d  AED /defi efibr brill illato atorr.

 After about 2 minutes, if still alone, activate emergency response system and retrieve AED (if not already done).

 Yes,  Yes, shockable

 AED analyzes rhythm. Shockable rhythm?

No, nonshockable

Give 1 shock. Resume CPR immediately for about 2 minutes (until prompted by AED to allow

Resume CPR immediately for about 2 minutes (until prompted by AED to allow rhythm check).

rhythm check). Continue until ALS providers take over or victim starts to move.

Continue until ALS providers take over or victim starts to move.

*Signs of poor perfusion may include cool extremities, decrease decrease in responsiveness responsiveness,, weak pulses, paleness, mottling (patchy skin appearance), and cyanosis (turning blue).

 

BLS Healthcare Provider Pediatric Cardiac Arrest  Algorithm  Algorith m for 2 or More Rescuers—2015 Rescuers—2015 Update Update  Verify  V erify scene safety. safety.

 Victim is unresponsive. Shout for nearby help. First rescuer remains with victim. Second rescuer activates emergency response system and retrieves AED and emergency equipment. Normal breathing, has pulse

Look for no breathing or only gasping and check pulse (simultaneously). Is pulse definitely  felt  felt within 10 seconds?

Monitor until emergency responders arrive.

No normal breathing, has pulse

No breathing or only gasping, no pulse

Provide rescue breathing: 1 breath every 3-5 seconds, or about 12-20 breaths/min. breaths/min. •  Ad  Add d comp compre ressi ssions ons if pulse remains ≤60/min with signs of poor perfusion.* •  Act  Activa ivate te e emer mergen gency cy response system (if not already done) after 2 minutes. • Continue rescue breathing; check pulse about every 2 minutes. If no pulse, begin CPR (go to “CPR” box).

CPR First rescuer begins CPR with 30:2 ratio (compressions to breaths). When second rescuer returns, use 15:2 ratio (compressions to breaths) breaths).. Use AED as soon as it is available.

 AED analyzes rhythm. Shockable rhythm?  Yes,  Yes, shockable

Give 1 shock. Resume CPR immediately for about 2 minutes (until prompted by AED to allow rhythm check). Continue until ALS providers take over or victim starts to move.

No, nonshockable

Resume CPR immediately for about 2 minutes (until prompted by AED to allow rhythm check). Continue until ALS providers take over or victim starts to move.

*Signs of poor perfusion may include cool extremities, decr decrease ease in responsivene responsiveness, ss, weak pulses, paleness, mottling (patchy skin appearance), and cyanosis (turning blue).

 

Relief of Foreign-Body Airway Obstruction

 Adults and  Adolescents

 

 

choking?” If the victim nods “yes” and cannot talk, severe airway obstruction is present. Take steps step s immediately to relieve the obstruction.

2. Give abdominal thrusts/Heimlich maneuver or chest thrusts for pregnant or

obese victims. 3. Repeat abdominal thrusts (or chest thrusts if the victim is pregnant or obese) until effective or the victim becomes unresponsive.

(Age Less Than 1 Year)

(Age 1 Year to Puberty) 1.  Ask “Are you

1.  Ask “Are you

Infants

Children

 

 

choking?” If the victim nods “yes” and cannot talk, severe airway obstruction is present. Take steps step s immediately to relieve the obstruction.

1.  If the v victim ictim cannot

make any sounds or breathe, severe airway obstruction is present.

2. Give abdominal thrusts/Heimlich maneuver.

2.  Give up to 5 back slaps  and  up  up to 5 chest thrusts.

3. Repeat abdominal thrusts until effective or the victim becomes unresponsive.

3.  Repeat step 2 until effective or the victim becomes unresponsive.

unresponsive  Victim becomes unresponsi ve 4.  Activate the emer emergency gency response sy system stem via mobile device (if appropriat appropriate) e) or send someone to do so. After about 2 minutes of CPR, if you are alone with no mobile device, leave the victim to activate the emergency resp response onse system (if no one has already done so). 5.  Lower the victim to the floor floor.. Begin CPR, starting with chest compressio compressions. ns. Do not check for a pulse. 6.  Before you deliver br breaths, eaths, look into the mouth. If you see a foreign body body that can be easily removed, remove remove it. 7.  Continue CPR until advanced providers arrive.