2025 AHA BLS

AED

Automated External Defibrillator

CCF

Chest Compression Fraction

FBAO

Foreign Body Airway Obstruction

ROSC

Return of Spontaneous Circulation

BLS vs ALS

Basic Life Support

Advanced Life Support

CPR

cardiopulmonary resuscitation

T-CPR

Telecommunicator-assisted Cardiopulmonary Resuscitation

CPR should be started within __ seconds of recognizing cardiac arrest.

10 seconds

Compression Rate for Adults, Children, & Infants

100 - 120 beats per minute (110 is the most optimal)

Adult Compression Depth

at least 2 inches, but not more than 2.4 inches (5-6 cm)

Child Compression Depth

1/3 diameter of chest or 2 inches (5 cm)

Infant Compression Depth

1/3 diameter of chest or 1.5 inches (4 cm)

Chest Compression

Ejects blood from left ventricle

Chest Decompression (RECOIL!!!)

Refills blood into left ventricle

Limit interruptions in chest compressions to __ seconds or less.

10 seconds

How much air delivered with rescue breaths

Only enough to make the chest rise and fall

Risk of Excessive Ventilation

Gastric Distention (leads to VOMITING)

AHA age range for "Infant"

Younger than 1 year (excluding neonates)

With children, to determine if Child or Adult BLS is indicated, the rescuer should look for:

Signs of puberty, facial/chest/underarm hair, breast development

Program to place AEDs in public locations.

Public Access Defibrillation (PAD) programs

6 Links of the Chain of Survival

- Recognition/Activation

- High-Quality CPR

- Defibrillation

- Advanced Resuscitation

- Post-Cardiac Arrest Care

- Recovery

Check responsiveness in infants by

tapping the infant's heel.

Check responsiveness in adults by

tapping the shoulders and shouting "Hey! Are you OK?"

When arriving at a suspected cardiac arrest victim

check for a pulse and breathing simultaneously. (Max 10 seconds)

Compression to Ventilation Ratio (Adult, 1 rescuer)

30:2

Compression to Ventilation Ratio (Adult, 2 rescuers)

30:2

Compression to Ventilation Ratio (Child, 1 rescuer)

30:2

Compression to Ventilation Ratio (Child, 2 rescuers)

15:2

Compression to Ventilation Ratio (Infant, 1 rescuer)

30:2

Compression to Ventilation Ratio (Infant, 2 rescuers)

15:2

Adult Ventilation Rate when providing artificial ventilation

10 breaths per minute (Once every 6 seconds)

Pediatric Ventilation Rate when providing artificial ventilation (8 years or less)

20-30 breaths per minute (Once every 2-3 seconds)

Adults & Children: Check pulse at the

Carotid Artery

Infants: Check pulse at the

Brachial Artery

Target CCF for a resuscitation team

> 60% , with a goal of 80%

LUD

Lateral Uterine Displacement (if pt visibly pregnant)

During manual LUD the uterus is moved to the patient's _____ side.

Left

Maneuver to open the airway (no spinal injury)

Head-Tilt Chin Lift (HTCL)

Maneuver to open the airway (suspected spinal injury)

Jaw Thrust

Mouth-to-Mask breaths without supplemental Oxygen

about 17% o2 delivered

Bag-Mask breaths without supplemental Oxygen

about 21% o2 delivered

Bag-Mask breaths WITH supplemental Oxygen

up to 100% o2 delivered

Preferred way to deliver bag-mask ventilations

Using 2 rescuers: one to seal the mask and one to squeeze the bag

Technique if 1 rescuer delivers ventilations

E-C clamp

Compressors should swap every __ minutes.

every 2 minutes (5 cycles of 30:2)

Stopping an abnormal heart rhythm using electricity

Defibrillation

2 shockable arrhythmias

ventricular fibrillation & ventricular tachycardia

To operate an AED

1. Power on

2. Follow prompts

Anterolateral (AL) AED pad placement

Under right clavicle, Left lateral ribs

Anteroposterior (AP) AED pad placement

Center of chest, Center of back

Adult AED pads can be used on children & infants.

Child/Infant pads MUST NOT be used on adults.

Cardiac Arrest victim just removed from water

Quickly wipe the chest before placing AED

Patients with implanted pacemakers

Avoid placing pad directly over the device (usually not a problem, pacemakers placed on left side, pad goes on right side)

Patients with medication patches on the chest

Remove patch and wipe skin before placing pad

3 core components of Team Dynamics

1. Roles & Responsibilities

2. Communication

3. Debriefing

Responsible for monitoring CPR quality & providing real-time feedback

The CPR Coach

Closed-Loop Communication

Repeating back an instruction to verify you heard correctly

Best time to swap chest compressors

When AED is analyzing the rhythm (minimize interruptions in compressions)

Infant or Child has a Heart Rate less than 60 bpm

Begin CPR (even if the baby still has a pulse and/or spontaneous breathing)

a rate less than 60 bpm is not able to perfuse a child's brain

Why 15:2 in pediatric cardiac arrest?

1. more likely to be respiratory cause

2. less reserve oxygen in peds

Device used to reduce the shock dose

Pediatric Dose Attenuator

Preferred defibrillation device for infants (less than 1 year)

Manual Defibrillator

these have the ability to deliver weight-based dose shocks, safer for infant, requires PALS training

Preferred direct ventilation technique for infants

Mouth-to-Mouth-and-Nose

Class of drugs that cause respiratory depression, apnea, and risk for cardiac arrest

Opioids

(fentanyl, opium/heroin, morphine, codeine, oxycodone, hydrocodone)

Reverses effects of opioids

Narcan (naloxone)

Top priority if cardiac arrest is suspected to be caused by overdose

High-Quality Chest Compressions are ALWAYS the top priority.

Narcan administration is important, but takes a back seat to CPR

Heart Attack vs Sudden Cardiac Arrest

Heart Attack- blood flow blockage, could cause cardiac arrest

Sudden Cardiac Arrest- rhythm (electrical) problem, a common cause of SCA is a person having a massive heart attack but there are many other causes of SCA.

An alert adult is experiencing signs of a heart attack (chest pain, breathing difficulty, nausea/vomiting)

Give Aspirin (162 to 325 mg, chewed)

Stroke Assessment (F.A.S.T.)

Facial Droop?

Arm Drift?

Slurred Speech?

Time this started?

With Stroke Patients, Last known normal refers to

last known to be without signs of a stroke (important for treatment options)

Leading cause of death children 1 to 4 years in the US

Drowning

Anaphylaxis

Severe, life-threatening allergic reaction requiring immediate treatment with epinephrine

Mild vs Severe Airway Obstruction (Partial obstruction vs Complete obstruction

Mild/Partial: forceful coughing with some air exchange

Severe/Complete: unable to cough or exchange air

Adult or Child is choking and is still conscious

5 back blows, followed by 5 abdominal thrusts

Adult or Child was choking and is now unconscious

Begin CPR

Infant is choking and is still conscious

5 back blows, followed by 5 chest thrusts

Modified choking treatment in late pregnancy & obese patients

Chest thrusts instead of abdominal thrusts

Extra step taken during CPR if choking

Check for visible object in airway

(only remove if can see all of the FBAO, no blind finger sweeps)

Chest Compression Fraction; CCF = _________________________

CCF = actual chest compression time / total code time

(ex. 16 minutes actual CPR / 20 minute total code = 80% CCF)

The Resuscitation Triangle

Airway- delivers breaths

Compressor- 100-120 bpm

Monitor/CPR Coach- AED, Real-time feedback

Maternal cardiac arrest: baby compresses the ___________

inferior vena cava

SpO2 target if having heart attack

90% (too much oxygen can worsen the damage)

SpO2 target if having a stroke

94% (too much oxygen can worsen the damage)

ECG

electrocardiogram

ACLS

Advanced Cardiac Life Support

PALS

Pediatric Advanced Life Support

PPE

personal protective equipment

VT

ventricular tachycardia, v-tach

VF

ventricular fibrillation, v-fib

AED pads must contact

the patient's skin

BLS airway adjunct (no gag reflex present)

oropharyngeal airway (OPA)

BLS airway adjunct (gag reflex is present)

nasopharyngeal airway (NPA)

Top Priority when arriving at a cardiac arrest victim

Confirm Scene Safety

look for hazards like fire, chemicals, down lines, etc

When advanced airway is placed

Swap to continuous compressions with ventilations at 10 breaths per minute (20-30 for peds)

Four Fatal Dysrhythmias

1. Ventricular Fibrillation (VF)

2. Ventricular Tachycardia (VT)

3. Asystole

4. Pulseless Electrical Activity (PEA)

2 things MANDATORY before pressing shock

Check for Pulse

Clear the patient

You just witnessed a cardiac arrest

Activate the emergency response (call 911 or code blue)

The AED should be used

immediately, when it becomes available

Apply pads around the hands of the compressor and turn it on

Assessing a suspected cardiac arrest and the patient has a pulse and adequate breathing

Position them into the recovery position and stay with them until 911 arrives

If you are the only rescuer for an infant or child and you did NOT witness the collapse, when should you activate the emergency response system and get AED?

After performing 5 cycles (2 min) of CPR

unwitnessed peds arrest: prioritize CPR before calling for help or retrieving the AED, likely respiratory cause, less oxygen reserves