Basic Life Support (BLS) Guidelines

Basic Life Support (BLS)

Compression Rate

  • Rate: 100-120 compressions per minute
  • Depth: 2-2.4 inches (5-6 cm)

Compression-Ratio

  • Ratio: 30:2
  • Use AED ASAP: Automated External Defibrillator should be used as soon as available.
  • Minimize Interruptions: Minimize any interruptions during compressions.

BLS - Immediate Care for Patients With:

  • Cardiac Arrest: Failure of the heart to pump blood effectively.
  • Respiratory Arrest: The cessation of breathing.
  • Airway Obstruction: Ensuring the airway is clear and unblocked.
  • Main Goal: Maintain circulation and oxygenation until advanced care arrives.

BLS Sequence

  1. CAB (Change from ABC)
    • C - Circulation: Start CPR immediately.
    • A - Airway: Ensure the airway is open.
    • B - Breathing: Provide breaths if necessary.

Detailed Procedures

Circulation
  • Rate: 100-120 compressions per minute.
  • Depth: 2-2.4 inches (5-6 cm).
  • Allow Full Recoil: After each compression, allow the chest to fully recoil to maintain adequate blood flow.
  • Minimize Interruptions: Avoid stopping compressions to ensure effective circulation.
Airway Management
  • Open Airway Techniques:
    • Head-Tilt Chin-Lift: Common method to open the airway.
    • Jaw Thrust: Use if trauma is suspected to avoid moving the spine.
Breathing
  • Give 2 Breaths: After every 30 compressions.
  • Watch for Chest Rise: Ensure that the chest rises visibly—this indicates that air is getting into the lungs.
  • Compression to Ventilation Ratio: For adults, it is 30 compressions to 2 breaths (1 to 2 rescuers).

Advanced Airway Placement

  • Continuous Compressions: If an advanced airway is in place, provide 1 breath every 6 seconds (10 breaths per minute).
Using the AED (Automated External Defibrillator)
  • Turn on AED ASAP: Follow the prompts given by the device.
  • Shock if advised: Administer a shock if indicated by the AED.
  • Resume CPR immediately after the shock is administered.
Key Rhythms that Require Shock
  1. Ventricular Fibrillation (VF): Disorganized electrical signals in the heart causing ineffective contractions.
  2. Pulseless Ventricular Tachycardia (VT): A rapid heart rhythm that does not effectively pump blood.

Effective Ventilation

  • Ensure Proper Oxygen Delivery: Administer 100% oxygen if available.
  • Assist with Advanced Airway: Monitor for chest rise and breath sounds.

Common Mistakes in BLS

  • Shallow Compressions: Compressing the chest insufficiently or too lightly.
  • Compression Rate Too Slow or Fast: Maintaining the correct tempo is essential for effectiveness.
  • Interrupting Compressions Too Often: Each pause decreases the efficacy of CPR.
  • Over-Ventilating: Providing too much air can disrupt the circulation.

Signs of Effective CPR

  • Visible Chest Rise: A clear indication that air is moving into the lungs.
  • Good Recoil: Proper chest recoil allows for blood return to the heart.
  • Minimal Pauses: Keeping interruptions to a minimum ensures effective treatment.
  • ETCO₂: If available, an end-tidal CO₂ reading should be over 10 mmHg, indicating effective compressions.

When to Start and Stop CPR

  • Start CPR If:
    • The patient is unresponsive.
    • No pulse is detected.
    • No breathing or only gasping is observed.
  • Stop CPR When:
    • There is a return of spontaneous circulation (ROSC).
    • A detectable pulse is found.
    • Help takes over (advanced providers arrive).
    • The rescuer is physically exhausted and cannot continue effectively.