Page 1 PT 102 - Basic Life Support LQ May 6, 2021

Basic Life Support - To perform on adult, knee above the patient’s head and:
- Refers to the care healthcare providers and public safety - .One hand on each side of the head with the thumbs
professionals provide to patients who are experiencing near the corners of the mouth pointed toward the
respiratory arrest, cardiac arrest, or airway obstruction. chin, using the elbows for support
- Includes the following: - Slide the fingers into position under the anles of the
- Psychomotor skills for CPR patient’s jawbone without moving the head or neck
- Using an automated external defribrillator (AED) - Thrust the jaw upward without moving the head or
- Relieving an obstructed airway neck to lift the jaw and open the airway
- Focuses on the integration of the following key skills to help Simultaneous Breathing and Pulse Check
rescuers achieve optimal outcomes: • Once airway is open, simultaneously check for breathing and a
- Critical thinking carotid pulse, for at least 5 but no more than 10 seconds
- Problem solving • TO CHECK BREATHING:
- Communication - Look to see if the patient’s chest rises and falls
- Team dynamics - Listen for escaping air and feel for it against the side of your
cheek
Arriving On Scene - NORMAL: quiet, regular and effortless
- Using your Senses - “Agonal breaths” – isolated, infrequent gasping in the
- Is it safe? absence of other breathing in a patient who is
- Is immediate danger involved? unresponsive
- What happened? What is the nature of the illness or the • TO CHECK FOR PULSE:
MOI? - Palpate the carotid artery by sliding two fingers into the
- How many patient are involved? groove of the patient’s neck
- Is anyone else available to help? - Alternative: you may check the femoral artery – palpate the
- What is your initial impression area between the hip and groin
- Initial Impression Primary Assessment Results
- Does the patient look sick? • Respiratory Arrest
- Is he or she awake or moving? - NO Breathing, (+) Pulse
- Look for signs that may indicate a life-threatening emergency - To care:
- Give ventilations – supply oxygen
Primary Assessment of the Unresponsive Adult Patient - 1 ventilation every 5 to 6 seconds for adults with each
Level of Consciousness (LOC) ventilation lasting about 1 second and making the chest
• Check if the patient is responsive rise
- If yes: obtain patient’s consent, reassure him or her and try to - Continue until:
find out what happened - Begins to breathe on his or her own
- If silent or not moving: check for responsiveness – tap the - Another trained rescuer takes over
patient o the shoulder and shout, “Are you okay?” - Patient has NO pulse – should begin CPR or use
- APVU AED
- A: Alert - full awake, but may still be confused - Scene becomes UNSAFE
- V: Verbal - responds to verbal stimuli • Cardiac Arrest
- P: Painful - responds to painful stimuli - NO breathing, (-) pulse, unresponsive
- U: Unresponsive - does not respond - Ensure the Cardiac Chain of Survival
Airway - Early access
• If alert and talking: airway is OPEN - Early CPR
• If unresponsive: Make sure he/she is in SUPINE position to - Early defibrillation
effectively evaluate airway - Early advanced life support
• Two methods to open the airway:
- Head-tilt/Chin Technique Providing CPR/AED for Adults
- Press down the forehead while pulling up on the bony • Cardiorespiratory Resuscitation
part of the chin with two to three fingers of the other hand - Circulates the blood that contains oxygen to the vital organs
- For adults: tilt the head past a neutral position to open the of a patient in cardiac arrest when the heart and breathing
airway while avoiding hyperextension of the neck have stopped Includes chest compressions and ventilations
- Modified Jaw Thrust Technique as well as the use of an automated external defribrillator
- When a patient is suspected of having a head, neck, or
spinal injury

 Page 2 PT 102 - Basic Life Support LQ May 6, 2021

Compressions - Often used by a single rescuer - but two are needed to

- To ensure high-quality CPR: effectively operate a BVM
- Patient is on a firm, flat surface - To use:
- The chest is exposed - Assemble as needed
- Hands are correctly positioned with the heel of one hand in - Open the airway past neutral position while positioned at
the center of the chest on the lower half of the sternum with the top of the patient’s head
the other hand on top - 1st rescuer: Use an E-C hand position
- Arms are as straight as possible, with the shoulders directly - 2nd rescuer: provide ventilations - 400
over the hands to promote effective compressions
- Correct rate of at least 100 per minute to a maximum of 120 Stopping CPR
per min - CPR with 30 compressions followed by 2 ventilations
- Proper depth: at least 2 inches for adults • Chest be allowed - Stop when:
to fully recoil between each compression - (+) sigs of return of spontaneous circulation (ROSC)
- Adults: 30 chest compressions followed by 2 ventilations - RECOVERY POSITION: Modified H.A.IN.E.S recovery
positions: used for patients with suspected head, neck or
Ventilations spinal injury
- Supplies oxygen to a patient who is not breathing - Kneel at the side of the patient and roll the patient toward
- Methods: the rescuer
- Mouth-to-mouth - Place the top leg on the other with both knees in a bent
- Pocket mask position
- Bag valve mask (BVM) resuscitator - Align the arm on top with the upper body
- Mouth-to-Mouth - AED is ready to analyze the patient’s rhythm
- If pocket mask or BVM mask is not available - Other trained rescuers take over and relieve you from
- Open the airway past a neutral position using the head-tilt/ compression or ventilation responsibilities
chin-lift technique - You are presented with a valid do not resuscitate (DNR)
- Pinch the nose shut and make a complete seal over the order
patient’s mouth with your mouth - You are alone and too exhausted to continue
- Give ventilations by blowing into the patient’s mouth - Scene becomes unsafe
- During this method, the patient receives a concentration of
oxygen at ~ 16 percent compared to the ambient air (20%) Automated External Defibrillators (AED)
- What will you do if the chest does not rise after the 1st • Portable electronic device that analyze the patient’s heart rhythm
breath? and can provide defribrillation
- Pocket Mask • (+) Cardiac arrest - AED should be applied ASAP if readily
- Create a barrier between your mouth and the patient’s mouth available
and nose • Two specific dysrhythmias:
- Protect you from contact with a patient’s blood, vomitus and - Ventricular fibrillation
saliva, and from breathing the air that the patient exhales - Ventricular Tachycardia
- To use a pocket mask:
- Assemble the mask and valve Using an AED
- Open the airway past the neutral position using the head- • Turn it on first
tilt/chin-lift technique from the patient’s side when alone • Make sure the patient’s chest is clearly exposed and dry
- Place the mask over the mouth and nose of the patient • Apply the appropriate-sized pads for the patient’s age in the
starting from the bridge of the nose, then place the proper location on the bare chest
bottom of the mask below the mouth to the chin - One pad: upper right chest below the right clavicle to the
- Seal the mask by placing the “webbing” between your right of the sternum
index finger and thumb on the top of the mask above the - Other pad: L side of the chest on the midaxillary line a few
valve while placing your remaining fingers on the side of inches below the left armpit
the patient’s face. • Plug in the connector and push the analyze buttpn
- Other hand – place your thumb along the base of the • Tell everyone to “clear” while the AED is analyzing
mask while placing your bent index finger under the • When “clear” is announced, have the rescuer performing the
patient’s thumb, lifting the face into the mask compressions to stop and hove a few inches above the check
- Bag-Valve-Mask Resuscitator • Observe the AED analysis and prepare for a shock to be
- Handheld device used to ventilate patients and administer • Deliver the shock by pressing the shock button, if indicated
higher concentrations of oxygen than a pocket mask

 Page 3 PT 102 - Basic Life Support LQ May 6, 2021

• After the shock is delivered, immediately start the compressions CPR/AED for Children
and perform about 2 minutes of CPR until the AED prompts that • Compression:
it is reanalyzing, the patient shows signs of ROSC, or as - Rate: 100 - 120 per min
instructed - Depth: only about 2 inches
• Do not wait for the AED to prompt to begin CPR after a shock or • Compressions-to-Ventilation Ratio:
no shock advised message - Same = 30:2
- 2 rescuer - 15:2
AED Safety
CHILD
• AED’s are very safe and built for almost any environment ADULT (Age 1 through
• Safe also for patients who have pacemakers, other implantable onset of Puberty)
cardioverter defibrillators or metal body piercings
• (+) Medication patches - act swiftly and remove the patch with a AIRWAY
gloved hand and wipe away the medication from the skin
Head-Tilt/Chin- Slightly past neutral
• DO’s Lift
Past neutral position
position
- Before shocking, make sure that NO ONE is touching or is in
contact with the patient VENTILATIONS
- Use AED is (+) cardiac arrest
- Safe for pregnant women Respiratory 1 ventilation every 5 to 1 ventilation every
Arrest 6 seconds 3 seconds
• DONT’s
- Use alcohol to wipe the chest dry
COMPRESSIONS
- Touch the patient while AED is analysing
- Touch the patient while device is defibrillating Hands centered on
Hands centered on
- Defibrillate when around flammable or combustible materials Hand Position
lower half of sternum
lower half of
sternum
One and Two-Rescuer CPR - Adults
Rate 100-120/minute 100-120/minute
One Rescuer CPR Two Rescuer CPR
Depth At least 2 inches About 2 inches
Hand centered on Hand centered on
Hand Compressions:
lower half of the lower half of the One rescuer: 30:2 One rescuer: 30:2
Position Ventilations
sternum sternum Two rescuers: 30:2 Two rescuers: 15:2
Ratio
At least 100 but no
At least 100 but no
Rate more than 120 per AED
more than 120 per min
min
Child pads: age 1-8
Depth At least 2 inches At least 2 inches Adult pads: age > 8
AED Pads years, weight < 55
years, weight > 55 lbs
lbs
Compression
30:2 30:2
Ventilations One pad on upper
right chest below
R1: team leader, right clavicle to the
performs the scene One pad on upper right
right of the
size up and primary chest below right
sternum; other pad
assessment, begins AED Pad clavicle to the right of
on left side of chest
the CPR Placement the sternum; other pad
just below nipple
R2: Calls for additional on left side of chest just
line; or if pad risk
resoruces and gets/ below nipple line
touching each
prepares the AED other, use anterior/
posterior placement
Providing CPR/AED for Children and Infants
• Consent CPR/AED for Infants
- Obtain consent from the child’s parent or legal guardian if
INFANT
they are present (Birth to Age 1)
- To gain consent: state who you are, what you observe and
what you plan to do AIRWAY
- If no parent or legal guardian: consent is implied in life-
threatening situations

 Page 4 PT 102 - Basic Life Support LQ May 6, 2021

INFANT
(Birth to Age 1)

Head-Tilt/Chin-Lift Neutral position

VENTILATIONS

Respiratory Arrest 1 ventilation every 3 seconds

COMPRESSIONS

One rescuer: two fingers centered

on sternum about 1 finger-width
below nipple line
Hand Position
Two rescuers: two thumbs
centered on sternum encircling
chest about 1 finger-width below
nipple line

Rate 100-120/minute

Depth About 1 1/2 inches

Compressions: Ventilations One rescuer: 30:2

Ratio Two rescuers: 15:2

AED

Child pads: below age 1

AED Pads
Adult pads if child pads not
available

Use anterior/posterior placement

— one pad in middle of chest and
AED Pad Placement
other pad on back between
scapulae