Updated BLS Unit of Competencies As of 041822 Part 2A

BASIC LIFE
SUPPORT
Based on 2020 International Liaison Committee on Resuscitation (ILCOR) Guidelines
Department of Health
Basic Life Support Training
UNIT OF COMPETENCY 2
Cardiopulmonary Resuscitation (CPR)
and
Automated External Defibrillator (AED)
SL.ppt/TR/FC 20 2
UNIT OF COMPETENCY 2
Part A: Cardiopulmonary Resuscitation
(CPR)
SL.ppt/TR/FC 20 3
LEARNING OBJECTIVES
At the end of the discussion, the participants should be able to
correctly:
1. Explain what CPR is;
2. Recognize the criteria for when to start, not to start, and
when to stop CPR;
3. Discuss the CPR sequence;
4. Enumerate the components of High Quality CPR; and
5. Illustrate the BLS Cardiac Arrest Algorithm.
At the end of the demonstration, participants should be able

to precisely:
1. Perform correct CPR techniques to an Adult, Child/Infant
who are in cardiac arrest
CARDIOPULMONARY RESUSCITATION (CPR)
A series of assessments and interventions using

techniques and maneuvers made to bring victims
of cardiac and respiratory arrest back to life.
WHEN TO START CPR
If you see a victim who is:
1. Unconscious/Unresponsive
2. Not breathing or has no normal breathing (only
gasping)
3. No definite pulse
Note: Responders need to generally assume that all

victims have infectious diseases so that safety protocols
must be completely observed at all times.
WHEN NOT TO START CPR
All victims of cardiac arrest should receive CPR unless:
1. Patient has a valid DNAR (Do Not Attempt

Resuscitation) order.
2. Patient has signs of irreversible death (Rigor
Mortis, Decapitation, Dependent Lividity).
RIGOR LIVOR MORTIS

MORTIS
3. No physiological benefit can be expected because the
vital functions have deteriorated as in septic or
cardiogenic shock.
4. Confirmed gestation of < 23 weeks or birth weight <
400 grams, anencephaly.
5. Attempts to perform CPR would place the rescuer

at risk of physical injury.
WHEN TO STOP CPR
S SPONTANEOUS signs of circulation are restored

T TURNED over to medical services or properly trained and
authorized personnel
O OPERATOR is already exhausted and cannot continue CPR

P PHYSICIAN assumes responsibility (declares death, takes over,
etc.)
S SCENE becomes unsafe (such as traffic, impending or ongoing

violence—gun fires, etc)
S SIGNED waiver to stop CPR

Note: The video presentation is only for demonstration purposes and not for any advertisements.
CPR SEQUENCE
The C-A-B
• Core concept: Oxygen to the Brain!
• In order: Compression-Airway-Breathing
• Compressions create blood flow by increasing intra-
thoracic pressure and directly compress the heart;
generate blood flow and oxygen delivery to the
myocardium and brain.
CAB: COMPRESSION
• CIRCULATION represents a heart that is actively
pumping blood, most often recognized by the
presence of a pulse in the neck (or other peripheral
pulses)
• Assume there is NO CIRCULATION if the following

exist: Unresponsive, Not breathing, Not moving and
Poor skin color (cyanotic)
• Return of Spontaneous Circulation (ROSC) - sign of

life
CAB: COMPRESSION
INFANTS
CHILDREN (age less than
ADULTS & (age 1 year to 1 year,
ADOLESCENTS
puberty) excluding
newborns)
COMPRESSION
RATE 100-120 per minute
At least 2 At least 1/3 Antero-Posterior (AP)
inches (5cm) diameter of the chest
COMPRESSION but should
DEPTH not exceed About 2 inches About 1.5
2.4 inches (5cm) inches (4cm)
(6cm)
CAB: COMPRESSION
Proper Position in Performing CPR
CAB: COMPRESSION
ADULT CPR
• Kneel facing the victim’s chest

• Place the heel of one hand on the
center of the chest
• Place the heel of the second hand
on top of the first so that the
hands are overlapped and
parallel.
CAB: COMPRESSION
CHILD CPR
• Lower half of the sternum,
between the nipples.
• One hand only/ two hands for big

children
• 30:2 for single rescuer, 15:2 for 2-

man rescuer (optional for HCP).
CAB: COMPRESSION
INFANT CPR
• Just below the nipple line, lower

half of sternum
• Two fingers, flexing at the wrist

(lone rescuer)
• 2 thumb-encircling hands
technique (two rescuers)
CAB: Open AIRWAY
• This must be done to ensure an open passage for
spontaneous breathing or mouth to mouth during CPR
CAB: Open AIRWAY
• Head-Tilt/Chin-Lift Maneuver
Tilt the head back with your one hand and lift up the chin
with your other hand
CAB: Open AIRWAY
• Jaw-Thrust Maneuver
A technique that can be done by at least two highly
trained BLS providers (if suspected with cervical trauma).
CAB: Open AIRWAY
• Jaw-Thrust Maneuver
REMEMBER!
• During COVID-19 Pandemic, opening the victim’s

mouth without protection for responder is not
advisable (Maintaining open airway is still a MUST
during CAB).
• Cover the victim’s mouth and nose with cloth or

mask before performing chest compression.
CAB: BREATHING
• Maintain open airway
• Pinch nose shut (if mouth to mouth RB is
preferred)
• Open your mouth wide, take a normal breath, and
make a tight seal around outside of victim’s mouth
• Give 2 full breaths (1 sec each breath)
• Observe chest rise
• 30:2 (Compression to Ventilation ratio)
• 5 cycles or 2 minutes
CAB: BREATHING
During Pandemic,
Single rescuer
• Avoid direct mouth to mouth ventilation. Use a

pocket mask if there is a need for rescue breathing
specially for a child/infant with an arrest most likely
respiratory in nature. If unwilling and unable, Hands-
only CPR is a MUST.
• Perform Hands-Only CPR until Advanced Medical

Help arrives while assessing victim every after 2
minutes of continuous compressions.
CAB: BREATHING
During Pandemic,
Two rescuers
• Perform chest compressions with ventilations via

BVM with a ratio of 30:2 for 5 cycles or 2 minutes (30
Chest compressions delivered within 15-18 seconds).
• Give 2 ventilations via tight sealed Bag-Valve-Mask

(BVM) with a High-Efficiency Particulate Air (HEPA)
filter with 1 second each ventilation.
HIGH-QUALITY CPR
1. Correct Compression Site
2. Adequate Compression Rate (100-120/minute)
3. Adequate Compression Depth

ADULT: at least 2 inches (5cm) but should not exceed 2.4
inches (6cm)
CHILDREN: about 2 inches (5cm)
INFANTS: about 1.5 inches (4cm)
4. Chest Recoil completed after each compression

5. Minimize interruptions to less than 10 seconds in between
chest compressions
6. Avoidance of Excessive Ventilation Department of Health
CPR
CPRQuality
Quality
HCP Adult Cardiac Arrest Algorithm (IHCA) • Push hard (at least 2 inches [5 cm]) and fast [100-
120/min) and allow complete chest recoil.
1 • Minimize interruptions in compressions.
Start CPR • Avoid excessive ventilation.
A • Give oxygen • Change compressor every 2 minutes, or sooner if
• Attach monitor/defibrillator
fatigued.
• If no advanced airway, 30:2 compression-ventilation
Yes No ratio.
Rhythm shockable? • Quantitative waveform capnography
2 Shock
Shock Energy for for
Energy Defibrillation
Defibrillation
VF/pVT 9 Asystole/PEA
• Biphasic: Manufacturer recommendation (eg, initial
dose of 120-200 J); if unknown, use maximum
3 Shock Epinephrine available.
ASAP Second and subsequent doses should be equivalent, and
4 higher doses may be considered.
CPR 2 min 10 • Monophasic: 360 J
• IV/IO access CPR 2 min Drug
DrugTherapy
Therapy
• IV/IO access • Epinephrine IV/IO dose: 1 mg every 3-5 minutes
No • Epinephrine every 3-5 min • Amiodarone IV/IO dose:
Rhythm shockable? • Consider advanced airway,
First dose: 300 mg bolus.
capnography
Yes Second dose: 150 mg or
5 Yes Lidocaine IV/IO dose:
Shock First dose: 1-1.5 mg/kg.
6 Rhythm shockable?
Second dose: 0.5-0.75 mg/kg.
CPR 2 min
Advance
Advance Airway
Airway
• Epinephrine every 3-5 min
• Consider advanced airway, capnography No • Endotracheal intubation or supraglottic advanced
airway
• Waveform capnography or capnometry to confirm and
Rhythm shockable? 11 monitor ET tube placement
CPR 2 min • Once advanced airway in place, give 1 breath every 6
Yes • Treat reversible causes
seconds (10 breaths/min) with continuous chest
7
Shock compressions
8 Return
Returnofof Spontaneous
Spontaneous Circulation (ROSC)
Circulation (ROSC)
CPR 2 min No Rhythm Yes • Pulse and blood pressure
• Amiodarone or lidocaine shockable? • Abrupt sustained increase in PETCO2 (typically ≥40
• Treat reversible causes
mm Hg)
• Spontaneous arterial pressure waves with intra-arterial
12 Go to 5 or 7 monitoring
• If no signs of return of spontaneous
circulation (ROSC), go to 10 to 11 Reversible
Reversible Causes
Causes
• If ROSC, go to Post-Cardiac Arrest Care Hypovolemia; Hypoxia; Hydrogen ion (acidosis);
• Consider appropriateness of continues Hypo-/hyperkalemia; Hypothermia; Tension
resuscitation pneumothorax; Tamponade, cardiac; Toxins;
Basic Life Support
Thrombosis, Training
pulmonary; Thrombosis, coronary.
For training purposes, the following steps can be applied for
HCP Adult Cardiac Arrest Algorithm (IHCA)
HCP Pediatric Cardiac Arrest Algorithm (IHCA)
1
Start CPR CPR Quality
A • Begin bag-mask ventilation and give • Push hard (≥ 1/3 of anteroposterior diameter of chest) and
oxygen fast (100-120/min) and allow complete chest recoil
• Attach monitor/defibrillator • Minimize interruptions in compressions
Yes No • Change compressor every 2 minutes, or sooner if fatigued
Rhythm shockable?
• If no advanced airway. 15:2 compression-ventilation ratio
• If advanced airway, provide continuous compressions and
2 9 give a breath every 2-3 seconds
VF/pVT Asystole/PEA
Shock Energy for Defibrillation
• First shock 2 J/kg
3 Shock Epinephrine • Second shock 4 KJ/kg
ASAP • Subsequent shocks ≥4 J/kg. maximum 10 J/kg or adult
4 dose
CPR 2 min 10
• IV/IO access CPR 2 min Drug Therapy
• IV/IO access • Epinephrine IV/IO dose: 0.01 mg/kg (0.1 mL/kg of the
No • Epinephrine every 3-5 min 0.1 mg/mL concentration).
Rhythm shockable? • Consider advanced airway and Max dose 1 mg.
capnography Repeat every 3-5 minutes.
Yes If no IV/IO access, may give endotracheal dose: 0.1 mg/kg
5 Yes (0.1 mL/kg of the 1 mg/mL concentration).
Shock • Amiodarone IV/IO dose:
6 Rhythm shockable?
5 mg’kg bolus during cardiac arrest. May repeat up to 3
CPR 2 min total doses for refractory VF/pulseless VT or
• Epinephrine every 3-5 min Lidocaine IV/IO dose:
• Consider advanced airway No
Initial: 1 mg/kg loading dose
Rhythm shockable? 11 Advance Airway

CPR 2 min • Endotracheal intubation or supraglottic advanced airway
Yes • Treat reversible causes • Waveform capnography or capnometry to confirm and
7 monitor ET tube placement
Shock
Return of Spontaneous Circulation (ROSC)
8 No
CPR 2 min Rhythm Yes • Pulse and blood pressure
• Amiodarone or lidocaine shockable? • Abrupt sustained increase in PETCO2
• Treat reversible causes (typically ≥40 mm Hg)
• Spontaneous arterial pressure waves with intra-arterial
monitoring
12 Go to 7
Reversible Causes
• If no signs of return of spontaneous
• Hypovolemia; Hypoxia; Hydrogen ion (acidosis);
circulation (ROSC), go to 10 to 11
Hypoglycemia; Hypo-/hyperkalemia; Hypothermia;
• If ROSC, go to Post-Cardiac Arrest Care
Department
Tension of Health
pneumothorax; Tamponade, cardiac; Toxins;
Thrombosis,
Basic pulmonary;
Life Support Thrombosis, coronary.
Training
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BLS Healthcare Provider Adult Cardiac Arrest Algorithm
(OHCA)
1
Check Scene Safety:
 Area is safe?
 Possible COVID-19 case?
 PPEs on?
2
Introduce yourself
4 3
Call for help:
 Instruct someone to call for help NO Check the victim if: Signs of Return of YES
 Use a phone with a hands-free option  Responsive? Spontaneous
 Get an AED/defibrillator  Moving? Circulation (ROSC)
-- Go to AED Algorithm
5 9
Simultaneously check the following if:
YES Monitor and observe or contact
- Breathing?
the Barangay Health Emergency
- With Pulse?
Response Team (BHERT)
(Shall be done within 10 seconds)
NO
6
If no definite pulse and no breathing or no
normal breathing e.g., gasping:
Cover the victim’s mouth and nose with

surgical mask/cloth
8
Re-assess after 2 minutes (refer to 5)
7 Compress:  If with signs of ROSC, go to 9
1 Rescuer: Hands-only CPR (continuous
compressions of 100-120 per minute)  If no signs of ROSC, go to 7 or
2 Rescuers: (30:2) Compression to consider appropriateness of
ventilation ratio if a BVM is available. continued resuscitation
BLS Lay Rescuer Adult Cardiac Arrest Algorithm
1
Check Scene Safety:
 Area is safe?
 PPEs on?
2
Introduce yourself
3
Check the victim if:
NO  Responsive? Signs of Return YES
 Moving? of Spontaneous
Circulation
 Breathing?
(ROSC)
4
8
Call for help:
 Instruct someone to call for help Monitor and observe or contact
 Use a phone with a hands-free option the Barangay Health Emergency
 Get an AED/defibrillator Response Team (BHERT)
5
Cover the victim’s mouth and nose

with surgical mask/cloth
7
6 Re-assess after 2 minutes (refer to 3)
Compress:  If with signs of ROSC, go to 8
 Hands-only CPR (100-120
compressions per minute) for 2  If no signs of ROSC, go to 6 or
minutes consider appropriateness of
continued resuscitation
BLS Healthcare Provider Pediatric Cardiac Arrest
Algorithm (OHCA)
1
Check Scene Safety:
 Area is safe?
 PPEs on?
2
Introduce yourself
4 3
Call for help:
• Instruct someone to call for help NO Check the victim if:
Signs of Return of YES
• Use a phone with a hands-free option  Responsive? Spontaneous

• Get an AED/defibrillator (if applicable):  Moving? Circulation (ROSC)
5 9
Simultaneously check the following if:
YES Monitor and observe or contact
- Breathing?
the Barangay Health Emergency
- With Pulse?
Response Team (BHERT)
(Shall be done within 10 seconds)
NO
6 Note: Rescuers who are caregivers or household
If no definite pulse and no breathing or no members of the child will probably have already
normal breathing e.g., gasping: been exposed to the virus, and are likely to be
more willing to provide support regardless of the
potential increased risk.
Cover the victim’s mouth and nose with
surgical mask/cloth
8
1 Rescuer: Hands-only CPR (continuous
compressions of 100-120 per minute)  If no signs of ROSC, go to 7 or
2 Rescuers: (15:2) Compression to consider appropriateness of Department of Health
ventilation ratio if a BVM is available. continued resuscitation Basic Life Support Training
BLS Lay Rescuer Pediatric Cardiac Arrest Algorithm
1
Check Scene Safety:
 Area is safe?
 Possible COVID-19 case? Note: Rescuers who are caregivers or
household members of the child will
 PPEs on? probably have already been exposed to the
virus, and are likely to be more willing to
2 provide support regardless of the potential
Introduce yourself increased risk.
3
Check the victim if:
NO  Responsive? Signs of Return YES
 Moving? of Spontaneous
 Breathing? Circulation
(ROSC)
4
Call for help: 8
 Instruct someone to call for help Monitor and observe or contact
 Use a phone with a hands-free option the Barangay Health Emergency
 Get an AED/defibrillator Response Team (BHERT)
5
Cover the victim’s mouth and nose
with surgical mask/cloth
7
 Hands-only CPR (100-120
compressions per minute) for 2  If no signs of ROSC, go to 6 or
minutes consider appropriateness of
continued resuscitation
Table of Comparison for Adults & Adolescents, Children, and Infants
CHILDREN INFANT
COMPONENT ADULTS AND ADOLESCENTS
(Age 1 year to Puberty) (<1 year excluding newborns)
Scene safety Make sure the environment is safe for rescuers and victim
Check for responsiveness
No breathing or only gasping (ie, no normal breathing)
Recognition of cardiac arrest No definite pulse felt within 10 seconds
(Breathing and pulse check can be performed simultaneously in less than 10 seconds)
If you are alone with no mobile phone,
Activation of emergency response leave the victim to activate the emergency Witnessed collapse — Follow steps for adults and adolescents on the left
system response system and get the AED before Unwitnessed collapse — Give 5 cycles (2 minutes) of CPR
beginning CPR
Compression-Ventilation ratio 1 or 2 rescuers 1 rescuer (30:2)
without advanced airway 30:2 2 or more rescuers (15:2)
Compression rate 100-120/min.
At least 1/3 of the AP diameter of the At least 1/3 of the AP diameter of the
Compression Depth At least 2 inches (5cm) chest chest
or About 2 inches (5cm) or About 11/2 inches (4 cm)
1 rescuer
2 hands or 1 hand (optional for very 2 fingers in the center of the chest,
just below the nipple line.
2 hands on the lower half of the breastbone
Hand placement small child) on the lower half of the 2 or more rescuers
(sternum)
breastbone 2 thumb-encircling hands in the
(sternum) center of the chest, just below the
nipple line
Chest recoil Allow the recoil of chest after each compressions; do not lean of the chest after each compression
Minimizing interruptions Limit interruptions in chest compressions to less than 10 seconds
Location for Pulse Check (HCP only) Carotid Pulse Carotid Pulse or Femoral Pulse Brachial Pulse or Femoral Pulse
1 or 2 rescuers 1 rescuer 1 rescuer
1-29 up to 5 cycles 1-29 up to 5 cycles 1-29 up to 5 cycles
(30 compressions within 18 seconds) (30 compressions within 18 seconds) (30 compressions within 18 seconds)
Counting for standardization
2 or more rescuers 2 or more rescuers
Purpose
1-14, 1 up to 10 cycles 1-14, 1 up to 10 cycles
(15 compressions within 9 seconds) (15 compressions within 9 seconds)
Primary CPR Procedures
➢ Continue CPR until

• AED arrives and starts to analyze
• EMS providers take over the care of the victim
➢ Reassess victim every after 2 minutes
➢ Rescuers may switch roles (for Two-Man Rescuers)
➢ If patient becomes conscious, place patient in
RECOVERY POSITION.
Recovery Position
ADULT
Recovery Position
INFANT
CPR with Advanced Airway (HCP ONLY)
• Cycles of 30 compressions:2
ventilations should be continued
until an advanced airway is placed
• If an advanced airway is already in

place:
➢ Continuous chest
compressions at a rate of 100-
120 per minute, without
pauses for ventilation.
➢ Ventilation rate of 1 breath
every 6 sec. (10 breaths per
minute)
120 COMPRESSIONS/MINUTE
Tabulation / Checklist of CPR Sequence Among Adult and Pediatric
Cardiac Arrest for Healthcare Provider (HCP)
ADULT/
CPR Sequence ADOLE- CHILD INFANT
SCENT
1. CHECK SCENE SAFETY. Check if:
a. Area is safe/appropriate?
✓ ✓ ✓
b. Possible EREID case?
c. PPEs on? (at least Facemask, Hand gloves)
2. INTRODUCE YOURSELF (Consent Acquirement). ✓ ✓ ✓
3. CHECK FOR RESPONSIVENESS (Look for signs of life like
✓ ✓ ✓
movement, breathing pattern)
a. Tap the shoulder ✓ ✓ -
b. Tap/stimulate the sole of the feet - - ✓
4. IF UNRESPONSIVE: - - -
a. CALL FOR HELP. ACTIVATE EMERGENCY MEDICAL SERVICE,
GET AED if available.
✓ ✓ ✓
(If lone rescuer during adult cardiac arrest or if witnessed collapse
during child/infant arrest)
a.1 Shout for nearby help/Instruct someone to call for help / Use
mobile phone (Use of social media/Apps to summon rescuers, ✓ ✓ ✓
if available)
a.2 Activate “Code Blue Protocol" in health facility ✓ ✓ ✓
IHCA IHCA IHCA
b. Perform 5 cycles or 2 minutes CPR first before calling for help for
- ✓ ✓
unwitnessed collapse during child/infant arrest
ADULT/
SCENT
5. CHECK PULSE AND BREATHING SIMULTANEOUSLY
✓ ✓ ✓
a. Check Breathing (Look for Chest rise and fall)
b. Check Pulse ✓ ✓ ✓
b.1 Carotid ✓ ✓
b.2 Femoral - ✓ ✓
b.3 Brachia - - ✓
6. COVER VICTIM’S MOUTH AND NOSE WITH SURGICAL
✓ ✓ ✓
MASK/CLOTH
7. PERFORM HIGH QUALITY CPR ✓ ✓ ✓
a. Correct Hand Placement and Compression Site ✓ ✓ ✓
a.1. Two overlapping hands on the center of the chest, lower half
of the breastbone. (*optional for large stature child victim) ✓ ✓ -
a.2. One hand on the center of the chest, lower half of the
✓ ✓ -
breastbone. ( **optional for small stature adult victim)
a.3. Two fingers on the center of the chest, just below the nipple ✓
- -
line 1 rescuer
a.4. Two thumb-encircling hands technique in the center of the ✓
- -
chest, just below the nipple line 2 rescuers
b. Adequate Compression Rate (100-120/minute)
✓ ✓ ✓
c. Adequate Compression Depth ✓ ✓ ✓
ADULT/
SCENT
c.1 At least 2 inches (5cm) but should not exceed 2.4 inches (6cm) ✓ - -
c.2 About 2 inches (5cm) - ✓ -
c.3 About 1.5 inches (4cm) - - ✓
d. Allow Complete Chest Recoil after each compression (Do not lean
✓ ✓ ✓
on the chest)
e. Limit Interruptions to less than 10 sec. in between cycle of chest
✓ ✓ ✓
compressions
f. Avoid Excessive Ventilation. (Do not hyperinflate) ✓ ✓ ✓
f.1 Via Bag-Valve-Mask (BVM): Attach a HEPA filter between
the bag and the mask and after delivering compressions, give ✓ ✓ ✓
two ventilations
f.1.1 If a BVM is not available or intubation is difficult, place a
high flow oxygen delivery device such as a non- ✓ ✓ ✓
rebreather mask (covered with a mask/cloth) at 15 LPM. IHCA IHCA IHCA
f.2 Via Mechanical Ventilator: Do not disconnect the ventilator ✓ ✓ ✓
circuit, increase FiO2 to 1.0 (100%) and IHCA IHCA IHCA
f.2.1 Set the ventilator to deliver 10 breaths per minute. ✓
IHCA
f.2.2 Set the ventilator to deliver 20 to 30 breaths per minute. ✓ ✓
IHCA IHCA
ADULT/
SCENT
f.3 No direct mouth to mouth ventilation is encouraged during
pandemic or EREID conditions. However, rescuers who are
family/household members of the victim and have already
been exposed to the illness are more likely willing to provide
✓ ✓ ✓
support regardless of the potential increased risk. Thus, such
rescuer may deliver 2 normal breaths (each breath just
enough air to make the chest rise to be given at 1 second).
8. COMPRESSION TO VENTILATION (CV) RATIO: - - -

a. Hands-only/Compression only; no ventilation during EREID
condition or rescuer is unwilling to perform mouth to mouth
✓ ✓ ✓
resuscitation (Continuous compressions of 100-120 per minute for
2 minutes)
b. If mouth to mouth resuscitation is feasible: - - -
b.1 30:2 CV ratio to be done for 5 cycles or equivalent to 2
minutes (30 chest compressions must be done within 15 to ✓ ✓
✓ 1 1
rescuer rescuer
18 seconds then 2 breaths)
b.2 15:2 CV ratio to be done for 10 cycles or equivalent to 2 ✓ ✓
minutes (15 chest compressions within 8 to 9 seconds then 2 - 2
2
rescuer
breaths) s
rescuers
c. If BVM is available with 2 or more rescuers -
Department of Health - -
ADULT/
SCENT
c.1 30:2 CV ratio to be done for 5 cycles or equivalent to 2 minutes
(30 chest compressions must be done within 15 to 18 seconds ✓ - -
then 2 breaths)
- ✓ ✓
(15 chest compressions within 8 to 9 seconds then 2 breaths)
c.3 Continuous compression WITHOUT PAUSES for ventilation if
✓ ✓ ✓
patient has advanced airway
c.3.1 Give ventilation every 6 seconds of continuous chest
✓ - -
compressions
c.3.2 Give ventilation every 2 to 3 seconds of continuous
✓ ✓
chest compressions
9. RE-ASSESS THE VICTIM EVERY AFTER 5 CYCLES or 2 MINUTES ✓ ✓ ✓
a. Check for pulse (and breathing) for not more than 10 seconds ✓ ✓ ✓
b. Check for responsiveness for not more than 10 seconds - - -
10. REPEAT NO. 7 (PERFORM HIGH QUALITY CPR) If still Unresponsive
✓ ✓ ✓
or No ROSC
11. PLACE VICTIM IN RECOVERY POSITION, If with
✓ ✓ ✓
ROSC/Responsiveness
a. Side-lying position ✓ ✓ -
b. Cradle position ✓
- Small ✓
child
Cardiac Arrest for Lay Rescuer (LR)
ADULT/
SCENT
1. CHECK SCENE SAFETY. Check if:
a. Area is safe/appropriate?
✓ ✓ ✓
b. Possible EREID case?
c. PPEs on? (at least Facemask, Hand gloves)
2. INTRODUCE YOURSELF (Consent Acquirement). ✓ ✓ ✓
3. CHECK FOR RESPONSIVENESS (Look for signs of life like
✓ ✓ ✓
movement, breathing pattern)
a. Tap the shoulder ✓ ✓ -
b. Tap/stimulate the sole of the feet - - ✓
4. IF UNRESPONSIVE: - - -
a. CALL FOR HELP. ACTIVATE EMERGENCY MEDICAL SERVICE,
GET AED if available.
✓ ✓ ✓
(If lone rescuer during adult cardiac arrest or if witnessed collapse
during child/infant arrest)
a.1 Shout for nearby help/Instruct someone to call for help / Use
mobile phone (Use of social media/Apps to summon rescuers, ✓ ✓ ✓
if available)
b. Perform 5 cycles or 2 minutes CPR first before calling for help for
- ✓ ✓
unwitnessed collapse during child/infant arrest
ADULT/
SCENT
6. COVER VICTIM’S MOUTH AND NOSE WITH SURGICAL
✓ ✓ ✓
MASK/CLOTH
7. PERFORM HIGH QUALITY CPR ✓ ✓ ✓
a. Correct Hand Placement and Compression Site ✓ ✓ ✓
a.1. Two overlapping hands on the center of the chest, lower half
of the breastbone. (*optional for large stature child victim) ✓ ✓ -
a.2. One hand on the center of the chest, lower half of the
✓ ✓ -
breastbone. ( **optional for small stature adult victim)
a.3. Two fingers on the center of the chest, just below the nipple
- - ✓
line
b. Adequate Compression Rate (100-120/minute)
✓ ✓ ✓
c. Adequate Compression Depth ✓ ✓ ✓
c.1 At least 2 inches (5cm) but should not exceed 2.4 inches
✓ - -
(6cm)
c.2 About 2 inches (5cm) - ✓ -
c.3 About 1.5 inches (4cm) - - ✓
d. Allow Complete Chest Recoil after each compression (Do not
✓ ✓ ✓
lean on the chest)
e. Limit Interruptions to less than 10 sec. in between cycle of chest
✓ ✓ ✓
compressions
ADULT/
SCENT
f. Avoid Excessive Ventilation. (Do not hyperinflate) ✓ ✓ ✓
f.1 Via Bag-Valve-Mask (BVM): Attach a HEPA filter between
the bag and the mask and after delivering compressions, give ✓ ✓ ✓
two ventilations
f.2 No direct mouth to mouth ventilation is encouraged during
pandemic or EREID conditions. However, rescuers who are
family/household members of the victim and have already
been exposed to the illness are more likely willing to provide
✓ ✓ ✓
support regardless of the potential increased risk. Thus, such
rescuer may deliver 2 normal breaths (each breath just
enough air to make the chest rise to be given at 1 second).
8. COMPRESSION TO VENTILATION (CV) RATIO: - - -

a. Hands-only/Compression only; no ventilation during EREID
condition or rescuer is unwilling to perform mouth to mouth
✓ ✓ ✓
resuscitation (Continuous compressions of 100-120 per minute for
2 minutes)
b. If mouth to mouth resuscitation is feasible: - - -
b.1 30:2 CV ratio to be done for 5 cycles or equivalent to 2 minutes
✓ ✓ ✓
(30 chest compressions must be done within 15 to 18 seconds 1 rescuer 1 rescuer
then 2 breaths)
b.2 15:2 CV ratio to be done for 10 cycles or equivalent to 2 minutes
✓ ✓
-
(15 chest compressions within 8 to 9 seconds then 2 breaths) 2 rescuers 2 rescuers
ADULT/
SCENT
c. If BVM is available with 2 or more rescuers - - -
(30 chest compressions must be done within 15 to 18 seconds ✓ - -
then 2 breaths)
- ✓ ✓
(15 chest compressions within 8 to 9 seconds then 2 breaths)
c.3 Continuous compression WITHOUT PAUSES for ventilation if
✓ ✓ ✓
patient has advanced airway
c.3.1 Give ventilation every 6 seconds of continuous chest compressions ✓ - -
c.3.2 Give ventilation every 2 to 3 seconds of continuous chest
✓ ✓
compressions
9. RE-ASSESS THE VICTIM EVERY AFTER 5 CYCLES or 2 MINUTES ✓ ✓ ✓
a. Check for pulse (and breathing) for not more than 10 seconds ✓ ✓ ✓
b. Check for responsiveness for not more than 10 seconds - - -
10. REPEAT NO. 7 (PERFORM HIGH QUALITY CPR) If still Unresponsive or
✓ ✓ ✓
No ROSC
11. PLACE VICTIM IN RECOVERY POSITION, If with ROSC/Responsiveness ✓ ✓ ✓
a. Side-lying position ✓ ✓ -
b. Cradle position ✓
- Small ✓
child
DID WE MEET OUR OBJECTIVES?
At the end of the discussion, the participants should be able to

correctly:
1. Explain what CPR is;
2. Recognize the criteria for when to start, not to start, and
when to stop CPR;
3. Discuss the CPR sequence;
4. Enumerate the components of High Quality CPR; and
5. Illustrate the BLS Cardiac Arrest Algorithm.
At the end of the demonstration, participants should be able

to precisely:
1. Perform correct CPR techniques to an Adult, Child/Infant
who are in cardiac arrest
ANY QUESTIONS?

Updated BLS Unit of Competencies As of 041822 Part 2A

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BASIC LIFE

At the end of the demonstration, participants should be able

A series of assessments and interventions using

Note: Responders need to generally assume that all

1. Patient has a valid DNAR (Do Not Attempt

RIGOR LIVOR MORTIS

5. Attempts to perform CPR would place the rescuer

S SPONTANEOUS signs of circulation are restored

O OPERATOR is already exhausted and cannot continue CPR

S SCENE becomes unsafe (such as traffic, impending or ongoing

S SIGNED waiver to stop CPR

• Assume there is NO CIRCULATION if the following

• Return of Spontaneous Circulation (ROSC) - sign of

• Kneel facing the victim’s chest

• One hand only/ two hands for big

• 30:2 for single rescuer, 15:2 for 2-

• Just below the nipple line, lower

• Two fingers, flexing at the wrist

• During COVID-19 Pandemic, opening the victim’s

• Cover the victim’s mouth and nose with cloth or

• Avoid direct mouth to mouth ventilation. Use a

• Perform Hands-Only CPR until Advanced Medical

• Perform chest compressions with ventilations via

• Give 2 ventilations via tight sealed Bag-Valve-Mask

2. Adequate Compression Rate (100-120/minute)

3. Adequate Compression Depth

4. Chest Recoil completed after each compression

Rhythm shockable? 11 Advance Airway

* Rescuers who are caregivers or household

* Rescuers who are caregivers or household

* Rescuers who are caregivers or household

* Rescuers who are caregivers or household

* Rescuers who are caregivers or household

* Rescuers who are caregivers or household

* Rescuers who are caregivers or household

* Rescuers who are caregivers or household

Cover the victim’s mouth and nose with

Cover the victim’s mouth and nose

➢ Continue CPR until

• If an advanced airway is already in

8. COMPRESSION TO VENTILATION (CV) RATIO: - - -

8. COMPRESSION TO VENTILATION (CV) RATIO: - - -

At the end of the discussion, the participants should be able to

At the end of the demonstration, participants should be able

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