3. What is BLS ??
Basic life support refers to the type of care that first responders, healthcare
providers and public safety professionals provide to anyone who is
experiencing cardiac arrest , respiratory arrest and obstructed airway.
-American Red Cross
6. CHECK RESPONSE
Approach safely
Check response
Call for help
Check breathing and pulse
30 Chest compressions
2 rescue breaths
Rapid defibrillation
ALS
7. Shake shoulders gently
Ask “Are you all
right?” If he responds
• Find out what is wrong.
• Reassess regularly.
CHECK RESPONSE
8. CALL FOR HELP
Approach safely
Check response
Call for help
Check breathing and pulse
30 chest compressions
2 rescue breaths
Rapid defibrillation
ALS
9. CHECK BREATHING & PULSE
• Check breathing and
pulse simultaneously
• Do not confuse agonal
breathing with NORMAL
breathing
10. Check breathing?
• Inspecting the chest rise of patient while palpating carotid
pulse (saves time)
• OR Lay rescuer can check by keeping our fingers in front of
nostrils/keeping ears close to nose to check if any blow of
expired air is present or not.
• Agonal gasps or abnormal breathing patterns may get
confused with normal respiration by lay man rescuer.
12. 30 CHEST COMPRESSIONS
Approach safely
Check response
Call for help
Check breathing and pulse
30 chest compressions
2 rescue breaths
ALS
Rapid defibrillation
13. C P R
• Start CPR immediately after checking and observing there is
no
1. RESPONSIVENESS
2. BREATHING
3. PULSE
14. Chest Compressions
• Technique-
o Position yourself at patient’s side
o firm, flat surface and
o remove all the clothings
o Put the heel of one hand on the centre of chest (sternum) at
the level of nipples and put your other hand on the top of that
hand.
16. Chest Compression
• Technique-
o Lock all joints ; movement is allowed only at hip joint
o Push hard and fast (100 - 120 times / min)
o At the end of each compression, chest is allowed to recoil
completely
• Depth- 5 cms to 6 cms (2 inches to 2.4 inches)
17. RESCUE BREATHS
Approach safely
Check response
Call for help
Check breathing and pulse
30 chest compressions
2 rescue breaths
Rapid defibrillation
ALS
20. Rescue Breath
• Each rescue breath over 1 second
• Visible chest rise
• 30 compression: 2 breaths (no advanced aiway)
• Advanced airway-
o Give 1 breath every 6 to 8 seconds without attempting to
synchronise breaths between compressions
o 8-10 breaths per min
22. Defibrillation
• Important in saving patient of cardiac arrest
• Mechanism-
A defibrillation shock must be strong enough to stun or excite
a large majority of the cardiac tissue. If a sufficient portion of
the cardiac tissue were made temporarily unexcitable by a
shock, the uncoordinated wavefronts of excitation that
perpetuate VF would be extinguished, and would allow
normal cardiac excitation and contraction to resume.
23. What is AED?
• Automated External Defibrillator
• A portable electronic device that automatically diagnose the life-
threatening cardiac arrhythmias of ventricular defibrillation and
pulseless VT and is able to treat them through defibrillation.
• Possible for more people to respond to medical emergency
where defibrillation is required
• Can be used by lay-rescuer trained in CPR
25. AEDs
• Made part of emergency response program
• Gives simple audio and visual commands,making its use easy
• Should be available at public places like stations, stadiums,
airports, malls etc.
• Can’t be overriden manually and takes upto 10-20 sec to
detect arrhythmias
• Now a part of BLS program because early
defibrillation is found to increase survival rate of patient
29. What is ACLS??
Advanced cardiac life support or advanced cardiovascular
life support refers to a set of clinical guidelines for the
urgent and emergent treatment of life threatening
cardiovascular conditions that will cause or have caused
cardiac arrest , using advanced medical procedures,
medications and techniques.
-AMERICAN HEART ASSOCIATION
32. Advanced Airway
Endotracheal intubation or supraglottic
advanced airway
Once advanced airway in place, give 1
breath every 6 seconds (10 breaths/min)
with continuous chest compressions
33. Is the rhythm shockable?
Continue performing excellent chest compressions while
the defibrillator or AED is being attached. Reassume CPR
immediately after any shock is given .
Biphasic defibrillation are recommended because of their
increased efficacy at lower energy level. Start with the
dose recommended by the manufacturer which is typically
120-200J
34. MANAGEMENT OF SPECIFIC ARRHYTHMIAS
VF and PULSELSS VT are nonperfusing rhythms,
emanating from the ventricles for which early rhythm
identification , defibrillation and CPR are the mainstays of
treatment.
Early defibrillation is the most critical action in the resuscitation
effort, followed by the performance of the excellent CPR.
35. Every shock after the initial shock should be of equal
or greater strength
If VF or pulseless VT persists after at least one
attempt at defibrillation and two minutes of CPR ,
give epinephrine (1mg IV every 3 to 5 mins) while
CPR is performed continuously
Amiodarone is given in case of persistent shockable
rhythm
36. Shock Energy for Defibrillation
Biphasic: Manufacturer recommendation
(eg, initial dose of 120-200 J); if unknown,
use maximum available. Second and
subsequent doses should be equivalent, and
higher doses may be considered.
• Monophasic: 360 J
37. ASYSTOLE AND PULSELESS ELECTRICAL ACTIVITY
Asystole is defined as a complete absence of demonstrable
electrical and mechanical cardiac activity
Pulseless electrical activity (PEA) is defined
as any of a heterogenous group of organized
electrocardiographic rhythm without sufficient mechanical
contraction of the heart to produce a palpable pulse or
measurable blood pressure.
38. After initiating CPR, treat reversible cause
as appropriate and administer epinephrine
(1mg IV every 3 to 5minutes)
Atropine is no longer recommended for the
treatment of asystole or PEA.
40. Return of Spontaneous Circulation
(ROSC)
Pulse and blood pressure can be
observed on the monitor
Spontaneous arterial pressure waves
with intra-arterial monitorin
42. POST CARDIAC ARREST CARE
The following summarizes the AHA algorithm for adult post cardiac
arrest care :
Optimize ventilation and oxygenation
Treat hypotension
Perform a 12 lead ECG to determine whether acute ST elevation or
ischemia is present
For ST elevation myocardial infarction (STEMI) , perform coronary
reperfusion with PCI.
#3:A level of medical care which is used for victims of life-
threatening illnesses or injuries until they can be given full medical care at a hospital. It can be provided by trained medical personnel, including emergency medical technicians, paramedics, and by qualified bystanders.
