Basic Life Support Certification is designed for healthcare providers or people who want to learn Basic Life Support skills. Professions that usually need a BLS online include nurses, nursing assistants, medical assistants' respiratory therapists, dentists, dental assistants, paramedics, EMTs, police officers, firefighters, physical therapists, occupational therapists, etc. If you have a Basic Life Suppor certification or recertification coming up, this BLS Cheat sheet will be your best friend. This cheat sheet covers the essential concepts necessary for completing the Basic Life Support certification, including Adult OHCA Chain of Survival.
General Concepts
Main Components of CPR (C - A - B)
The main components of CPR are often remembered as "C-A-B," representing Chest Compressions, Airway, and Breathing. These components are critical in maintaining blood circulation and oxygen supply to vital organs, increasing the chances of survival until advanced medical help arrives.
C - Chest Compressions: Chest compressions are the foundation of CPR. They help circulate oxygen-rich blood to vital organs, especially the brain. Proper technique is crucial to ensure effectiveness. To perform Chest Compressions:
- Place the heel of one hand on the center of the victim's chest (lower half of the sternum).
- Use the other hand to interlace fingers and keep the elbows straight.
- Compress the chest at least 2 inches deep (adults) at a rate of 100-120 compressions per minute.
- Allow the chest to recoil fully between compressions.
A - Airway: Establishing an open airway is vital for effective ventilation and the delivery of oxygen to the lungs. Ensure the victim's airway is clear of any obstructions. To open the airway:
- Tilt the victim's head backward gently while lifting the chin up with two fingers.
- Look, listen, and feel for signs of breathing for no more than 10 seconds.
B - Breathing: Once the airway is open, provide rescue breaths to deliver oxygen to the victim's lungs. This step is particularly important if the victim is not breathing normally. To provide Rescue Breaths:
- Maintain an effective seal over the victim's mouth and nose.
- Deliver 2 rescue breaths after every 30 chest compressions.
- Each breath should last about 1 second and make the chest rise visibly.
High-Quality CPR
High-quality CPR is crucial for increasing the chances of survival in cardiac arrest situations. It involves a combination of effective chest compressions, maintaining an open airway, and providing adequate ventilation. Here are the key elements of high-quality CPR:
- Early Recognition and Activation: Recognize the signs of cardiac arrest and activate the emergency response system immediately. Early activation ensures that professional help is on the way.
- Early Chest Compressions: Start chest compressions as soon as possible. Delaying compressions reduces the chances of survival. Begin with a compression rate of 100-120 compressions per minute.
- Adequate Compression Depth: Compress the chest at least 2 inches (5 cm) for adults. Ensure that the chest fully recoils between compressions. Inadequate depth can compromise blood flow.
- Allowing Full Chest Recoil: Allow the chest to fully recoil between compressions. Incomplete chest recoil reduces blood flow and the effectiveness of compressions.
- Minimizing Interruptions: Minimize interruptions in chest compressions. Every second counts, and prolonged pauses can significantly impact survival rates.
- Effective Ventilations: If providing rescue breaths, ensure an effective seal over the victim's mouth and nose. Deliver each breath over 1 second, with enough volume to make the chest rise visibly.
- Maintaining a Proper Compression-to-Ventilation Ratio: Follow the recommended compression-to-ventilation ratio. For adults, it is 30 compressions to 2 breaths. For hands-only CPR, continuous compressions without interruptions are often recommended.
- Avoiding Excessive Ventilations: Avoid over-ventilating the victim. Too much emphasis on rescue breaths can lead to delays in chest compressions, which are the priority.
- Team Coordination (if applicable): In a healthcare setting with a team of providers, effective communication and coordination are essential. Assign roles and switch roles to prevent fatigue and maintain quality CPR.
- Using Feedback Devices (if available): If available, use CPR feedback devices that provide real-time information on compression depth, rate, and recoil. These tools can help optimize performance.
Adult Chain of Survival - IHCA (In-Hospital Cardiac Arrest)
In-hospital cardiac arrest (IHCA) demands a swift and coordinated response to maximize the chances of survival. The Adult Chain of Survival for IHCA outlines a systematic approach within healthcare facilities. It begins with the rapid recognition of cardiac arrest, prompting an immediate activation of the hospital's emergency response system. Subsequently, the focus shifts to the delivery of high-quality CPR, minimizing interruptions in chest compressions. The chain includes the potential use of defibrillation to restore a normal heart rhythm and progresses to advanced life support administered by healthcare professionals. Post-cardiac arrest care, including targeted temperature management, forms the final link in this critical chain, striving to optimize the patient's recovery prospects.
Adult Chain of Survival - OHCA (Out-of-Hospital Cardiac Arrest)
Out-of-hospital cardiac arrest (OHCA) presents unique challenges, necessitating a community-oriented approach. The Adult Chain of Survival for OHCA emphasizes early recognition and activation of emergency services. Immediate high-quality CPR is crucial, focusing on chest compressions to maintain blood circulation. Rapid defibrillation with an automated external defibrillator (AED) by bystanders or emergency responders is a pivotal step. Advanced life support follows, delivered by healthcare professionals upon arrival. The chain concludes with post-cardiac arrest care, recognizing the importance of ongoing medical attention beyond the initial resuscitation efforts.
Pediatric Chain of Survival
Cardiac emergencies in pediatric patients demand specialized care, and the Pediatric Chain of Survival outlines a sequence tailored to their unique needs. Early recognition of distress and activation of emergency services are paramount. The chain prioritizes immediate high-quality CPR, adjusted to the size and age of the child. Rapid defibrillation is crucial in the presence of a shockable rhythm. Advanced life support, administered by trained healthcare providers, follows. The chain culminates in post-cardiac arrest care, recognizing the significance of ongoing medical attention and support for pediatric patients on their journey to recovery.
BLS for Adults
Basic Life Support (BLS) for adults is a critical set of interventions aimed at sustaining life during cardiac arrest or other medical emergencies. It primarily involves chest compressions and, if trained, rescue breaths.
One-Rescuer BLS Steps for Adults:
Two-rescuer BLS Steps for Adults:
Steps for Performing CPR for Adults:
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BLS for Children
Basic Life Support (BLS) for children requires adapting interventions to meet the unique physiological needs of pediatric patients. If a child is unresponsive and not breathing normally, the caregiver should immediately activate the emergency response system. Effective chest compressions, adjusted to the child's size, and, if trained, rescue breaths are key components. Timely use of an Automated External Defibrillator (AED) is crucial in cases of shockable rhythms. The emphasis is on maintaining a high-quality and continuous cycle of compressions and ventilations until professional help arrives or spontaneous breathing resumes.
One-Rescuer BLS Steps for Children:
Two-Rescuer BLS Steps for Children:
Steps for Performing CPR for Children:
BLS for Infants
BLS for infants is tailored to the distinctive characteristics of the youngest patients. In the event of an unresponsive infant, activating the emergency response system is the immediate priority. Chest compressions, performed with two fingers, and, if trained, rescue breaths are initiated. Attention to the infant's smaller size and unique anatomy is critical. The use of an Automated External Defibrillator (AED) is rare but may be necessary in specific situations. The focus is on maintaining a high-quality and continuous cycle of compressions and ventilations until professional assistance arrives or spontaneous breathing resumes.
One-Rescuer BLS Steps for Infants:
Two-rescuer BLS Steps for Infants:
Steps for Performing CPR for Infants:
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Choking response training
Recovery position technique course
BLS Algorithm
BLS algorithms are a set of guidelines that provide healthcare providers with step-by-step instructions on how to perform Basic Life Support (BLS) in a medical emergency. BLS algorithms are designed to help healthcare providers quickly and accurately assess the patient’s condition, determine the appropriate course of action, and provide high-quality care. The American Heart Association has developed several BLS algorithms for adults, children, and infants.
Adult BLS Algorithm:
Infant and Child BLS Algorithm:
AED Usage
Using an automated external defibrillator (AED) is critical in the Chain of Survival. An AED is a device that can be used to deliver an electric shock to the heart to restore normal rhythm during cardiac arrest.
Steps for Using an AED:
AED Usage Points of Emphasis:
CPR With An Advanced Airway
CPR with an advanced airway involves providing life support measures to a person in cardiac arrest while utilizing advanced airway devices such as an endotracheal tube or supraglottic airway. Here's an overview of the key considerations:
- Scene Safety: Ensure the safety of yourself, the victim, and any bystanders before approaching the scene.
- Recognition and Activation: Recognize signs of cardiac arrest and activate the emergency response system immediately.
- Begin CPR: Initiate high-quality chest compressions. For lay rescuers, the emphasis is often on hands-only CPR. For healthcare providers, incorporate advanced airway management early if possible.
- Advanced Airway Placement: Healthcare providers may secure an advanced airway (endotracheal tube or supraglottic airway) to maintain an open airway and facilitate more effective ventilation.
- Ventilation: Provide rescue breaths through the advanced airway at a rate of about 1 breath every 6 to 8 seconds.Confirm chest rise with each ventilation to ensure proper airway placement.
- Chest Compressions: Continue high-quality chest compressions with minimal interruptions. Coordinate compressions and ventilations effectively.
- Defibrillation (if applicable): If a defibrillator is available and indicates a shockable rhythm, administer a shock according to guidelines. Resume CPR immediately after defibrillation.
- Medications and Advanced Interventions: Administer medications and other advanced interventions as per the guidelines and under the direction of healthcare professionals. In a healthcare setting, ensure effective communication and coordination among team members for seamless care.
- Monitoring: Continuously monitor the patient's response to interventions, adjusting care as needed.
- Post-Cardiac Arrest Care: Provide comprehensive post-resuscitation care, including targeted temperature management if indicated, and transfer the patient to appropriate medical facilities.
Airway Equipment Options:
This BLS cheat sheet serves as a quick reference guide for healthcare providers, offering a concise yet comprehensive overview of the essential steps in Basic Life Support. Remember that timely and effective interventions, such as prompt recognition of cardiac arrest, immediate initiation of high-quality chest compressions, and proper use of automated external defibrillators, significantly impact patient outcomes. Regular training, adherence to guidelines, and staying informed about any updates in resuscitation protocols are critical to ensuring that healthcare providers are well-prepared to deliver life-saving care during emergencies. Review our BLS certification study guide and take a BLS practice test now to check your knowledge.
Frequently Asked Questions
Is there a recommended approach for managing a patient with suspected opioid overdose during BLS?
For a patient with a suspected opioid overdose during BLS, healthcare providers should prioritize the administration of naloxone, if available. Naloxone is an opioid antagonist that can reverse the effects of opioid toxicity. Simultaneously, providers should follow established protocols for managing opioid overdoses, ensuring airway patency, initiating chest compressions if necessary, and providing ventilatory support. Timely intervention with naloxone can be life-saving.
How does BLS differ when performed on a pregnant patient in different trimesters?
When performing BLS on a pregnant patient, adjustments are made based on the trimester. During chest compressions, healthcare providers should manually displace the uterus to the left in the third trimester to enhance blood flow. However, the overall principles of BLS remain consistent, emphasizing the importance of effective chest compressions and ventilation while considering the unique physiological changes associated with pregnancy.
How do healthcare providers handle potential infectious risks during BLS?
Healthcare providers must prioritize infection control measures during BLS to mitigate potential risks. Use personal protective equipment (PPE), including gloves and, if necessary, masks, to reduce the risk of exposure to bodily fluids. Additionally, minimize aerosol-generating procedures when possible. Rigorous adherence to infection control protocols ensures both patient and provider safety while delivering essential life support.
Can healthcare providers administer medications during BLS?
Healthcare providers, particularly those with advanced training, may administer medications during BLS. The decision to use medications is often guided by specific protocols and the patient's condition. Medications may include epinephrine to support circulation or other drugs depending on the cause of the cardiac arrest. Proper dosage, administration, and knowledge of medication interactions are critical considerations.
How does BLS transition into advanced life support (ALS)?
BLS transitions into ALS when healthcare providers with advanced training, such as paramedics or advanced practice nurses, arrive on the scene. Advanced interventions may include advanced airway management, intravenous medications, and additional diagnostics. Seamless communication and collaboration between BLS and ALS providers ensure a smooth transition, optimizing patient care.
How should healthcare providers approach BLS in mass casualty incidents?
In mass casualty incidents, healthcare providers should prioritize a systematic and organized approach to BLS. Triage becomes essential to identify and treat patients with the greatest need first. Coordination with other providers, effective communication, and resource allocation are crucial. Providers should be prepared to adapt their skills to the scale of the incident, emphasizing the principles of BLS while addressing the unique challenges of managing multiple casualties.
How does the use of therapeutic hypothermia fit into post-cardiac arrest care during BLS?
Therapeutic hypothermia, or targeted temperature management, is often part of post-cardiac arrest care in BLS. Healthcare providers may initiate cooling measures for eligible patients to mitigate neurological damage. This involves carefully controlling the patient's body temperature within a specific range for a defined duration. Coordinated efforts and adherence to established protocols are crucial in implementing therapeutic hypothermia effectively.
Can healthcare providers use mobile applications or technology-assisted tools for BLS support?
Healthcare providers can leverage mobile applications and technology-assisted tools for BLS support. These tools may offer real-time guidance, simulation scenarios, and reference materials. However, providers should ensure that any technology used aligns with established guidelines and does not compromise the quality or safety of BLS interventions.