BLS - Basic Life Support

Original article by Tom Leach | Last updated on 28/6/2014
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Introduction

This is 'life support' without any extra equipment. Pure 'CPR' as a lay person might understand it. It is basically a temporary solution to try and keep the person alive until proper equipment can be brought to try and reverse the underlying cardiac arrest. However, in situations where the underlying cause is respiratory failure, then it can actually completely reverse the damage without the need for additional equipment.
 
If the oxygen supply to the brain is lost for more than 3-4 minutes then permanent cerebral damage will result. Therefore you have to be as quick as possible!
BLS is an international protocol designed to be taught to al hospital staff members and to members of the general public.
These guidelines were introduced in November 2005, and were simplified and placed greater emphasis on the number of chest compressions.
 

Method

  • Check for danger! Make sure the situation is safe
  • Check for a response – shake the victim’s shoulders and ask loudly if they are ok. If they respond, then you should leave them where they are, provided they are not in danger. Try and find out what is wrong then go and get help. Return to the patient as soon as you can and keep re-assessing them.
  • If they do not respond, then:
    • Shout for Help!
    • Open the patient’s airway, by doing the head tilt and chin lift.
  • Listen for normal breathing and look to see if you can see the patient’s chest rising and falling. Can you feel breath on your cheek? Do this for no more than 10 seconds. Don’t confuse gasping irregular breaths (which are often associated with cardiac arrest) with normal breathing. If you have any doubts about normal breathing, then assume the patient is not breathing normally.
  • If they are breathing normally, put them in the:
  • Recovery position – Imagine the patient lying flat on their back. Lift up their left knee and put the outside of their left hand against their right cheek. Roll the patient onto their right hand side, making sure their hand is in contact with their cheek at all times. Their right arm should be stretched out at 90’ to their torso. Do not keep the person laid on one side for more than 30 minutes due to the pressure on their arm. Swap them over to the other side before then.
  • If they are not breathing normally, then Go and get help – call for an ambulance! If you are on your own you might have to leave the victim.
 
  • When you return, you should start chest compressions. You should kneel on the patient’s right hand side. Put your hand in the middle of the patient’s chest, about 2 fingers above the level of the bottom of the sternum. Interlock your fingers. Don’t apply pressure on the stomach or on the very bottom of the sternum! Position yourself so you are vertically over the patient’s chest and keep you arms straight. Press down about 5-6cm. You should aim to do 100 compressions a minute, or about 2 per second. Some recommend imagining the pace of a song in your head… and performing chest compressions to the ‘beat’. Apparently two appropriately speedy songs are:
    • Staying Alive – The BeeGees
    • Nelly the Elephant – The Nursery Rhyme
 
  • After 30 compressions, open the airway again, doing the head tilt and chin lift. Pinch the nose closed, and whilst still maintaining the chin lift and keeping the mouth open, take a normal breath and give two breaths to the patient. Breathe out for about 1 second. You should see the patient’s chest rise. If not, the its likely the air is going into the stomach, and you are not correctly holding the patient’s head in the ‘head tilt, chin lift’ position. Allow the air to come out of the patient and then do the same again. You should maintain the chin lift at all times. After this start 30 compressions again. Don’t ever attempt more than 2 breaths. If the chest doesn’t rise, then check for obstructions. If there is more than one person present, you should swap over about every 2 minutes to prevent fatigue. You should continue resuscitation until help arrives, or until the victim recovers, or until you can no longer continue because you are exhausted.
 

Exceptions

For children, you should give 5 rescue breaths before starting chest compressions, and you should attempt CPR for 1 minute before going for help.
These same exceptions should be applied if the victim is suspected of drowning.