BLS

1 Basic Life SupportProvider HandbookBy Dr. Karl DisqueBLSP resented by the: Disque FoundationEmpowered by the2015- 2020 Guidelines and StandardsCopyright 2018 Satori Continuum PublishingAll rights reserved. Except as permitted under Copyright Act of 1976, no part of this publication can be reproduced, distributed, or transmitted in any form or by any means, or stored in a database or retrieval system, without the prior consent of the publisher. Satori Continuum Publishing 1810 E Sahara Ave. Suite 1507 Las Vegas, NV 89104 Printed in the United States of AmericaEducational Service DisclaimerThis Provider Handbook is an educational service provided by Satori Continuum Publishing. Use of this service is governed by the terms and conditions provided below. Please read the statements below carefully before accessing or using the service.

2 By accessing or using this service, you agree to be bound by all of the terms and conditions herein. The material contained in this Provider Handbook does not contain standards that are intended to be applied rigidly and explicitly followed in all cases. A health care professional s judgment must remain central to the selection of diagnostic tests and therapy options of a specific patient s medical condition. Ultimately, all liability associated with the utilization of any of the information presented here rests solely and completely with the health care provider utilizing the of CONTENTSG eneral Concepts of Basic Life Support .. 4 Initiating Chain of Survival 52015 BLS Guideline Changes 6 BLS for Adults .. 8 One-Rescuer BLS/CPR for Adults 9 CPR StepsTwo-Rescuer BLS/CPR for Adults 11 Adult Mouth-to-Mask Ventilation 12 Adult Bag-Mask Ventilation 12 Self-Assessment for Adult BLS 14 Use of Automated External Defibrillator.

3 15 AED Steps 16 Self-Assessment for AED 18 BLS for Children (1 to 8 years) .. 19 One-Rescuer BLS for Children 20 Two-Rescuer BLS for Children 20 Child VentilationBLS for Infants (0 to 12 months) .. 23 One-Rescuer BLS for Infants 24 Two-Rescuer BLS for Infants 25 AED for Children and Infants .. 26 AED Steps for Children and Infants 26 Self-Assessment for AED in Children and Infants 28 Airway Management .. 29 Mouth-to-Mouth Rescue Breathing 29 Adults and Older Children Mouth-to-MouthInfants Mouth-to-Mouth/NoseRescue Breathing 32 Relief of Choking .. 33 Choking in Adults or Children 33 Abdominal Thrusts (Heimlich Maneuver)Choking in Infants 35 Back Blows and Chest Thrusts in InfantsSelf-Assessment for Relief of Choking 36 Additional Tools .. 37 Medicode 37 CertAlert+ 37 BLS Review Questions.

4 38 Chapter 1 2 3 4 5678910 Take NoteAccording to the Centers for Disease Control (CDC), heart disease continues to be the leading cause of death in the United States and is responsible for over 600,000 deaths every year. Research continues to improve how we respond with life-saving techniques to emergencies. These techniques are based on the most current research and are organized into a systematic response called the Chain of Survival, which begins with Basic Life Support (BLS). The Chain of Survival provides the person the best chance to receive the care needed and return to a healthy heart pumps blood through the lungs, where blood takes in oxygen and releases carbon dioxide. This blood then returns to the heart where it is pumped out to vital organs the heart and brain as well as the rest of the body.

5 When the heart stops, blood flow stops, and the person quickly becomes unconscious. Without blood flow, the heart and the brain quickly become damaged due to lack of oxygen. The actions that make up BLS try to prevent or slow the damage until the cause of the problem can be corrected. BLS improves a person s chance of surviving until advanced care becomes available. Taking the right action quickly and confidently can make the difference between life and death for a person dealing with cardiac arrest. Keys for BLS: Quickly start the Chain of Survival. Deliver high-quality chest compressions to circulate oxygen to the brain and vital organs. Know when and how to use an Automatic External Defibrillator (AED). Provide rescue breathing. Understand how to work with other rescuers as part of a team. Know how to treat choking.

6 >> Next: Initiating Chain Of Survival4 GENERAL CONCEPTS OF BASIC LIFE SUPPORTBLS Basic Life SupportGENERAL CONCEPTS OF BASIC LIFE SUPPORTINITIATING CHAIN OF SURVIVALE arly initiation of BLS has been shown to increase the probability of survival for a person dealing with cardiac arrest. To increase the odds of surviving a cardiac event, the rescuer should follow the steps in the Adult Chain of Survival (Figure 1).Adult Chain of Survival Emergencies in children and infants are not usually caused by the heart. Children and infants most often have breathing problems that trigger cardiac arrest. The first and most important step of the Pediatric Chain of Survival is prevention (Figure 2). Pediatric Chain of Survival>> Next: 2015 BLS Guideline ChangesBLS Basic Life Support5 POST-CARDIAC ARREST CAREADVANCED LIFE SUPPORTDEFIBRILLATE WITH AEDPERFORM EARLY CPRRECOGNIZE SYMPTOMS & ACTIVATE EMSPOST-CARDIAC ARREST CAREADVANCED LIFE SUPPORTACTIVATE EMSPERFORM EARLY CPRPREVENT ARRESTF igure 1 Figure 22015 BLS GUIDELINE CHANGESThe American Heart Association (AHA) published their 2015 guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) in the scientific journal Circulation.

7 resuscitation research continues to show that high-quality CPR is increasing survival rates for hospital discharge. The AHA s updated 2015 guidelines expand on many of the recommendations made in 2010 and continue to focus on high-quality chest compressions as the intervention is most likely to improve resuscitation AHA s analysis of the research conducted since the 2010 guidelines shows that resuscitation outcomes improve when high-quality chest compressions are started immediately. The characteristics that define high-quality compressions remain as pushing hard and fast. RateIn 2010, the recommended rate was at least 100 compressions per minute. The 2015 update to the CPR guideline now reflects a target compression rate of 100-120 per minute. The increased compression rate is likely to lead to a decrease in cardiac output due to incomplete cardiac filling during chest 2015 guideline now defines the target depth for adult compressions to be between inches (5-6 centimeters).

8 Research reviewed by the AHA revealed that compressions delivered beyond this depth may result in increased risk of resuscitation related injuries, such as rib fractures, which is what led to this change in 2015 AHA s guidelines continue to emphasize that the rescuer technique will play a major role in the quality of compressions delivered. In real life resuscitations, rescuers are likely to provide compressions that are too slow, too shallow, and interrupted too often. Both training and practice are important in developing good technique, with frequent refresher training for skills and knowledge. During training and review, detailed feedback especially on rate and depth of compressions should be change from the traditional ABC (Airway, Breathing, Compressions) sequence in 2010 to the CAB (Compressions, Airway, Breathing) sequence was confirmed in the 2015 guidelines.

9 The emphasis on early initiation of chest compressions without delay for airway assessment or rescue breathing has resulted in improved outcomes. RatioThe 2015 guidelines still recommend traditional CPR cycles of 30 chest compressions to two rescue breaths for one-rescuer CPR in all age groups and for two-rescuer CPR in adults. The 15:2 ratio of compressions to breaths remains in the 2015 guidelines for two-rescuer CPR for children and chest compressions are most valuable in saving a life. Even if you do not know how to do anything else, chest compressions are better than doing nothing. The AHA points out that most rescuers are likely to have a speakerphone equipped cell phone, and bystanders calling 911 can be instructed by EMS dispatchers to perform hands only CPR. Additionally, the AHA continues to call on communities to increase public access to AEDs.

10 >> Next: 2015 BLS Guidelines continued6 BLS Basic Life Support Take NoteIn 2010, the American Heart Association (AHA) released a revision of the BLS guidelines. Approximately, every five years, the AHA updates the guidelines for CPR and ECC. The content contained herein is based on the most recent AHA publications on BLS and will periodically compare previous and revised recommendations for a comprehensive review. Below are the details of the changes made to 2015 guidelines for BLS: Previously, the initial steps were Airway, Breathing, Compressions, or ABC. The literature indicates that starting compressions early in the process will increase survival rates. Therefore, the steps have been changed to Compressions, Airway, Breathing, or CAB. This is intended to encourage early CPR and avoid bystanders interpreting agonal breathing as signs of life and withholding CPR.