Lecture Chapter 13
Introduction -
- The principles of basic life support (BLS) were introduced in 1960.
- Since then, specific techniques for the management of cardiac arrest and the delivery of emergency
and cardiac care have been reviewed and revised every 5 to 6 years.
- The goal is to produce the best recommendations possible given the available scientific evidence.
Note (1) -
The most recent review of the guidelines was conducted by the International Liaison
Committee on Resuscitation (ILCOR). This revision occurred as a result of a rigorous and systematic
review of the newest scientific evidence surrounding the treatment of cardiac arrest and the
provision of emergency and cardiac care, using validated, transparent, and scientifically rigorous
methodology to produce the best recommendations possible given the available evidence.
Basic Life Support (BLS) -
Noninvasive emergency lifesaving care that is used to treat medical conditions, including
airway obstruction, respiratory arrest, and cardiac arrest.
Care focuses on the ABCs -
- Airway (obstruction)
- Breathing (respiratory arrest)
- Circulation (cardiac arrest or severe bleeding)
CAB -
- Compressions
- Airway
- Breathing
If the patient is in cardiac arrest, a CAB sequence is used -
Chest compressions are essential and must be started as quickly as possible.
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,Word of Wisdom (1) -
(1) Remember, brain cells die every second that they are deprived of oxygen. Permanent
brain damage is possible after only 4 to 6 minutes without oxygen. (1)
Cardiopulmonary Resuscitation (CPR) -
The combination of chest compressions and rescue breathing used to establish adequate
ventilation and circulation in a patient who is not breathing and has no pulse.
The steps for Cardiopulmonary Resuscitation (CPR) include: -
- Restore circulation by performing chest compressions to circulate blood to the vital organs
of the body.
- Perform 30 high-quality compressions to a depth of 2 to 2.4 inches (5 to 6 cm) in an adult at the
rate of 100 to 120 per minute.
- Open the airway with the jaw-thrust or head tilt-chin lift maneuver.
- Restore breathing by providing rescue breaths (via mouth-to-mask ventilation or a bag-valve mask
[BVM]).
+ Administer 2 breaths, each over 1 second, while visualizing for chest rise.
Advanced Life Support (ALS) -
- Advanced lifesaving procedures, including cardiac monitoring, administration of intravenous
fluids and medications, and the use of advanced airway adjuncts. EMTs may be trained in some of
these areas.
When done correctly -
- BLS care can maintain life for a short time until
ALS measures can be started.
- To survive cardiac arrest, effective CPR at an adequate rate and depth with minimal interruptions is
essential until defibrillation can be administered.
Goal of CPR -
- Establish circulation and artificial ventilation in a patient who is not breathing and has no
pulse.
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, - Help restore spontaneous breathing and circulation; however, defibrillation and advanced
interventions are often necessary.
- For CPR to be effective, you must be able to quickly identify a patient who is in respiratory and/or
cardiac arrest and immediately begin BLS measures.
The Components of CPR -
- The American Heart Association (AHA) has determined the chain of survival that can
improve the chance of successful resuscitation of a patient who experiences sudden cardiac arrest.
- A successful resuscitation is defined not only by the return of spontaneous circulation (ROSC), but
also the survival of the patient to hospital discharge.
AHA -
American Heart Association
American Heart Association (AHA) -
determined the chain of survival that can improve the chance of successful resuscitation of a
patient who experiences sudden cardiac arrest.
According to the American Heart Association (AHA) -
88% of sudden cardiac arrests occur in the home. Few patients who experience cardiac arrest
in the prehospital environment survive unless a rapid sequence of events takes place. If any one of
the links in the chain isn't maintained, the patient is more likely to die.
Return of Spontaneous Circulation (ROSC) -
The return of a pulse and effective blood flow to the body in a patient who previously was in
cardiac arrest.
Five Links in the Chain of Survival -
- Recognition and activation of the emergency response system
- Immediate, high-quality CPR
- Rapid defibrillation
- Basic and advanced emergency medical services
- Advanced life support and postarrest care
3|Page
Introduction -
- The principles of basic life support (BLS) were introduced in 1960.
- Since then, specific techniques for the management of cardiac arrest and the delivery of emergency
and cardiac care have been reviewed and revised every 5 to 6 years.
- The goal is to produce the best recommendations possible given the available scientific evidence.
Note (1) -
The most recent review of the guidelines was conducted by the International Liaison
Committee on Resuscitation (ILCOR). This revision occurred as a result of a rigorous and systematic
review of the newest scientific evidence surrounding the treatment of cardiac arrest and the
provision of emergency and cardiac care, using validated, transparent, and scientifically rigorous
methodology to produce the best recommendations possible given the available evidence.
Basic Life Support (BLS) -
Noninvasive emergency lifesaving care that is used to treat medical conditions, including
airway obstruction, respiratory arrest, and cardiac arrest.
Care focuses on the ABCs -
- Airway (obstruction)
- Breathing (respiratory arrest)
- Circulation (cardiac arrest or severe bleeding)
CAB -
- Compressions
- Airway
- Breathing
If the patient is in cardiac arrest, a CAB sequence is used -
Chest compressions are essential and must be started as quickly as possible.
1|Page
,Word of Wisdom (1) -
(1) Remember, brain cells die every second that they are deprived of oxygen. Permanent
brain damage is possible after only 4 to 6 minutes without oxygen. (1)
Cardiopulmonary Resuscitation (CPR) -
The combination of chest compressions and rescue breathing used to establish adequate
ventilation and circulation in a patient who is not breathing and has no pulse.
The steps for Cardiopulmonary Resuscitation (CPR) include: -
- Restore circulation by performing chest compressions to circulate blood to the vital organs
of the body.
- Perform 30 high-quality compressions to a depth of 2 to 2.4 inches (5 to 6 cm) in an adult at the
rate of 100 to 120 per minute.
- Open the airway with the jaw-thrust or head tilt-chin lift maneuver.
- Restore breathing by providing rescue breaths (via mouth-to-mask ventilation or a bag-valve mask
[BVM]).
+ Administer 2 breaths, each over 1 second, while visualizing for chest rise.
Advanced Life Support (ALS) -
- Advanced lifesaving procedures, including cardiac monitoring, administration of intravenous
fluids and medications, and the use of advanced airway adjuncts. EMTs may be trained in some of
these areas.
When done correctly -
- BLS care can maintain life for a short time until
ALS measures can be started.
- To survive cardiac arrest, effective CPR at an adequate rate and depth with minimal interruptions is
essential until defibrillation can be administered.
Goal of CPR -
- Establish circulation and artificial ventilation in a patient who is not breathing and has no
pulse.
2|Page
, - Help restore spontaneous breathing and circulation; however, defibrillation and advanced
interventions are often necessary.
- For CPR to be effective, you must be able to quickly identify a patient who is in respiratory and/or
cardiac arrest and immediately begin BLS measures.
The Components of CPR -
- The American Heart Association (AHA) has determined the chain of survival that can
improve the chance of successful resuscitation of a patient who experiences sudden cardiac arrest.
- A successful resuscitation is defined not only by the return of spontaneous circulation (ROSC), but
also the survival of the patient to hospital discharge.
AHA -
American Heart Association
American Heart Association (AHA) -
determined the chain of survival that can improve the chance of successful resuscitation of a
patient who experiences sudden cardiac arrest.
According to the American Heart Association (AHA) -
88% of sudden cardiac arrests occur in the home. Few patients who experience cardiac arrest
in the prehospital environment survive unless a rapid sequence of events takes place. If any one of
the links in the chain isn't maintained, the patient is more likely to die.
Return of Spontaneous Circulation (ROSC) -
The return of a pulse and effective blood flow to the body in a patient who previously was in
cardiac arrest.
Five Links in the Chain of Survival -
- Recognition and activation of the emergency response system
- Immediate, high-quality CPR
- Rapid defibrillation
- Basic and advanced emergency medical services
- Advanced life support and postarrest care
3|Page
