ADULT 1-RESCUER BLS SEQUENCE
STEP ACTION
1 Verify that the scene is safe for you and the victim.
“Coming through, coming through. The scene is safe!”
2 Check for responsiveness. Tap the victim’s shoulder and shout,
“Hey, hey are you okay?”
3 Activate the emergency response system as appropriate in your
setting.
q If alone: “Help! Someone?! Help!”
q If not alone:
• In-hospital: “Call a code and get a crash cart!”
• Out-of-hospital: “Activate Emergency Response and get
an AED!”
4 Check pulse and breathing for 5-10seconds.
5 No pulse and breathing? Proceed with HIGH QUALITY CPR!
ADULT COMPRESSIONS
STEPS ACTION
1 Position yourself at the side of the victim’s side.
2 Make sure the victim is lying face-up on a firm, flat surface.
3 Position your hands and body to perform chest compressions:
ü Put the heel of one hand in the center of the victim’s chest,
on the lower half of the breastbone (sternum)
ü Put the heel of your other hand on top of the first hand.
ü Straighten your arms and position your shoulder directly over
your hands.
4 Give compressions at a rate of 100-120/min.
5 Press down at least 2 inches (5cm) with each compression.
6 At the end of each compression, make sure you allow the chest to
recoil completely.
7 Minimize interruptions of chest compressions/
ADULT COMPRESSIONS
ADULT BREATHS
A. Opening Airway
HEAD TILT-CHIN LIFT JAW THRUST
ADULT BREATHS
A. Opening Airway
HIGH QUALITY CPR
1. Start compressions within 10 seconds of recognition.
2. Push hard, push fast: compress at a rate of 100 to 120/min with a
depth of
oAt least 2 inches (5cm) for adults
oAt least one third the depth of the chest, about 2 inches
(5cm), for children
oAt least one third the depth of the chest, about 1 ½ (4cm),
for infants
3. Allow complete chest recoil after each compression.
4. Minimize interruptions in compression (try to limit interruptions
to less than 10 seconds).
5. Give effective breaths that make the chest rise.
6. Avoid excessive ventilation.
AUTOMATED EXTERNAL DEFIBRILLATION FOR
ADULT AND CHILDREN 8 YEARS AND OLDER
STEPS ACTION
1 Power on the AED.
2 Attach AED pads to victim's bare chest.
Plug-in the connecting cables to AED device.
3 “Clear” the victim to allow the AED to analyze the rhythm.
4 “Shock is advise.” Clear the victim and deliver the shock.
“Shock is NOT advised” Proceed to Step 5.
5 Immediately resume CPR
6 After about 5 cycles or 2 minutes of CPR, AED will promt you to repeat
steps 3 and 4.
AUTOMATED EXTERNAL DEFIBRILLATION FOR
ADULT AND CHILDREN UNDER 8 YEARS OF AGE
ADULT BREATHS
C. BAG MASK DEVICE
ADULT 2-RESCUER BLS SEQUENCE
Adult BLS Summary
[Link] safety assessment.
[Link] for responsiveness (Tap both shoulders).
[Link] for help.
[Link] of Pulse: Carotid Pulse
[Link] Emergancy Response
[Link] placement: two hands
[Link] hard with a depth of at least 2 inches (5cm)
[Link] fast with a speed of 100- 120/mins
[Link] ratio is 30:2.
[Link] is every 5 cycles or 2 mins.
TEAM DYNAMICS
A. ROLES
1. Knowing Your Limitations
2. Constructive Intervention
B. WHAT TO COMMUNICATE
1. Knowledge Sharing
2. Summarizing and
Reevaluation
C. HOW TO COMMUNICATE
1. Closed - Loop Communication
2. Clear Messages
3. Mutual Respect
TEAM DYNAMICS
CHILD BLS
STEP ACTION (Witnessed and Alone) STEP ACTION (Unwitnessed and Alone)
1 Verify that the scene is safe for you and the 1 Verify that the scene is safe for you and the
victim. victim.
“The scene is safe!” “The scene is safe!”
2 Check for responsiveness. Tap the victim’s 2 Check for responsiveness. Tap the victim’s
shoulder and shout, “Hey, hey are you okay?” shoulder and shout, “Hey, hey are you okay?”
3 Activate the emergency response system as 3 Activate the emergency response system as
appropriate in your setting, “Help! Someone?! appropriate in your setting, “Help! Someone?!
Help!” Help!”
4 Check pulse and breathing for 5-10seconds. 4 Check pulse and breathing for 5-10seconds.
5 Leave the child, then Activate Emergency 5 Proceed with HIGH QUALITY CPR!
Response.
6 Proceed with HIGH QUALITY CPR! 6 After 2 minutes of CPR, still no puls/changes,
leave the child and Activate Emergency Response.
CHILD BLS
Adult BLS vs Child BLS Summary
1. Witnessed or Unwitnessed arrest.
2. Scene safety assessment.
3. Checking for responsiveness (Tap both shoulders).
4. Call for help.
5. Checking of Pulse: Carotid or Femoral pulse
6. Activate Emergancy Response (Witnessed)
Start High Quality CPR (Unwitnessed)
6. Hand placement: one hand or two hands depending on child's torso.
7. Push hard with a depth of at least one third the depth of the chest, about 2
inches (5cm), for children
8. Push fast with a speed of 100- 120/mins
9. 1-Rescuer: Compression ratio is 30:2.
10. 2-Rescuer: Compression ratio is 15:2.
11. 1-Rescuer: Switching is every 5 cycles or 2 mins.
12. 2-Rescuer: Switching is every 10 cycles or 2 mins.
INFANT BLS
STEP ACTION (Witnessed and Alone) STEP ACTION (Unwitnessed and Alone)
1 Verify that the scene is safe for you and the 1 Verify that the scene is safe for you and the
victim. victim.
“The scene is safe!” “The scene is safe!”
2 Check for responsiveness. Tap the victim’s 2 Check for responsiveness. Tap the victim’s sole
sole of feet/foot, and shout “Baby, baby, baby” of feet/foot, and shout “Baby, baby, baby”
3 Activate the emergency response system as 3 Activate the emergency response system as
appropriate in your setting, “Help! Someone?! appropriate in your setting, “Help! Someone?!
Help!” Help!”
4 Check pulse and breathing for 5-10seconds. 4 Check pulse and breathing for 5-10seconds.
5 Leave the child, then Activate Emergency 5 Proceed with HIGH QUALITY CPR!
Response.
6 Proceed with HIGH QUALITY CPR! 6 After 2 minutes of CPR, still no puls/changes,
leave the child and Activate Emergency Response.
INFANT BLS
Adult BLS vs Child BLS vs Infant BLS
Summary
2. Scene safety assessment.
3. Checking for responsiveness (Tap both sole of feet or foot).
4. Call for help.
5. Checking of Pulse: Brachial pulse
6. Activate Emergancy Response (Witnessed)
Start High Quality CPR (Unwitnessed)
6. Hand placement: 2-Finger Technique (1- Rescuer)
Hand placement: 2-Thumb Encircling Hand Technique (2- Rescuer)
7. Push hard with a depth of about 1 ½ (4cm), for infants
8. Push fast with a speed of 100- 120/mins
9. 1-Rescuer: Compression ratio is 30:2.
10.2-Rescuer: Compression ratio is 15:2.
11.1-Rescuer: Switching is every 5 cycles or 2 mins.
12.2-Rescuer: Switching is every 10 cycles or 2 mins.
AUTOMATED EXTERNAL DEFIBRILLATION FOR
ADULT AND CHILDREN LESS THAN 8 YEARS OF AGE
SPECIAL CONSIDERATIONS
A. Mouth-to-Mouth Ventilations
SPECIAL CONSIDERATIONS
B. Rescue Breathing
Rescue Breathing Rescue Breathing (Child and Compressions to
Ventilation Compressions to
(Adult) Infant) Breaths (Child and
Technique Breaths (Adult)
Infant)
• Compresion rate of
100 - 120/min
• Give 1 breath every • Compression rate • 30 compressions to
• Give 1 breath every 3 - 5 No advance
5 - 6 seconds (about of 100 to 120/min 2 breaths (1
seconds (about 12 to 20 airway in
10 to 12 breaths per • 30 compression to rescuer)
breaths per minute) place
minute) 2 breaths • 15 compressions to
2 breaths (2
rescuers)
• Compression rateof 100 to 120/min
• Give each breath in 1 second • Continuous compressions without pauses
• Each breath should result in visible chest rise. Advance airway
fpr breaths
• Check the pulse about every 2 minutes. in place
• 1 breath every 6 seconds (10 breaths per
minute) for adults, children and infants
SPECIAL CONSIDERATIONS
C. Opioid-Associated Life Threaatening Emergency
Step Action
Scene
Verify scene safety
assessment
1 Check for responsiveness and get help.
2 Assess breathing and pulse.
3 Determins next actions based on breathing and pulse.
A. If victim is breathing normally and a pulse is present:
- Monitor responsiveness, breathing and pulse
B. If the victim is not breathing normally but pulse is present:
- Provide rescue breathing
- Confirm that emergency response system has been activated.
- If opioid overdose is suspected, administer naloxone per local protocols and monitor for response
- Continue rescue breathing and check the pulse about every 2 minutes. Be ready to perform high-quality CPR if
you do not feel a pulse
C. If the victim has no breathing and no pulse:
- Provide High quality CPR and use AED if available
- If opioid overdose is suspected, administer naloxone per local protocols and monitor for response
- Continue until the advanced care team takes over or if the victim starts to move.
SPECIAL CONSIDERATIONS
D. Adult and Child Choking
Inability to speak or breath
Cyanosis (Turning blue)
SPECIAL CONSIDERATIONS
D. Adult and Child Choking
SPECIAL CONSIDERATIONS
D. Adult and Child Choking
Choking Relief in an Unresponsive Adult or
Child
1. Shout for help. Activate emergency
response if someone is available.
2. Gently lower the victim to the ground .
3. PRIORITY: Begin CPR. No need to check
the pulse.
4. Each time you open the airway to give
breaths, open the victim's mouth wide and
look for the [Link] you can see it,
remove it. Never perform blind finger sweep.
5. After 5 cycles or 2 minutes of CPR,
activate ERS if someone has not already
done so.
SPECIAL CONSIDERATIONS
F. Infant Choking
SPECIAL CONSIDERATIONS
F. Infant Choking
Choking Relief in an Unresponsive Infant:
1. Shout for help. Activate emergency response if someone
is available.
2. Place the infant on a firm, flat surface.
3. PRIORITY: Begin CPR. No need to check the pulse.
4. Each time you open the airway to give breaths, open the
victim's mouth wide and look for the object. If you can see
it, remove it. Never perform blind finger sweep.
5. After 5 cycles or 2 minutes of CPR, activate ERS if
someone has not already done so.