Chapter 14: BLS Resuscitation (Basic Life Support)

Historical Background

• BLS principles introduced in the early 1960s
• CPR as known today has been revised and improved since its inception
• Reviewed every 5 years; latest review in 2020 by American Heart Association

Importance of BLS

• Non-invasive emergency life care: treats airway obstruction, respiratory arrest, and cardiac arrest
• Focus on ABCs: Airway, Breathing, Circulation
• Critical timing: Start within 4-6 minutes to prevent irreversible brain damage

Basic Components of CPR

• Reestablish circulation and artificial ventilation
• Chest compressions, airway opening, rescue breathing
• Use of BVM (bag valve mask) with supplemental oxygen

Differences Between BLS and ALS

• ALS involves advanced techniques (e.g., cardiac monitor, IVs, advanced airway)
• BLS focuses on immediate, initial response

Chain of Survival

1. Early recognition and activation of EMS
2. High-quality CPR
3. Early defibrillation
4. Basic and advanced EMS
5. Post-arrest care and recovery

CPR Procedure

• Survey the scene for safety
• Assess ABCs quickly (<10 seconds)
• Begin CPR for unresponsive patients without pulse or breathing
• AED use: Apply as soon as available, especially important for adults

Special Considerations

• Infants/children CPR: Typically due to respiratory issues; need good quality CPR
• Adjust methods for infants/children: Use pediatric pads, adjust airway position
• Special cases: Pacemakers, wet patients, transdermal patches

CPR Techniques

• Proper compression technique on the lower half of the sternum
• Avoid leaning between compressions to allow chest recoil
• Two-person CPR preferred to reduce fatigue

Airway Management

• Head tilt-chin lift maneuver; jaw thrust for suspected spinal injury
• Use recovery position if no injury and patient is breathing

Special Devices

• Impedance threshold device and other mechanical aids
• Mechanical compression devices: Piston and vest types

Foreign Body Obstruction

• Heimlich maneuver: Used for adults and children >1 year
• Back slaps and chest thrusts for infants
• Special care for unconscious patients

CPR in Special Situations

• Opioid overdose: Combine rescue breathing with naloxone
• Pregnancy: Adjust position to relieve pressure on aorta and vena cava

Psychological and Emotional Support

• Handling family members during resuscitation
• Communicate clearly and involve family in the process
• Provide grief support post-resuscitation

Maintaining CPR Skills

• Regular practice on mannequins
• CPR certification renewal every two years

Key Takeaways

• Critical timing and proper technique are vital
• Continuous learning and skills maintenance are essential for effective BLS
• CPR and AED usage combined are crucial in saving lives