summary of key bls components for adults children and infant
DESCRIPTION
AHA 2010TRANSCRIPT
Highlights of the 2010
American Heart
Association Guidelines for
Basic Life Support
What are the KEY CHANGES in the
2010 BLS Guidelines?
1. Change in Sequence from A-B-C to C-A-B
What are the KEY CHANGES in the
2010 BLS Guidelines?
2. Emphasis on High Quality CPR
• Compression rate of at least 100/minute (this is a change
from “approximately” 100/min)
• Compression depth of at least 2 inches (5 cm) in adults
and at least 1/3 of the antero-posterior diameter of the
chest in infants and children (the depth of 1½ to 2 inches
in adults is no longer used and the depth used for children
and infants is deeper than in previous versions of the
guideline)
• Allowing complete chest recoil, minimizing interruptions
in chest compressions, and avoiding excessive
ventilations continue to be important components of high-
quality CPR.
What are the KEY CHANGES in the
2010 BLS Guidelines?
3. Removal of “Look, Listen, and Feel for breathing”
• Removed because bystanders fail to start CPR when they
observe “gasping” in a victim
• “Look, listen, and feel” delay the start of chest
compressions
• The new chest compressions first sequence encourages
rescuers to activate the emergency response system and
begin CPR immediately if the victim is unresponsive and
not breathing or not breathing normally and has no pulse.
Adult BLS Overview
Step Action
1 Assess the victim for a response and look for normal or
abnormal breathing. If there is no response and no
breathing or no normal breathing, shout for help.
2 If you are alone, activate the emergency response
system/call a code, and get an AED/Defibrillator if
available and return to the victim. If there are multiple
rescuers, ask someone to call a code and get an
AED/Defibrillator.
3 Check the victim’s pulse (5-10 secs)
4 If there is no pulse, perform CPR starting with
compressions first.
Algorithm for Adult BLS
Pediatric BLS Overview
Step Action
1 Assess the child for a response and check breathing. If
there is no response and no breathing or only gasping,
shout for help.
2 If someone responds, send that person to activate the
emergency response system and get an
AED/Defibrillator.
In a child who suddenly collapses and you are alone,
first activate the emergency response system and get
an AED/Defibrillator.
3 Check the child’s pulse (5-10 secs)
4 If there is no pulse, or despite adequate ventilation and
oxygenation heart rate is <60 bpm, perform CPR
starting with compressions first.
5 After 5 cycles, if someone has not already done so,
activate the emergency response system and get an
AED/Defibrillator.
Algorithm for Pediatric BLS
Pulse Check (Adult and Child)
Step Action
1 Locate the trachea,
using 2-3 fingers.
2 Slide these 2 fingers
into the groove
between the trachea
and the muscles at the
side of the neck. Feel
for the carotid pulse.
3 Check the pulse for 5-
10 secs. If there is no
pulse, start CPR.
Pulse Check (Infant)
Step Action
1 Place 2-3 fingers on the
inside of the upper arm,
between the infant’s
elbow and shoulder.
2 Press the index and
middle fingers gently
on the inside of the
upper arm for 5-10 secs
when attempting to feel
the pulse.
Chest Compressions (Adults)
Step Action
1 Position yourself at the
victim’s side.
2 Make sure the victim is
lying face up on a firm,
flat surface.
3 Put the heel of one
hand on the center of
the victim’s chest on
the lower half of the
breastbone.
4 Put the heel of your
other hand on top of
the first hand.
Chest Compressions (Adults)
Step Action
5 Straighten your arms
and position your
shoulders directly over
your hands.
6 Push hard and fast.
7 Allow complete chest
recoil.
8 Minimize interruptions.
2 Finger Chest Compressions for
Single Rescuer (Infant)
Step Action
1 Place the infant on a
firm flat surface.
2 Place 2 fingers on the
center of the infant’s
chest just below the
nipple line. Do not
press below the breast
bone.
3 Push hard and fast at
least 1/3 of the AP
diameter of the chest.
4 Allow complete chest
recoil.
5 Minimize interruptions.
2 Thumb-Encircling Hands Chest
Compressions for 2 Rescuers (Infant)
Step Action
1 Place both thumbs side
by side in the center of
the infant’s chest on
the lower half of the
breastbone.
2 Encircle the infant’s
chest and support the
infant’s back with the
fingers of both hands.
3 Use both thumbs to
depress the breastbone
at least 1/3 the AP
diameter of the infant’s
chest.
4 Push hard and fast.
2 Thumb-Encircling Hands Chest
Compressions for 2 Rescuers (Infant)
Step Action
5 Allow complete chest
recoil.
6 After 15 compressions,
pause to allow 2nd
rescuer to give 2
breaths.
7 Continue CPR in a 15:2
compression to
ventilation ratio and
switch roles every 2
minutes.
Opening the Airway:
Head Tilt-Chin Lift
Step Action
1 Place one hand on the
victim’s forehead and
push with your palm to
push the head back.
2 Place the fingers of the
other hand under the
bony part of the lower
jaw near the chin.
3 Lift the jaw to bring the
chin forward.
Using the Bag-Mask During
2-Rescuer CPR
Step Action
1 Position yourself above
the victim’s head.
2 Place the mask on the
victim’s face.
3 Perform a head tilt. Use
the thumb and index
finger of one hand to
make a “C” on the side
of the mask. Use the
remaining fingers to
form an “E” and lift the
angle of the jaw.
4 Squeeze the bag to give
breaths (1 second
each) and watch for
chest rise.
Using the AED
Step Action
P Power ON.
A Attach the pads to the
victim’s bare chest.
A Clear the patient and
analyze the rhythm.
S If the AED advises a
shock, it will tell you to
clear the victim. If no
shock is needed, and
after any shock
delivery, immediately
resume CPR.
Rescue Breathing
Adult Rescue Breathing Pediatric Rescue Breathing
1 breath every 5-6 secs or
about 10-12 breaths/minute
1 breath every 3-5 secs or
about 12-20 breaths/minute
• Rescue breathing is used when a victim has a pulse but is not
breathing effectively. Rescuers should give ventilations
without chest compressions.
• Give each breath in 1 second
• Each breath should result in visible chest rise
• Check the pulse every 2 minutes
CPR with an Advanced Airway
(ET/LMA/Combitube)
Adult Rescue Breathing Pediatric Rescue Breathing
1 breath every 6-8 secs or
about 8-10 breaths/minute
independent of chest
compressions
1 breath every 6-8 secs or
about 8-10 breaths/minute
independent of chest
compressions
Recognizing Choking in a
Responsive Adult or Child
Mild Airway Obstruction Severe Airway Obtruction
Signs:
• Good air exchange
• Can cough forcefully
• May wheeze between
coughs
Signs:
• Poor or no air exchange
• Weak, ineffective cough or
no cough at all
• High pitched noise while
inhaling or no noise at all
• Respiratory distress
• Cyanosis
• Unable to speak
• Universal choking sign
Rescuer Actions Rescuer Actions
• Encourage coughing
• Do not interfere with victim’s
attempts to expel the
foreign body
• If obstruction persists,
activate emergency
response
• Ask the victim is he or she is
choking, if the victim nods
yes and cannot talk, you
must try to relieve the
obstruction
Relieving Choking in a Responsive
Victim 1 Year of Age or Older
Step Action
1 Stand or kneel behind
victim and wrap your
arms behind victim’s
waist.
2 Make a fist with one
hand.
3 Grasp your fist with
your other hand and
press your fist into the
victim’s abdomen with
a quick, forceful,
upward thrust.
4 Repeat until object is
expelled or the victim
becomes unresponsive.
Recognizing Choking in a
Responsive Infant
Mild Airway Obstruction Severe Airway Obtruction
Signs:
• Good air exchange
• Can cough forcefully
• May wheeze between
coughs
Signs:
• Poor or no air exchange
• Weak, ineffective cough or
no cough at all
• High pitched noise while
inhaling or no noise at all
• Respiratory distress
• Cyanosis
• Unable to cry
Rescuer Actions Rescuer Actions
• Do not interfere with victim’s
attempts to expel the
foreign body
• If obstruction persists,
activate emergency
response
• If the infant cannot make
any sounds or breathe, you
must try to relieve the
obstruction
Relieving Choking in a Responsive
Infant
Step Action
1 Kneel or sit with the
infant in your lap.
2 Hold the infant face
down with the head
slightly lower than the
chest, resting on your
forearm. Support the
infant’s head and jaw
with your hand. Rest
your forearm on your
thigh for support.
3 Deliver 5 back slaps
forcefully between the
infant’s shoulder blades
using the heel of your
hand.
Relieving Choking in a Responsive
Infant
Step Action
4 After delivering back
slaps, place your free hand
on the infant’s back
supporting the back of
infant’s head with the
palm of your hand.
5 Turn the infant carefully
supporting the head and
neck. Hold the infant face-
up, with your forearm
resting on your thigh. Keep
infant’s head lower than
the trunk.
6 Provide 5 quick downward
chest thrusts over the
lower half of the
breastbone.
7 Repeat until obstruction is
removed or the infant
becomes unresponsive.
Summary of Key BLS Components
for Adults, Children, and Infants