| The
following protocol on Basic Life Support (BLS) is advised by the
Resuscitation Council and supersedes all previous protocols.
Basic Life Support consists of the following
sequences of actions: |
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| 1 |
Look for danger |
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- Ensure that the
casualty, any bystanders, and you are safe.
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| 2 |
Check for a response |
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- Gently shake the casualty's
shoulders and ask loudly "Are you alright?"
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| 3A |
If he responds: |
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- Leave him in the position in
which you find him provided there is no further danger.
- Try to find out what is wrong
with him and get help if needed.
- Reassure him regularly.
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| 3B |
If he does not
respond: |
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- Shout for help (assuming
you are alone).
- Turn the casualty onto his back
and open the airway using head tilt and chin lift:
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| 4 |
Keeping the airway
open, look, listen and feel for normal breathing |
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- Look for chest movement.
- Listen at the casualty's
mouth for breathing.
- Feel for air on your
cheek.
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In the first few minutes after a cardiac arrest
a casualty may be barely breathing or taking infrequent noisy gasps (agonal
breathing). Do not confuse this with normal breathing - treat as
not breathing.
Look, listen and feel for 10 seconds to
determine if the casualty is breathing normally. If you have any doubt
about whether the breathing is normal act as if it is not
normal.
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| 5A |
If he is
breathing normally: |
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- Put him into the
recovery position.
- If an ambulance has not been
called, call 999 or go for help.
- Check for continued breathing.
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| 5B |
If he is not
breathing normally |
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- If an ambulance has not been
called, call 999 or go for help.
- If you do
have the AED and oxygen commence
defibrillation.
- If you do not
have the AED and oxygen:
- Kneel by the side of the
casualty, place the heal of one hand on
the casualty's chest between the nipples.
- Place the heel of your other
hand on top of the first hand.
- Interlock the fingers of your
hands and ensure that pressure is not applied over the casualty's
ribs. Do not apply any pressure over the upper abdomen or the bottom
end of the bony sternum (breastbone).
- Position yourself vertically
above the casualty's chest and, with your arms straight, press down on
the sternum 4-5 cm.
- After each compression release
all the pressure on the chest without losing contact between your
hands and the sternum. Repeat at a rate of about 100 times a minute (a
little less than 2 compressions a second).
- Compression and release should
take equal amounts of time.
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Combine chest compressions with
rescue breaths |
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- After 30 compressions open the
airway again using head tilt and chin lift
- Pinch the soft part of the
casualty's nose closed, using the index finger and thumb of your hand
on his forehead.
- Allow his mouth to open but
maintain chin lift.
- Take a normal breath and place
your lips around his mouth, making sure that you have a good seal.
- Blow steadily into his mouth
whilst watching for his chest to rise; take about 1 second for his
chest to rise as in normal breathing; this is an effective rescue
breath.
- Maintaining head tilt and chin
lift, take your mouth way from the casualty and watch for his chest to
fall as air comes out.
- Take another normal breath and
blow into the casualty's mouth once more to give a total of 2
effective rescue breaths. Then return your hands without delay to the
correct position on the sternum and give a further 30 chest
compressions.
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Alternatively use the bag/valve/mask to "breath for" the casualty |
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- Continue with chest
compressions and rescue breaths in a ratio of 30:2.
- Stop to recheck the casualty
only if he starts breathing normally, otherwise do not
interrupt resuscitations
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If rescue breaths do not
make the chest rise as in normal breathing, then before your next
attempt: |
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- Check the casualty's mouth and
remove any visual obstruction.
- Recheck that there is adequate
head tilt and chin lift.
- Do not attempt more than 2
breaths each time before returning to chest compressions.
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If possible your partner,
or another rescuer, should take over CPR about every 2 minutes to
prevent fatigue. Ensure the minimum of delay during the change-over. |
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| 6 |
Chest-compression-only
CPR |
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- If you are not able, or are
unwilling, to give rescue breaths, give chest compressions only.
- If chest compressions only are
given, these should be continuous at a rate of 100 a minute.
- Stop to recheck the casualty
only if he starts breathing normally; otherwise do not
interrupt resuscitation.
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| 7 |
Continue resuscitation
until: |
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- Qualified help arrives and
takes over,
- the casualty starts breathing
normally, or
- you become exhausted.
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