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BLS Algorithms and Training 2020
(Basic Life Support)

Welcome to the Basic Life Support (BLS) algorithms and training by United Medical Education. Here we will discuss basic life saving interventions for patients in respiratory and cardiac distress and the importance of teamwork in a critical emergency. The life saving interventions of BLS are primarily for the purpose of maintaining circulation and oxygenation of the brain and other vital organs until Advanced Cardiac Life Support (ACLS) or other interventions can be initiated by trained healthcare providers.

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Welcome to the free BLS algorithm page offered by United Medical Education. Here you will be able to review critical interventions needed to save a life and earn your BLS provider card. Learn more about our BLS certification.

CPR: for adults

CABD (Circulation, Airway, Breathing, Defibrillate)

There is a common acronym in BLS used to guide providers in the appropriate steps to assess and treat patients in respiratory and cardiac distress. This is CAB-D (Circulation, Airway, Breathing, Defibrillate). The following scenario will help guide you in performing CAB-D.

You find an adult lying on the ground.

Assess to make sure the scene is safe for you to respond to the down patient.

Assess Responsiveness: Stimulate and speak to the adult asking if they are ok. Look at the chest and torso for movement and normal breathing.

If unresponsive:

Place patient supine on a hard flat surface.

Circulation

check for carotid pulse

If the patient has a pulse:

Move to the airway and rescue breathing portion of the algorithm:

If the patient doesn’t have a pulse:

Begin 5 cycles of CPR (lasts approximately 2 minutes).

Start with chest compressions:

1 cycle of adult CPR is 30 chest compressions to 2 rescue breaths.

If two providers are present: switch rolls between compressor and rescue breather every 5 cycles.

chest compressions
chest compressions from front

Airway

In the event of an unwitnessed collapse, drowning, or trauma:

Use the Jaw Thrust maneuver. (This maneuver is used when a cervical spine injury cannot be ruled out.):

In the event of a witnessed collapse with no reason to assume a C-spine injury:

Use the Head Tilt-Chin Lift maneuver:

chin lift

Breathing

Scan the patients chest and torso for possible movement during the “assess unresponsiveness” portion of the algorithm. Watch for abnormal breathing or gasping.

If the patient is breathing adequately:

Continue to assess and maintain a patent airway and place the patient in the recovery position. (Only use the recovery position if its unlikely to worsen patient injury.)

If the patient is not breathing or is breathing inadequately:

If the patient has a pulse:

If the patient has no pulse:

During normal CPR without an advanced airway:

During normal CPR with an advanced airway:

If patient has a pulse and no CPR is required:

If there is a foreign body obstruction:

rescue breaths
rescue breaths with mask and ambu bag

Recovery position
(lateral recumbent or 3/4 prone position):

This position is used to maintain a patent airway in the unconscious person.

Continue to assess and maintain access of airway.
Avoid the recovery position if it will sustain injury to the patient.

recovery position

Defibrillate

Arrival of the AED (Automated External Defibrillator)

Power:

Attachment:

Analyze:

A short pause in CPR is required to allow the AED to analyze the rhythm.

If the rhythm is not shockable:

If the shock is indicated:

AED
placement of AED pads

CPR: for infants 0-1 in age

CABD (Circulation, Airway, Breathing, Defibrillate)

An infant is found lying on the ground.

Assess to make sure the scene is safe for you to respond to the down patient.

Assess Unresponsiveness: Lightly shake or tap the infant’s foot and say their name. Look at the chest and torso for movement and normal breathing.

If the infant is unresponsive:

Circulation

Feel for either the brachial or femoral pulse (Do not check for more than 10 seconds).

brachial and femoral pulse

If the infant has a pulse:

Move to the airway and rescue breathing portion of the algorithm.

If the infant doesn’t have a pulse:

Begin 5 cycles of CPR (lasts approximately 2 minutes).

Start with Chest Compressions:

(One Provider: 1 cycle is 30 chest compressions to 2 rescue breaths) (Two Providers: 1 cycle is 15 chest compressions to 2 rescue breaths)

If you have two providers: switch rolls between compressor and rescue breather every 2 minutes or 5 cycles of CPR.

infant chest compressions

Airway

In the event of an unwitnessed collapse, drowning, or trauma:

Use the Jaw-Thrust maneuver. (This maneuver is used when cervical spine injury cannot be ruled out.):

In the event of a witnessed collapse and there’s no reason to assume C-spine injury:

Use the Head Tilt-Chin Lift maneuver:

infant chin lift

Breathing

Scan the patients chest and torso for possible movement during the “assess unresponsiveness” portion of the algorithm. Watch for abnormal breathing or gasping.

If the infant has adequate breathing:

If the infant is not breathing or is inadequately breathing:

If the infant has a pulse:

If the infant doesn’t have a pulse:

During normal CPR with an advanced airway:

If the patient has a pulse and no CPR is required:

infant rescue breaths

Recovery position for infants

Defibrillate

Arrival of AED (Automated External Defibrillator)

Power:

Attachment:

Analyze:

A short pause in CPR is required to allow the AED to analyze the rhythm.

If the rhythm is not shockable:

If shock is indicated:

Manual defibrillators are preferred for infant use. If the manuals defibrillator is not available the next best option is an AED with a pediatric attenuator. An AED without a pediatric attenuator can also be used.

AED
AED for infant use

CPR: for a child older than 1 year of age to puberty

CABD (Circulation, Airway, Breathing, Defibrillate)

You find a child lying on the ground.

Assess to make sure the scene is safe for you to respond to the down patient.

Assess Unresponsiveness:

If unresponsive:

(One provider) If alone and collapse is un-witnessed:

If alone and collapse is witnessed:

Place patient supine on a hard flat surface.

Circulation

check for carotid pulse

If pulse:

Move to the airway and rescue breathing portion of the algorithm:

If no pulse:

Begin 5 cycles of CPR (lasts approximately 2 minutes)

Start with chest compressions:

(One Provider: 1 cycle is 30 chest compressions to 2 rescue breaths) (Two Providers: 1 cycle is 15 chest compressions to 2 rescue breaths)

If you have two providers: switch rolls between compressor and rescue breather every 2 minutes or 5 cycles of CPR.

child one arm chest compressions
chest compressions top view

Airway

In the event of an unwitnessed collapse, drowning, or trauma: Use the Jaw-Thrust maneuver. (this maneuver is used when cervical spine injury cannot be ruled out):

In the event of a witnessed collapse and there’s no reason to assume a C-spine injury: Use the Head Tilt-Chin Lift maneuver.

Breathing

Scan the patients chest and torso for possible movement during the “assess unresponsiveness” portion of the algorithm. Watch for abnormal breathing or gasping that will require additional ventilatory support.

If adequate breathing:

Continue to assess and maintain a patent airway and place the child in the recovery position. (Only use the recovery position if its unlikely to worsen patient injury)

If not or inadequate breathing:
has a pulse: Commence rescue breaths immediately.
no pulse: Begin CPR (go to Circulation portion of the algorithm).

During normal CPR without an advanced airway:
(One provider) Provide at least 6 rescue breaths per minute.
(Two provider) Provide at least 12 rescue breaths per minute.

During normal CPR with an advanced airway:

If patient has a pulse and no CPR is required:

If foreign body obstruction:

rescue breaths
rescue breaths with mask and ambu bag

Recovery position (lateral recumbent or 3/4 prone position)

This position is used to maintain a patent airway in the unconscious person.

recovery position

Defibrillate

Arrival of AED (Automated External Defibrillator)

Power:

Attachment:

Analyze:

A short pause in CPR is required to allow the AED to analyze the rhythm.

If rhythm is not shockable:

If shock is indicated:

An AED with a pediatric attenuator should be used in children under 8 years of age if available. An AED without a pediatric attenuator can also be used.

AED
top photo for infant AED use

Choking: Adult to Child Over 1 Year Old

Heimlich maneuver

Signs and symptoms of a child/adult choking:

Universal signal for choking:
patient has both hands wrapped around the base of their throat.
With complete airway obstruction, the child is unable to speak, cry, or provide any sounds of respiration.
The patient may be confused, weak, obtunded, or cyanotic.

Partial airway obstruction may result in stridor or a high-pitched audible noise during respiration. Partial airway obstruction may allow for a productive cough or allow the patient to speak.

Get the patient’s attention and ask them if they are choking.
Assess for signs and symptoms of airway obstruction.

If partial airway obstruction:

If complete airway obstruction:

How to perform the Heimlich maneuver:

If patient becomes unconscious:

Before attempting rescue breaths during normal CPR, assess the airway, removing any visually present obstruction.
Do not use a blind finger sweep in an attempt to remove an obstruction.

Choking: Infant Under 1 Year Old

choking infant

Signs and symptoms of an infant choking:

With complete airway obstruction, the infant is unable to speak, cry, or provide any sounds of respiration. The infant may be confused, weak, obtunded, or cyanotic.

Partial airway obstruction may result in stridor or a high-pitched audible noise during respiration. If the child has a partial airway obstruction, powerful cough, or strong audible cry, do not attempt the Heimlich maneuver.

If signs and symptoms of choking are present and infant is conscious:

Position the patient:

Interventional Back Blows:

Reposition the patient:

Interventional Chest Thrusts:

If becomes unconscious:

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