Steps in performing Basic Life Support (BLS) / Cardiopulmonary resuscitation (CPR) a brief overview: Free NCLEX-RN resource

Basic Life Support (BLS) is an emergency procedure performed to maintain circulation and breathing in a person experiencing cardiac arrest or respiratory failure. It includes techniques such as Cardiopulmonary Resuscitation (CPR), the use of an Automated External Defibrillator (AED), and relief of choking.

1. Steps for CPR (Adult)

AHA Chain of Survival:

1.   Recognize cardiac arrest and activate emergency response (Call 911)

2.   Early CPR with high-quality chest compressions

3.   Rapid defibrillation with an AED

4.   Advanced life support (when EMS arrives)

5.   Post-cardiac arrest care

Performing CPR on Adults:

1.   Check for responsiveness: Tap the person and shout, "Are you okay?"

2.   Call for help: Activate emergency response and get an AED.

3.   Check for breathing and pulse (for no more than 10 seconds).

o   No normal breathing or pulse → Begin CPR

4.   Start chest compressions (C-A-B Sequence):

o   Compressions: 30 compressions at a depth of at least 2 inches, at a rate of 100-120 per minute. Do NOT delay chest compressions. It is crucial to Minimize Interruptions in chest compressions.

o   Airway: Open the airway using the head-tilt and chin-lift method.

o   Breathing: Provide 2 rescue breaths, each lasting 1 second, ensuring chest rise.

5.   Use AED as soon as it arrives and follow prompts.

6.   Continue CPR until help arrives or the victim shows signs of life.

2. CPR Modifications for Infants and Children

Infant (0-12 months) CPR:

·       Check responsiveness (tap the foot, call name).

·       Perform 5 initial rescue breaths if unresponsive before calling for help.

·       Compressions:

o   Use two fingers (or two thumbs for two rescuers).

o   Press about 1.5 inches (4cm) deep (1/3 of the chest diameter).

o   30:2 ratio (single rescuer), 15:2 ratio (two rescuers).

·       Breaths: Cover the nose and mouth with your mouth and deliver gentle puffs.

Child (1-8 years) CPR:

·       Use one or two hands for chest compressions.

·       Compress about 2 inches deep.

·       Maintain a 30:2 ratio (single rescuer) and a 15:2 ratio (two rescuers).

·       Use AED with pediatric pads (if available).

3. Choking Management

Conscious Adult or Child:

·       Perform the Heimlich maneuver:

o   Stand behind, wrap arms around the abdomen, and deliver upward abdominal thrusts.

o   Repeat until the object is expelled or the victim becomes unconscious.

Unconscious Adult or Child:

·       Call 911, start CPR, and check for a foreign object between compressions.

Infant Choking:

·       Perform back blows and chest thrusts:

o   Hold the infant face-down on your forearm, and deliver 5 back slaps.

o   Turn the infant face up, and give 5 chest thrusts.

o   Repeat until the object is expelled or the infant becomes unresponsive.

4. AED Use

·       Turn on the AED and follow voice prompts.

·       Attach pads to the upper right chest and lower left side (for adults).

·       Child AED pads should be used for children under 8 years. Never use child AED pads on adults.

·       Clear the patient before delivering a shock.

·       Resume CPR immediately after a shock until medical help arrives.

5. Special Considerations

·       Pregnant Women: Perform CPR as usual; if advanced pregnancy, tilt the patient slightly to the left.

·       Drowning Victims: Provide rescue breaths first before chest compressions.

·       Opioid Overdose: Use naloxone, if available in addition to CPR.

 6. Summary

·       Compressions first (C-A-B sequence).

·       Push hard and fast (100-120 bpm).

·       Use AED as soon as possible.

·       Minimize interruptions in compressions.

·       For infants and children, adapt compressions and breath ratio.