BLS Course Training Materials

These algorithms are the latest 2015 version from the American Heart Association

BLS Algorithm Cards Panel One

The first key concept of Basic Life Support (BLS) is the order of actions that must be performed. It is important to remember the correct order spelt out by the acronym “C”, “A” and “B”, and not the traditionally taught A-B-C.

“C” stands for Chest Compressions, in other words checking and maintaining the patient’s Circulation. “A” stands for Airway, underpinning the importance of checking for the patency of the patient’s airway. “B” stands for Breathing, highlighting the role of ensuring adequate oxygenation via a patent airway.

BLS Algorithm Cards Panel Two

There are a few key concepts in carrying out basic life support. The rationale for these concepts is shown in table 1.

Table 1 Concepts and Rationale for Carrying Out Basic Life Support

Crucial Concepts

Rationale

Start compressions within 10 seconds of identification of cardiac arrest.

Establish circulation in as quick of a timeframe as possible to minimize the risk of depriving the brain tissue of oxygen.

Push hard, push fast.

Adequate chest compressions (in both rate and force) ensure that circulation is mantained as close as possible to cardiac output.

Allow complete chest recoil after each compression.

The recoil allows blood to flow into the chest and heart.

Minimize interruptions in between compressions (less than 10 seconds if possible).

Jerky movements can decrease the effectiveness of the resuscitation and increase the likelihood of injuries.

Give effective breaths to ensure the chest rises.

Effectual breaths provide a clear airway and proper oxygenation of the lungs.

Avoid excessive ventilation.

Excessive ventilation can compromise venous return and cardiac output.

BLS Algorithm Cards Panel Three

Basic Life Support can be summarized in five simple steps.

Step One - Assess the patient and take note if the patient is unresponsive, not breathing or breathing abnormally (tachypnea).

Step Two - Activate the emergency response team as quickly as possible and retrieve an AED, an automated external defibrillator.

Step Three - Assess the patient’s pulse, looking for any abnormal rhythms or total absence of pulse.

Step Four - Start Cardio-Pulmonary Resuscitation (CPR) as indicated—depending on the assessment of the patient—chest compressions in the absence of pulse, airway clearing, and mouth-to-mouth resuscitation in absence of breathing or labored breathing.

Step Five - Use the AED to check for the patients heart rhythm and apply shocks if indicated, for example, in ventricular fibrillation (v-fib).

BLS Algorithm Cards Panel Four

To expand further on the five steps of BLS, a detailed breakdown of each step is in table 2.

Table 2 Detailed Analysis of the Five Steps of Basic Life Support

No.

Step

Notes

1

Assess the patient and take note if the patient is unresponsive, not breathing, or breathing abnormally (tachypnea).

Proper assessment of the patient allows for the correct decision to be made. This enhances the probability of success for the resuscitation.

2

Activate the emergency response teams as quickly as possible and retrieve an AED.

The defibrillator is an important piece of equipment in resuscitation, and is usually easily obtainable, even in public areas. Do seek the help of a second rescuer, if available, to retrieve the defibrillator so that the first rescuer can focus on the patient.

3

Assess the patient’s pulse, looking for any abnormal rhythms or total absence of pulse.

Check the pulse for no less than 5 seconds and no more than 10 seconds. If the patient has a definite pulse, the focus can then shift to patient's airway and breathing, giving 1 breath every 5-6 seconds and rechecking the pulse every 2 minutes.
If the patient has no pulse, chest compressions should be started (step four).

4

Start CPR as indicated—depending on the assessment of the patient—Chest compressions in the absence of pulse, airway clearing, and mouth-to-mouth resuscitation in absence of breathing or labored breathing.

CPR should be performed in cycles of 30 compressions and 2 breaths, at a rate of 100-120/min, with compression depth of at least 2 inches (5 cm) and allowing for proper chest recoil after each compression.
Remember to minimize interruptions to the cycles and avoid excessive ventilation to the patient for the best results.

5

Use the AED to check for the patients heart rhythm and apply shocks if indicated, for example, in ventricular fibrillation (v-fib).

When the defibrillator arrives, apply the leads of the machine onto the patient's chest to check for any heart rhythm. If the rhythm is shockable, apply one shock and immediately continue CPR for 2 minutes before rechecking the rhythm again.
If the rhythm is not shockable, immediately resume CPR for 2 minutes and recheck rhythm after every 2 minutes. Continue this cycle until Advanced Life Support providers arrive to take over or until the patient starts to move.

BLS Algorithm Cards Panel Five

Pediatric Basic life support generally follows the same steps and principles as adult basic life support, but with a few key differences. The differences are bolded in the table 3 for your reference.

Table 3 Pediatric BLS

No.

Step

Notes

1

Assess the patient and take note if the patient is unresponsive, not breathing, or breathing abnormally (tachypnea).

Proper assessment of the patient allows for the correct decision to be made. This enhances the probability of success for the resuscitation.

2

Activate the emergency response team as quickly as possible and retrieve an AED.

The defibrillator is an important piece of equipment in resuscitation, and is usually easily obtainable, even in public areas. Do seek the help of a second rescuer, if available, to retrieve the defibrillator so that the first rescuer can focus on the patient. If you are alone, in the situation of a sudden collapse, activate the emergency response team and obtain a defibrillator before further attending to the patient.

3

Assess the patient’s pulse, looking for any abnormal rhythms or total absence of pulse.

Check the pulse for no less than 5 seconds and no more than 10 seconds. If the patient has a definite pulse, the focus can then shift to patient's airway and breathing, giving 1 breath every 3 seconds, adding compressions if pulse remains under 60 beats per minute despite adequate oxygenation and ventilation. Recheck the pulse every 2 minutes.
If the patient has no pulse, chest compressions should be started (step four).

4

Start CPR as indicated depending on the assessment of the patient—chest compressions in the absence of pulse, airway clearing, and mouth-to-mouth resuscitation in absence of breathing or labored breathing.

CPR should be performed in cycles of 30 compressions and 2 breaths, at a rate of 100-120/min, with compression depth of at least half the anterior-posterior diameter of the chest (1.5 inches (4cm) in infants and 2 inches (5cm) in children) and allowing for proper chest recoil after each compression. If two rescuers are available, begin cycles of 15 compressions with 2 breaths.
Remember to minimize interruptions to the cycles and avoid excessive ventilation to the patient for the best results.

5

Use the AED to check for patients heart rhythm and apply shocks if indicated, for example, in ventricular fibrillation (v-fib).

Use the defibrillator as soon as available. When the defibrillator arrives, apply the leads of the machine onto the patient’s chest to check for any heart rhythm. If the rhythm is shockable, apply one shock and immediately continue CPR for 2 minutes before rechecking the rhythm again.
If the rhythm is not shockable, immediately resume CPR for 2 minutes and recheck rhythm after every 2 minutes. Continue this cycle until Advanced Life Support providers arrive to take over or until the patient starts to move.

Written by and last updated

Last reviewed by on Mar 27, 2017