Basic Life Support

Adult and Pediatric

Dr. Sinan Genç
Ankara University School Medicine
Department of Emergency Medicine
Basic Life Support
• With an unconscious casualty who is not breathing normally,
priorities can be remembered by the initials C-A-B.
• C: Circulation
• A: Airway
• B: Breathing
Basic Life Support
• Upon determining that the casualty is not breathing, begin chest
compressions immediately to maintain blood circulation(C) to get
oxygenated blood to the tissues.
• After providing the initial circulation for the casualty, it is important to
maintain an open airway (A) and to breathe (B) for the casualty to
get oxygen into the body.
Basic Life Support
• In an adult during the first minutes after the heart stops (cardiac
arrest), the blood oxygen level remains constant, so chest
compressions are more important than rescue breaths in the initial
phase of resuscitation.
• After two to four minutes, the blood oxygen level falls and rescue
breathing becomes important as well.
• The combination of chest compressions and rescue breaths is called
cardiopulmonary resuscitation, or CPR.
Basic Life Support
• In addition to CPR, a machine called an automated external
defibrillator (AED) can be used to deliver an electric shock that may
restore a normal heartbeat.
Basic Life Support
• If you have not had any formal training in CPR, or you are unwilling or
unable to give rescue breaths, you can give chest compressions only.
• The 112 (or 911) dispatcher will give instructions for performing chest
compression-only CPR
Chain of Survival
Importance of Maintaining Circulation
• If the heart stops beating, blood does not circulate through the body.
• As a result, vital organs—most importantly the brain—become
starved of oxygen.
• Brain cells are unable to survive for more than three to four minutes
without a supply of oxygen.
Importance of Maintaining Circulation
• Some circulation can be maintained artificially by chest compressions.
• These act as a mechanical aid to the heart in order to get blood
flowing around the body.
• Pushing vertically down on the center of the chest increases the
pressure in the chest cavity, expelling blood from the heart and
forcing it into the tissues.
• As pressure on the chest is released, the chest recoils, or comes back
up, and more blood is “sucked” into the heart; this blood is then
forced out of the heart by the next compression.
Importance of Maintaining Circulation
• To ensure that the blood is supplied with enough oxygen, chest
compressions should be combined with rescue breathing.

• However, even if you do not feel comfortable providing rescue

breaths or are not trained to do so, it is very important that you still
provide chest compressions.
Restoring Heart Rhythm
• A machine called an AED (automated external defibrillator) can be
used to attempt to restart the heart when it has stopped.
• The earlier the AED is used, the greater the chance of the casualty
surviving.
• With each minute’s delay, the casualty’s chances of survival fall.
• AEDs can be used safely and effectively without training.
Restoring Heart Rhythm
• These machines can now be found in many public places, such as
railroad and bus stations, shopping centers, airports, and government
buildings.
• They are generally housed in cabinets, often marked with a lightning
bolt, and placed where they can be easily found and accessed.
Airway
• An unconscious casualty’s airway can become narrowed or blocked.
• This may be due to muscular control being lost, which allows the
tongue to fall back and block the airway.
• When this happens, the casualty’s breathing becomes difficult and
noisy and may stop.
• Lifting the chin and tilting the head back lifts the tongue away from
the entrance to the air passage, allowing delivery of rescue breaths.
Airway
• Lifting the chin and tilting the
head back lifts the tongue away
from the entrance to the air
passage, allowing delivery of
rescue breaths.
Breathing
• Exhaled air contains about 16 percent oxygen (only five percent less
than inhaled air) and a small amount of carbon dioxide.
• Your exhaled breath therefore contains enough oxygen to supply
another person with oxygen—and potentially keep him alive—when it
is forced into his lungs during rescue breathing.
Breathing
• By giving rescue breaths, you force air into casualty’s air passages.
• This reaches the air sacs (alveoli) in the lungs, and oxygen is then
transferred through tiny blood vessels (capillaries) to red blood cells.
• When you take your mouth away from the casualty’s, his chest falls,
and air containing waste products is pushed out, or exhaled, from his
lungs.
• This process, performed together with chest compressions, can
supply the tissues with oxygen until help arrives.
Improving the Chance of Survival
• Get access to advanced care as early as possible
• call for help; call an ambulance immediately
• Start CPR fast.
• Use an AED (defibrillator) as soon as possible.
• Continue CPR until advanced care help arrives.
Cardiopulmonary
Resuscitation
Adults
Adult – CPR
• Check for dangers and hazards.
• Consider safety.
• Response
• Shout and tap the casualty to see
if they respond.
• Send for HELP.
• Call an ambulance immediately
Adult – CPR
• Airway open
• Open the airway using Head
tilt/Chin lift
Adult – CPR
• Breathing:
• Check for normal breathing.
• Look, listen and feel for
breathing – airflow at the mouth
and nose
• Check for no more than 10
seconds.
Adult – CPR

If not breathing normally If breathing and unconscious

• Start CPR • Position the casualty in the
Stable Side Position.
• Monitor for breathing, treat for
shock.
• Go for help if alone.
Adult – CPR
• Circulation / CPR – Start CPR
• Position casualty laying on their
back on a hard, flat surface.
• Compressions
• Give 30 compressions.
• Rate of compressions:
• 100–120 per minute.
• Hands on centre of chest
• use heels of hands
Adult – CPR
• Circulation / CPR – Start CPR
• Depth: 1/3 depth of chest
• 5 to 6 cms on an adult
• 4 to 5 cms for a child
• 4 cms for an infant.
• Smooth up and down pressure.
• Minimise pauses.
Adult – CPR
• Give two effective rescue
breaths
• Over one second each.
• An effective breath is completed
when the chest begins to rise.
Adult – CPR
• Defibrillation
• Get and attach AED as soon as
possible and follow voice
prompts.
• Use AED as soon as possible for
all ages.
Adult – CPR
• Continue CPR at a ratio of 30:2

• Give 30 compressions to two

breaths until help arrives or the
casualty begins to breathe.
Cardiopulmonary
Resuscitation
Pediatric
Resuscitation
Child (and infants under one year old)
• For the purposes of resuscitation a child is considered to be aged
eight years and below.
• Unlike adults, children are rarely affected by cardiac arrest due to
heart attack.
• Most non-breathing children are the result of airway and breathing
problems.
• When you are alone and the child or infant is not breathing, perform
CPR for one minute then call an ambulance immediately.
Resuscitation
Child under eight years old (includes infant)
• Check for dangers and hazards.
• Consider safety.
• Check for response.
• Shout and tap, pick infant up
• Send for help
• Ask bystanders to call an
ambulance immediately.
• If alone, stay with the child or
infant. Consider AED.
Resuscitation
Child under eight years old (includes infant)
Airway open
• Child – Head tilt/Chin lift
• Infant – Move head into neutral
position and support lower jaw
as pictured.
Resuscitation
Child under eight years old (includes infant)
Check for normal breathing
• Look, listen and feel for
breathing
• No more than 10 seconds

• IF NOT BREATHING NORMALLY,

start CPR.
• IF ALONE, go for help after one
minute of CPR.
Resuscitation
Child under eight years old (includes infant)
Circulation / CPR – start CPR
• 30 compressions.
• Rate of compressions:
• 100-120 per minute.
• Apply smooth up and down
pressure.
Resuscitation
Child under eight years old (includes infant)
Child 1–8 years old Infant under one year old
• Position one hand on the centre • Two fingers just below the
of the chest. nipple line.
• Depth of compressions should • Depth of compressions should
be 1/3 of the chest depth. be 1/3 of the chest depth.
Resuscitation
Child under eight years old (includes infant)
Give two effective rescue breaths
• An effective breath is completed
when the chest begins to rise.
• Each rescue breath delivered
over one second.
Resuscitation
Child under eight years old (includes infant)
Continue CPR at a ratio of 30:2
• IF ALONE, go for help after one
minute of CPR.
• Give 30 compressions to two
breaths until there is either a
response from the child or until
help arrives.
Resuscitation
Child under eight years old (includes infant)
Defibrillation
• Attach AED as soon as possible
and follow voice prompts.
• For smaller children, place pad
on the centre of the chest and
the other pad on the upper back
between the shoulder blades.
Resuscitation
Child under eight years old (includes infant)
• If child begins to breathe, position on their side and monitor
breathing.