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Adult BLS -> DRSABCD
Danger:
- check for environmental hazards
- Fire, wet floors, chemical spills, sharps, body fluids, unstable relatives etc
- continue only when dangers have been removed and environment is safe
Response:
- COWS -> Can you hear me, Open your eyes, What's your name, Squeeze my hand
- Gently squeeze shoulder/trapezius muscle if no response to voice
- Signs of life -> eye opening, verbal, movement
Send for help:
- shout for help in 4 directions
- call an ambulance
- press the emergency button if in hospital
- request BLS equipment and AED where available
Airway:
- open the airway
- tongue is the most common cause of obstruction in unconcious patients
- chin lift and head tilt
- jaw thrust if spine injury suspected
- remove obvious foreign material, vomit, blood etc
Breathing:
- 1 ear close to the patient's nose and mouth, and your eyes directed to their chest
- Look, listen and feel for at most 10 seconds
- Look at the chest for rising and falling
- Listen and feel with your ear for breathing
- if no response start CPR
Cardiopulmonary resuscitation:
- Alternate 30 compressions with 2 breaths
- interlock hands over centre lower half of chest
- shoulders above hands and elbows straight
- 100 -120 compressions/min
- compress to 1/3 depth of chest (about 5cm)
- let chest re-expand between compressions
- Bag valve mask (Ambu bag) -> open airway (chin lift, head tilt, jaw thrust); use mask to form tight seal over nose and mouth (1 hand C-E grip or double hand grip if extra help available); squeeze bag over 1 second and watch chest rise; let air escape and watch chest fall; repeat for second breath then restart compressions
Defibrillator (AED):
- attach pads below right clavicle and left lower lateral chest
- ensure dry skin, no hair, and away from pacemaker or ecg pads
- follow AED prompts
- stand clear of patient when AED is analysing the rhythm (every 2 minutes) and when it advises to deliver shock
- restart compressions if no shock required or soon after shock is delivered
When to stop CPR:
- experienced help arrives and takes over
- patient shows signs of life
- physically exhausted and unable to continue CPR
This information is for academic purposes only and opinions are likely to differ. Please always refer to your local guidelines and protocols for recommended clinical practices.
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(HRE)