What are the steps for Basic Life Support (BLS) in an emergency situation?

Basic Life Support (BLS) Steps in an Emergency Situation

The most effective Basic Life Support (BLS) sequence begins with ensuring scene safety, checking responsiveness, activating emergency response, and immediately starting chest compressions before rescue breaths (CAB sequence) for victims in cardiac arrest. 1, 2

Initial Assessment

• Verify scene safety before approaching the victim 3
• Check for responsiveness by tapping the victim and shouting "Are you all right?" 1, 3
• Look for no breathing or only gasping while checking for responsiveness 1
• For healthcare providers: Check for pulse (taking no more than 10 seconds) while simultaneously checking for no breathing or only gasping 1
• If unresponsive with no normal breathing (or only gasping) and no pulse, assume cardiac arrest 1

Activation of Emergency Response

• For lay rescuers: If alone, phone 9-1-1 immediately (with phone on speaker mode) and follow dispatcher instructions 1, 2
• For healthcare providers: If alone, activate emergency response system and get AED/defibrillator before starting CPR 1
• If two rescuers are present, one should start CPR immediately while the second activates emergency response and retrieves an AED 1

High-Quality CPR

• Begin chest compressions as quickly as possible after recognizing cardiac arrest 1, 4

• Use the CAB sequence (Compressions, Airway, Breathing) rather than ABC 4

• Compression technique:

  • Position victim on a firm, flat surface 1
  • Place heel of hand on lower half of sternum 5
  • Arms extended, elbows locked, shoulders directly over victim's chest 5
  • Compress at least 2 inches (5-6 cm) deep for adults 2, 3
  • Rate of 100-120 compressions per minute 2, 5
  • Allow complete chest recoil between compressions 2, 3
  • Minimize interruptions in chest compressions 2, 4

• For lay rescuers not trained: Provide compression-only CPR 1, 4

• For trained rescuers: Perform cycles of 30 compressions followed by 2 breaths 1, 5

• For healthcare providers:

  • Single rescuer: 30 compressions to 2 ventilations 1, 3
  • Two rescuers: 30 compressions to 2 ventilations for adults; 15 compressions to 2 ventilations for pediatric patients 1, 3

Early Defibrillation

• Use AED as soon as it becomes available 1, 3
• Turn on the AED and follow the prompts 1
• If shockable rhythm is detected:
  • Deliver 1 shock 1, 3
  • Resume CPR immediately after shock for 2 minutes 1, 3
  • Minimize interruptions in chest compressions 1, 4

Special Situations

• For victims with pulse but inadequate breathing:
  • Provide rescue breaths at rate of 1 breath every 5-6 seconds (10-12 breaths/minute) 1, 2
  • Check pulse approximately every 2 minutes 1, 2
• For suspected opioid overdose, administer naloxone if available 2, 6

Common Pitfalls to Avoid

• Taking too long to check for pulse (limit to 10 seconds maximum) 1, 2
• Interrupting chest compressions unnecessarily 2, 4
• Incomplete chest recoil, which prevents full cardiac refilling 2, 3
• Excessive ventilation, which can reduce cardiac output 4
• Delaying defibrillation when AED is available 1, 4

Termination of CPR

• Continue CPR until:
  • The victim shows signs of life (movement, normal breathing) 5
  • Emergency medical services take over 5
  • An AED prompts for analysis or shock delivery 5
  • The rescuer becomes too exhausted to continue 5

Following these steps in the correct sequence maximizes the chance of survival for victims of cardiac arrest by maintaining vital organ perfusion until advanced care can be provided.