Summary of Key BLS Components for Adults Children and Infant

Highlights of the 2010

American Heart

Association Guidelines for

Basic Life Support

What are the KEY CHANGES in the

2010 BLS Guidelines?

1. Change in Sequence from A-B-C to C-A-B



2. Emphasis on High Quality CPR

• Compression rate of at least 100/minute (this is a change

from “approximately” 100/min)

• Compression depth of at least 2 inches (5 cm) in adults

and at least 1/3 of the antero-posterior diameter of the

chest in infants and children (the depth of 1½ to 2 inches

in adults is no longer used and the depth used for children

and infants is deeper than in previous versions of the

guideline)

• Allowing complete chest recoil, minimizing interruptions

in chest compressions, and avoiding excessive

ventilations continue to be important components of high-

quality CPR.



3. Removal of “Look, Listen, and Feel for breathing”

• Removed because bystanders fail to start CPR when they

observe “gasping” in a victim

• “Look, listen, and feel” delay the start of chest

compressions

• The new chest compressions first sequence encourages

rescuers to activate the emergency response system and

begin CPR immediately if the victim is unresponsive and

not breathing or not breathing normally and has no pulse.

Adult BLS Overview

Step Action

1 Assess the victim for a response and look for normal or

abnormal breathing. If there is no response and no

breathing or no normal breathing, shout for help.

2 If you are alone, activate the emergency response

system/call a code, and get an AED/Defibrillator if

available and return to the victim. If there are multiple

rescuers, ask someone to call a code and get an

AED/Defibrillator.

3 Check the victim’s pulse (5-10 secs)

4 If there is no pulse, perform CPR starting with

compressions first.

Algorithm for Adult BLS

Pediatric BLS Overview

Step Action

1 Assess the child for a response and check breathing. If

there is no response and no breathing or only gasping,

shout for help.

2 If someone responds, send that person to activate the

emergency response system and get an

AED/Defibrillator.

In a child who suddenly collapses and you are alone,

first activate the emergency response system and get

an AED/Defibrillator.

3 Check the child’s pulse (5-10 secs)

4 If there is no pulse, or despite adequate ventilation and

oxygenation heart rate is <60 bpm, perform CPR

starting with compressions first.

5 After 5 cycles, if someone has not already done so,

activate the emergency response system and get an

AED/Defibrillator.

Algorithm for Pediatric BLS

Pulse Check (Adult and Child)

Step Action

1 Locate the trachea,

using 2-3 fingers.

2 Slide these 2 fingers

into the groove

between the trachea

and the muscles at the

side of the neck. Feel

for the carotid pulse.

3 Check the pulse for 5-

10 secs. If there is no

pulse, start CPR.

Pulse Check (Infant)

Step Action

1 Place 2-3 fingers on the

inside of the upper arm,

between the infant’s

elbow and shoulder.

2 Press the index and

middle fingers gently

on the inside of the

upper arm for 5-10 secs

when attempting to feel

the pulse.

Chest Compressions (Adults)

Step Action

1 Position yourself at the

victim’s side.

2 Make sure the victim is

lying face up on a firm,

flat surface.

3 Put the heel of one

hand on the center of

the victim’s chest on

the lower half of the

breastbone.

4 Put the heel of your

other hand on top of

the first hand.

Chest Compressions (Adults)

Step Action

5 Straighten your arms

and position your

shoulders directly over

your hands.

6 Push hard and fast.

7 Allow complete chest

recoil.

8 Minimize interruptions.

2 Finger Chest Compressions for

Single Rescuer (Infant)

Step Action

1 Place the infant on a

firm flat surface.

2 Place 2 fingers on the

center of the infant’s

chest just below the

nipple line. Do not

press below the breast

bone.

3 Push hard and fast at

least 1/3 of the AP

diameter of the chest.


recoil.

5 Minimize interruptions.

2 Thumb-Encircling Hands Chest

Compressions for 2 Rescuers (Infant)

Step Action

1 Place both thumbs side

by side in the center of

the infant’s chest on

the lower half of the

breastbone.

2 Encircle the infant’s

chest and support the

infant’s back with the

fingers of both hands.

3 Use both thumbs to

depress the breastbone

at least 1/3 the AP

diameter of the infant’s

chest.

4 Push hard and fast.

2 Thumb-Encircling Hands Chest

Compressions for 2 Rescuers (Infant)

Step Action


recoil.

6 After 15 compressions,

pause to allow 2nd

rescuer to give 2

breaths.

7 Continue CPR in a 15:2

compression to

ventilation ratio and

switch roles every 2

minutes.

Opening the Airway:

Head Tilt-Chin Lift

Step Action

1 Place one hand on the

victim’s forehead and

push with your palm to

push the head back.

2 Place the fingers of the

other hand under the

bony part of the lower

jaw near the chin.

3 Lift the jaw to bring the

chin forward.

Using the Bag-Mask During

2-Rescuer CPR

Step Action

1 Position yourself above

the victim’s head.

2 Place the mask on the

victim’s face.

3 Perform a head tilt. Use

the thumb and index

finger of one hand to

make a “C” on the side

of the mask. Use the

remaining fingers to

form an “E” and lift the

angle of the jaw.

4 Squeeze the bag to give

breaths (1 second

each) and watch for

chest rise.

Using the AED

Step Action

P Power ON.

A Attach the pads to the

victim’s bare chest.

A Clear the patient and

analyze the rhythm.

S If the AED advises a

shock, it will tell you to

clear the victim. If no

shock is needed, and

after any shock

delivery, immediately

resume CPR.

Rescue Breathing

Adult Rescue Breathing Pediatric Rescue Breathing

1 breath every 5-6 secs or

about 10-12 breaths/minute



• Rescue breathing is used when a victim has a pulse but is not

breathing effectively. Rescuers should give ventilations

without chest compressions.

• Give each breath in 1 second

• Each breath should result in visible chest rise

• Check the pulse every 2 minutes

CPR with an Advanced Airway

(ET/LMA/Combitube)

Adult Rescue Breathing Pediatric Rescue Breathing



independent of chest

compressions



independent of chest

compressions

Recognizing Choking in a

Responsive Adult or Child

Mild Airway Obstruction Severe Airway Obtruction

Signs:

• Good air exchange

• Can cough forcefully

• May wheeze between

coughs

Signs:

• Poor or no air exchange

• Weak, ineffective cough or

no cough at all

• High pitched noise while

inhaling or no noise at all

• Respiratory distress

• Cyanosis

• Unable to speak

• Universal choking sign

Rescuer Actions Rescuer Actions

• Encourage coughing

• Do not interfere with victim’s

attempts to expel the

foreign body

• If obstruction persists,

activate emergency

response

• Ask the victim is he or she is

choking, if the victim nods

yes and cannot talk, you

must try to relieve the

obstruction

Relieving Choking in a Responsive

Victim 1 Year of Age or Older

Step Action

1 Stand or kneel behind

victim and wrap your

arms behind victim’s

waist.

2 Make a fist with one

hand.

3 Grasp your fist with

your other hand and

press your fist into the

victim’s abdomen with

a quick, forceful,

upward thrust.

4 Repeat until object is

expelled or the victim

becomes unresponsive.

Recognizing Choking in a

Responsive Infant

Mild Airway Obstruction Severe Airway Obtruction

Signs:

• Good air exchange

• Can cough forcefully

• May wheeze between

coughs

Signs:

• Poor or no air exchange

• Weak, ineffective cough or

no cough at all

• High pitched noise while

inhaling or no noise at all

• Respiratory distress

• Cyanosis

• Unable to cry

Rescuer Actions Rescuer Actions

• Do not interfere with victim’s

attempts to expel the

foreign body

• If obstruction persists,

activate emergency

response

• If the infant cannot make

any sounds or breathe, you

must try to relieve the

obstruction


Infant

Step Action

1 Kneel or sit with the

infant in your lap.

2 Hold the infant face

down with the head

slightly lower than the

chest, resting on your

forearm. Support the

infant’s head and jaw

with your hand. Rest

your forearm on your

thigh for support.

3 Deliver 5 back slaps

forcefully between the

infant’s shoulder blades

using the heel of your

hand.


Infant

Step Action

4 After delivering back

slaps, place your free hand

on the infant’s back

supporting the back of

infant’s head with the

palm of your hand.

5 Turn the infant carefully

supporting the head and

neck. Hold the infant face-

up, with your forearm

resting on your thigh. Keep

infant’s head lower than

the trunk.

6 Provide 5 quick downward

chest thrusts over the

lower half of the

breastbone.

7 Repeat until obstruction is

removed or the infant

becomes unresponsive.

Summary of Key BLS Components

for Adults, Children, and Infants

Documents

Summary of Key BLS Components for Adults Children and Infant