BLS For Teacherr

HEALTH EMERGENCY MANAGEMENT STAFF
Republic of the Philippines

Department of Health
Office of the Secretary

BLS for HCP
At the end of this module, participants shall
be able to:
1. Explain the procedure of getting started during emergency.

2. Describe the five emergency action principles .
3. Enumerate golden rules in giving emergency care.
4. Demonstrate how to do initial assessment of the victim.
5. Discuss the basic precautions in disease prevention.
1. PLANNING
Emergency plan should be

established based on:
1. anticipated needs
2. available resources
4
2. PROVISION OF LOGISTICS
The emergency response begins with the preparation of
equipment and personnel before any emergency occurs.
5
GETTING STARTED
3. INITIAL RESPONSE
a. A =Ask for HELP.
b. I = Intervene
c. D = Do no further harm.
4. INSTRUCTION TO BY-STANDERS
Proper information and
instruction to bystander/s
would provide:
Organized first aid

care.
6
1. SURVEY THE SCENE
2. INITIAL ASSESSMENT OF THE VICTIM
3. ACTIVATE MEDICAL ASSISTANCE
4. SECONDARY ASSESSMENT OF THE VICTIM
5. REFERRAL FOR FURTHER EVALUATION
ANDMANAGEMENT
1. SURVEY THE SCENE
Once you recognized that an
emergency has occurred and
decide to act, you must:
make sure the scene of the

emergency is safe for you,
the victim/s, and any
bystander/s.
Elements of the Survey the Scene
1. Scene safety.
2. Mechanism of injury or
nature of illness.
3. Determine the number of
patients.
4. Determine additional
resources.
2. DO A PRIMARY SURVEY OF THE VICTIM
In every emergency situation, you must first find out if
there are conditions that are an immediate threat to
the victims life.
Check for Check for

Responsiveness Breathing
Abnormal Breathing
Examples:
1. Gasping
2. Irregular rise and fall of the chest
3. Wheezing
4. Gargling sound
5. Cannot speak
6. Unresponsive but snoring
3. ACTIVATE MEDICAL ASSISTANCE (AMA)
OR TRANSFER FACILITY
In some emergency, you will have enough time to call for specific
medical advice before administering first aid. (Call First) But
in some situations, you will need to attend to the victim first.
(Care First)
In our local setting we Activate
Medical Assistance by calling our
local health unit or
call our nearest hospital local hospital
barangay health station or
transfer facility.
Call First and Care First
Both trained and untrained
bystanders should be While for infants and children a
instructed to Activate Medical Care First approach is
Assistance as soon as they recommended.
have determined that an
adult victim requires
emergency care Call
First.
Information to be remembered
in activating Medical Assistance:
-WHAT happened?
-LOCATION?
-NUMBER of Persons Injured?
-EXTENT of Injury
-The TELEPHONE no. from where you are calling?
-PERSON who activated Medical Assistance must identify him/herself and drop
the phone last.
SL.ppt/TR/FC7
For sudden collapse in victim of all ages, the lone rescuer should
* call the emergency response number( e.g.161, 117, 168 or

nearest hospital )
* use an AED, when readily available
* return to the victim to begin CPR (and use the AED )
For unresponsive victim of all ages with likely asphyxial arrest (e.g.
drowning) the HCP should
* deliver at least 5 cycles (2 min.) of CPR before leaving

the victim
* call the emergency response number
* use an AED, if available
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4. DO A SECONDARY ASSESMENT OF THE VICTIM
It is a systematic method of gathering additional information about injuries or
conditions that may need care.
a. Interview the victim
S- signs and symptoms
A - allergies
M - medications
P - past medical history
L - last meal taken
E - events prior to injury or incident
b. Check vital signs- every 15 minutes if stable condition, and

every 5 minutes if unstable
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c. Head to toe examination
D- deformity
C- contusion
A- abrasion
P- punctures
B- burn
T- tenderness
L- laceration
S- swelling
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5. REFERRAL OF THE VICTIM FOR FURTHER
EVALUATION AND MANAGEMENT
It refers to the transfer of a victim to hospital or health
care facility if necessary for a definitive treatment.
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1. Do obtain consent when possible
2. Do think of the worst
3. Do remember to identify yourself
4. Do provide comfort and emotional support
DOs 5. Do respect the victim( modesty and privacy)
6. Do be as calm and direct as possible
7. Do care for the most serious injuries first
8. Do assist the victim on medication
9. Do keep on lookers away from the injured person
10. Do handle the victim to a minimum
11. Do loosen tight clothing
1. Do not let the victim see his/her injuries
2. Do not leave the victim alone except to get
help
DONTS
3. Do not assume that the victims obvious
injuries are the only one
4. Do not make any unrealistic promises
5. Do not trust the judgment of a confused
person
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BODY SUBSTANCE ISOLATION (BSI)
Are precautions taken to isolate or prevent risk
of exposure from any other type of bodily substance
using personal protective equipment (PPE).
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Basic Precautions and Practices
1. Personal Hygiene 2. Protective Equipment 3. Equipment Cleaning

& Disinfecting
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Were we able to:
1. Explain the procedure of getting started during

emergency.
2. Describe the five emergency action principles .
3. Enumerate golden rules in giving emergency care.
4. Demonstrate how to do initial assessment of the
victim.
5. Discuss the basic precautions in disease prevention.
Republic of the Philippines
Department of Health
Office of the Secretary

BLS for HCP
Module 2: Introduction to B L S
OBJECTIVES:
At the end of this module, participants shall be able
to:
1. Explain the concept of the module.
2. Identify the three kinds of Life Support.
3. Identify the five links in the Chain of Survival for
Adult and Pediatric patients.
4. Identify the anatomical positions, directions,
locations and regions of the human body.
SL.ppt/TR/FC 2 25
Module 2: Introduction to B L S
Cont of OBJECTIVES:
5. Discuss the anatomy and physiology of the

respiratory, circulatory, and nervous systems.
6. Discuss the risk factors for cardiovascular disease.
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Module 2: Basic Life Support
THREE KINDS OF LIFE SUPPORT
1. BASIC LIFE SUPPORT (BLS)
BLS is the foundation for saving lives following

cardiac arrest.
Fundamental aspects of adult BLS include immediate

recognition of sudden cardiac arrest and activation of
the emergency response system, early performance of
high quality CPR, and rapid defibrillation when
appropriate.
2010 AHA Guidelines for CPR

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Module 2: BASIC LIFE SUPPORT
2. ADVANCED CARDIAC LIFE SUPPORT (ACLS)
ACLS interventions aimed at preventing cardiac arrest include airway management,

ventilation support, and treatment of bradyarrhythmias and tachyarrhythmias. For
the treatment of cardiac arrest, ACLS interventions build on the basic life support
(BLS) foundation of immediate recognition and activation of the emergency
response system, early CPR, and rapid defibrillation to further increase the
likelihood of ROSC (Return Of Spontaneous Circulation) with drug therapy,
advanced airway management, and physiologic monitoring.
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Module 2: BASIC LIFE SUPPORT
3. Post Cardiac Arrest Care

Systematic postcardiac arrest care after return of spontaneous
circulation (ROSC) can improve the likelihood of patient survival with
good quality of life. Postcardiac arrest care has significant potential to
reduce early mortality caused by hemodynamic instability and later
morbidity and mortality from multiorgan failure and brain injury.
SL.ppt/TR/FC 6 29
Adult Chain of Survival
1 2 3 4 5
Immediate Early Rapid Advance Post-Cardiac
Recognition CPR Defibrillation Life Arrest Care
and Support
Activation
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FIVE LINKS for ADULT VICTIMS
1. The First Link: Immediate Recognition and Activation
It is the event initiated after the patients collapse until the arrival of Emergency
Medical Services personnel prepared to provide care.
2. The Second Link: EARLY CPR
It is most effective when started immediately after the victims collapse. The
probability of survival approximately doubles when it is initiated before the arrival
of EMS.
3. The Third Link: Rapid DEFIBRILLATION
It is most likely to improve survival. It is the key intervention to increase the chances
of survival of patients with out-of-hospital cardiac arrest.
4. The Fourth Link: ACLS
Provided by highly trained personnel like paramedics.
5. The Fifth Link: Post Cardiac Arrest Care
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Pediatric Chain of Survival
1 2 3 4 5
Safety Early Activate Advance Post-Cardiac
of Rescuer CPR Emergency Life Arrest Care
and Victim Response Support
System
SL.ppt/TR/FC 9 32
Each link in the PEDIATRIC CHAIN OF SURVIVAL must be strong to maximize survival
and a neurologically intact outcome after life threatening cardiovascular emergencies
1. The First Link: Safety of Rescuer and Victim

Always make sure that the area is safe for you and the victim. Although
provision of CPR carries a theoretical risk of transmitting infectious
disease, the risk to the rescuer is very low.
2. The Second Link: EARLY AND EFFECTIVE BYSTANDER CPR

It is most effective when started immediately after the victims collapse. The
probability of survival approximately doubles when it is initiated before the arrival
of EMS. It is associated with successful return of spontaneous circulation and
neurologically intact survival in children.
SL.ppt/TR/FC 10 33
Each link in the PEDIATRIC CHAIN OF SURVIVAL must be strong to maximize
survival and a neurologically intact outcome after life threatening cardiovascular
emergencies
3. The Third Link: RAPID ACTIVATION OF THE EMS (OR OTHER EMERGENCY
RESPONSE) SYSTEM
It is most likely to improve survival. It is the key intervention to increase the chances
of survival of patients with out-of-hospital cardiac arrest.
4. The Fourth Link: EFFECTIVE ADVANCED LIFE SUPPORT (INCLUDING

RAPID STABILIZATION AND TRANSPORT TO DEFINITIVE CARE &REHABILITATION)
Initial steps in stabilization (provide warmth by placing baby under a radiant heat
source, position head in a sniffing position to open the airway, clear airway w/ bulb
syringe or suction catheter, dry baby and stimulate breathing.
5. Post-Cardiac Arrest Care
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ANATOMICAL TERMS
(Position, direction and location of a body part)
1. Anatomical position 9. Lateral

2. Superior 10. Internal
3. Inferior 11. External
4. Proximal 12. Superficial
5. Distal 13. Deep
6. Anterior 14. Supine position
7. Posterior 15. Prone position
8. Medial 16. Lateral recumbent
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ANATOMICAL TERMS
(Position, direction and location)
Supine Position Prone Position
Lateral Recumbent/ Recovery Position
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BODY REGIONS
1. Cranial Cavity 4. Abdominal Cavity
Brain Liver Stomach
Pancreas Kidney
Intestines Spleen
2. Spinal Cavity
Spinal Cord
5. Pelvic Cavity
3. Thoracic Cavity Bladder
Lungs Rectum
Heart Reproductive organs
SL.ppt/TR/FC 15 37
Systems of the Human Body:
* Respiratory System
* Circulatory System
* Nervous System
* Integumentary System
* Digestive System
* Excretory System
* Reproductive System
* Musculo-skeletal System
SL.ppt/TR/FC 16 38
BODY SYSTEMS
1. Nervous System 2. Respiratory System 3. Circulatory System
4. Digestive System 5. Urinary System 6. Reproductive System
7. Musculo-Skeletal System 8. The Skin
SL.ppt/TR/FC 17 39
ANATOMY AND PHYSIOLOGY
1. The Respiratory System

It delivers oxygen to the body, as
well as removes carbon dioxide
from the body. The passage of air
into and out of the lungs is called
respiration. Breathing in is called
inspiration or inhalation. Breathing
out is called expiration or
exhalation.
SL.ppt/TR/FC 21 40
RESPIRATORY SYSTEM
Diaphragm is the thin layer of muscle that separates the chest cavity containing the lungs and
heart from the abdominal cavity containing the intestines and digestive organs.
Trachea (windpipe ) is a tube extending from below the voice box into the chest where it splits
into two branches, the bronchi, that lead to each lung.
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SL.ppt/TR/FC 20
Air that enters the lungs contains:

21% O2
trace of CO2
Breathing
Air exhaled from the lungs contains:
16% O2
4% CO2
42
Superior vena cava
(oxygen-poor blood
from head and upper
body
2. The Circulatory System

It delivers oxygen and
nutrients to the bodys
Left pulmonary
tissues and removes waste Right pulmonary
artery (blood to
vein
products. It consists of the right lung)
heart, blood vessels, and Right atrium
blood.
Right ventricle
Inferior vena cava

(oxygen-poor blood
from lower body
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Circulation
SL.ppt/TR/FC 24 44
*Clinical death
0 - 1 min. - cardiac irritability
1 - 4 min. - brain damaged not likely
4 - 6 min. - brain damage possible
*Biological death
6 - 10 min. - brain damaged very likely
over 10 min. - irreversible brain damaged
SL.ppt/TR/FC 25 45
3. The Nervous System
It is composed of the brain, spinal cord and

nerves. It has two major functions
communication and control. It lets a person be
aware of and react to the environment. It
coordinates the bodys responses to stimuli and
keeps body systems working together.
SL.ppt/TR/FC 26 46
1. Risk Factors that cannot be changed
Heredity
Age
Gender
2 . Risk Factors that can be changed:
Cigarette smoking
Hypertension
Elevated cholesterol and triglyceride levels
Lack of exercises
Obesity
Stress
Diabetes mellitus
HEART ATTACK ( Myocardial Infarction)
It occurs when the oxygen

supply to the heart muscle
(myocardium) is cut-off for a
prolonged period of time. This
cut-off results from a reduced
blood supply due to severe
narrowing or complete
blockage of the diseased
artery. The result is death
(infarction) of the affected
part of the heart.
SIGNS AND SYMPTOMS OF HEART ATTACK
1. Chest Discomfort
2. Sweating
3. Nausea
4. Shortness of Breath
5. Pain radiating to the lower jaw, arms,
epigastric area, or back
6. Sudden fainting
EMERGENCY MANAGEMENT OF HEART ATTACK
1. Recognized the signs and symptoms of heart attack

and take action.
2. Have patient stop what he or she is doing and sit or lie
him/her down in a comfortable position. Do not let the
patient move around.
3. Have someone call the physician or ambulance for help.
4. If patient is under medical care, assist him/her in taking

his/her prescribed medicine/s.
Module
BLS for HCP 3
Respiratory Arrest and
Rescue Breathing
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Module 3: Respiratory Arrest and Rescue
Breathing
OBJECTIVES:
At the end of this module, participants shall be able to:
1. Describe what is respiratory arrest.
2. Identify the causes of respiratory arrest.
3. Describe the ways in ventilating the lungs.
4. Demonstrate how to provide rescue breathing for an adult,
child, & infant who show signs of circulation but has
inadequate or not breathing.
Is the condition in which breathing stops or is inadequate.
Is a technique of blowing air into a persons lungs to

supply him or her with the oxygen needed to survive.
1. Obstruction
Anatomical
Mechanical
2. Diseases
Bronchitis
Pneumonia
COPD
3. Other causes
Electrocution
Circulatory Collapse
Strangulation
Chest Compression ( by other physical force )
Drowning
Poisoning
Suffocation
Jaw - thrust maneuver
Maximum tilt of the head
1. Mouth-to- 2. Mouth-
Mouth to-Nose
3. Mouth-to-Mouth
and Nose 4. Mouth-to-
Stoma
5. Mouth-to- 6. Mouth-to-
Face Shield Mask
7. Bag Mask
Device
Checking for breathing
Take 5 to 10 seconds (no more than

10seconds) to check for normal breathing
in an unresponsive adult, infant or child.
Table of Comparison on Rescue Breathing
for Adult, Child and Infant
Adult Child Infant
Opening of airway (Head-

Maximum tilt of the head Neutral position Neutral position
Tilt_ Chin-Lift Maneuver)
Method Mouth-to-mouth or mouth-to-nose Mouth-to-mouth and nose
Breaths 2 Normal breath enough to clearly rise the chest
SL.ppt/TR/FC 44 61
Ventilation With an Advanced
Airway
When the victim has an advanced airway in place during
CPR, rescuers no longer deliver cycles of 30
compressions and 2 breaths (ie, they no longer interrupt
compressions to deliver 2 breaths).
Instead, continuous chest compressions are performed at

a rate of at least 100 per minute without pauses for
ventilation, and ventilations are delivered at the rate of 1
breath about every 6 to 8 seconds (which will deliver
approximately 8 to 10 breaths per minute).
Important Points
Ways to ventilate the
Take a normal (not a deep) breath before
giving a rescue breath to a victim.
Give each breath over 1 second. Each breath
should make the chest rise.
If the victims chest does not rise when the first
rescue breath is delivered, perform the head
tiltchin lift again (for Healthcare Provider- can
do Jaw trust maneuver) before giving the
second breath.
Module
BLS for HCP4
Cardiopulmonary
Resuscitation
SL.ppt/TR/FC 20 64
Module 4: Cardiopulmonary Resuscitation
OBJECTIVES:
At the end of this module participants should be able to:

a. Define cardiopulmonary resuscitation
b. Perform correct cardiopulmonary resuscitation techniques to
an adult, child and infant who are in cardiac arrest
c. Discuss other alternative forms of CPR
d. Enumerate the criteria for when to start, not to start and
when to stop CPR
SL.ppt/TR/FC 2 65
CARDIOPULMONARY
RESUSCITATION (CPR)
is series of assessments and interventions

using techniques and manoeuvres made
to bring victims of cardiac and respiratory
arrest back to life.
All victims of cardiac arrest should receive

CPR
DO NOT START CPR
All victims of cardiac arrest should receive CPR
unless:
1. Patient has a valid DNAR (Do Not Attempt
Resuscitation) order.
2. Patient has signs of irreversible death (Rigor
Mortis, Decapitation, Dependent Lividity).
3. No physiological benefit can be expected
because the vital functions have deteriorated
as in septic or cardiogenic shock.
67
DO NOT START CPR
All victims of cardiac arrest should receive CPR

unless:
4. Confirmed gestation of < 23 weeks or birth

weight < 400 grams, anencephaly.
5. Attempts to perform CPR would place the

rescuer at risk of physical injury.
68
WHEN TO STOP CPR
All rescuers who have started resuscitation
procedures should continue to do so unless:
1. Effective and spontaneous (normal)

breathing and circulation has been restored.
2. Responsibility is assumed by a more senior
emergency medical professional who may
determine unresponsiveness to resuscitation
efforts such as a paramedic arriving on the
scene or a physician in the emergency room.
69
WHEN TO STOP CPR
All rescuers who have started resuscitation
procedures should continue to do so unless:
3. Recognition of reliable criteria indicating
irreversible death (Physician).
4. Rescuer is unable to continue resuscitation
due to exhaustion, the scene is no longer
safe, or when continued resuscitation may
place other lives at risk.
5. Presentation of a valid DNAR order to the
rescuer.
70
CARDIAC ARREST
What do we do?
1. Establish scene safety.

2. Introduce self to establish authority.
3. Shake the victim and Shout, Are you
alright?
4. No response: Shout Help! Activate
medical assistance (and bring me an
AED)!
5. If you are alone, you must LEAVE the
patient to call for help (and get an
AED). Once this is accomplished, return
to the patient immediately.
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SL.ppt/TR/FC10
The C-A-Bs
Core concept: Oxygen to the Brain!

In order: -Chest Compression-Airway-
Breathing
Start Chest compression immediately do not
delay
These build on each other.
ALWAYS FOLLOW YOUR CABs!!!
Basic Life Support ebec 2009

73
CPR: C-Chest Compression
Chest Compression
- These compression create blood flow by
increasing intrathoraxic (insde the rib cage)
pressure and directly compressing the heart.
These generate blood flow and oxygen to
the myocardium (muscle of the heart) and
brain. We can achieve circulation!
CIRCULATION represents a heart that

is actively pumping blood, most often
recognized by the presence of a pulse
in the neck

74
CPR: CHEST COMPRESSIONS
Place the other

hand over the first
(and interlock
your fingers)
You should be on
your knees
squarely at the
patients side.
Basic Life Support ebec 2009 75

Cardiopulmonary Resuscitation
CPR: CHEST COMPRESSIONS
Push hard, push fast. Depress the chest 1.5-2

inches at a rate of 100 times per minute
Do not bounce or bend elbows.
Release pressure after depressing the chest
while still keeping contact with the victims
chest.
THIS IS A RATIO.DO THIS 30 TIMES
THEN DELIVER
TWO BREATHS (30:2).

77
CPR: A- Open AIRWAY
This must be done to

ensure an open passage
for spontaneous
breathing OR mouth to
mouth during CPR
Head-Tilt/Chin-Lift
Tilt the head back with
your hand and lift up on
the chin
Jaw Thrust Maneuver for
suspected spinal injury.

CPR: A- Open AIRWAY
Jaw-Thrust
Maneuver is strictly
a Healthcare
Provider technique.
Not for Lay
Rescuers.

CPR: Check for B- BREATHING
.
BREATHING: Deliver TWO quick breaths
that make the chest rise.
Allow the chest to fall completely between
breaths.
Turn your head towards the patients chest as
you inhale for the 2nd breath.
You cannot breathe for a patient or
assess breathing without first
opening the airway.

80
1. Mouth-to- 2. Mouth-
Mouth to-Nose
3. Mouth-to-Mouth
and Nose 4. Mouth-to-
Stoma
SL.ppt/TR/FC 41 81
5. Mouth-to- 6. Mouth-to-
Face Shield Mask
7. Bag Valve
Mask Device
SL.ppt/TR/FC 42 82
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83
SL.ppt/TR/FC10
CPR: Putting It Together
Ratio:30 compressions/2 breaths
Rate: Approx: 100 compressions per
minute
Depth: 1.5-2 inches
Cycles: 1 cycle = 30 compressions and 2
breaths
Five cycles should take no more than 2
minutes

84
CPR: All Together Now
1. Establish scene safety.
2. Introduce self to establish
authority
3. Determine unresponsiveness
=is the patient moving, is
he/she motionless
4. Determine breathing if NO
breathing or abnormal breathing.

85
Abnormal breathing
Examples
1. gasping
2. Irregular rise and fall of the
chest

86
CPR: All Together Now
5. If unresponsive and not breathing, and
what is the skin color? Go get HELP!
Activate EMS.
6. Perform 30 Compressions on the chest
7. A- Airway- Open it! Head/Tilt chin lift
8. B- give Two breaths
9. Do this until AED/Defibrillator arrives,
ALS provider takes over, or victim
starts to move.

87
Child CPR
Child CPR
Lower half of the sternum, between
the nipples.
One hand only (?)
30:2 for single rescuer, 15:2 for 2-
man rescuer (optional for HCP).

88
Pediatric CPR
Infant CPR
Just below the nipple line, lower half of
sternum
Middle and ring finger, flexing at the wrist
2-thumbs hand encircling technique
Puff only for artificial ventilation (observe
for visible chest rise)

89
INFANT 1- AND 2-Rescuer CPR
1. Survey the scene.

2. Introduce Self
3. Check for responsiveness
4. If UNRESPONSIVE activates medical
assistance
5. C-CIRCULATION Compression
6. A- AIRWAY (supine)
SL.ppt/TR/FC 20 90
7. B-BREATHING Give 2 breaths with
visible chest rise
(2nd rescuer arrives takes over breathing with Bag-

Valve Mask)
1st rescuer pauses to allow 2nd rescuer to

give 2 breaths
SL.ppt/TR/FC 20 91
8. 1st rescuer continue compression and

pauses to allow 2nd rescuer to give 2 breath
(rescuers switches places with little interruption. 1st
rescuer takes over breathing using bag-valve mask)
9. Finish cycles of CPR
10. Check circulation (LLF for 5-10 sec.)after

every 5 cycles
SL.ppt/TR/FC 20 92
When to STOP :
S - SPONTANEOUS signs of circulation are
restored
T -TURNED over to medical services or
properly trained and authorized personnel
O - OPERATOR is already exhausted and
cannot continue CPR
P - PHYSICIAN assumes responsibility
(declares death, takes over, etc.)
S SCENE becomes unsafe (such as traffic,
impending or ongoing violencegun fires,
etc)
S SIGNED waiver to stop CPR
Alternative CPR
Compression-only CPR:
Outcome is better than outcome of NO CPR
Lay rescuers should do compression-only if

they are unwilling or unable to provide
rescue breaths
Alternative CPR
Cough CPR
No role when the victim is unresponsive
No role in lay CPR

component adult children Infant
Recognition Unresponsive for all ages
No breathing, not breathing or only gasping.
CPR sequence CAB CAB CAB
Compression rate At least 100/min
Compression depth At least 2 At least 1/3 AP At leas 1/3 AP
inches (5 cm) depth depth
Chest wall recoil Allow complete recoil between compression, rotate

rescuer every 2 mins. or every 5 cycle.
Compression Minimize interruptions in chest compressions

interruption attempt to limit interruptions to less than 10
seconds
Compression to 30:2 30:2 30:2
ventilation ratio
component adult child Infant
Ventilation; Compression only

when rescuer
untrained or
trained and not
proficient.
DONT's in External Chest
Compression
1. Jerker
2. Massager
3. Bender
4. Rocker
5. Bouncer
6. Double Crosser
Recovery Position in CPR
Adult and Child
Adult and Child
Adult and Child
Adult and Child
QUESTIONS?
WERE WE ABLE TO:
a. Define cardiopulmonary resuscitation

b. Perform correct cardiopulmonary
resuscitation techniques to an adult, child
and infant who are in cardiac arrest
c. Discuss other alternative forms of CPR
d. Enumerate the criteria for when to start, not
to start and when to stop CPR
SL.ppt/TR/FC 2 105
BLSModule
for HCP
5
Foreign Body Airway
Obstruction Management
106
Module 5: Foreign Body Airway Obstruction
Management
OBJECTIVES:
At the end of this module, participants shall be able to
effectively:
1. Explain the concept of FBAO management.

2. Discuss the causes, types and classification of
obstruction
3. Discuss theory and precaution of abdominal thrust
SL.ppt/TR/FC 45 107
5. Demonstrate proper application of abdominal thrust to
conscious and unconscious adult and child
6. Demonstrate back slap and chest thrust to a conscious and
unconscious infant
7. Demonstrate self administration of abdominal thrust.
8. Demonstrate the proper technique of abdominal thrust
under special circumstances as in pregnant women, and
obese victim.
SL.ppt/TR/FC 20 108
- is a condition when solid material like
chunked foods, coins, vomitus, small toys
etc. are blocking the airway.
SL.ppt/TR/FC 20 109
1. IMPROPER CHEWING OF LARGE PIECES OF FOOD
2. EXCESSIVE ALCOHOL INTAKE
a. relaxation of tongue back into the throat
b. Aspirated vomitus (stomach content)
3. PRESENCE OF LOOSE UPPER AND LOWER DENTURES
4. FOR CHILDREN WHO ARE RUNNING WHILE EATING
5. FOR SMALLER CHILDREN OF HAND-TO-MOUTH STAGE LEFT UNATTENDED.
SL.ppt/TR/FC 46 110
1. ANATOMICAL OBSTRUCTION
2. MECHANICAL
OBSTRUCTION
SL.ppt/TR/FC 47 111
1. ANATOMICAL OBSTRUCTION
It happens when the tongue drops back and obstructs the throat. Other
causes are acute asthma, croup, diphtheria, swelling, and cough
(whooping).
SL.ppt/TR/FC 47 112
2. MECHANICAL
OBSTRUCTION
When foreign objects lodge in
the pharynx or airways; fluids accumulate
in the back of the throat.
SL.ppt/TR/FC 48 113
1. MILD OBSTRUCTION
2. SEVERE
OBSTRUCTION
SL.ppt/TR/FC 20 114
1. MILD OBSTRUCTION
A. Signs:
1. Good air exchange

2. Responsive and can cough forcefully
3. May wheeze between coughs.
4. Has increased respiratory difficulty and possibly
cyanosis.
SL.ppt/TR/FC 20 115
B. Rescuer Actions:
As long as good air exchange continues,
1. Encourage the victim to continue spontaneous coughing
and
breathing efforts.
2. Do not interfere with the victims own attempts to expel
the foreign body, but stay with the victim and monitor his
or her condition.
3. If mild airway obstruction persists, activate the emergency
response system.
SL.ppt/TR/FC 20 116
2. SEVERE OBSTRUCTION
A. Signs:
1. Poor or no air exchange,

2. Weak or ineffective cough or no cough at all,
3. High-pitched noise while inhaling or no noise at all,
4. Increased respiratory difficulty,
5. Cyanotic (turning blue)
SL.ppt/TR/FC 20 117
cont.
6. Unable to speak
7. Clutching the neck with the thumb and fingers making
the
universal sign of choking.
8. Movement of air is absent.
B. Rescuer Actions:
Ask the victim if he or she is choking. If the
victim nods and
cannot talk, severe airway obstruction is present and
you must
activate the emergency response system and AED
once the victim becomes unconscious.
SL.ppt/TR/FC 20 118
-is a sign
wherein the
victim is
clutching his/her
neck with one or
both hands and
gasping for
breath.
SL.ppt/TR/FC 20 119
Abdominal thrusts is an emergency
procedure for removing a foreign
object lodged in the airway that is
preventing a person from
breathing.
REMEMBER :
A.T.should not be used in
infants under 1 year of age
due to risk of causing injury.
SL.ppt/TR/FC 50 120
3
2
1
ai
r
Site
(compression)
121
SL.ppt/TR/FC 20
Foundation Facts: Complications
from Abdominal Thrusts
1. Incorrect application of the Abdominal Thrust can

damage the chest, ribs and internal organs.
2. May also vomit after being treated with the Abdominal
Thrust.
3. They should be examined by a Physician to rule out any
life-threatening complications.
SL.ppt/TR/FC 20 122
Back slaps / Chest thrust to a conscious infant
SL.ppt/TR/FC 20 123
To apply the Abdominal Thrust maneuver to oneself:
Make a fist with one hand and place it in the middle of the body at
a spot
above the navel and below the breastbone, then grasp the
fist with the
other hand and push sharply inward and upward.
SL.ppt/TR/FC 20 124
If this fails,
The victim should press the upper abdomen over ;
the back of a chair,
edge of a table,
porch railing or something similar and thrust up and
inward until the object is dislodged.
SL.ppt/TR/FC 20 125
SELF ADMINISTRATION
SELF ADMIN OF A.T.
SL.ppt/TR/FC 20 126
OBVIOUSLY PREGNANT AND
VERY OBESE PEOPLE
The main difference in performing the

Abdominal Thrust on this group of people is
in the placement of the fists.
Instead of using abdominal thrusts, chest
thrusts are used.
The fists are placed against the middle of
the breastbone and the motion of the chest
thrust is in and inward, rather than upward.
If the victim is unconscious, the chest
thrusts are similar to those used in CPR.
SL.ppt/TR/FC 20 127
Caution: Pregnant and Obese Victims
If the victim is pregnant or obese,
perform chest thrusts instead of abdominal
thrusts or chest compression.
SL.ppt/TR/FC 20 128
FBAO Management
Adult / Child / Infant
1. Determine scene safety.
2. Introduce yourself patient, guardian and
or bystander.
3. Determine level of breathing difficulty by
checking:
a. Infant- ineffective coughs, weak or
absence of
cry. if so, tell parents/guardian that
you are
there to help.( may I help )
b. Child/Adult- by asking if the victim is
choking.
If so, tell the victim that you are
there to help.
( may I help )
4. Properly position the patient.
a. Infant- support the infant on
rescuers knee or lap
b. Child/Adult - Assume straddle
position behind.
5. Locate proper site:
a. Infant- give 5 back slaps and 5
chest thrust using 2 fingers
techniques.
b. Child/Adult- for abdominal thrust,
properly
position balled fist on the patient
Properly perform abdominal thrust
SL.ppt/TR/FC 20 130
Cont, pt becomes unconscious
6. If the patient become unconscious. Carefully lay
down unconscious patient.
7. Shout for help. Activate Medical Assistance, get

AED if available and beguine CPR with out pulse
check.
8. Properly perform 30 chest Compression no pulse

check.
9. Check oral cavity for presence of foreign body. If

foreign body is visible, perform finger sweep.
10. If foreign body is not visible.

11. Give 2 blows, and immediately give 30

compressions.
Simply looking into the mouth should not significantly
increase the time needed to attempt the ventilations and
proceed to the 30 chest compressions.
12. Each time the airway is open during CPR look for
the foreign body. If visible remove.
13. Continue CPR until foreign body is remove or

patient regain consciousness.
SL.ppt/TR/FC 20 132
12. If foreign body is removed. Check patency of

airway by giving two breaths, note for visible
chest rise,
14. Check for signs of breathing and pulse. If patient

has sign of spontaneous circulation and breathing,
properly place in recovery position.(Do log roll)
SL.ppt/TR/FC 20 133
DID WE MEET OUR OBJECTIVES ?
WERE WE ABLE TO :
Understand the concept of FBAO management.

- Definition of FBAO
Discuss the:
- causes
- types
- classification of obstruction
SL.ppt/TR/FC 45 134
WERE WE ABLE TO :
Discuss theory and precaution of abdominal

thrust
Demonstrate proper application of abdominal
thrust to
an adult and child who is :
- conscious
- unconscious
SL.ppt/TR/FC 20 135
WERE WE ABLE TO :
Demonstrate back slap and chest thrust to a

- conscious
- unconscious infant
Demonstrate self administration of abdominal
thrust.
Demonstrate the proper technique of abdominal
thrust under special circumstances as in
- pregnant women
- obese victim.
SL.ppt/TR/FC 20 136
Module 6
BLS for HCP
Automated External
Defibrillator (AED)
137
Module 6: Automated External Defibrillator
OBJECTIVES:
After completing this module, participants will be able to:
1. Define AED
2. Explain the indications and importance of early
defibrillation.
3. Enumerate the 4 universal steps of an AED operation.
4. Explain the special conditions that affect the use of an AED
138
Basic Life Support Visual Aids
DOH-HEMS Automated External Defibrillator (AED)
SKILL OBJECTIVE:
After completing this session, participants will be able to -
Demonstrate how to properly use AED to an adult, child & infant who are in
cardiac arrest.
Definition
AEDs are sophisticated, computerized devices that can

analyze heart rhythms and generate high voltage
electric shocks.
Indications and Importance

Early defibrillation is critical for victims of
sudden cardiac arrest because:
The most frequent rhythm in sudden
cardiac arrest is VF
The most effective treatment for VF is
defibrillation
Defibrillation is most likely to be
successful if it occurs within minutes
of collapse (cardiac arrest)
Defibrillation may be ineffective if it is
delayed
VF deteriorates to asystole if not
treated
Causes of VF and
Cardiac Arrest
Hypoxia
Near drowning
Burst lung
Decompression illness
Rebreather malfunction
Choking
Carbon monoxide poisoning
Bleeding
Heart attack
Drug overdose
Treatment
Automated External Defibrillator

(AED)
Controlled electrical shock
May restore an organized
rhythm
Enables heart to contract &
pump blood
Evidence
100
For every minute

Survival Rate
80
defibrillation is delayed
the victims survival rate
(%)
60
decreases by 10%
40
20
0
5 10 15 20 25 30
Time to Defibrillation
(minutes)
Several factors that can affect AED

analysis
Patient movement (eg. agonal gasp)
Repositioning the patient
Use AED only when victims have the

following 3 clinical findings
No response
No breathing
No Pulse
Note: Defibrillation is also indicated for pulseless ventricular tachycardia (VT)
Special Conditions that Affect

the Use of AED
The victim is less than 1 year old.

The victims has a hairy chest.
The victim is lying in water, immersed in water,
or water is covering the victims chest.
The victim has implanted defibrillator, or
pacemaker.
The victim has a transdermal medication patch
or other object on the surface of the skin where
the AED electrode pads are placed.
Different Types of AED

1. AED Trainer
Not capable of delivering a shock
Do not allow to be confused with real units
2. Semi-automated Defibrillator
Requires the user to press the button for analysis
and shock
3. Fully Automated Defibrillator

No intervention required for analysis and shock
They are programmed to run self-test and they will
indicate when maintenance is needed
How Does Defibrillation Work?

1. A brief high voltage electrical shock
2. Through the heart between pads on the chest
3. Shock briefly stops electrical heart activity
4. May restart beating with a normal rhythm
5. But not everyone can be saved, even with
defibrillation
Parts of an AED
Example: AED Trainer
Pads connector port
On button
Analyze
button
Shock
button
Pads
Defibrillator
AED Procedures
BLS until AED available
Diagnose cardiac arrest
Unresponsive
Not breathing
normally
Go for or send someone
for AED
30 compressions
2 rescue breaths
Continue 30:2
RB+CC = CPR
Attach AED
Power on
Follow voice prompts
Cut suit
Attach AED (contd)
Dry skin/shave if
necessary
Attach AED pads

Adult pads vs Child pads
Attach AED (contd)
Attach pads
Keep following voice

prompts
Clear the victim and press

analyze button
Giving a shock
Be sure no one is
touching the victim
Press Shock button if
instructed
Resume CPR
immediately after
giving 1 shock
Follow voice prompts
Record events
Basic Life Support CPR Visual Aids
DOH-HEMS Introduction to BLS - CPR
DOH-HEMS Adult BLS Algorhythm
AED/defibrillator ARRIVES
Check Rhythm
Shockable rhythm?
Not Shockable
Shockable
Resume CPR immediately

for 5 cycles
Give 1 shock Check rhythm every
Resume CPR immediately 5 cycles; continue until ALS
for 5 cycles providers take over or
victim starts to move
Adult BLS Algorhythm

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HEALTH EMERGENCY MANAGEMENT STAFF

Republic of the Philippines

HEALTH EMERGENCY MANAGEMENT STAFF

1. Explain the procedure of getting started during emergency.

Emergency plan should be

Organized first aid

make sure the scene of the

Check for Check for

* call the emergency response number( e.g.161, 117, 168 or

* deliver at least 5 cycles (2 min.) of CPR before leaving

b. Check vital signs- every 15 minutes if stable condition, and

1. Personal Hygiene 2. Protective Equipment 3. Equipment Cleaning

1. Explain the procedure of getting started during

HEALTH EMERGENCY MANAGEMENT STAFF

5. Discuss the anatomy and physiology of the

6. Discuss the risk factors for cardiovascular disease.

BLS is the foundation for saving lives following

Fundamental aspects of adult BLS include immediate

2010 AHA Guidelines for CPR

2. ADVANCED CARDIAC LIFE SUPPORT (ACLS)

ACLS interventions aimed at preventing cardiac arrest include airway management,

3. Post Cardiac Arrest Care

1. The First Link: Safety of Rescuer and Victim

2. The Second Link: EARLY AND EFFECTIVE BYSTANDER CPR

4. The Fourth Link: EFFECTIVE ADVANCED LIFE SUPPORT (INCLUDING

5. Post-Cardiac Arrest Care

1. Anatomical position 9. Lateral

Supine Position Prone Position

Lateral Recumbent/ Recovery Position

1. Nervous System 2. Respiratory System 3. Circulatory System

4. Digestive System 5. Urinary System 6. Reproductive System

7. Musculo-Skeletal System 8. The Skin

1. The Respiratory System

Air that enters the lungs contains:

ANATOMY AND PHYSIOLOGY

2. The Circulatory System

products. It consists of the right lung)

heart, blood vessels, and Right atrium

Inferior vena cava

3. The Nervous System

It is composed of the brain, spinal cord and

It occurs when the oxygen

1. Recognized the signs and symptoms of heart attack

3. Have someone call the physician or ambulance for help.

4. If patient is under medical care, assist him/her in taking

Is a technique of blowing air into a persons lungs to

Maximum tilt of the head

Take 5 to 10 seconds (no more than

Opening of airway (Head-

Method Mouth-to-mouth or mouth-to-nose Mouth-to-mouth and nose

Breaths 2 Normal breath enough to clearly rise the chest

Instead, continuous chest compressions are performed at

At the end of this module participants should be able to:

is series of assessments and interventions

All victims of cardiac arrest should receive

All victims of cardiac arrest should receive CPR

4. Confirmed gestation of < 23 weeks or birth

5. Attempts to perform CPR would place the

1. Effective and spontaneous (normal)

1. Establish scene safety.

Core concept: Oxygen to the Brain!

Basic Life Support ebec 2009

CIRCULATION represents a heart that