CPR and Basic Life Support

It is vital that anyone overdosing or having an adverse reaction to drugs receives

professional help quickly. If Cardiopulmonary Resuscitation (CPR) is required and you know
how to perform it then do so. CPR means giving rescue breaths followed by a number of chest
compressions, and repeating this cycle continuously until the ambulance arrives. If you’re not
sure, the following guide will help you to perform CPR.

First Aid techniques

 Head-tilt, chin-lift: Place one hand on the forehead and the fingers of the other hand
on the bony part of the chin. Tilt the head back using the hand on the forehead, and at
the same time lift the jaw upwards with the fingers of the other hand.
 Jaw thrust: Place one hand on either side of the head. Place your fingers in the
angles of the jaw and lift the jaw forward without tilting the head back.
 Finger sweep: Used with abdominal thrusts to clear a foreign body airway
obstruction in an unconscious casualty. Open the mouth by grasping the lower jaw
and tongue between thumb and fingers and lifting the jaw. Insert the index finger of
the other hand along the inside of the cheek, and deeply into the throat. Use a
hooking action to dislodge any foreign object.

Before starting CPR

 Ensure your own safety first, then that of the victim (for example, if the victim is
lying on a road, take steps to alert oncoming traffic).
 Gently tap the victim and shout “are you all right?” If the victim can respond and
there is no further danger from their location, leave the victim in the position they are
in. If there is no response, shout for help. Send for help if there is more than one
rescuer present.
 Ask that person to dial 111 for an ambulance and return to confirm that the
ambulance is on the way. Tell the ambulance dispatcher the location and telephone
number closest to the scene and be prepared to provide other information before
hanging up.
 Do not hang up until instructed to do so.
 If alone, the rescuer should assess the victim for unresponsiveness and absence of
signs of life before going for help.
 The victim must be on his/her back on a firm surface.

If the victim is unconscious, breathing and has other signs of life, turn the victim onto
his/her side in the recovery position and ensure the airway is kept open.

CPR
It is recommended that CPR be learned and practiced under trained supervision.

1. Position the casualty lying on their back. Ensure they are on a firm surface.
2. Kneel to one side of the casualty.
 3. Locate the notch where the ribs meet the breastbone.
4. Place the middle finger of one hand in the notch and the index finger next to the
middle finger.
5. Place the heel of the other hand next to the two fingers.
6. Place the other hand on top so the heels of both hands are over the same point on the
breastbone.
7. Interlock the fingers to keep them off the chest.
8. With your elbows straight and locked, and your shoulders over the casualty’s chest,
press straight down using the weight of your body to compress the breastbone 4-5cm
(the depth of an adult’s thumb). Use a smooth uninterrupted rhythm allowing equal
time for compression and relaxation.
9. Give 30 compressions at a rate of 80-100 compressions a minute.
10. Give two slow, full breaths.
11. Reposition hands and administer a further 30 compressions/two breaths.
12. Continue the ratio of 30 compressions/two breaths. After completing four cycles of
chest compressions and breaths, administer two further breaths and then check the
pulse in the neck.

Recovery position
The recovery position is designed for unconscious casualties (but do not use if you
suspect the casualty has neck or spinal injuries). It helps to maintain an open airway and allows
vomit and other fluid to drain freely from the mouth. To move a casualty lying on their back into
the recovery position, follow these steps:

1. Kneel beside the casualty.

2. With the casualty lying on their back, extend the arm nearest to you above the
casualty’s head.
3. Bring their other arm across the chest to place the palm on the opposite shoulder.
4. Take the farthest away from you and cross it over the other leg at the ankle.
5. Roll the casualty towards you by placing your hand on their hip and your other hand
on their shoulder.
6. The casualty will now be lying on their side, resting on your thighs.
7. Tilt the head to ensure the airway is open.
8. Bend the top leg at a right angle.

The casualty will now lie in a stable unsupported position.

BASIC LIFE SUPPORT

Basic Life Support, or BLS, generally refers to the type of care that first-responders,
healthcare providers and public safety professionals provide to anyone who is experiencing
cardiac arrest, respiratory distress or an obstructed airway. It requires knowledge and skills
in cardiopulmonary resuscitation (CPR), using automated external defibrillators (AED)
and relieving airway obstructions in patients of every age.
STEPS
Although you never hope that an emergency arises, as a BLS provider, it's your job to be
prepared to respond quickly, and appropriately. In order to do so, there are certain BLS steps
that you'll need to perform every time, and some steps that you'll only have to perform on an
as-needed basis.
Assess, Recognize and Care

The Assess, Recognize and Care concept is a systematic, continuous approach for
rapid assessment, accurate recognition and immediate care in emergency situations. An
acutely ill patient’s condition can change rapidly, and deterioration can follow; therefore,
frequent assessment, recognition and care are critical.

The Assess, Recognize and Care concept begins with a rapid assessment, which
includes:

 Performing a visual survey to assess for safety, formulate an initial impression of

the patient and determine the need for additional resources
 Checking responsiveness
 Opening the airway and simultaneously checking for breathing and a pulse if the
patient is unresponsive.
After you complete your rapid assessment, provide care based on the conditions found.

Basic life support for adults

 Ensure a safe environment.

 Assess response. If no response, get help.
 Send someone to call an ambulance.
 If you are alone and telephone is immediately available, use it to call an ambulance
(111).
 Open the airway using head-tilt, chin-lift method.
 Use jaw thrust technique if spinal injuries are suspected. (Place one hand on either
side of the head. Place your fingers in the angles of the jaw and lift the jaw forward
without tilting the head back.)
 Remove foreign material or vomit if it is visible in the mouth.
 Look, listen and feel for breathing. This check should take three to five seconds.
 If breathing is present and adequate, place the person in the recovery position and
monitor airways, breathing and circulation.
 If breathing is absent or inadequate, continue with basic life support
 Pinch the nostrils to prevent air escaping.
 Give two slow, full breaths into the mouth, watching the chest fall after each breath
as the casualty exhales.
 If the chest does not rise, reposition the casualty’s head and try again.
 If the chest still does not rise, the airway may be obstructed.
 Check the airway. If you see a foreign body, gently ‘hook’ it out.
 Check the carotid pulse in the casualty’s neck.
  Place three fingers on the Adam’s apple and slide them towards you into the groove
at the side of the neck between the windpipe and the muscles.
 Press gently to feel for a pulse. This check should take up to 10 seconds.
 If the pulse is present, continue rescue breathing at a rate of one breath every five
seconds.
 Every time you take a breath, the casualty will need a breath also.
 If the casualty has no pulse, continue rescue breathing and begin chest compressions.
This combined technique is known as cardiopulmonary resuscitation (CPR).

Basic Life Support for Parents

Your ability to help in an emergency could determine your children’s survival. If you
know basic first aid, you can make a big difference. Children and teenagers can also make a
difference if they have the skills to help.

Such first aid training can help them to help others, and to keep them focused in an
emergency. For information on training in basic first aid in your area, contact Red Cross or St
Johns Ambulance. Ask also for their useful first aid guides.

The first rule in an emergency with your child is to stay calm. This will help keep the
child calm and will help you assess whether emergency services are needed. If you are unsure,
ring 111 anyway. Remember that if you are calling from a payphone or cell phone, the call is
free. Make a quick assessment of the child, so you can advise the ambulance service. For
example:

 Is the child awake?

 Can the child talk to you?
 Is the child breathing?
 Is the child bleeding severely?

Obstructed airway cycle - adult and children above 1 year

The complete actions for dealing with choking in an unconscious adult are as follows:

 Commence 30 chest compressions (see above for how to perform CPR).

 Look for obstruction in mouth, remove if object is visible.
 Attempt 2 rescue breaths
 If unsuccessful repeat cycle until breathing or medical help arrives.

Obstructed airway cycle - infant

The actions for dealing with choking in an unconscious infant are as follows:

 Place infant on a firm surface

 Open airway to neutral position, check for normal breathing. Look for and remove
foreign objects.
 30 compressions and 2 small, gentle rescue breaths. Continue with breaths and
compressions until object is dislodged or medical help arrives.