Tubigon Emergency Response

Service and Support Unit

(T.E.R.S.S.U)

Refresher Course on Basic Life Support (BLS) and

First Aid in Observance of the National Disaster
Resilience Month 2021
BASIC LIFE
SUPPORT

JULY 16, 2021

PRINCIPLES OF EMERGENCY CARE:
GETTING STARTED:
– EMERGENCY PLANS SHOULD BE STABLISHED BASED ON ANTICIPATED NEEDS AND AVAILABLE RESOURCES.
– THE EMERGENCY RESPONSE BEGINS WITH THE PREPARATION OF EQUIPMENT AND PERSONNEL BEFORE
ANY EMEGENCY OCCURS.
– PROPER INFORMATION & INSTRUCTION TO A BYSTANDER/S WOULD PROVIDE ORGANIZED FIRST AIDE
CARE.
– REMEMBER THE INITIAL RESPONSE AS FOLLOWS:
 ASK FOR HELP
 INTERVENE
 DO NOT DO FURTHER HARM
EMERGENCY ACTION PRINCIPLES
1. SURVEY THE SCENE:
– ONCE YOU RECOGNIZED THAT AN EMERGENCY HAS OCCURRED &
DECIDE TO ACT, YOU MUST MAKE SURE THAT THE SCENE OF THE
EMERGENCY IS SAFE FOR YOU, THE VICTIM/S, & THE BYSTANDER/S.
– TAKE TIME TO SURVEY THE SCENE AND ANSWER THESE
QUESTIONS:
 IS THE SCENE SAFE?
 WHAT HAPPENED? NATURE OF INCIDENT
 HOW MANY PEOPLE ARE INJURED?
 ARE THERE BYSTANDERS WHO CAN HELP?
 THEN IDENTIFY YOURSELF AS A TRAINED FIRST AIDER.
 GET CONSENT TO GIVE CARE
2. ACTIVATE MEDICAL ASSISTANCE:

– IN SOME EMERGENCIES , YOU WILL NEED TO CALL FOR

SPECIFIC MEDICAL ADVISE BEFORE ADMINISTERING FIRST AID.
BUT IN SOME SITUATIONS, YOU WILL NEED TO ATTEND TO THE
VICTIMS FIRST.
– CALL FIRST AND CPR FIRST. BOTH TRAINED AND UNTRAINED
BYSTANDERS SHOULD BE INSTRUCTED TO ACTIVATE MEDICAL
ASSISTANCE AS SOON AS THEY HAVE DETERMINED THAT AN
ADULT VICTIM REQUIRES EMERGENCY CARE.
CALL FIRST CPR FIRST

– ADULTS & ADOLESCENTS – ADULTS AND ADOLESCENTS WITH

LIKELY ASPHYXIAL ARREST (e.g
DROWING)

– WITNESSED COLLAPSE OF
– UNWITNESSED COLLAPSE OF
CHILDREN & INFANTS
CHILDREN AND INFANTS
CALL FIRST CPR FIRST

– IF YOU ARE ALONE WITH NO MOBILE – GIVE 5 CYCLES (2 MINUTES) OF CPR

PHONE, LEAVE THE VICTIM TO – LEAVE THE VICTIM TO ACTIVATE
ACTIVATE EMERGENCY RESPONSE
EMERGENCY RESPONSE SYSTEM
SYSTEM & GET AED/EMERGENCY
AND GET THE AED.
EQUIPMENT BEFORE BEGINNING
CPR. – RETURN TO THE CHILD OR INFANT
– OTHERWISE, SEND SOMEONE & & RESUME CPR; USE THE AED AS
BEGIN CPR IMMEDIATELY; USE THE SOON AS IT IS AVAILABLE
AED AS SOON AS IT IS AVAILABLE
– USE OF SOCIAL MEDIA TO SUMMON
RESCUERS

– USE OF MOBILE PHONE IN ACTIVATION

OF EMERGENCY MEDICAL SERVICE (EMS)
– INFORMATION TO BE REMEMBERED IN ACTIVATING
MEDICAL ASSISSTANCE:
• WHAT HAPPENED?
• LOCATION?
• NUMBER OF PERSONS INJURED?
• EXTENT OF INJURY & FIRST AID GIVEN?
• THE TELEPHONE NUMBER FROM WHERE YOU ARE CALLING?
• PERSON WHO ACTIVATED MEDICAL ASSISTANCE MUST IDENTIFY
HIM/HERSELF & DROP THE PHONE LAST.
3. DO PRIMARY SURVEY:
• IN EVERY EMERGENCY SITUATION, YOU MUST FIRST FIND OUT IF
THERE ARE CONDITIONS THAT ARE OF IMMEDIATE THREAT TO THE
VICTIM’S LIFE.

CHECK FOR RESPONSIVENESS, PERFORM COMPRESSION, OPEN THE

AIRWAY, AND PERFORM RESCUE BREATHING.

4. DO SECONDARY SURVEY:
• IT IS A SYSTEMATIC METHOD OF GATHERING ADDITIONAL
INFORMATION ABOUT THE INJURIES OR CONDITIONS THAT MAY NEED
CARE.
4.1 INTERVIEW THE VICTIM
S -SIGNS AND SYMPTOMS
A -ALLERGIES
M -MEDICATIONS
P -PAST MEDICAL HISTORY
L -LAST MEAL TAKEN
E -EVENTS PRIOR TO INJURY
4.2 CHECK VITAL SIGNS
EVERY 15 MINS. FOR STABLE CONDITION & EVERY 5 MINS. IF
UNSTABLE
4.1 HEAD-TO-TOE EXAMINATION
D -DEFORMITY
C -CONTUSION
A -ABRASION
P -PUNCTURE
B -BURN
T -TENDERNESS
L -LACERATION
S -SWELLING
5. PROPER REFERRAL TO ADVANCE MEDICAL AUTHORITY
FOR FURTHER EVALUATION AND MANAGEMENT.

• ENDORSEMENT TO EMS/AMBULANCE
TEAM/EMERGENCY RESPONSE TEAM OR PHYSICIAN
• REFER/TRANSPORT VICTIM TO NEAREST HEALTH FACILITY
INTRODUCTION TO BASIC
LIFE SUPPORT (BLS)
THREE KINDS OF LIFE SUPPORT

1. BASIC LIFE SUPPORT:

• A SET OF EMERGENCY PROCEDURES THAT CONSIST OF
RECOGNIZING RESPIRATORY OR CARDIAC ARREST AND THE PROPER
APPLICATION OF CARDIO-PULMONARY RESUSCITATION (CPR) WITH
OR WITHOUT AUTOMATED EXTERNAL DEFIBRILLATION (AED) OR
FOREIGN BODY AIRWAY OBSTRUCTION MANAGEMENT (FBAO) AND
RESCUE BREATHING (RB) OR TO MAINTAIN LIFE UNTIL A VICTIM
RECOVERS OR ADVANCED LIFE SUPPORT IS AVAILABLE.
THREE KINDS OF LIFE SUPPORT

2. ADVANCED CARDIOVASCULAR LIFE

SUPPORT(ACLS)

• A SET OF CLINICAL INTERVENTIONS FOR THE

URGENT TREATMENT OF CARDIAC ARREST AND
OTHER LIFE THREATENING EMERGENCIES, AS
WELL AS THE KNOWLEDGE AND SKILLS TO
DEPLOY THOSE INTERVENTIONS
THREE KINDS OF LIFE SUPPORT

3. PROLONGED LIFE SUPPORT

• FOR POST RESUSCITATIVE AND LONG TERM

RESUSCITATION WITH THE USE OF ADJUNCTIVE
EQUIPMENT SICH AS VENTILATOR, CARDIAC
MONITOR, PULSE OXIMETER, ETC.
OUT OF HOSPITAL CARDIAC
ARREST (OHCA)

ADULT CHAIN OF SURVIVAL

THE FIRST LINK: RECOGNITION & ACTIVATION OF
EMERGENCY RESPONSE SYSTEM

 LAY RECUERS MUST RECOGNIZE THE PATIENT’S ARREST

AND CALL FOR HELP, IF THE VICTIM IS UNRESPONSIVE
WITH ABSENT OR ABNORMAL BREATHING, THE
RESCUER SHOULD ASSUME THAT THE VICTIM IS IN
ACRDIAC ARREST. RESCUERS CAN ACTIVATE AN
EMERGENCY RESPONSE (i.e THROUGH USE OF A
MOBILE PHONE) WITHOUT LEAVING THE VICTIM’S
SIDE.
THE SECOND LINK: IMMEDIATE HIGH-QUALITY CPR

 IF THE LAY RESCUER FINDS AN UNRESPONSIVE VICTIM IS

NOT BREATHING OR NOT BREATHING NORMALLY (e.g
GASPING), HIGH QUALITY CPR SHALL BE STARTED
IMMEDIATELY. THE PROBABILITY OF SURVIVAL
APPROXIMATELY DOUBLES WHEN IT IS INITIATED BEFORE
THE ARRIVAL OF EMS.
THE THIRD LINK: RAPID DEFIBRILLATION

 IT IS RECOMMENDED THAT THE PUBLIC ACCESS

DEFIBRILLATION (PAD) PROGRAMS BE
IMPLEMENTED IN COMMUNITIES WITH
INDIVIDUALS AT RISK FOR OHCA. THIS WOULD
ENABLE BYSTANDERS TO RETRIEVE NEARBY AEDs
AND USE IT WHEN OHCA OCCURS.
THE FOURTH LINK: BASIC & ADVANCED
EMERGENCY MEDICAL SERVICE

 IF PROVIDED BY HIGHLY TRAINED PERSONNEL

LIKE EMERGENCY MEDICAL TECHNICIANS
(EMTs) AND PARAMEDICS PROVISION OF
ADVANCED CARE OUTSIDE THE HOSPITAL
WOULD BE POSSIBLE.
THE FIFTH LINK: ADVANCE LIFE SUPPORT & POST
ARREST CARE

 POST CARDIAC ARREST CARE AFTER RETURN OF

SPONTANEOUS CIRCULATION (ROSC) CAN IMPROVE THE
LIKELIHOOD OF PATIENT SURVIVAL WITH GOOD QUALITY
OF LIFE.
OUT OF HOSPITAL CARDIAC
ARREST (OHCA)

PEDIATRIC CHAIN OF SURVIVAL

THE FIRST LINK: PREVENTION OF INJURIES,
ACCIDENTS & TRAUMA

 IN CHILDREN, THE LEADING CAUSE OF DEATH IS

INJURY, AND VEHICULAR ACCIDENTS ARE THE
MOST COMON CAUSES OF FATAL CHILDHOOD
INJURIES AND CHILD PASSENGER’S SAFETY SEATS
CAN REDUCE THE RISK OF DEATH.
THE SECOND LINK: EARLY CPR

 IT IS MOST EFFECTIVE WHEN STARTED

IMMEDIATELY AFTER THE VICTIM’S COLLAPSE.
THE PROBABILITY OF SURVIVAL APPROXIMATELY
DOUBLE WHEN IT IS INITIATED BEFORE THE
ARRIVAL OF EMS. IT IS ASSOCIATED WITH
SUCCESSFUL RETURN OF SPONTANEOUS
CIRCULATION AND NEUROLOGICALLY INTACT
SURVIVAL IN CHILDREN.
THE THIRD LINK: EARLY ACCESS TO EMS

 IT IS WHEN INITIATED AFTER THE BABY

COLLAPSED TO RECOGNIZE THAT THE VICTIMHAS
EXPERIENCED A CARDIAC ARREST UNTIL THE
ARRIVAL OF EMERGENCY MEDICAL SERVICES
PERSONNEL COMPETENT TO PROVIDE CARE.
THE FOURTH LINK: EARLY & EFFECTIVE PEDIATRIC
ADVANCED LIFE SUPPORT

 INITIAL STEPS IN STABILIZATIONPROVIDE

WARMTH BY PLACING BABY UNDER A RADIANT
HEAT SOURCE, POSITION HEAD IN A ‘SNIFFING’
POSITION TO OPEN THE AIRWAY, CLEAR THE
AIRWAY WITH BULB SYRINGE OR SUCTION
CATHETER, DRY BABY AND STIMULATE
BREATHING.
THE FIFTH LINK: POST ARREST CARE

 POST CARDIAC ARREST CARE AFTER RETURN OF

SPONTANEOUS CIRCULATION (ROSC) CAN
IMPROVE THE LIKELIHOOD OF PATIENT SURVIVAL
WITH GOOD QUALITY OF LIFE.
BODY SYSTEMS
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.
THE CIRCULATORY SYSTEM

– IT DELIVERS OXYGEN AND NUTRIENTS TO

THE BODY’S TISSUES AND REMOVES
WASTE PRODUCTS. IT CONSISTS OF THE
HEART, BLOOD VESSELS, AND BLOOD.
BREATHING AND CIRCULATION

– AIR THAT ENTERS THE LUNGS CONTAINS

ABOUT 21% OXYGEN AND ONLY A TRACE OF
CARBON DIOXIDE.
– AIR THAT IS EXHALED FROM THE LUNGS
CONTAINS ABOUT 16% OXYGEN AND 4%
CARBON DIOXIDE
– THE RIGHT SIDE OF THE HEART PUMPS
BLOOD TO THE LUNGS, WHERE BLOOD PICKS
UP OXYGEN AND RELEASES CARBON DIOXIDE.
BREATHING AND CIRCULATION

– THE OXYGENATED BLOOD THEN RETURNS TO

THE LEFT SIDE OF THE HEART, WHERE IT IS
PUMPED TO THE TISSUES OF THE BODY.
– IN THE BODY TISSUES, BLOOD RELEASES OXYGEN
AND TAKES UP CARBON DIOXIDE AFTER WHICH
IT FLOWS BACK TO THE RIGHT SIDE OF THE
HEART.
– ALL BODY TISSUES REQUIRE OXYGEN, BUT THE
BRAIN REQUIRES MORE THAN ANY OTHER
TISSUE.
CLINICAL DEATH – DEATH AS JUDGED BY THE
MEDICAL OBSERVATION OF CESSATION OF VITAL
FUNCTIONS.

– 0 - 1 MIN. – CARDIAC IRRITABILITY

– 1 - 4 MIN. – BRAIN DAMAGED NOT LIKELY
– 4 - 6 MIN. – BRAIN DAMAGE POSSIBLE
BIOLOGICAL DEATH – WHERE THE VICTIM’S BRAIN IS
DAMAGED AND CELLS IN THE VICTIM’S BRAIN AND
OTHER ORGANS DIE FROM A LACK OF OXYGEN.

– 6-10 MIN. – BRAIN DAMAGED VERY LIKELY

– MORE THAN 10 MIN. – IRREVERSIBLE BRAIN
DAMAGED
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 BODY’S
RESPONSES TO STIMULI AND KEEPS BODY
SYSTEMS WORKING TOGETHER.
WHAT IS CARDIOPULMONARY
RESUSCITATION (CPR)?

– IS A SERIES OF ASSESSMENT AND

INTERVENTIONS USING TECHNIQUES
AND MANEUVERS MADE TO BRING
VICTIMS OF CARDIAC AND
RESPIRATORY ARREST BACK TO LIFE.
CARDIAC ARREST

– IS THE CONDITION IN WHICH

CIRCULATION CEASES AND VITAL
ORGANS ARE DEPRIVED OF
OXYGEN.
THREE CONDITIONS OF
CARDIAC ARREST

CARDIO VASCULAR COLLAPSE

 THE HEART IS STILL BEATING BUT ITS ACTION IS SO WEAK

THAT BLOOD IS NOT BEING CIRCULATED THROUGH THE
VASCULAR SYSTEM TO THE BRAIN AND BODY TISSUES.
VENTRICULAR FIBRILLATION

 OCCURS WHEN THE INDIVIDUAL FASCICLES OF

THE HEART BEAT INDEPENDENTLY RATHER THAN
IN COORDINATED, SYNCHRONIZED MANNER
THAT PRODUCES RHYTHMIC HEART BEAT.
CARDIAC STANDSTILL

 IT MEANS THAT THE HEART HAS

STOPPED BEATING.
WHEN TO START CPR?

IF YOU SEE A VICTIM WHO IS:

– UNCONSCIOUS/UNRESPONSIVE
– NO BREATHING OR HAS NO NORMAL BREATHING (ONLY
GASPING)
– NO DEFINITE PULSE
 WHEN NOT TO START CPR?

ALL VICTIMS OF CARDIAC ARREST SHOULD RECEIVE CPR UNLESS:

 PATIENT HAS A VALID DNAR (DO NOT ATTEMPT RESUSCITATION) ORDER
 NO PHYSIOLOGICAL BENEFIT CAN BE EXPECTED BECAUSE THE VITAL FUNCTIONS HAVE
DETERIORATED AS IN SEPTIC OR CARDIOGENIC SHOCK
 CONFIRMED GESTATION OF <23 WEEKS OR BW <400GRAMS, ANENCEPHALY (BETWEEN 37-41
WEEKS, 2700-4000GRAMS)
 ATTEMPTS TO PERFORM CPR WOULD PLACE THE RESCUER AT RISK OF PHYSICAL INJURY
 PATIENT HA A SIGNS OF IRREVERSIBLE DEATH
 RIGOR MORTIS
 DECAPITATION
 DEPENDENT LIVIDITY
WHEN TO STOP CPR?

S – SPONTANEOUS SIGNS OF CIRCULATION ARE RESTORED

T – TURNED OVER TO MEDICAL SERVICES OR PROPERLY TRAINED & AUTHORIZED PERSONNEL
O – OPERATOR IS ALREADY EXHAUSTED & CANNOT CONTINUE CPR
P – PHYSICIAN ASSUMES RESPONSIBILITY (DECLARES DEATH, TAKES OVER, ETC)
S – SCENE BECOMES UNSAFE (SUCH AS TRAFFIC, IMPENDING OR ONGOING VIOLENCE)
S – SIGNED WAIVER TO STOP CPR
COMPRESSION ONLY-CPR

– IF A PERSON CANNOT PERFORM MOUTH-

TO-MOUTH VENTILATION FOR AN ADULT
VICTIM, CHEST COMPRESSION ONLY-CPR
SHOULD BE PROVIDED RATHER THAN NO
ATTEMPT OF CPR BEING MADE.
COMPRESSION ONLY-CPR

– CHEST COMPRESSION ONLY-CPR IS RECOMMENDED ONLY

IN THE FOLLOWING CIRCUMSTANCES:
 WHEN A RESCUER IS UNWILLING OR UNABLE TO
PERFORM MOUTH-TO-MOUTH RESCUE BREATHING, OR
 FOR USE IN DISPATCHER-ASSISTED CPR INSTRUCTIONS
WHERE THE SIMPLICITY OF THIS MODEFIED
TECHNIQUE ALLOW UNTRAINED BYSTNADERS TO
RAPIDLY INTERVENE.
THE COMPRESSION-AIRWAY-BREATHING (C-A-B)
 
• EARLY CPR IMPROVES THE LIKELIHOOD OF SURVIVAL
• CHEST COMPRESSIONS ARE THE FOUNDATIONS OF
CPR
• COMPRESSIONS CREATE BLOOD FLOW BY INCREASING
INTRA-THORACIC PRESSURE AND DIRECTLY
COMPRESS THE HEART, GENERATE BLOOD FLOW AND
OXYGEN DELIVERY TO THE MYOCARDIUM AND BRAIN.
CAB: COMPRESSION
• CIRCULATION REPRESENTS A HEART THAT IS ACTIVELY
PUMPING BLOOD, MOST OFTEN RECOGNIZED BY THE
PRESENCE OF PULSE IN THE NECK
• ASSUME THERE IS NO CIRCULATION IF THE FOLLOWING
EXIST: UNRESPONSIVE, NOT BREATHING, NOT MOVING,
AND POOR SKIN COLOR
• ROSC – RETURN OF SPONTANEOUS CIRCULATION SIGN OF
LIFE
ADULT CPR
• KNEEL FACING THE VICTIM’S CHEST
• PLACE THE HEEL OF ONE HAND ON
THE CENTER OF THE CHEST
• PLACE THE HEEL OF THE SECOND
HAND ON TOP OF THE FIRST SO THE
HANDS ARE OVERLAPPED AND
PARALLEL.
CHILD CPR
• LOWER HALF OF THE STERNUM,
BETWEEN NIPPLES
• ONE HAND ONLY/TWO HANDS
• 30:2 FIR SINGLE RESCUER; 15:2
FOR 2-MAN RESCUER
(OPTIONAL FOR HCP)
INFANT CPR
• JUST BELOW THE NIPPLE LINE,
LOWER HALF OF STERNUM (1
FINGER BREADTH BELOW
IMAGINARY NIPPLE LINE)
• TWO FINGERS, FLEXING AT THE
WRIST (LONE RESCUER)
• THUMB-ENCIRCLING HANDS
TECHNIQUE (TWO RESCUERS)
CAB – OPEN AIRWAY
• THIS MUST BE DONE TO ENSURE AN
OPEN PASSAGE FOR SPKNTANEOUS
BREATHING OR MOUTH TO MOUTH
DURING CPR
 
 
HEAD TILT/CHIN-LIFT MANUEVER
• TILT THE HEAD BACK WITH YOUR ONE
HAND AND LIFT UP THE CHIN WITH YOUR
OTHER HAND.
JAW-THRUST MANUEVER
• IS STRICLTY A HEALTHCARE PROVIDER
TECHNIQUE AND NOT FOR LAY RESCUERS
(IF SUSPECTED WITH CERVICAL TRAUMA).
PLACE THE INDEX AND MIDDLE FINGERS
TO PHYSICALLY PUSH THE POSTERIOR
ASPECTS OF THE LOWER JAW UPWARDS
WHILE THE THUMBS PUSH DOWN ON THE
CHIN TO OPEN THE MOUTH.
  

CAB – BREATHING
 
• MAINTAIN OPEN AIRWAY
• PINCH NOSE SHUT (IF MOUTH TO MOUTH RB IS PREFERRED)
• OPEN YOUR MOUTH WIDE, TAKE A NORMAL BREATH, AND MAKE A
TIGHT SEAL AROUND OUTSIDE OF VICTIM’S MOUTH
• GIVE 2 FULL BREATHS (1 SEC EACH BREATH)
• OBSERVE CHEST RISE
• 30:2 (COMPRESSION TO VENTILLATION RATIO)
• 5 CYCLES OR 2 MINUTES
BASIC LIFE SUPPORT SEQUENCE
 

1. VERIFY SCENE SAFETY

• SURVEY THE SCENE FIRST
• MAKE SURE THE ENVIRONMENT IS SAFE FOR RESCUERS
AND VICTIM
• OBSERVE STANDARD PRECAUTIONS (WEAR PPE)
 
2. INTRODUCE YOURSELF
• MAKE SURE TO INTRODUCE YOURSELF FIRST BEFORE
ENGAGING WITH THE VICTIM
 
BASIC LIFE SUPPORT SEQUENCE
 

3. CHECK FOR RESPONSIVENESS

• CHECK FOR RESPONSIVENESS BY
TAPPING THE VICTIM AND ASK LOUDLY,
“ARE YOU OKAY?”
• ADULT, ADOLESCENTS AND CHILD BLS
 TAP THE SHOULDER
• INFANTS BLS
 TAP THE SOLE OF THE FEET
 
BASIC LIFE SUPPORT SEQUENCE
 
 
4. ACTIVATE EMERGENCY RESPONSE SYSTEM
(EMS)
• SHOUT FOR NEARBY HELP
• ACTIVATE EMS VIA MOBILE PHONE OR
PHONE PATCH
• SEND SOMEONE TO DO SO
• IF YOU ARE ALONE WITH NO MOBILE
PHONE, LEAVE THE VICTIM TO ACTIVATE
THE EMS, AND GET THE AED (IF READILY
AVAILABLE) BEFORE BEGINNING CPR
BASIC LIFE SUPPORT SEQUENCE
 
 
5. RECOGNITION OF CARDIAC ARREST
• UNRESPONSIVE
• NO BREATHING OR ONLY GASPING
• NO PULSE
CHECK FOR BREATHING AND PULSE SIMULTANEOUSLY FOR NO MORE TTHAN 10
SECONDS
 
HOW TO CHECK FOR BREATHING
• OBSERVE FOR CHEST RISE
• DISTINGUISH BETWEEN NORMAL BREATHING FROM NO NORMAL BREATHING
(ONLY GASPING)

 HOW TO CHECK FOR PULSE

• ADULT & ADOLESCENT
 CHECK FOR CAROTID PULSE
• PEDIATRIC
 CHILD BLS
• CHECK FOR CAROTID PULSE
 INFANT BLS
• CHECK FOR BRACHIAL OR FEMORAL PULSE
TABLE OF COMPARISON ON
CPR FOR ADULTS &
ADOLESCENTS, CHILDREN
AND INFANTS
RECOVERY POSITION IN PCR
 
ADULT AND CHILD
• BEND THE ARM OF THE
PATIENT AND PLACE THE BACK
OF THE VICTIM’S HAND
AGAINST HIS/HER CHEEK AND
HOLD THERE
• TURN THE VICTIM TOWARDS
YOU AS ONE UNIT
FOREIGN BODY AIRWAY
OBSTRUCTION
IS A CONDITION WHEN SOLID
MATERIAL LIKE CHUNKED FOODS,
COINS, VOMITUS, SMALL TOYS, ETC.
ARE BLOCKING THE AIRWAY
CAUSES OF OBSTRUCTION
 
• IMPROPER CHEWING OF LARGE PIECES OF FOOD
• EXCESSIVE INTAKE OF ALCOHOL
 RELAXATION OF TOUNGUE BACK INTO THE THROAT
 ASPIRATED VOMITUS (STOMACH CONTENT)
• PRESCENCE OF LOOSE UPPER AND LOWER DENTURES
• CHILDREN WHO ARE RUNNING WHILE EATING
• FOR SMALLER CHILDREN OF “HAND-TO-MOUTH” STAGE LEFT
UNATTENDED
TWO TYPES OF OBSTRUCTION
 
• ANATOMICAL OBSTRUCTION
 WHEN TONGUE DROPS BACK AND OBSTRUCT THE THROAT.
OTHER CAUSES ARE ACUTE ASTHMA, CROUP, DIPTHERIA,
SWELLING, AND COUGH (WHOOPING)
• MECHANICAL OBSTRUCTION
 WHEN FOREIGN OBJECTS LODGE IN THE PHARYNX OR
AIRWAYS; FLUIDS ACCUMULATE IN THE BACK OF THE
THROAT
CLASSIFICATION OF OBSTRUCTION
 
MILD OBSTRUCTION
SIGNS:
• GOOD AIR EXCHANGE
• RESPONSIVE AND CAN COUGH FORCEFULLY
• MAY WHEEZE BETWEEN COUGHS
• HAS INCREASED RESPIARATORY DIFFICULTY
AND POSSIBLY CYANOSIS
CLASSIFICATION OF OBSTRUCTION
MILD OBSTRUCTION
RESCUER ACTIONS:
AS LONG AS GOOD AIR EXCHANGE CONTINUES
• ENCOURAGE THE VICTIM TO CONTINUE SPONTANEOUS
COUGHING AND BREATHING EFFORTS
• DO NOT INTERVENE WITH THE VICTIM’S OWN ATTEMPTS TO EXPEL
THE FOREIGN BODY BUT STAY WITH THE VICTIM AND MONITOR
HIS OR HER CONDITION
• IF THE PATIENT BECOMES UNCONSCIOUS/UNRESPONSIVE,
ACTIVATE THE EMERGENCY RERSPONSE SYSTEM
SEVERE OBSTRUCTION
SIGNS:
• POOR OR NO AIR EXCHANGE
• WEAK OR INEFFECTIVE COUGH OR NO COUGHH AT ALL
• HIGH-PITCHED NOISE WHILE INHALING OR NO NOISE AT ALL
• INCREASED RESPIRATORY DIFFICULTY
• CYANOTIC (TURNING BLUE)
• UNABLE TO SPEAK
• CLUTCHING THE NECK WITH THE THUMB AND FINGERS MAKING
THE UNIVERSAL SIGN OF CHOKING
• MOVEMENT OF AIR IS ABSENT
SEVERE OBSTRUCTION

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
PERFORM ABDOMINAL/CHEST THRUST AND ONCE
UNCONSCIOUS/UNRESPONSIVE ACTIVATE TH
EMERGENCY RESPONSE SYSTEM
UNIVERSAL SIGN OF
CHOKING IS A SIGN
WHEREIN THE VICTIM IS
CLUTCHING HIS/HER NECK
WITH ONE OR BOTH HANDS
AND GASPING FOR BREATH
ABDOMINAL THRUST
• IS AN EMERGENCY PROCEDURE FOR
REMOVING A FOREIGN OBJECT
LODGED IN THE AIRWAY THAT IS
PREVENTING A PERSON FROM
BREATHING.
REMEMBER:
• ABDOMINAL THRUST SHOULD
NOT BE USED IN INFANTS UNDER
1 YEAR OF AGE DUE TO RISK OF
CAUSING INJURY.
FINGER SWEEP
• A TECHNIQUE
RECOMMENDED FOR
RELIEVING BODY AIRWAY
OBSTRUCTION
RESCUE BREATHING (RB)
• IS A TECHNIQUE OF
BREATHING AIR INTO
PERSON LUNGS TO
SUPPLY HIM OR HER
WITH THE OXYGEN
NEEDED TO SURVIVE.
COMPLICATIONS FROM ABDOMINAL THRUSTS
 
• INCORRECT APPLICATION OF THE ABDOMINAL THRUST CAN
DAMAGE THE CHEST, RIBS, AND INTERNAL ORGANS
• MAY ALSO VOMIT AFTER ADMINISTERING THE ABDOMINAL
THRUST
• THEY SHOULD BE EXAMINED BY A PHYSICIAN TO RULE OUT ANY
LIFE-THREATENING COMPILCATIONS
PERFORMING THE CHEST THRUST IN OBVIOUSLY
PREGNANT AND VERY OBESE PEOPLE
 
• THE MAIN DIFFERENCE IN PERFORMING THE
ABDOMINAL THRUST ON THIS GROUP OF PEOPLE
IS THE PLACEMENT OF THE FISTS
• INSTEAD OF ABDOMINAL THRUST, CHEST THRUSTS
ARE USED
• THE FISTS ARE PLACED AGAINST THE MIDDLE OF
THE BREASTBONE AND DO THE CHEST THRUST
• IF THE VICTIM IS UNCONSCIOUS, THE CHEST
THRUSTS ARE SIMILAR TO THOSE USED IN CPR.
 
CAUTION: IF THE PREGNANT OR OBESE VICTIM
BECOMES UNSONSCIOUS, CALL FOR HELP AND
PERFORM 30 CHEST COMPRESSION
FBAO MANAGEMENT
• DETERMINE SCENE SAFETY
• INTRODUCE YOURSELF
• DETERMINE LEVEL OF BREATHING DIFFICULTY BY CHECKING:
 INFANT – INEFFECTIVE COUGHS, WEAK OR ABSENCE OF CR. IF SO,
TELL PARENTS/GUARDIAN THAT YOU ARE THERE TO HELP
 CHILD/ADULT – BY ASKING IF THE VICTIM IS CHOKING, “CAN YOU
COUGH?” IF SO, TELL THE VICTIM THAT YOU ARE THERE TO HELP
 FBAO MANAGEMENT
• PROPERLY POSITION THE PATIENT
• INFANT – SUPPORT THE INFANT ON RESCUER’S KNEE OR LAP
• CHILD/ADULT – ASSUME STRADDLE POSITION BEHIND
• LOCATE PROPER SITE
• INFANT – GIVE 5 BACK SLAPS AND 5 CHEST THRUSTS USING 2 FINGER
TECHNIQUES
• CHILD/ADULT – FOR ABDOMINAL THRUST, PROPERLY POSITION
BALLED FIST ON THE PATIENT. PROPERLY PERFORM ABDOMINAL
THRUST (AT LEAST 5 THRUST)
 FBAO MANAGEMENT
• IF THE PATIENTS BECOME UNSCONSIOUS, CAREFULLY
LAY HIM/HER DOWN
• CALL FOR HELP TO ACTIVATE MEDICAL ASSISTANCE AND
PERFORM 30 CHEST COMPRESSION
• CHECK ORAL CAVITY FOR PRESENCE OF OBSTRUCTION.
IF FOREIGN BODY IS VISIBLE PERFORM FINGER SWEEP,
IF NOT VISIBLE PROPERLY ADMINISTER FIRST RB
 FBAO MANAGEMENT
• IF AIR BOUNCE BACK, RE-POSITION PATIENT’S HEAD
AND PROPERLY ADMINISTER SECOND RB
• IF AIR GOES IN, ASSESS FOR PULSE AND
CONSCIOUSNESS
• IF PATIENT BECOMES CONSCIOUS, PROPERLY PLACE
PATIENT IN RECOVERY POSITION.