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 ADULT BASIC LIFE SUPPORT
THEORETICAL GUIDELINES FOR TRAINING AND ASSESSMENT Organisational Learning Unit
Northern Sector Office: Level 2, Campus Centre, Randwick Hospitals Campus.
Phone: 93825313
Fax: 93825280
BASIC LIFE SUPPORT
GUIDELINES
Version Control
Released by
Version
Release Date
Review Date
Organisational Learning Unit 1
September 2008.
January 2009
Organisational Learning Unit 1.1 January 2009. June 2009 Acknowledgements
The following people have contributed to the development of these learning resources:
SESIH Education Assessment and Training Subcommittee (EATS). Committee members as of
July 2008:
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Michelle Brady
Jenny Broe
David Collins
Lynette Higgs
Jon Magill
Catherine Molihan
Kim O’Leary
Alex Pile
Suzanne Schacht
Garry Skinner
Carolyn Smith
Jayne Tesch
Gai Vereker
Bruce Way
Lis Woodhart
Lian Zheng
The Sutherland Hospital
The Prince Of Wales Hospital
The Prince of Wales Hospital
Sydney/Sydney Eye Hospital
Prince of Wales Hospital
Royal Hospital for Women
Shoalhaven Hospital
St Vincent’s Hospital
SESIAH
War Memorial Hospital
Sydney Children’s Hospital
Organisational Learning Unit SESIAH
The Wollongong Hospital
Prince of Wales Hospital
The Sutherland Hospital
War Memorial Hospital
Published by the Organisational Learning Unit, SESIAHS
© 2008 Organisational Learning Unit
ALL RIGHTS RESERVED
This publication is protected by copyright. No part may be reproduced, stored in a retrieval system or transmitted in any form
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BASIC LIFE SUPPORT
GUIDELINES
Contents
SESIH Facility Emergency Numbers
5
Glossary
7
Basic Life Support Mandatory Training and Assessment
9
Foreword to Guidelines
11
Basic Life Support Flowchart
13
Steps in Adult Basic Life Support
15
APPENDIX 1
24
APPENDIX 2
25
APPENDIX 3
26
References:
29
Diagrams and Appendices:
30
IMPORTANT NOTE
The provision of Basic Life Support within SESIH Facilities and Services must take into
account applicable aspects of the setting in which Basic Life Support is provided,
which include:
•
Local emergency response systems;
•
The use and availability of resuscitation equipment and resources;
•
Occupational Health and Safety Requirements (e.g. situational risks
associated with electrical and biological hazards and the use of personal
protective equipment); and
•
Infection Control Policies and procedures (e.g. the use of standard and
additional precautions).
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SESIH Facility Emergency Numbers
Albion Street Center
Dial 0-000
Bulli Hospital
Dial 666
Calvary Healthcare Kogarah
Dial 777
Coaldale Hospital
Dial 0-000
David Berry Hospital
Dial 0-000
Garrawarra Centre
Dial 333
Kiama Hospital
Dial 0-000
Langton Centre
Dial 0-000
Milton Ulladulla Hospital
Dial 0-000
Prince of Wales Hospital
Dial 777
Port Kembla Hospital
Dial 222
Royal Hospital for Women
Dial 777
Shellharbour Hospital
Dial 222
Shoalhaven District Hospital
Dial 9222
St George Hospital
Dial 666
St Vincent’s Hospital
Dial 555
Sydney Childrens Hospital
Dial 777
Sydney/Sydney Eye Hospital
Dial 55
The Sutherland Hospital
Dial 777
The Wollongong Hospital
Dial 222
War Memorial (Waverley)
Dial 777
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Glossary
Airway
The passage from the nose and mouth through which air
passes into the lungs.
Aspiration
The act of inhaling fluid and particles into the lungs.
Automatic External
defibrillator (AED)
A device that analyses the electrical rhythm of the heart
and charges automatically if a shockable rhythm
(ventricular fibrillation or ventricular tachycardia) is
recognised. The device provides the operator with audible
and /or visual prompts on actions required for safe delivery
of and electrical shock.
Cardiac Arrest
Cessation of heart function.
Carotid pulse
The pulse that can be felt over one of the two main arteries
in the neck located either side of the windpipe (trachea).
Choking
Life threatening blockage of the airway.
Defibrillation
The application of a controlled electric shock to the heart
through the chest wall in order to stop a cardiac arrhythmia
(ventricular fibrillation or ventricular tachycardia). The aim of
the shock is to restore the heart's normal rhythm.
External Cardiac
compressions
Rhythmic pressure applied through the heal of both hands
over the sternum (breastbone) during cardiac arrest in an
attempt to circulate blood around the body.
Finger sweep
Using the fingers to attempt to dislodge a foreign body from
the mouth or throat of an unconscious person.
Head Tilt
The backward tilting of the head in an attempt to open the
airway in an unconscious person.
Inflation
The movement of air into a person’s lungs using a rescuer’s
expired air or with the aid of special ventilation equipment.
Jaw thrust
The forward pressure applied behind the boney part of the
jaw (below the ears) to move the jaw upward and away
from the chest in order to open the airway in an
unconscious person.
Ventricular Fibrillation
An abnormal irregular heart rhythm where very rapid
uncoordinated fluttering contractions of the ventricles
(lower chambers of the heart), are insufficient to pump
blood and oxygen to the vital organs. If not immediately
treated death will occur within 3-5 minutes.
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Basic Life Support Mandatory Training and
Assessment
These guidelines provide the foundation for the South East Sydney and Illawarra Health
Service (SESIH) Basic Life Support Mandatory Training and Assessment Program which
consists of:
1. A theoretical component
2. A practical component
3. An assessment component
Learning outcomes
The learning outcomes for the SESIH Basic Life Support (BLS) Mandatory Training and
assessment program are as follows:
1. Theoretical Foundations
y
Outline the responsibilities of the single rescuer in a Cardiac Arrest;
y
Outline each step in the ARC Adult Basic Life Support algorithm (DRABCD);
y
Identify the process for summoning assistance in a Cardiac Arrest;
y
Discuss the use of personal protective equipment during resuscitation.
2. Skills Assessment
y
Identifies hazards to health and safety of self and others;
y
Minimises immediate risk to health and safety of self and others by isolating
hazards;
y
Assesses vital signs of collapsed person;
y
Recognises the need for CPR;
y
Summons assistance;
y
Performs CPR in accordance with ARC guidelines.
See Appendix 1 for the SESIH Adult Basic Life Support Assessment Criteria
Skills assessment frequency:
All staff for whom Basic Life Support is deemed a mandatory skill are required to have
their Adult BLS skills assessed on a yearly basis.
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Foreword to Guidelines
Basic Life Support
Has been defined by the Australian Resuscitation Council (ARC) as “…the preservation of
life by the initial establishment of and /or maintenance of airway, breathing and
circulation, and related emergency care.” (ARC, 2006: Glossary of Terms: p2)
Cardiopulmonary Resuscitation
Cardiopulmonary resuscitation (CPR) includes the technique of combining rescue breathing
with chest compression. The aim of CPR is to maintain temporarily a critical amount of
circulation to the heart and the brain (Handley et al, 2005:S7; ARC, 2006: Guideline 7)
About the Chain of Survival
The European Resuscitation Council (ERC) describes the steps involved in successful
resuscitation as the Chain of Survival (Nolan, 2005: S3). Each step is outlined below.
1. Early Recognition of Collapse/Emergency: Recognising those at risk of cardiac
arrest and calling for help has the potential to avert a cardiac arrest.
2. Early Initiation of Cardiopulmonary Resuscitation: Effective CPR can dramatically
increase survival from ventricular fibrillation in sudden cardiac arrest by buying time
until successful defibrillation.
3. Early Defibrillation: Survival rates can be improved (49-75%) if CPR and
defibrillation are initiated within 3-5 minutes.
4. Early Advanced Life Support and Post Resuscitation Care: Effective post
resuscitation care can preserve function particularly of the heart and brain.
Figure 1: ERC Chain of Survival (Nolan, 2005, S 5.)
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Steps in Adult Basic Life Support
When a person collapses, his/her life may depend on the successful application of the
principles of the DRABCD of resuscitation:
D = Danger
R = Response
A = Airway
B = Breathing
C = Circulation
D = Defibrillation with AED (in facilities where AED’s available)
(ARC, 2006, Guideline 7)
If someone collapses in your presence, or you find someone collapsed, take the
following steps:
Danger
Assess for danger and remove the person and yourself to a safe environment if necessary
(ARC, Guideline: 2.1 2002; Guideline 2.3 2005). Note: Do not attempt to move someone
by yourself, wait until help arrives to assist you.
Response
Determine responsiveness: Gently grasp and squeeze the person’s shoulders, speak to the
person by name if it is known. (ARC, 2006, Guideline: 3.1). Ask loudly “are you all right?”
If Responsive
• Make the person comfortable and
observe airway breathing and
circulation (ABC);
(ARC, 2004, Guideline: 3.1)
• Check Blood pressure and pulse;
• Call for nursing/medical help to
review person promptly.
If Unresponsive
• Summon HELP first
(ARC, 2006, Guideline: 2.1)
Call/send for help; or
If unlikely to get help easily, dial
the emergency number for your
facility or service (See Page 5);
- State the nature of the
emergency
- Give location
- Identify whether emergency
involves an adult or child
• Note the time;
• Assess Airway Breathing and
Circulation.
-
Airway
Open the airway
When a person is unconscious, all muscles are relaxed. If the person is lying on their back
the tongue falls against the back of the throat and obstructs the airway. To open the
airway:
• Lay person flat on the back on firm surface (do not roll onto side);
• Apply head tilt /chin lift (see Figure 2) and/or jaw thrust (see Figure 3),
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Airway (cont)
Manoeuvres to open Airway
Head Tilt/ Chin lift
The simplest way of ensuring an open
airway in an unconscious person is to
use a head tilt chin lift technique,
thereby lifting the tongue from the back
of the throat:
•
•
Place your hand on the person’s
forehead and gently tilt the head
back.
With your fingertips under the
point of the persons chin, lift the
chin to open the airway.
Figure 2: Head tilt chin lift
Jaw thrust
In the jaw thrust manoeuvre the jaw is
displaced forward, pulling the tongue
away from the back of the throat:
•
•
Position yourself behind the head
of the person;
Place fingers behind the bony
part of the jaw (below the ears)
and thrust the jaw upward and
away from the chest.
Figure 3: Jaw Thrust
Clearing the airway:
•
Visually inspect airway;
•
If safe to do so manually remove any visible solids or loose fitting dentures using
gloved hands. Note: Only perform a finger sweep if there is a visible obstruction.
(Handley et al, 2005:s17).
•
Use suction if available to clear secretions/vomitus from the airway. If suction not
available roll person on side, if safe to do so, and drain fluid from the mouth.
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Breathing
Once the airway is cleared and open, check for normal breathing for a period of up to 10
seconds, using the following method. Note that an occasional gasp or noisy breathing is
not considered normal breathing.
•
•
Look and Feel for movement of lower chest or upper abdomen;
Listen and Feel: for escape of air from nose and mouth.
(ARC, 2008, Guideline: 5)
If Breathing Absent
or not normal
If Breathing Normally
• Place person in the recovery position
(see Figure 4):
• Ensure person is on a firm surface;
• Using mouth to mask resuscitation
method, give 2 rescue breaths each
of 1 second duration (See Figure 5;
See also Appendix 2);
Figure 4: Recovery position
• Check for continued breathing and
give oxygen flow rate to 15
litres/minute, if available;
• Note: Stay with the person until help
arrives.
Figure 5: Mouth to mask method
(ARC, 2008, Guideline: 5)
• If there is an oxygen source available
attach to the mask (flow rate to 15
litres/minute);
• Deliver a breath of sufficient volume
to see the chest rise;
• Note: If the chest does not rise
recheck head tilt and chin lift;
recheck mask seal; and do not
attempt more than two breaths each
time before commencing or returning
to chest compressions;
• Care should be taken not to use too
much force to inflate lungs. If
excessive force is used there is a risk
that air will inflate the stomach
resulting in regurgitation of stomach
contents and aspiration into the lungs.
ARC, 2008, Guideline: 5; Nolan et al, 2005)
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KEY POINT: RESCUE BREATHING WITHOUT CHEST COMPRESSIONS
Information for Experienced Clinicians
In the event an experienced clinician determines that an adult person with palpable pulses
requires support of ventilation:
•
rescue breaths can be delivered at a rate of approximately 10 breaths per minute (one
breath every 5 to 7 seconds);
•
each breath should be of sufficient volume to see the chest rise. If the chest does not
rise, head tilt /chin lift and mask seal should be rechecked;
•
Avoid inflating lungs with too much force as there is a risk that air will inflate the
stomach resulting in regurgitation of stomach contents and aspiration into the lungs;
•
Reassess for a pulse every 10 breaths but spend no more than 10 seconds doing so;
•
Be prepared to commence compressions if a pulse is no longer palpable;
•
If the person resumes breathing normally place in recovery position.
(ARC, 2006, Guideline 6; Nolan et al, 2005:S 44) Circulation
Ensure person is on a firm surface. Keeping the airway open, check for signs of life. If no
signs of life present (i.e. person is unconsciousness, there is no movement and no normal
breathing or coughing) commence chest compressions immediately. Experienced clinicians
may choose to check for a carotid pulse but are advised to spend no more than 10 seconds
doing so.
Performing Chest compressions
•
Visualise and locate the centre of the persons chest (i.e. between the nipples);
•
Kneel or stand vertically over the person so that your shoulders are over the sternum
and your arms are straight;
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Performing Chest compressions (cont)
•
Place the heel of one hand in the middle of the sternum and place the other hand on
top for additional force;
Figure 6: Hand placement for compressions
•
Do not apply pressure over the ribs;
•
Compress the sternum, hard and fast, to at least 1/3 the depth of chest at a rate of
100 per minute. Ratio of compressions to breaths should be 30:2;
Figure 7: Depth of compressions
• Compressions should be rhythmic with equal time for compression and relaxation.
Note: Do not lift your hands from the sternum during compressions
(ARC, 2006, Guideline 6)
KEY POINT: RESUSCITATION IN LATE PREGNANCY
“In the obviously pregnant woman the pregnant uterus causes pressure on the major
abdominal vessels when she lies flat, reducing venous return to the heart. The pregnant
woman should be positioned on her back with her shoulders flat and sufficient padding
(pillow or wedge) under the right buttock to give obvious pelvic tilt to the left.”
(ARC, 2006, Guideline 7: p3)
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Additional Points on Compression
•
Effective chest compressions generate a small, but critical amount of blood flow to the
myocardium and brain and increases the likelihood of effective defibrillation;
•
Both one operator and two operators should perform the same compression to
ventilation ratio of 30:2;
•
Once an advanced airway has been secured (i.e. tracheal intubation) continue
compressions uninterrupted. Ventilations should be delivered at approximately 10
breaths per minute or one breath every 5 to 7 seconds. Note : Compressions should
only be interrupted to perform rhythm analysis or to defibrillate; (Nolan et al
2005:S 44).
•
Performing chest compressions and rescue breaths at a ratio of 30:2 is tiring; it is
therefore recommended that the person doing compressions be changed every 2
minutes or when he/she becomes fatigued.
(ARC, 2006, Guideline 6)
Duration of CPR
Cardiopulmonary resuscitation should continue until:
•
Signs of life return;
•
Qualified help arrives;
•
It is impossible to continue (e.g. exhaustion);
•
An authorised person pronounces life extinct.
(ARC, 2006, Guideline 7)
KEY POINT: PERFORMING CHEST COMPRESSIONS ONLY
In cases where there is no barrier device or mask available for performing mouth to mask
ventilations, an acceptable alternative is to give uninterrupted chest compressions at a
rate of 100/minute (Koster et al, 2008) until qualified help arrives to secure an airway
and commence rescue breathing.
Note that the ARC states “Ventilation remains important in a significant proportion of
cardiac arrests. These include cardiac arrests … due to drowning or airway obstruction,
in-hospital cardiac arrests and resuscitation attempts beyond the first 3 to 4 minutes.
Compression-only CPR is insufficient in these circumstances”
(ARC Advisory Statement Compression only CPR: April 2008)
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Automated External Defibrillation (AED)
Note: The following section applies only to those facilities where AED’s are available and
staff have been trained in their use.
Introduction
Along with early initiation of cardiopulmonary resuscitation, early defibrillation is a key
link in the Chain of Survival’ following cardiac arrest (Nolan 2005:S4). Ventricular
Fibrillation (VF) is the most frequent initial rhythm in sudden cardiac arrest with
defibrillation being the most effective treatment.
Survival rates following cardiac arrest can be improved provided CPR and defibrillation is
initiated early (within 3-5 minutes). Every minute a person remains in cardiac arrest
represents a 10 % reduction in the likelihood of their survival to discharge from hospital
(ARC, 2004: Guideline 10).
An Automated External Defibrillator (AED) is a portable automatic device that uses voice
and visual prompts to guide the lay rescuer or heath care professional in safely attempting
defibrillation in cardiac arrest (ARC: 2004, Guideline 10; Hadley et al , 2005 )
Sequence for using an AED
•
Verify that the person has no signs of life (i.e. unconsciousness, no movement, no
normal breathing or coughing)
•
Initiate DRABC according to the guidelines outlined in pages 16 – 20 of this document;
•
As soon as the AED arrives the staff member operating the machine should switch it on
and follow the spoken or visual prompts provided;
°
Whilst continuing CPR, expose the patients’ chest and attach the electrode pads in
the following positions:
-
Sternal Pad – Right Mid-clavicular line over 2nd intercostal space (See Figure 8);
Apex Pad – Left Mid-axillary line over 6th intercostal space (See Figure 8).
(Deakin & Nolan, 2005: S28)
Figure 8: Placement of Defibrillator Electrodes
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Sequence for using an AED (cont)
°
The staff member operating the AED should ensure all personnel stand away from
the patient and bed while the AED analyses the rhythm. Incorrect or delayed
diagnosis may occur if the patient is moved or handled during this process.
CAUTION
Note that some intermittent radio transmissions can interfere with rhythm analysis
function of an AED if a transmitter or receiver (i.e. two- way radio/ ‘walkie
talkie’) is used within 2 metres of patients during this process
(Circulation, 2000, 102 :(8))
•
•
If shock is indicated:
°
The staff member operating the AED should advise all personnel to “Stand
Clear” before any shock is delivered;
°
This warning should be followed by a visual inspection of the area by the staff
member operating the AED to ensure:
-
no-one is in contact with the bed or the patient;
-
there is no water in the vicinity of the patient.
there is no free flowing oxygen in the vicinity of the AED electrodes;
°
The staff member operating the AED should then push the ‘Shock’ button as
directed;
°
Upon delivery of shock, external cardiac compression and rescue breathing
should be resumed immediately and all AED prompts should be followed until
qualified help arrives;
If shock not indicated, and there are no signs of life, immediately resume external
cardiac compression and rescue breathing until qualified help arrives.
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Points on Defibrillation Safety
•
Ensure defibrillator electrode pads are completely adhered to the skin. Air pockets
between the skin and the pads can result in burns to the skin during defibrillation or an
ineffective shock to be delivered. If the patient’s chest is excessively hairy it may be
necessary to clip hair so the electrode pads will adhere to the chest. If the patient is
diaphoretic, wipe the chest carefully before attaching pads (AHA, 2005, Part 5).
•
Avoid positioning defibrillator pads over any of the following:
°
°
°
Monitoring electrodes and/or leads;
Transdermal patches containing glyceryl trinitrate, nicotine, analgesics,
hormone replacements or antihypertensives;
Any implanted medical device such as an implantable defibrillator or
pacemaker.
Doing any of these things may cause electrical arching and/or burns during
defibrillation and may also cause the defibrillation current to be diverted away from
the heart (AHA, 2005, Part 5).
•
Remove any free flowing oxygen from the vicinity of the defibrillator electrode pads,
as this presents a fire hazard during defibrillation (AHA, 2005, Part 5).
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APPENDIX 1
Adult Basic Life support Assessment Criteria
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APPENDIX 2
Airway management: Mouth to Mask Ventilation
Use this method to deliver rescue breaths until help arrives. Follow facility guidelines for
assembly and use of mask. Ensure a disposable bacteria/viral filter is inserted between
the mask and the operator.
Mouth to Mask resuscitation sequence (see Figure 9):
•
Position yourself at persons head (See figure 9);
•
If there is an oxygen source available, attach to the mask;
•
Place mask (with filter/one way valve attached) over person’s mouth and
nose;
•
Ensure an adequate seal over mouth and nose using both hands;
•
Place your mouth around the filter/valve attached to the mask (See Figure
9);
•
Blow through filter/valve giving enough volume to see the persons chest
rise. Note: Allow time for the person to exhale before delivering next
breath;
•
If chest does not rise re-check head tilt, chin lift and mask seal.
(ARC, 2008, Guideline: 5)
Figure 9: Mouth to Mask Ventilation
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APPENDIX 3
Airway Management: Adult foreign body obstruction
Foreign body airway obstruction (FBAO) is an uncommon but potentially treatable cause of
accidental death. The signs and symptoms of obstruction will depend on the cause and the
severity of the condition. For example, in the conscious person who has inhaled a foreign
body, there may be extreme anxiety, agitation, gasping, coughing or loss of voice.
However in the unconscious person FBAO may not be apparent until rescue breathing is
attempted.
The Adult FBAO sequence (see also Figure 10):
•
If the person shows signs of mild airway obstruction, (i.e. they have an effective
cough), encourage him/her to cough but do nothing else;
•
If the person shows signs of severe airway obstruction and is conscious apply up to
five back blows:
ƒ stand to the side and slightly behind the person:
ƒ lean the person well forward, give up to 5 sharp blows between the
shoulder blades with the heel of your hand;
ƒ check to see if each back blow has relieved the airway obstruction.
•
If the person at any time becomes unconscious:
ƒ
Support the person carefully to the ground – do not place yourself in danger
by ‘catching’ the person;
ƒ
Summon HELP:
- Call/send for help;
- Dial the facility emergency number state “Cardiac Arrest” and give
location;
ƒ
Begin CPR at a compression to ventilation ratio of 30:2
(ARC, 2008 Guideline 5; ARC, 2006 Guideline 4, 6, & 7).
Figure 10. Adult FBAO Management
Assess Severity
Severe airway obstruction
Mild Airway obstruction
(ineffective cough)
(effective cough)
Unconscious
Conscious
Start CPR
5 back blows
Encourage Cough
If not effective, give 5
Continue to check for
chest thrusts.
deterioration to ineffective
cough or until obstruction
cleared
After: Australian Resuscitation Council (2006)
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Adult Basic Life Support Quiz Questions
The following Quiz in designed to assess the readers understanding of the Guidelines
outlined in this document. The quiz can be undertaken as a self directed exercise or as
part of a facilitated question and answer session with other learners.
1. You find an adult person collapsed in a hospital corridor. What should you do
first?
Determine responsiveness
Assess for danger
Commence CPR
Call for help
(Need help? See Page 15)
2. What is your first priority after you determine the person is unresponsive?
Make a note of the time
Assess airway and breathing
Call for help
Give two breaths
(Need help? See Page 15)
3. Of the options listed below indicate which one is recommended for opening the
airway of a collapsed adult who isn’t breathing?
Roll person onto the left side and perform a backward head tilt
Perform a Heimlich manoeuvre
Use Head tilt /chin lift or jaw thrust manoeuvre
Use a finger sweep of the mouth to clear any obstruction
(Need help? See Page 15, 16)
4. If the person does not commence breathing after you have opened the airway,
what should you do?
Check the airway again
Put the person in the coma position
Start chest compressions
Start rescue breathing
(Need help? See Page 17)
5. When commencing rescue breathing, how many initial breaths do you give?
2
3
4
5
(Need help? See Page 17)
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6. A person with no ‘signs of life’ is:
Unconsciousness/unresponsive
Not moving
Not breathing normally
All of the above
(Need help? See Page 18)
7. You determine the collapsed person has no signs of life, what is it
recommended that you do now:
Call for Help
Feel for a pulse
Start chest compressions
Check their pupils
(Need help? See Page 18)
8. When locating the site for chest compressions in an adult it is recommended to
visualise the centre of the chest.
True
False
(Need help? See Page 18)
9. When performing CPR the recommended ratio of compressions to breaths is?
100 compressions to 2 breaths
30 compressions to 2 breaths
15 compressions to 2 breaths
5 compressions to 2 breaths
(Need help? See Page 18)
10. It is recommended that CPR continue until:
An authorised person pronounces life extinct
Qualified help arrives to assist
Exhaustion prevents you continuing
Signs of life return
All of the above
(Need help? See Page 19)
11. Basic Life support now includes defibrillation:
True
False
(Need help? See Page 20)
12. What number do you call in your facility in the event of a Cardiac Arrest?
Basic Life Support Theoretical Guidelines for Training and Assessment
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BASIC LIFE SUPPORT
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References:
Anonymous (2000) “Part 4: The Automated External Defibrillator: Key Link in the Chain of Survival”,
Circulation, Vol. 108: (8) pp. 160-176.
American Heart Association (2005), ‘American Heart Association Guidelines for Cardiopulmonary
Resuscitation and Emergency Cardiovascular Care.’ Circulation, Vol.112, (22): Supplement 1: 1136.
[http://circ.ahajournals.org/cgi/reprint/112/22_suppl/III-5] Accessed: March 5th 2008.
American Heart Association (2005), ‘Part 4: Adult Basic Life Support’ Circulation, Vol.112, (24):
Supplement 1:IV19-IV-34.
[http://circ.ahajournals.org/cgi/reprint/112/24_suppl/IV-19] Accessed: March 5th 2008.
Australian Resuscitation Council (2008). ‘Advisory Statement: Compression only CPR, The
Australian Resuscitation Council Online. [www.resus.org.au] Accessed July 9th 2008
Australian Resuscitation Council (2008). ‘Index of Guidelines’, The Australian Resuscitation
Council Online. [www.resus.org.au] Accessed July 9th 2008
Australian Resuscitation Council (2006). ‘Glossary of Terms’ Australian Resuscitation Council
Online. [www.resus.org.au] Accessed July 9th 2008
Deakin, C.; Nolan, J. (2005), ‘European Resuscitation Council Guidelines for
Resuscitation 2005 Section 3. Electrical therapies: Automated external defibrillators, defibrillation,
cardioversion and pacing.’ Resuscitation (2005) 67S1, S25—S37
Handley, A.J.; Koster, R.; Monsieurs, K; Perkins, G. D.; Davies, S.; Bossaert, L. (2005) ‘European
Resuscitation Council Guidelines for Resuscitation: Section 2. Adult Basic Life support and use of
automated external defibrillators.’ Resuscitation Vol. 67 (S1): S10.
[http://www.erc.edu/index.php/guidelines_download_2005/en/] Accessed, March 5th 2008.
Koster R.W. Bossaert, L.L.; Nolan, J.P. Zideman, D. (2008). ‘Advisory Statement of the European
Resuscitation Council on Basic Life Support.’
[http://www.erc.edu/index.php/docLibrary/en/viewDoc/775/3/] Accessed, March 5th 2008.
Nolan, J. (2005). ‘European Resuscitation Council Guidelines for Resuscitation 2005: Section 1.
Introduction.’ Resuscitation, Vol. 67: (S1)
[http://www.erc.edu/index.php/guidelines_download_2005/en/] Accessed March 5th 2008.
Nolan, J. and Baskett, P. (2005), ‘European Resuscitation Council Guidelines for Resuscitation.’
Resuscitation, Vol. 67: (S1) [http://www.erc.edu/index.php/guidelines_download_2005/en/]
Accessed March 5th 2008.
Nolan, J.; Deakin, C.D.; Soar, J.; Bottiger, B.W.; Smith, G. (2005) ‘European Resuscitation Council
Guidelines for Resuscitation: Section 4. Adult Advanced Life Support.’ Resuscitation Vol. 67 (S1):
S51. [http://www.erc.edu/index.php/guidelines_download_2005/en/] Accessed, March 5th 2008.
Basic Life Support Theoretical Guidelines for Training and Assessment
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BASIC LIFE SUPPORT
GUIDELINES
Diagrams and Appendices:
Basic Life Support Flow Chart (Page 13)
Australian Resuscitation Council (2006)
[http://www.resus.org.au/public/arc_basic_life_support.pdf] Accessed March 5th 2008.
Figure 1: Chain of Survival
Nolan, J. (2005) ‘European Resuscitation Council Guidelines for Resuscitation: Section 1.
Introduction.’ Resuscitation Vol. 67 (S1): S5.
[http://www.erc.edu/index.php/guidelines_download_2005/en/] Accessed, March 5th 2008.
Figure 2: Head Tilt Chin Lift
Nolan, J.; Deakin, C.D.; Soar, J.; Bottiger, B.W.; Smith, G. (2005) ‘European Resuscitation Council
Guidelines for Resuscitation: Section 4. Adult Advanced Life Support.’ Resuscitation Vol. 67 (S1):
S51. [http://www.erc.edu/index.php/guidelines_download_2005/en/] Accessed, March 5th 2008.
Figure 3: Jaw Thrust
Nolan, J.; Deakin, C.D.; Soar, J.; Bottiger, B.W.; Smith, G. (2005) ‘European Resuscitation Council
Guidelines for Resuscitation: Section 4. Adult Advanced Life Support.’ Resuscitation Vol. 67 (S1):
S51. [http://www.erc.edu/index.php/guidelines_download_2005/en/] Accessed, March 5th 2008.
Figure 4: Recovery Position
Handley, A.J.; Koster, R.; Monsieurs, K; Perkins, G. D.; Davies, S.; Bossaert, L. (2005) ‘European
Resuscitation Council Guidelines for Resuscitation: Section 2. Adult Basic Life support and use of
automated external defibrillators’ Resuscitation Vol. 67 (S1): S10.
[http://www.erc.edu/index.php/guidelines_download_2005/en/] Accessed, March 5th 2008.
Figure 6: Hand Placement for Chest Compressions
Handley, A.J.; Koster, R.; Monsieurs, K; Perkins, G. D.; Davies, S.; Bossaert, L. (2005) ‘European
Resuscitation Council Guidelines for Resuscitation: Section 2. Adult Basic Life support and use of
automated external defibrillators’ Resuscitation Vol. 67 (S1): S10.
[http://www.erc.edu/index.php/guidelines_download_2005/en/] Accessed, March 5th 2008.
Figure 7: Depth of Compressions
Handley, A.J.; Koster, R.; Monsieurs, K; Perkins, G. D.; Davies, S.; Bossaert, L. (2005) ‘European
Resuscitation Council Guidelines for Resuscitation: Section 2: Adult Basic Life support and use of
automated external defibrillators.’ Resuscitation Vol. 67 (S1): S11.
[http://www.erc.edu/index.php/guidelines_download_2005/en/] Accessed, March 5th, 2008.
Figure 8: Placement of Defibrillator electrodes
Phillips Medical Systems (2004), ‘Heartstart Home Automated External Defibrillator: Instructions for
use.’ Edition 6. Phillips Electronics, North America.
[http://www.heartstarthome.com/resources/HeartStart/docs/InstructionsForUse.pdf] Accessed,
March 10th 2008.
Figure 10: Adult Forign Body Airway Obstruction
Nolan, J.; Deakin, C.D.; Soar, J.; Bottiger, B.W.; Smith, G. (2005) ‘European Resuscitation Council
Guidelines for Resuscitation: Section 4. Adult Advanced Life Support.’ Resuscitation Vol. 67 (S1):
S53. [http://www.erc.edu/index.php/guidelines_download_2005/en/] Accessed, March 5th 2008.
Appendix 1: Adult Basic Life Support Assessment Criteria
South Eastern Sydney and Illawarra Area Health Service (2005) Adult Basic Life Support Assessment
Criteria, Incorporating the Automated External Defibrillator (AED).
Basic Life Support Theoretical Guidelines for Training and Assessment
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Appendix 2: Mouth to Mask Ventilation
Nolan, J.; Deakin, C.D.; Soar, J.; Bottiger, B.W.; Smith, G. (2005) ‘European Resuscitation Council
Guidelines for Resuscitation: Section 4. Adult Advanced Life Support.’ Resuscitation Vol. 67 (S1):
S53. [http://www.erc.edu/index.php/guidelines_download_2005/en/] Accessed March 5th 2008.
Appendix 3: Adult Foreign Body Obstruction Management flow chart
After: Australian Resuscitation Council (2006). ‘Management of Foreign Body Airway Obstruction
Choking: Guideline 6.’ Australian Resuscitation Council Online. [www.resus.org.au] Accessed
July 9th 2008
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