Introduction Welcome to COMPREHENSIVE BASIC LIFE SUPPORT Course. BLS is the foundation for saving lives after cardiac arrest. You will learn the skills of highquality cardiopulmonary resuscitation (CPR) for victims of all ages. The skills you learn in this course will enable you to recognize cardiac arrest, activate the emergency response system early, and respond quickly. Course Objectives After successfully completing the BLS Course, you should be able to: Describe the importance of high-quality CPR and its impact on survival Describe all of the steps of the Chain of Survival Apply the BLS concepts of the Chain of Survival Recognize the signs of someone needing CPR Perform high-quality CPR for an adult Describe the importance of early use of an automated external defibrillator (AED) Demonstrate the appropriate use of an AED Provide effective ventilations by using a barrier device Perform high-quality CPR for a child Perform high-quality CPR for an infant Describe the importance of teams in multirescuer resuscitation Perform as an effective team member during multirescuer CPR Describe the technique for relief of foreign-body airway obstruction for an adult or child Describe the technique for relief of foreign-body airway obstruction for an infant List the priorities, roles, and responsibilities of first aid rescuers Describe the key steps in first aid Remove protective gloves (skill you will demonstrate) Find the problem (skill you will demonstrate) Describe the assessment and first aid actions for the following life-threatening conditions: heart attack, difficulty breathing, choking, severe bleeding, shock, and stroke Use an epinephrine pen (skill you will demonstrate) Control bleeding and bandaging (skill you will demonstrate) Recognize elements of common injuries Recognize elements of common illnesses Describe how to find information on preventing illness and injury Recognize the legal questions that apply to first aid rescuers

Age Definitions Age Adults Children Infants Definition Adolescents and older 1 year of age to puberty Less than 1 year of age What Is Cardiopulmonary Resuscitation Cardiopulmonary Resuscitation or CPR is an emergency medical procedure indicated in victims of cardiac arrest and in limited victims of severe symptomatic cardiovascular and circulatory compromise. A victim of cardiac arrest is defined as a person who is unresponsive, pulseless, and apneic (or exhibiting agonal respirations). Agonal respirations are ineffective breaths produced with poor respiratory effort, volume, quality, or rate that are unsustainable of life. CPR technique typically includes external delivery of chest compressions and ventilations/breaths. CPR produces circulation in the absence of spontaneous cardiac output and allows for delivery of oxygen rich blood throughout the body. Effectively delivered CPR prolongs cellular death and may allow time for more definitive care to be delivered in a cardiac arrest situation.

Overcoming Hurdles fpersons faced with a cardiac arrest situation are often hesitant to provide care due to the fear of doing something wrong or making things worse. Remember that persons in cardiac arrest are clinically dead. There is nothing you can do hurt them. Doing something is always better than doing nothing. The opportunity of survival you provide by providing CPR can mean the difference between life and death. REAL LIFE ADVICE: If you suspect someone needs CPR = Start CPR. If they don t move, wake-up, or tell you to stop = Continue CPR.

The Sad Facts There are approximately 383,000 out of hospital cardiac arrests each year in the United States. 70% of out-of-hospital cardiac arrests (OHCAs) occur in the home. 50% are unwitnessed. Outcome from OHCA remains poor: Only 10% of adult patients with nontraumaticcardiac arrest who have received resuscitative efforts from emergency medical services (EMS) survive to hospital discharge. The Life You Save Statistically if you are to ever perform CPR outside of a professional setting the chances are you ll be at home. Approach this training as if you are preparing to take care of your own loved one. Paying It Forward We ask you to consider who would be there to take care of you if you were the victim of cardiac arrest. Would they know what to do? If not - Share the knowledge. Knowledge is power and knowledge can make the difference between life and death. The life you help save, might be your own.

High Quality CPR Start compressions within 10 seconds of recognition of cardiac arrest. Push hard, push fast: Compress at a rate of 100 to 120/min with a depth of At least 2 inches (5 cm) for adults At least one third the depth of the chest, about 2 inches (5 cm), for children At least one third the depth of the chest, about 1½ inches (4 cm), for infants Allow complete chest recoil after each compression. Minimize interruptions in compressions (try to limit interruptions to less than 10 seconds). Give effective breaths that make the chest rise. Avoid excessive ventilation.

Rescuers Should Perform chest compressions at a rate of 100-120/min Compress to a depth of at least 2 inches (5 cm) Allow full recoil after each compression Minimize pauses in compressions Ventilate adequately (2 breaths after 30 compressions, each breath delivered over 1 second, each causing chest rise) Rescuers Should Not Compress at a rate slower than 100/min or faster than 120/min Compress to a depth of less than 2 inches (5 cm) or greater than 2.4 inches (6 cm) Lean on the chest between compressions Interrupt compressions for greater than 10 seconds Provide excessive ventilation (ie, too many breaths or breaths with excessive force)

SUMMARY OF HIGH-QUALITY CPR COMPONENTS FOR BLS PROVIDERS *Compression depth should be no more than 2.4 inches (6 cm). Abbreviations: AED, automated external defibrillator; AP, anteroposterior; CPR, cardiopulmonary resuscitation. Component Adults and Adolescents Children (Age 1 Year to Puberty) Infants (Age Less Than 1 Year, Excluding Newborns) Scene safety Recognition of cardiac arrest Make sure the environment is safe for rescuers and victim Check for responsiveness No breathing or only gasping (ie, no normal breathing) No definite pulse felt within 10 seconds (Breathing and pulse check can be performed simultaneously in less than 10 seconds) Activation of emergency response system If you are alone with no mobile phone, leave the victim to activate the emergency response system and get the AED before beginning CPR Otherwise, send someone and begin CPR immediately; use the AED as soon as it is available Witnessed collapse Follow steps for adults and adolescents on the left Unwitnessed collapse Give 2 minutes of CPRLeave the victim to activate the emergency response system and get the AED Return to the child or infant and resume CPR; use the AED as soon as it is available Compression-ventilation ratio without advanced airway 1 or 2 rescuers 30:2 1 rescuer 30:2 2 or more rescuers 15:2 Compression-ventilation ratio with advanced airway Compression rate Continuous compressions at a rate of 100-120/min Give 1 breath every 6 seconds (10 breaths/min) 100-120/min Compression depth At least 2 inches (5 cm)* At least one-third AP diameter of chest About 2 inches (5 cm) At least one-third AP diameter of chest About 1 1 2 inches (4 cm) Hand placement 2 hands on the lower half of the breastbone (sternum) 2 hands or 1 hand (optional for very small child) on the lower half of the breastbone (sternum) 1 rescuer 2 fingers in the center of the chest, just below the nipple line 2 or more rescuers 2 thumb encircling hands in the center of the chest, just below the nipple line Chest recoil Minimizing interruptions Allow full recoil of chest after each compression; do not lean on the chest after each compression Limit interruptions in chest compressions to less than 10 seconds

Quality Compressions are the foundation of High Quality CPR Compressions pump blood throughout the body. An immediate decrease in blood flow occurs anytime compressions are stopped. It takes several compressions to increase the blood flow after an interruption. Compressions cause increased pressure in chest cavity. Forces blood out of heart and into arteries to circulate to all parts of body When compressions are relaxed pressure is released, a vacuum is created, causing blood to flow back into heart. Minimize compressions as much as possible and only for the shortest amount of time possible.

Personal Safety Your number 1 priority in any situation should be your own personal safety. You should never put yourself in extreme danger to help someone else. You can not do any good for anyone if you become injured or killed. If you are uncomfortable or in fear for yourself immediately retreat to safety and await additional appropriate assistance. Personal Protective Equipment Personal protective equipment (PPE) is equipment worn to help protect the rescuer from health or safety risks. PPE will vary based your situation and circumstances. You should use appropriate PPE when available. Review the BloodbornePathogens section of this course for more information.

Nature of Emergencies & Staying Calm Emergencies by nature are stressful and take a toll on everyone involved. To be able to help someone else you must remember to remain calm. You must make rational decisions based upon the processing of rapid information related to the situation you're in (without influence of emotion/fear). Failure to remain calm and separate emotion may cause you to make poor decisions. These poor decisions may cost you or someone else their life. Calm rescuers equate to calm scenes. Nature of Emergencies & Staying Calm Before an emergency happens is the proper time to start preparing for it. Once the situation occurs there is little opportunity for planning and organization. Evaluate today in your daily life how you would respond to common emergency situations. Example: What would you do if a coworker collapsed while at work? Do you know the address to your workplace? Do you have an AED or First Aid Kit available? If so, where are they located? Are you familiar with their contents and operations?

Situational Variables The techniques and sequences presented during the course offer static approach to a resuscitation attempt. Every situation is unique. Your response will be determined by: Available emergency equipment Availability of trained rescuers Level of training expertise Local protocols Trained rescuers are encouraged to simultaneously perform some steps in an effort to reduce the time to first chest compression. Integrated teams of highly trained rescuers may use a choreographed approach that accomplishes multiple steps and assessments simultaneously rather than the sequential manner used by individual rescuers. Emphasis should be placed on high-quality CPR using performance targets rather than a cookbook checklist approach.