BASIC LIFE SUPPORT
Check for Danger
The most important part of Basic Life Support is the safety of the rescuer - you won't help the situation by becoming a casualty yourself!
The first thing that you must do is assess the safety of the scene and whether it is safe for you to approach. Remember to look out for things such as approaching cars, water, electric cables and falling masonry!
Once you have established that it is safe to approach the casualty, you must find out if they are unconscious. Do this by the "Shake and Shout" method - that is by saying loudly "Hello, can you hear me? Can you open your eyes for me?" Then you must shake them gently by the shoulders in case they cannot hear you.
It is important to give them a direct command in case they cannot speak.
Shout for help
It is important that help arrives as soon as possible - a passer by can be used to call an ambulance or help you roll the casualty.
Open the Airway
The most important action you can do for a casualty is open their airway. Whilst someone is unconscious, their tongue may fall backwards into the throat and block their airway.
To open the airway you must first place your hand on their forehead and then tilt the head backwards. This will lift the tongue off the back of the throat. This is called the Head Tilt.
Next you must place two fingers below the chin and lift it. This allows you to open the mouth and look in the airway for any obstructions. This is called the Chin Lift.
Once the airway has been opened, you must assess whether the casualty is breathing or not. To do this you must "Look, Listen and Feel" for breaths.
Whilst maintaining the airway you must hold your cheek near to the casualty's mouth and nose, and look at their chest. Look to see if their chest is rising and falling. Listen for any breaths sounds. Feel for breaths against your cheek. You must do this for 10 seconds.
Once you have established that the casualty is not breathing, it is important to call an ambulance.
You must give the operator certain pieces of information:
· Your name
· Where you are
· What you are wearing
· The condition of the casualty
· That you are trained in Basic Life Support
Remember, in most cases this casualty will have had a cardiac arrest and whilst CPR will buy them time, early defibrillation is vital to their chances of survival.
Lastly it is important that you find out how long the ambulance is likely to be. If you have asked someone else to call for you, make sure that they ask this and come back and tell you.
Deliver 2 Rescue Breaths
Once you have called the ambulance you must reopen the casualty's airway and deliver 2 Rescue breaths.
To do this, you must first pinch the nose. This will prevent air escaping through the nose rather than going into the lungs.
Once you have done this you must breathe into the patient for 2 seconds. This will inflate the lungs. Watch for the chest to rise. Do not breathe in too forcefully or air will go into the stomach.
Then you must allow the casualty to breathe out for 2 seconds. Watch for the chest to fall.
You must then wait 2 seconds before delivering the second breath.
You must deliver 2 effective rescue breaths. If you fail to get the breaths in you have up to 5 attempts to succeed. If you cannot get the breaths in within the 5 attempts, you must move on to the next stage of the sequence - i.e. Checking for signs of a circulation.
Once you have delivered the rescue breaths you must assess whether the casualty has an effective circulation. To do this you must look for the Signs of Life for 10 seconds
Whilst maintaining the airway you must hold your cheek near to the casualty's mouth and nose, and look at their chest. You must look for breathing, movements over the throat and chest, attempts to cough or movements of the extremities.
Once you have established that the casualty does not have an effective circulation, you must decide to perform Chest compressions
To do this you must first locate the bottom of the ribcage. To do this run your first two fingers along the bottom of the ribs until you reach the point at which the ribs meet.
Then you must place one finger on the point where the ribs meet and the second just above it. This will prevent you pressing on the stomach, or the bottom part of the sternum.
Then you must run your other hand down the casualty's chest until it meets your fingers. Do not place your hand over your fingers, this means that your hand is on the centre of the chest.
Then interlock your hands, straighten your arms and lock your elbows. Lean over the casualty and then push downwards onto the casualty's chest. You must perform 15 Chest compressions at the rate of 100 a minute and press to a third of the depth of the chest. In most adults this will be 4-5cm deep.
When to Stop
Once you have decided to approach a casualty you have a Duty of Care to them. This means that whilst they are unconscious you must act in their best interests and provide care for them to the level that you have been trained. Therefore, once you have established a Duty of Care, you must continue to care for that casualty.
In this case you must continue providing Basic Life Support and you may only stop IF:
The ambulance arrives and someone else is able to take over
Another BLS Provider can take over from you
You become too exhausted to continue