Adult BLS Theoretical Guidelines

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ADULT BASIC LIFE SUPPORTTHEORETICAL GUIDELINES FOR TRAINING AND ASSESSMENT

Organisational Learning UnitNorthern Sector Office: Level 2, Campus Centre, Randwick Hospitals Campus.

Phone: 93825313 Fax: 93825280



BASIC LIFE SUPPORT GUIDELINES

Basic Life Support Theoretical Guidelines for Training and Assessment ~ VERSION 1.1 ~ January 2009 Page 2

Version ControlReleased by Version Release Date Review Date

Organisational Learning Unit 1 September 2008. January 2009 Organisational Learning Unit 1.1 January 2009. June 2009

AcknowledgementsThe following people have contributed to the development of these learning resources:

SESIH Education Assessment and Training Subcommittee (EATS). Committee members as of

July 2008:

Michelle Brady The Sutherland Hospital Jenny Broe The Prince Of Wales Hospital David Collins The Prince of Wales Hospital Lynette Higgs Sydney/Sydney Eye Hospital Jon Magill Prince of Wales Hospital Catherine Molihan Royal Hospital for Women Kim O’Leary Shoalhaven Hospital Alex Pile St Vincent’s Hospital Suzanne Schacht SESIAH Garry Skinner War Memorial Hospital Carolyn Smith Sydney Children’s Hospital Jayne Tesch Organisational Learning Unit SESIAH Gai Vereker The Wollongong Hospital Bruce Way Prince of Wales Hospital Lis Woodhart The Sutherland Hospital Lian Zheng 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

by any means electronic, mechanical, photocopying, recording or otherwise without the written permission of the publisher.





ContentsSESIH Facil ity 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

• 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).

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;









SESIH Facili ty 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









GlossaryAirway

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 automatica lly 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 deliveryof 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 Cardiaccompressions

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 sweepUsing 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’sexpired 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 immediatelytreated death will occur within 3-5 minutes.









Basic Life Support Mandatory Training and AssessmentThese guidelines provide the foundation for the South East Sydney and Illawarra HealthService (SESIH) Basic Life Support Mandatory Training and Assessment Program whichconsists 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

Outline the responsibilities of the single rescuer in a Cardiac Arrest;

Outline each step in the ARC Adult Basic Life Support algorithm (DRABCD);

Identify the process for summoning assistance in a Cardiac Arrest;

Discuss the use of personal protective equipment during resuscitation.

2. Skills Assessment Identifies hazards to health and safety of self and others;

Minimises immediate risk to health and safety of self and others by isolatinghazards;

Assesses vital signs of collapsed person;

Recognises the need for CPR;

Summons assistance;

Performs CPR in accordance with ARC guidelines.

See Appendi x 1 f or t he SESIH Adult Basic Lif e Suppor t Assessment Cr it eri a

Skills assessment f requency: All staff for whom Basic Life Support is deemed a mandatory skill are required to havetheir Adult BLS skills assessed on a yearly basis.









Foreword to GuidelinesBasic Life Support

Has been defined by the Australian Resuscitation Council (ARC) as “…the preservation oflife by the initial establishment of and /or maintenance of airway, breathing andcirculation, and related emergency care.” (ARC, 2006: Glossary of Terms: p2)

Cardiopulmonary Resuscitation

Cardiopulmonary resuscitation (CPR) includes the technique of combining rescue breathingwith chest compression. The aim of CPR is to maintain temporarily a critical amount ofcirculation 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 successfulresuscitation as the Chain of Survival (Nolan, 2005: S3). Each step is outlined below.

1. Early Recognition of Collapse/Emergency: Recognising those at risk of cardiacarrest and calling for help has the potential to avert a cardiac arrest.

2. Early Initiation of Cardiopulmonary Resuscitation: Effective CPR can dramaticallyincrease survival from ventricular fibrillation in sudden cardiac arrest by buying timeuntil successful defibrillation.

3. Early Defibrillation: Survival rates can be improved (49-75%) if CPR anddefibrillation are initiated within 3-5 minutes.

4. Early Advanced Life Support and Post Resuscitation Care: Effective postresuscitation care can preserve function particularly of the heart and brain.

Figure 1: ERC Chain of Survival (Nolan, 2005, S 5.)

















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 = DangerR = Response

= Airway= 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 thefollowing steps:

DangerAssess 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 someoneby yourself, wait until help arrives to assist you.

ResponseDetermine responsiveness: Gently grasp and squeeze the person’s shoulders, speak to theperson by name if it is known. (ARC, 2006, Guideline: 3.1). Ask loudly “are you all right?”

If Responsive If Unresponsive

• 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.

• Summon HELP first

(ARC, 2006, Guideline: 2.1)

- Call/send for help; or

- If unlikely to get help easily, dialthe emergency number for your

fac ility or service (See Pa g e 5 );

- State the nature of the

emergency

- Give location

- Identify whether emergencyinvolves an adult or child

• Note the time;

• Assess Airway Breathing and

Circulation.

Ai rway

Open the airwayWhen a person is unconscious, all muscles are relaxed. If the person is lying on their backthe tongue falls against the back of the throat and obstructs the airway. To open theairway:

• 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),





Ai rway (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’sforehead and gently tilt the headback.

• With your fingertips under thepoint of the persons chin, lift thechin to o en the airwa .

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 headof the person;

• Place fingers behind the bonypart 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 usinggloved 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 notavailable roll person on side, if safe to do so, and drain fluid from the mouth.





Breathing

Once the airway is cleared and open, check for normal breathing for a period of up to 10seconds, using the following method. Not e t hat an occasional gasp or noisy br eat hing is

not consider ed normal br eat hing .

• 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 NormallyIf Breathing Absent

or not normal • Place person in the recovery position

(see Figure 4):

Figure 4: Recovery position

• Check for continued breathing and

give oxygen flow rate to 15

litres/minute, if available;

• Note: Sta y w ith the p erson unt i l help

a rrive s .

(ARC, 2008, Guideline: 5)

• 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 5: Mouth to mask method

• 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 c he st d o es no t riserec hec k hea d t ilt a nd c h in lif t ;

rec hec k m ask sea l; and d o no t

a t t emp t mo re t han tw o b rea t h s ea ch

t ime be fo re c om me nc ing o r re tu rn ing

to c hest co m p ression s ;

• Care should be taken not to use too

much force to inflate lungs. Ifexcessive force is used there is a risk

that air will inflate the stomachresulting in regurgitation of stomach

contents and aspiration into the lungs.ARC, 2008, Guideline: 5; Nolan et al, 2005)





KEY POINT: RESCUE BREATHING WITHOUT CHEST COMPRESSIONS

Information for Experienced Clinicians

In the event an experienced clinician determines that an adult person with palpable pulsesrequires support of ventilation:

• rescue breaths can be delivered at a rate of approximately 10 breaths per minute (onebreath every 5 to 7 seconds);

• each breath should be of sufficient volume to see the chest rise. If the chest does notrise, 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 thestomach 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 nosigns of life present (i.e. person is unconsciousness, there is no movement and no normalbreathing or coughing) commence chest compressions immediately. Experienced cliniciansmay 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 sternumand your arms are straight;





Performing Chest compressions (cont)

• Place the heel of one hand in the middle of the sternum and place the other hand ontop 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 of100 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


KEY POINT: RESUSCITATION IN LATE PREGNANCY

“In the obviously pregnant woman the pregnant uterus causes pressure on the majorabdominal vessels when she lies flat, reducing venous return to the heart. The pregnantwoman 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)





Additional Points on Compression

• Effective chest compressions generate a small, but critical amount of blood flow to themyocardium and brain and increases the likelihood of effective defibrillation;

• Both one operator and two operators should perform the same compression toventilation ratio of 30:2;

• Once an advanced airway has been secured (i.e. tracheal intubation) continuecompressions uninterrupted. Ventilations should be delivered at approximately 10breaths per minute or one breath every 5 to 7 seconds. Not e : Compr essions should

only be in te r rup t ed to per fo rm r hy thm ana lysis or t o def i b r i l l a t e ; (Nolan et al 2005:S 44).

• Performing chest compressions and rescue breaths at a ratio of 30:2 is tiring; it istherefore recommended that the person doing compressions be changed every 2minutes or when he/she becomes fatigued.


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 maskventilations, an acceptable alternative is to give uninterrupted chest compressions at arate of 100/minute (Koster et al, 2008) until qualified help arrives to secure an airwayand commence rescue breathing.

Note that the ARC states “Ventilation remains important in a significant proportion ofcardiac 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)





Automated External Defibr il lat ion (AED)

Note: The following section applies only to those facilities where AED’s are available andstaff have been trained in their use.

Introduction

Along with early initiation of cardiopulmonary resuscitation, early defibrillation is a keylink in the Chain of Survival’ following cardiac arrest (Nolan 2005:S4). VentricularFibrillation (VF) is the most frequent initial rhythm in sudden cardiac arrest withdefibrillation being the most effective treatment.

Survival rates following cardiac arrest can be improved provided CPR and defibrillation isinitiated early (within 3-5 minutes). Every minute a person remains in cardiac arrestrepresents 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 voiceand visual prompts to guide the lay rescuer or heath care professional in safely attemptingdefibrillation 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, nonormal 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 onand follow the spoken or visual prompts provided;

° Whilst continuing CPR, expose the patients’ chest and attach the electrode pads inthe 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







Points on Defibri llation Safety

• Ensure defibrillator electrode pads are completely adhered to the skin. Air pocketsbetween 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 benecessary to clip hair so the electrode pads will adhere to the chest. If the patient isdiaphoretic, 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 orpacemaker.

Doing any of these things may cause electrical arching and/or burns duringdefibrillation and may also cause the defibrillation current to be diverted away fromthe 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).





APPENDIX 1 Adul t Basic Li fe support Assessment Cri ter ia





APPENDIX 2 Airway management: Mouth to Mask Venti lat ion

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 betweenthe 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 andnose;

• Ensure an adequate seal over mouth and nose using both hands;

• Place your mouth around the filter/valve attached to the mask (See Figure9);

• Blow through filter/valve giving enough volume to see the persons chestrise. Note: Allow time for the person to exhale before delivering nextbreath;

• If chest does not rise re-check head tilt, chin lift and mask seal.

(ARC, 2008, Guideline: 5)

Figure 9: Mouth to Mask Ventilation





APPENDIX 3 Airway Management: Adul t 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 theseverity of the condition. For example, in the conscious person who has inhaled a foreignbody, 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 isattempted.

The Adult FBAO sequence (see also Figure 10):

• If the person shows signs of mild airway obstruction, (i.e. they have an effectivecough), 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: stand to the side and slightly behind the person:

lean the person well forward, give up to 5 sharp blows between theshoulder blades with the heel of your hand;

check to see if each back blow has relieved the airway obstruction.

• If the person at any time becomes unconscious:

Support the person carefully to the ground – do not place yourself in dangerby ‘catching’ the person;

Summon HELP:- Call/send for help;

- Dial the facility emergency number state “Cardiac Arrest” and givelocation;

Begin CPR at a compression to ventilation ratio of 30:2

(ARC, 2008 Guideline 5; ARC, 2006 Guideline 4, 6, & 7).

Assess Severity

Severe airway obstruction

(ineffective cough)

Encourage Cough

Continue to check for

deterioration to ineffective

cough or until obstruction

cleared

Mild Airway obstruction

(effective cough)

Unconscious

Start CPR

Conscious

5 back blows

If not effective, give 5

chest thrusts.

Figure 10. Adult FBAO Management

After: Australian Resuscitation Council (2006)





Adul t Basic Li fe Support Quiz Questions

The following Quiz in designed to assess the readers understanding of the Guidelinesoutlined 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 dofirst?

Determine responsivenessAssess for dangerCommence CPRCall 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 timeAssess airway and breathingCall for helpGive two breaths(Need help? See Page 15)

3. Of the options listed below indicate which one is recommended for opening theairway of a collapsed adult who isn’t breathing?

Roll person onto the left side and perform a backward head tilt

Perform a Heimlich manoeuvreUse Head tilt /chin lift or jaw thrust manoeuvreUse 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 againPut the person in the coma positionStart chest compressions

Start rescue breathing(Need help? See Page 17)

5. When commencing rescue breathing, how many initial breaths do you give?2345(Need help? See Page 17)





6. A person with no ‘signs of life’ is:Unconsciousness/unresponsiveNot movingNot breathing normallyAll of the above(Need help? See Page 18)

7. You determine the collapsed person has no signs of life, what is itrecommended that you do now:

Call for HelpFeel for a pulseStart chest compressionsCheck their pupils(Need help? See Page 18)

8. When locating the site for chest compressions in an adult it is recommended tovisualise the centre of the chest.

TrueFalse(Need help? See Page 18)

9. When performing CPR the recommended ratio of compressions to breaths is?100 compressions to 2 breaths30 compressions to 2 breaths

15 compressions to 2 breaths5 compressions to 2 breaths(Need help? See Page 18)

10. It is recommended that CPR continue until:An authorised person pronounces life extinctQualified help arrives to assistExhaustion prevents you continuingSigns of life returnAll of the above

(Need help? See Page 19)

11. Basic Life support now includes defibrillation:TrueFalse(Need help? See Page 20)

12. What number do you call in your facility in the event of a Cardiac Arrest?





References:Anonymous (2000) “Part 4: The Automated External Defibrillator: Key Link in the Chain of Survival”,

Circulat ion, Vol. 108: (8) pp. 160-176.

American Heart Association (2005), ‘American Heart Association Guidelines for CardiopulmonaryResuscitation and Emergency Cardiovascular Care.’ Cir culat ion, Vol.112, (22): Supplement 1: 1-

136.

[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’ Cir culat ion, 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

Austr al i an Resuscit at ion Council Onli ne . [www.resus.org.au] Accessed July 9th 2008

Australian Resuscitation Council (2008). ‘Index of Guidelines’, The Aust ra l i an Resuscit at ion

Council Onli ne . [www.resus.org.au] Accessed July 9th 2008

Australian Resuscitation Council (2006). ‘Glossary of Terms’ Aust ra l i an Resuscit at ion 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.’ Resuscitat ion (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 ofautomated external defibrillators.’ Resuscit at ion 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 St at ement of t he European

Resuscit at ion Council on Basic Lif e 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.’ Resuscit at ion, 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.’

Resuscit at ion, 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 CouncilGuidelines for Resuscitation: Section 4. Adult Advanced Life Support.’ Resuscit at ion Vol . 67 (S1):

S51. [http://www.erc.edu/index.php/guidelines_download_2005/en/] Accessed, March 5th 2008.





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 SurvivalNolan, J. (2005) ‘European Resuscitation Council Guidelines for Resuscitation: Section 1.Introduction.’ Resuscit at ion Vol . 67 (S1): S5.


Figure 2: Head Tilt Chin LiftNolan, J.; Deakin, C.D.; Soar, J.; Bottiger, B.W.; Smith, G. (2005) ‘European Resuscitation CouncilGuidelines for Resuscitation: Section 4. Adult Advanced Life Support.’ Resuscit at ion Vol . 67 (S1):


Figure 3: Jaw ThrustNolan, J.; Deakin, C.D.; Soar, J.; Bottiger, B.W.; Smith, G. (2005) ‘European Resuscitation CouncilGuidelines for Resuscitation: Section 4. Adult Advanced Life Support.’ Resuscit at ion Vol . 67 (S1):

S51. [http://www.erc.edu/index.php/guidelines_download_2005/en/] Accessed, March 5th 2008. Figure 4: Recovery PositionHandley, A.J.; Koster, R.; Monsieurs, K; Perkins, G. D.; Davies, S.; Bossaert, L. (2005) ‘EuropeanResuscitation Council Guidelines for Resuscitation: Section 2. Adult Basic Life support and use ofautomated external defibrillators’ Resuscit at ion 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) ‘EuropeanResuscitation Council Guidelines for Resuscitation: Section 2. Adult Basic Life support and use ofautomated external defibrillators’ Resuscit at ion Vol . 67 (S1): S10.


Figure 7: Depth of CompressionsHandley, A.J.; Koster, R.; Monsieurs, K; Perkins, G. D.; Davies, S.; Bossaert, L. (2005) ‘EuropeanResuscitation Council Guidelines for Resuscitation: Section 2: Adult Basic Life support and use ofautomated external defibrillators.’ Resuscit at ion Vol . 67 (S1): S11.

[http://www.erc.edu/index.php/guidelines_download_2005/en/] Accessed, March 5th, 2008.

Figure 8: Placement of Defibrillator electrodesPhillips 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 ObstructionNolan, J.; Deakin, C.D.; Soar, J.; Bottiger, B.W.; Smith, G. (2005) ‘European Resuscitation CouncilGuidelines for Resuscitation: Section 4. Adult Advanced Life Support.’ Resuscit at ion Vol . 67 (S1):


Appendix 1: Adult Basic Life Support Assessment CriteriaSouth Eastern Sydney and Illawarra Area Health Service (2005) Adult Basic Life Support AssessmentCriteria, Incorporating the Automated External Defibrillator (AED).




Appendix 2: Mouth to Mask VentilationNolan, J.; Deakin, C.D.; Soar, J.; Bottiger, B.W.; Smith, G. (2005) ‘European Resuscitation CouncilGuidelines for Resuscitation: Section 4. Adult Advanced Life Support.’ Resuscit at ion 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 chartAfter: Australian Resuscitation Council (2006). ‘Management of Foreign Body Airway Obstruction

Choking: Guideline 6.’ Austr al i an Resuscit at ion Council Onli ne . [www.resus.org.au] Accessed

July 9th 2008

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Adult BLS Theoretical Guidelines

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