As soon as the heart stops the delivery of oxygen to the tissues of the body ceases and the human brain can survive only 4 – 5 minutes without oxygen and leads to permanent brain damage despite restoration of circulation after this period. Even in the most developed setup, emergency response units with trained paramedics may take longer than 5 mins to arrive at such a scene and will be too late in terms of outcome.

Therefore, it is of vital importance that those who present at a scene of cardiac arrest should have learnt the basic life support skills which would increase the chances of survival of a cardiac arrest victim from inevitable death or life time morbidity until help arrives with Advanced Life Support (ALS) capability.

Most common cause of cardiac arrest is arrhythmias (abnormal rhythms) occurring as a result of abnormal electrical activity of heart triggered by variety of causes including coronary artery disease, congenital heart diseases, valvular heart disease, cardiomyopathy, toxins etc. The message implied is that it is fairly common and can occur at anywhere with a little or no warning at all.

A person who is having a cardiac arrest will suddenly collapse, unconscious, will be not breathing and arterial pulses will be absent. If this is to occur in a place the victim will be having only few minutes before death unless intervened urgently.

Disclaimer: the material posted on this page on basic life support is for learning purposes only. To learn to provide CPR and basic life support sign up for first aid and CPR training here.

Adult Basic Life Support Sequence

Before starting make sure that victim, bystanders and specially you (rescuer) are safe. E.g. in middle of a road crossing

• First check whether the victim is responsive or not, gently shake him or her and shout and ask “are you all right” to check for the response.

• If he is responding keep him in safe and easy accessible palace. Check what has gone wrong and reassess regularly and call for help if needed.

• If victim is not responding , call for Help (from nearby people as well as Emergency Response Team e.g. 911)

• Turn the patient on to his back and open the mouth. Total airway obstruction by falling back of tongue is possible in an unconscious patient. This can leads to cerebral hypoxia and irreversible brain damage in less than 5 minutes so ensuring airway patency is the must in basic life support. Basic airway manoeuvres can be used to prevent this.

• Head tilt and chin lift manoeuvres (as shown in the picture) place your hand on his forehead and gently tilt victims head back to prevent tongue obstructing the airway is recommended as a first aid measure

• Then asses the breathing, first look for the chest movements then listen for breath sounds and feel for expired air. Assess for <10 seconds and decide whether breathing is present or absent and it is normal or not. If you have any doubt about breathing takes it as an abnormal.

• If the victim is breathing and safe for an intervention, keep him/her in recovery position as shown in following.

• Call for help from ambulance services and continue the breathing assessment. If any doubt about the normal breathing start cardiopulmonary resuscitation.

• If not breathing normally call for ambulance services, if no facilities available send a bystander and start cardiopulmonary resuscitation immediately.

• Kneel by the side of the victim, place the heel of your one hand in the centre of the victims chest (which is the lower half of breastbone) and place the heel of your other hand on the top of the first hand and interlock your fingers.

• Position yourself vertical relative to the victim’s chest and keep your arms straight. Press down on victim’s chest about 5 to 6 cm. After each compression release the pressure but do not lose the contact between your hands and victims chest.

• Repeat the procedure at a rate 100 to 120 per minute.

  

• After 30 compressions open the airway as mentioned above using head tilt and chin lift, and give mouth to mouth breathing as follows.

• Place your left hand on victim’s forehead and pinch the soft part of his nose with thumb and index finger. Keep his/her mouth open while maintaining chin lift.

• Take a good breath, place your lips around victim’s mouth ensuring good seal  and whilst watching the chest rise blow steadily in to his/her mouth for 1second and  after removing your lips wait for 1 second for his/her chest to fall.

• Give another rescue breath similarly.

• The whole 2 rescue breaths should take less than 5 seconds.

• Immediately resume chest compressions for another 30 compressions and repeat 2 rescue breaths.

• Continue resuscitation at the rate 30: 2.
• Do not interrupt resuscitation to assess the breathing or pulses unless the patient shows signs of regaining consciousness like coughing, speaking, opening eyes and start breathing normally.

• If available change the rescuer every 2 -3 minutes to prevent fatigue.

• If you are not trained or not willing to give direct mouth to mouth rescue breathing use a handkerchief to cover his/her mouth or else give only chest compressions and continue at a rate of 100 to 120 per minute.

• Continue resuscitation until qualified staff takes over the victim or victim shows signs of consciousness or you become exhausted.

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