Basic Life Support - Protocols During Choking, Drowning and Cardiac Arrest

Numerous countries around the world have protocols on how to administer basic life support (BLS) and they are devised by the medical associations situated in those countries. Most places though have adopted the BLS protocols of the American Heart Association, and they include algorithms providing emergency management for conditions such as choking, drowning and cardiac arrest. BLS management protocols doesn't include treating affected individuals with invasive measures, such as putting up an intravenous line or intubating, or medications.

Emergency personnel such as ambulance workers, police officers, firefighter and lifeguards are required to be certified in performing BLS skills. Other individuals who need BLS training include security personnel, teachers, social workers and daycare providers. Parents and older children are also encouraged to learn BLS skills, especially when there is a new member of the family.

Performing high-quality CPR has been proven to improve a patient's survival rate, and gives advanced life support (ALS) providers time to arrive and administer this advanced level of care where needed. 

The availability of a device known as an automated external defibrillator (AED) is an integral part of BLS, and it improves the survival rate of patients in cardiac arrest due to shockable heart rhythms.

The aim of BLS is to promote appropriate blood circulation throughout the body with good quality chest compressions, making sure there's a clear airway and provide adequate ventilation for the patient. The principles of BLS is C.A.B. which stands for the following:

Circulation

You need to make sure that an adequate supply of blood transports oxygen and essential nutrients to the vital organs and tissues of the body. This is done by performing good-quality CPR and, in this case, means performing high-quality chest compressions.

Chest compressions should be completed as follows:

• Press hard and press fast at a rate of 100 compressions per minute for all age groups.
• Allow for full chest recoil to occur between each compression. 
• For adults push up to 5 cm, a child up to 4 cm and infants up to 3 cm or 1/3 of the chest diameter deep.
• Keep counting aloud so that you don't lose count.  

Airway

The airway need to be cleared, protected and maintained at all times so that an adequate amount of air can enter the lungs. NEVER perform a finger sweep to remove a foreign object in a person who is choking, as this can cause the object to be pushed further down the airway. Rather try to remove the object by performing the Heimlich maneuver.

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If the patient isn't breathing and the airway is clear, then you need to administer 2 breaths after each 30 chest compressions. This is done by using a face shield to administer breaths mouth-to-mouth, unless the patient is a family member or close friend, or a bag-valve mask (which is only available in very good first aid kits or carried by emergency health personnel). 

Breathing

A clear airway will allow the lungs to fill with oxygen and get rid of carbon dioxide provided they can inflate and deflate adequately. When administering breaths, you should make sure that the chest lifting adequately as this will suggest adequate filling of the lungs. If the chest isn't rising well enough, then you need to make sure that you're getting a good seal around the patient's mouth.

Contact your nearest hospital to find out where courses are being taught if you want to receive BLS training.