High-Quality BLS for Healthcare Providers

Performing high-quality Basic Life Support (BLS) is essential for maximizing survival rates in cardiac arrest patients. As a healthcare provider, your role extends beyond layperson CPR—you are expected to deliver precise, efficient, and uninterrupted resuscitation while integrating your efforts with an advanced care team.

Key Components of High-Quality BLS

• Early recognition of cardiac arrest (checking for responsiveness, breathing, and pulse).
• Minimizing interruptions to maximize perfusion.
• Ensuring proper compression depth and recoil to optimize blood flow.
• Providing effective ventilation without excessive breaths.

Chest Compressions: Depth, Rate, and Pulse Checks

1. High-Quality Chest Compressions

Chest compressions are the foundation of effective CPR. As a healthcare provider, ensure that your compressions meet the following criteria:

• Compression rate: 100-120 compressions per minute.
• Compression depth:
  • Adults: At least 2 inches (5 cm).
  • Children: At least 1/3 of the chest diameter (~2 inches or 5 cm).
  • Infants: At least 1/3 of the chest diameter (~1.5 inches or 4 cm).
• Full chest recoil: Allow complete recoil between compressions to promote blood return.
• Minimal interruptions: Limit pauses to less than 10 seconds (e.g., during AED use or ventilation).

2. Pulse Checks

Unlike layperson BLS, healthcare providers must check for a pulse before starting chest compressions. However, pulse checks should not delay care.

• For adults & children: Palpate the carotid artery in the neck.
• For infants: Palpate the brachial artery in the upper arm.
• Time limit: Do not spend more than 10 seconds checking for a pulse.
• If no pulse is found, or if you are unsure, start compressions immediately.

Effective Ventilation in HCP BLS

1. Rescue Breathing (When Pulse Is Present, But No Normal Breathing)

• Adults: 1 breath every 5-6 seconds (10-12 breaths per minute).
• Children & Infants: 1 breath every 3-5 seconds (12-20 breaths per minute).

Each breath should:

• Be delivered over 1 second.
• Cause visible chest rise.
• Avoid excessive ventilation, which can lead to gastric inflation and reduced cardiac output.

2. Minimizing Interruptions for High-Performance CPR

High-performance CPR means minimizing pauses while ensuring optimal compressions and ventilations. Key strategies include:

• Pre-planning rescuer role switches (every 2 minutes or 5 cycles of compressions).
• Using the “hover technique” to anticipate when to switch compressors.
• Delivering ventilations with no excessive force.
• Coordinating with an AED to minimize hands-off time.

Every second counts—focus on continuous, high-quality chest compressions to maximize survival!