2-RESCUER ADULT BLS

1. Verify that the scene is safe for the rescuers and the victim.
2. Check for responsiveness. Tap the victim’s shoulder and shout “are you ok”
3. If the victim is unresponsive, the first rescuer should assess the victim while the second rescuer activates Emergency Response System (for example, call 911 or mobilize Advanced Life Support team)

Scan the victim’s chest for rise and fall for no more than 10 seconds. If there’s no visible signs of normal breathing, the victim may be experiencing cardiac arrest.

Check pulse by palpating a carotid pulse. If not detected within 10 seconds, begin CPR.

Locating the carotid pulse

1. locate the trachea using 2 fingers
2. slide fingers into the groove between the trachea and the muscles at the side of the neck, where you can feel the carotid pulse
3. feel the pulse for no less than 5 but no more than 10 seconds. If you do not feel a pulse begin CPR

If the victim is not breathing normally but a pulse is present, provide rescue breathing

“Rescue breathing” is giving assisted breaths to an unresponsive victim who has a pulse but is not breathing. This can be done safely with a barrier device or bag-mask, or mouth to mouth if none available. Rescue breaths for adults are given at a rate of 1 breath every 5-6 seconds (about 10-12 breaths per minute)

• give each breath in 1 second
• each breath should result in visible chest rise
• check the pulse about every 2 minutes

Confirm that the ERS has been activated and continue rescue breathing. Check pulse about every 2 minutes and be ready to perform CPR. If opioid use is suspected, consider administering naloxone, if available.

If the victim is not breathing and has no pulse, begin CPR immediately:

1. the victim must be face up on a firm, flat surface. If you must move or roll them over, be extremely careful if you suspect head or neck injury
2. stand or kneel at the victim’s side
3. position your hands and body to perform chest compressions:
   • place the heel of one hand in the center of the victim’s chest, on the lower half of the breastbone (sternum)
   • place the heel of your other hand on top of the first hand
   • straighten your arms and position your shoulders directly over your hands
4. begin chest compressions at a rate of 100 to 120/minute (to the tune of Staying Alive)
5. Press fast and hard, at least 2 inches (5 cm) making sure you push straight down on the victim’s breastbone
6. at the end of each compression, allow the chest to recoil completely

As soon as the second rescuer returns, continue to perform 2 rescuer CPR (at compressions-to-ventilation ratio of 15:2), switching positions every 2 minutes or 5 cycles to reduce fatigue.