3.1 Adult Basic Life Support (BLS)

Definition

The American Heart Association (AHA) guidelines define adult CPR as appropriate for any person over the age of 8 years old or post-adolescence. This is identified by the presence of secondary sex characteristics, such as chest or underarm hair in males and any breast development in females.

Single Rescuer Adult BLS

  1. Verify Scene Safety: Ensure the area is safe for both you and the victim.
  2. Check for Responsiveness: Tap the victim’s shoulder and shout, “Are you okay?”
  3. Call for Help: If the victim is unresponsive, shout for nearby assistance.
  4. Activate the Emergency Response System (ERS): Call 911 or mobilize an Advanced Life Support (ALS) team if available.
  5. Retrieve AED and Emergency Equipment: If available, retrieve the Automated External Defibrillator (AED) and necessary emergency supplies or send someone else to get them.

Assessing Breathing and Pulse

  • Scan the victim’s chest for rise and fall for no more than 10 seconds.
  • If the victim is not breathing normally, they may be in cardiac arrest.
  • Check for a carotid pulse. If a pulse is not detected within 10 seconds, begin CPR immediately.

Locating the Carotid Pulse

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Locating the Carotid Pulse
Locating the Carotid Pulse

  1. Locate the trachea using two or three fingers.
  2. Slide your fingers into the groove between the trachea and the neck muscles to feel for the carotid pulse.
  3. Feel for at least 5 seconds but no more than 10 seconds. If no pulse is detected, begin CPR.

Rescue Breathing (If Pulse is Present, But No Normal Breathing)

Rescue breathing is the act of providing assisted breaths to an unresponsive victim who has a pulse but is not breathing.

This can be performed using:

  • A barrier device (e.g., face shield or mask).
  • A bag-mask device, if available.
  • Mouth-to-mouth if no other options exist.

Rescue Breathing for Adults:

  • Provide 1 breath every 5–6 seconds (about 10–12 breaths per minute).
  • Each breath should be given over 1 second and should result in visible chest rise.
  • Recheck the pulse approximately every 2 minutes.

Confirm ERS Activation: Ensure that emergency help has been called and continue providing rescue breathing. If opioid overdose is suspected, consider administering naloxone, if available.

When to Begin CPR

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

CPR Approach: Lay Rescuers vs. Healthcare Providers

Condition Action for Lay Rescuers Action for Healthcare Providers
No normal breathing, no pulse Hands-only CPR (compressions only) Full CPR (30:2 compressions-to-breaths)
No normal breathing, pulse present Monitor the victim until help arrives Rescue breathing (1 breath every 5–6 seconds)
Normal breathing, pulse present Stay with the victim & monitor Stay with the victim & monitor

Important Notes:

  • Hands-only CPR (chest compressions only) is preferred for lay rescuers who are untrained or unwilling to provide rescue breaths.
  • Healthcare providers should perform full CPR—compressions and rescue breaths—unless an advanced airway is in place.