Elsevier

Resuscitation

Volume 46, Issues 1–3, 23 August 2000, Pages 29-71
Resuscitation

Part 3: Adult Basic Life Support

https://doi.org/10.1016/S0300-9572(00)00271-9Get rights and content

Section snippets

Major Guidelines Changes

Following are the major guidelines changes related to adult basic life support, with the rationale for the change.

Epidemiology of Adult Cardiopulmonary Arrest: ‘Phone First’ (Adult)/‘Phone Fast’ (Infants and Children)

When the initial ECG is obtained, most adults with sudden (witnessed), nontraumatic cardiac arrest are found to be in VF [38]. For these victims, the time from collapse to defibrillation is the single greatest determinant of survival [1], [3], [27], [38], [39], [40], [41], [42], [43], [44], [45], [46]. The window of opportunity is small. Survival from cardiac arrest caused by VF declines by approximately 7% to 10% for each minute without defibrillation [47]. More than 12 minutes after collapse,

Respiratory Arrest

Respiratory arrest can result from a number of causes, including submersion/near-drowning, stroke, FBAO, smoke inhalation, epiglottitis, drug overdose, electrocution, suffocation, injuries, myocardial infarction, lightning strike, and coma from any cause. When primary respiratory arrest occurs, the heart and lungs can continue to oxygenate the blood for several minutes, and oxygen will continue to circulate to the brain and other vital organs [168]. Such patients initially demonstrate signs of

The Sequence of BLS: Assessment, EMS Activation, the ABCs of CPR, and the ‘D’ of Defibrillation

The BLS sequence described in this section applies to victims >8 years old. This sequence will be applied to older children, adolescents, and adults. For simplicity, the victim is consistently referred to as an ‘adult’ to differentiate the victim from a ‘pediatric’ victim who is <8 years old.

CPR Performed by 1 Rescuer

Laypersons with no specific duty or expectation to respond to emergencies in the workplace should be taught 1-rescuer CPR only, because the 2-rescuer technique is infrequently used by laypersons in rescue situations. If 2 rescuers are present, they can alternate performing 1-rescuer CPR. Whether 1- or 2-rescuer CPR is performed, rescuers should ensure scene safety. One-rescuer CPR should be performed as follows:

  • 1.

    Assessment: Determine unresponsiveness (tap or gently shake the victim and shout).

Epidemiology, Recognition, and Management of FBAO

Complete airway obstruction is an emergency that will result in death within minutes if not treated. The most common cause of upper-airway obstruction is obstruction by the tongue during loss of consciousness and cardiopulmonary arrest. An unresponsive victim can develop airway obstruction from intrinsic (tongue and epiglottis) and extrinsic (foreign body) causes. The tongue may fall backward into the pharynx, obstructing the upper airway. The epiglottis can block the entrance of the airway in

Changing Locations During CPR Performance

If the location is unsafe, such as a burning building, move the victim to a safe area and then immediately start CPR. Do not move a victim for convenience from a cramped or busy location until effective CPR is provided and the victim shows a return of signs of circulation or until help arrives. Whenever possible, perform CPR without interruption.

Rescuer Safety During CPR Training and CPR Performance

Safety during CPR training and in actual rescue situations has gained increased attention. The following recommendations should minimize possible risk of infectious complications to instructors and students during CPR training and actual CPR performance. The recommendations for manikin decontamination and rescuer safety originally established in 1978 by the Centers for Disease Control [322] have been updated twice by the AHA, the American Red Cross, and the Centers for Disease Control and

CPR: The Human Dimension

Since 1973, millions of people throughout the world have learned CPR. Although CPR is considered by some to be the most successful public health initiative in recent times, the cardiac arrest survival rate to hospital discharge averages 15%, with some studies reporting a favorable neurological status among such survivors [273].

Serious long-lasting physical and emotional symptoms may occur in rescuers who participate in unsuccessful resuscitation attempts. Rescuers may experience grief

BLS Research Initiatives

Continued improvement of BLS programs requires ongoing scientific research. This resuscitation research must ultimately translate into effective programs to teach CPR to anyone who may witness a cardiac arrest, so that if cardiac arrest occurs, the EMS system is activated immediately, CPR is skillfully performed, and survival is maximized. In many critical areas, insufficient data is available to guide resuscitation experts and clinicians. Because scientific data is lacking in some areas,

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