Basic life support (BLS) is a form of medical care used on patients who have life-threatening illnesses or injuries prior to being transported to a medical care facility or hospital, and is one of the foundational skills of EMS professionals. BLS is primarily used in a pre-hospital setting by EMTs, paramedics, firefighters, lifeguards, and police officers, however it can be taught to every day individuals who care to receive BLS training by taking a short course.

Basic life support techniques are formulated by medical bodies in most countries, and have guidelines on how to perform them depending on country. BLS guidelines contain protocols for management of certain conditions such as choking, cardiac arrest, drowning, and other common forms of injury. However BLS does not include advanced life support (ALS) techniques such as the use of drugs or invasive techniques.

Perhaps the most well-known form of BLS is cardiopulmonary resuscitation (CPR), which is meant to revive patients suffering from lack of air and allow enough time for more skilled medical responders to arrive and provide advanced life support (ALS) care.

The foundational lifesaving techniques employed when performing BLS are called CABS, short for circulation, airway and breathing.

• Circulation – Circulation is the ability to provide ample blood supply to various tissues throughout the body, most importantly critical organs so the body can deliver oxygen at a cellular level and remove metabolic waste through the distribution of blood to the body.
• Airway – Airway is the protection and maintenance of the body’s passageways for oxygen and carbon dioxide to pass between the lungs and atmosphere.
• Breathing – Breathing is the inflation and deflation of the lungs through airway.

Although a healthy body is able to maintain CABs on its own, an individual suffering from an illness or trauma must be assisted using BLS techniques to maintain their own CABs, and to maintain patients who are unable to do so. For example, an individual performing BLS on a patient may need to manually open the patient’s mouth to answer an oral or nasal adjunct to keep the airway clear. Assistance with breathing may include artificial respiration provided by emergency oxygen, and for circulation, bleeding control or CPR techniques may be employed to assist the heart to maintain its pumping action.

Basic Life Support Sequence

When an EMT administers basic life support is performed using a specific BLS sequence which are specific to adults or children.Below are the basic steps performed:

1. Make sure the victim is safe.
2. Determine the level of consciousness by asking the patient loudly if they are okay, and checking their response to pain.
3. determine if the victim has a cervical spine trauma, and if not, open their airway through the head tilt/chin lift maneuver. Provided there is suspected neck trauma, the patient’s airway is opened using the jaw thrust technique, and if ineffective the head tilt/chin lift maneuver should be performed very carefully.
4. Assess whether any foreign objects or obstructions are blocking the airway, and if so use the finger sweep technique to remove them.
5. Look, listen, and feel for breathing at least 5 seconds, but no more than 10 seconds. If the patient is able to breathe without assistance they should be placed in a recovery position, monitored and transported. If the patient is not breathing, immediate defibrillation should be performed.
6. Attempt to perform artificial ventilation techniques such as mouth-to-mouth resuscitation or by using a bag-valve-mask (BVM). Although unless using a face shield, mouth-to-mouth is no longer recommended. At this point the BLS practitioner should make sure the chest rises and falls, and if not, reposition the airway. Next, chest compressions should be performed, making sure to stop every 30 compressions to recheck the airway for obstructions and removing any instructions, then re-attempting ventilation.
7. If successful and breathing has restored through the ventilation’s, verify the patient’s pulse at the carotid artery. If a pulse is detected, continue performing artificial ventilation’s and transport the victim immediately to a medical care facility or hospital. If no pulses detected, begin CPR at a ratio of 30:2 compressions to ventilation’s at 100 compressions per minute for 5 cycles.
8. Afterward the BLS protocol should be repeated from the start by assessing the patient’s airway, checking for breathing, and spontaneous pulse.
9. the BLS protocols should continue until the patient regains a pulse, the EMS professional is replaced by another rescuer with higher training, the rescuer is too physically tired to continue CPR, or the patient is pronounced dead by an MD.

In medicine, the CPR cycle is often abbreviated as 30:2 (30 compressions, 2 ventilation’s or breaths). For infants and children, CPR uses a 15:2 cycle if two emergency responders are performing CTR, but in the case of only one rescuer, the 30:2 sequence should still be used. If two person CPR is being conducted on an infant or child, the “two hands encircling thumbs” technique should be used by the emergency responder.

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