BASIC LIFE

SUPPORT
JSI DEXTER M BONAYON, MD
BJMP MEDICAL OFFICER
 OBJECTIVE

To have a better understanding about the principles of first

aid and basic life support
To be able to perform first aid and basic life support in times
of need
To familiarize itself on the signs and symptoms of common
medical emergencies as well as its interventions as a first
responders
What is First Aid?
An immediate, temporary and continuing care given to a
person who has been injured or suddenly taken ill.
First Aid is the first care provided to manage an illness or
injury
Scope and Limitations
First aid does not imply medical treatment and is by no
means a replacement for it
 Why is it important to know First
Aid?

There are some simple things that you can do to

◦ reduce injury
◦ improve the condition
◦ save lives
If you are prepared, you can act
Some actions can make things worse
In some situations, the first minutes are the most important
Roles of First Aid
o It is a bridge that fills the gap between the
casualty and the physician
o It ends when the service of the physician
begins
o It is not intended to compete with the
treatment done by the physician
 WHAT IS BASIC LIFE SUPPORT?

An emergency procedure that consist of recognizing

respiratory or cardiac arrest or both and the proper
application of CPR to maintain life until a victim
recovers or advance life support is available
“CPR” – Cardio (heart) Pulmonary (lung) Resuscitation
Resuscitation can save the life of someone who isn’t breathing or
their heart isn’t beating
People have a chance of surviving if bystanders act immediately
First Aid Hygiene

It is important that first aid procedures be conducted with due regard
for the danger of cross-infection. Simple rules of personal hygiene and
wearing gloves are sufficient to guard both the first aid provider and
the casualty from contamination when treating or caring for a casualty.
Gloves & Face shield
Slide No. 8
Personal Hygiene
There are no documented cases of serious infection, after
rescue breathing
Washing hands when able
Use a face shield or a face mask, gloves when able
Provision of chest compression without mouth to mouth
ventilation is far better than not attempting resuscitation at
all

Slide No. 9
Chain of Survival
Respiratory System

Anatomy Review Respiratory Tract

Nose
Pharynx
Trachea
Bronchus
Bronchioles
Alveoli
Oxygen is a vital ingredient for sustaining life

Inhale : Exhale :

Oxygen
21 % Carbon dioxide
+
Oxygen 16 %
 O2 and CO2 exchange in
the air sac (Alveoli)

Oxygen is combined with

Haemoglobin in blood and is
carried to the cells of the body

Alveoli

Slide No. 13
Normal healthy adult:
16-20 breaths / minute

It will be increased when we run

or do physical work

Slide No. 14
Circulatory System
Anatomy Review

The Heart
4 chambers
Aorta
Vena Cava
Blood Vessels
•Arteries
•Veins
•Capillaries
 Circulatory System
Pumps blood to the whole body Normal healthy adults
• Human Body contains 60 - 100 beats / minute
5-6 liters of blood faster in children
• About 70 ml of blood is
circulated by each
contraction of the heart If the heart stops pumping
• In a healthy adult, the heart DEATH will occur!!!
circulates about 5 liters per
minute.
QUESTIONS!

Slide No. 18
BASIC LIFE
SUPPORT
IMPORTANCE OF BLS
WHY I SHOULD KNOW IT?

SAVING A LIFE !!

Slide No. 20
Minutes count
Resuscitation Rules (BMJ, 1999)
“No survival, if basic life support
is delayed for more than 10
minutes”

Remember the golden period

is about 4 minutes

Slide No. 21
I don’t know? What will you do? Bye, Ingat!

Get your cellphone,

take a selfie. Wala ako nakita!

Malay ko! Usyosos na lang!

Bahala sya dyan! Call for help!

Slide No. 22
Emergency Action Principles

Scene Size-up
Is the scene safe? What happened? Nature and cause of Injury? How many people are
injured?
Identify yourself as first aider

Primary Assessment
Check responsiveness.
Call for help (ask bystander to call for help)
Check the ABC’s

Secondary Assessment
Head to toe assessment
Approaching the sequence of BLS
DRsABCD
D - Danger
R - Response
S - shout for help
A - Airway
B - Breathing
C - Circulation
D - Defibrilator

Slide No. 24
Check for Danger
Check Safety
◦ Rescuer
◦ Bystanders
◦ Victim
Don’t be the next casualty

Slide No. 25
Check Response

Shake and Shout

Slide No. 26
If Responsive
Recovery Position
Look for bleeding or other injuries,
(Secondary Survey).
Seek Medical Assistance

To keep the airway open

To prevent aspiration of vomit

Slide No. 27
If Unresponsive

Shout for Help

Slide No. 28
Check Airway

Head Tilt Chin Lift method

Jaw Thrust (if suspected spine injury)
Remove any obstructions from mouth

Slide No. 29
Check Breathing

Look, Listen & Feel for 10 seconds Slide No. 30

No Normal Breathing
Commence CPR
(Cardio Pulmonary Resuscitation)

Slide No. 31
CPR – Chest Compression
30 X 2X

Rate: approximately 100 x/min

Depth: 4 to 5 cm for Adults
Depth: 1/3-1/2 of chest diameter
for children
ALWAYS ENSURE EFFECTIVE RECOIL

Slide No. 32
Slide No. 33
Defibrilator
Is a defibrillator available?
A defibrillator (also called AED – Automatic External
Defibrillator) is a machine which delivers an electric shock to
the heart
AEDs can save lives
Using the AED Defibrillator:

Follow the spoken/visual directions.

Follow the spoken/visual directions.
The victim must not be touched while the AED is analyzing the rhythm.
If a shock is indicated, ensure that the victim is not touched.
Push shock button as directed.
Resume CPR immediately starting with chest compression.
Repeat every 2 minutes.
The AED will re-analyze the rhythm. Follow the AED’s voice/visual prompts. If no shock is
indicated, immediately resume CPR.
 Continue resuscitation until
• Qualified help arrives and takes over
• Follow instructions – Continue compressions
• The victim shows signs of recovery
• You become exhausted and unable to continue

Slide No. 36
BLS Algorithm
DANGER
CHECK RESPONSIVENESS Shake and shout
Early Access

OPEN AIRWAY Head tilt/Chin lift

If breathing:
CHECK BREATHING Look, listen, and feel
Recovery position

NO NORMAL BREATHING

COMMENCE CPR

100 per minute

30:2 ratio

Slide No. 37
Emergency Action Principles
SECONDARY SURVEY
Importance of Secondary Survey
1. Documentation
2. Patient Monitoring
3. Legal Purposes
4. Pre – hospital report
A. Head to toe assessment
( DCAPBTLS – Trauma Case only )
D – Deformity
C – Contusions
A – Abrasions
P – Puncture
B – Burns
T – Tenderness
L – Lacerations
S - Swelling
B. Is the Casualty in Pain
OPQRST – Medical Cases Only – Pain )
O – Onset of Pain
P – Provocative/Palliative
Q – Quality of Pain
R – Radiation
S – Severity
T - Timing
C. History Taking (SAMPLE)
( For Conscious casualty Only – Medical and Trauma )
S – Signs and Symptoms
A – Allergies ( Food and Drug )
M – Medications
P – Past / Present Medical History (Hosp )
L – Last Meal ( Surgery )
E – Event leading to Injury (What,Where,When )
Slide No. 42
Common Medical Emergencies
Heart Attack (Myocardial Infarction)
It occurs when the blood and oxygen supply to the heart is reduced
causing damage to the heart muscle and preventing blood from
circulating effectively. It is usually caused by coronary heart disease.
The atherosclerotic plaque (buildup) inside the arterial wall
sometimes cracks, and this triggers the formation of a thrombus, or
clot.
A clot in the coronary artery interrupts the flow of blood and
oxygen to the heart muscle, leading to the death of heart cells in that
area
Rarely, sudden overwhelming stress can trigger a heart attack.
Risk Factors
Smoking
Hypertension (high blood pressure)
High fat diet
High blood cholesterol (LDL) levels
Diabetes
Male gender
Age
Heredity
Symptoms
- Chest pain behind the sternum (breastbone) - Shortness of breath that occurs suddenly
pain may radiate to the: may or may not be accompanied by
pain
neck, teeth, or jaw arms, shoulder, or
back - Sweating may be profuse
Pain that may be described as: - Nausea or vomiting
squeezing, aching, tightness, or pressure - Light-headedness dizziness or fainting
a tight band on the chest
"an elephant sitting on my chest"
"bad indigestion" or heartburn
pain may be intense or subtle
Prevention
Control cardiac risk factors whenever possible.
Control blood pressure and total cholesterol levels.
Avoid smoking
Modify diet if necessary (increase vegetables, vegetable oils, and fruits and
decrease animal fats)
Control diabetes
Lose weight if obese
Exercise
First Aid (Heart Attack)
Responsive
•Lie the casualty in a comfortable position
•Transfer the casualty immediately to the nearest hospital
•Monitor ABC
•Watch out for a possible cardiac arrest ( pulse, breathing )
then do CPR
First Aid (Heart Attack)
Unresponsive
•Check casualty’s ABC
•If necessary, begin Rescue breathing or CPR
•Have the casualty rest in a comfortable position
•Seek immediate medical help
•Do not give the casualty anything by mouth
•Continue to monitor ABC’s
•Stay with the casualty until medical help arrive
Cerebro Vascular Attack (CVA)
◦ is a condition that occurs when the blood flow to the brain
is interrupted long enough to cause damage.
◦ AKA – Stroke or Brain Attack
Causes
1. Thrombotic Stroke - gradual (deposited at blood vessel)
* a blood clot (thrombus) forms inside one of the brain's arteries
and blocks blood flow to a part of the brain
2. Embolic Stroke - no warning signals (obstruction on blood vessel )
* embolic stroke — is similar, but the blood clot forms
somewhere else in the body and travels through the bloodstream to the brain
artery
3. Hemorrhagic - thinning of blood vessel ( hypertensive )
* Hemorrhagic stroke involves bleeding within the brain,
damaging adjacent brain tissue.
Risk Factors
High Blood Pressure which is the most leading cause of stroke and the cause for increased risk
of stroke among people with diabetes
Diabetes
High blood cholesterol
Other specific risk factors include blood clots arising from Coronary Heart
Disease, Atrial Fibrillation, Heart Valve Disease and Carotid Artery Disease;
Illicit drug abuse, common causes in the younger population
Age
Signs and Symptoms
◦ Weakness or numbness of the face, arm, or leg (usually on
one side of the body)
◦ Blurred or decreased vision,especially in one eye.
◦ Problems speaking or understanding (slurring of speech)
◦ Unexplained, severe headache
◦ Dizziness, unsteadiness, or sudden fall
◦ Facial asymetry
◦ Tongue deviation
Prevention
Choose healthy foods and drinks
Keep health weight
Get a regular physical activity
Do not smoke, cigarette smoking increases the chance of having stroke
Limit alcohol intake
Control your medical conditions (heart disease, high blood pressure,
diabetes, high cholesterol)
Regularly check cholesterol level
Prevention
Control blood pressure, ensure that prescribed medication/s to
regulate blood pressure is/are religiously taken
Control diabetes to help keep blood sugar under control thus
lowering the risk of stroke
Treat heart disease
Take your medicines and follow doctor’s instructions carefully
Ensure If already had stroke or Transient Ischemic Attack (TIA),
ensure to follow treatment plan carefully to prevent further strokes
First Aid (CVA)
Responsive
•Lie the casualty in a comfortable position
•Transfer the casualty immediately to the nearest hospital
•Monitor ABC
•Watch out for a possible cardiac arrest ( pulse, breathing )
then do CPR
First Aid (CVA)
Unresponsive
•Check casualty’s ABC
•If necessary, begin Rescue breathing or CPR
•Have the casualty rest in a comfortable position
•Seek immediate medical help
•Do not give the casualty anything by mouth
•Continue to monitor ABC’s
•Stay with the casualty until medical help arrive
AIRWAY OBSTRUCTION

ASK JUST 1 QUESTION

“ARE YOU CHOKING?”

Slide No. 58
Choking
•When an object (often food) blocks the airway
•Often occurs while eating, victim may clutch the neck, look very
anxious, wheeze, suddenly can’t talk, may look like they are coughing
but little or no noise, fingers or lips may be turning blue
•Allow them to keep coughing BUT if it does not remove the blockage
•CALL for help (ambulance)
Airway Obstruction
Conscious
◦ Infants under 1 - Back Slapping and
chest thrusts
◦ Adults and kids older than 1 -
Abdominal thrust - 5x
Heimlichs Maneuver

Slide No. 60
Airway Obstruction
Unconscious
◦ Perform Chest compression
◦ Check mouth every time
airway opened and remove
any obstructions

Slide No. 61
Fever
Fever… A temperature over 37.8°C If symptoms are minor, no specific treatment
is required
•Many different illnesses cause fever
•You can use a simple over-the-counter
•Infection is a very common cause medication such as acetaminophen /
•Many infections are minor and get better paracetamol to lower the fever
without treatment (head cold/flu) •Drink plenty of fluids
•Sometimes serious infections are the cause •Rest
(malaria, dengue fever, meningitis, etc)
•If you have symptoms that indicate what type
•The possibilities depend on where you are of infection you have, then manage that
condition (diarrhoea, head cold, etc)
DO NOT:
Use aspirin in children
Use antibiotics without medical advice
Give any medication without asking about allergies
Fever: when to get help
If the patient is very sick, drowsy, not thinking clearly
Any other serious symptoms, e.g. vomiting
If a child and the fever is very high (over 39°C /102.2° F)
If the fever is not improving after about 3 days even if there are no other
symptoms
If there is a rash, immediately consult medical advice
 Vomiting and Diarrhea
• OFTEN caused by bacteria or parasites contained in Prevent dehydration:
contaminated food or water • Drink bottled water, soda, sports drinks or other clear fluids
• Diarrhea is when there are three or more loose stools • Use rehydration solutions if you have them
per day
• Keep sipping even if vomiting
• Can also have fever, abdominal cramps, and vomiting
• Avoid milk / dairy drinks
• Usually lasts 1-2 days and settles with no treatment.
• Choose low-residue, bland foods, such as rice, biscuits or
Can last one week dry bread
• Babies, children and people with underlying health • Anti-diarrheal (Loperamide / Diphenoxylate) can be used as
problems (such as heart trouble or diabetes) can get long as there is:
very sick very quickly
NO blood in the stools
NO bloating / swelling of the abdomen
Seek medical attention if:
 not improving after 2 days (1 day for a child)
 any severe symptoms
 blood in stool or vomit
 unable to keep any fluids down
 drowsiness
 very little urine, very dark urine or no urine (children – if no urine
for 6 hours, babies – no wet diaper for 3 hours)
Antibiotics can shorten the illness but should only be used when the
doctor advises they should be.
 Collapse
• When someone falls to the ground, and is unconscious Collapse: what to do

• There are many causes, some are minor others are • Let the person lie flat - on their side if possible.
serious • Don't let them try to stand or sit up
It may be minor if: • Lying flat improves blood flow to the brain
the person wakes up quickly after collapsing / lying flat • Lying on the side helps keep the airway clear
It is serious if there is: • If they don't wake up quickly,

no breathing OR Call for help

• Check if they are breathing - if not, start CPR
obvious bleeding OR
• If they are breathing - loosen any tight clothing, e.g. tie,
slurring of speech OR collar, belt
weakness or loss of movement of arms / legs / face • Stay with them until help arrives
Management of
Wound
Principles of Wound Management
Assess Injured part
Control bleeding if any
Small wounds – Prevent infection
Large wounds – Prevent shock, control bleeding
Wash wounds and abrasions with clean running water for >5 minutes
Wash until no signs of foreign matter
Apply antibiotic cream to superficial wounds,

Slide No. 68
Bleeding
Classified as:
◦ Arterial bleeding - spurting
◦ Venous bleeding – steady flow
◦ Capillary bleeding - oozing
Also divide as
◦ External Bleeding
◦ Internal Bleeding

Slide No. 69
Try and STOP the bleeding…
If there is a lot of bleeding, a “dirty” or deep wound, or anything deeper than skin
might be cut - seek medical attention.
Don’t forget - people might need a tetanus booster vaccination if the wound is
“dirty”.
If there is a minor cut or wound:
Wear gloves
Get a clean cloth or dressing and apply pressure to the area until it stops bleeding
Wash the wound – with water and then antiseptic
Keep the wound clean and dry until it heals
Wounds can get infected. If the area starts to swell, becomes more red and painful
or if there is pus - seek medical attention.
Control External Bleeding
Direct Pressure
Elevate
Press Pressure Point
(if necessary)
Pressure Bandage

Slide No. 71
Types of Wound

Slide No. 72
Signs of Internal Bleeding

Slide No. 73
Internal Bleeding
Ice Compress – to reduce pain and swelling

Severe Internal Bleeding

Be aware of shock process

Slide No. 74
How do you manage this?

Slide No. 75
Sprains and Strains
 Sprain
• A sprain is a bruise or a tear of a
muscle or “ligament” or tendon” Rest
(tissue which joins one bone to Ice compress
another, or a muscle to a bone)
• Most common location is the Compression Bandage
Ankle
Elevate

Slide No. 77
 Strain
Rest
Ice
• A strain is when a muscle is Bandage
stretched too much and part of it
tears Elevate
• It is also called a pulled muscle

Slide No. 78
Dislocation and Fractures
Anatomy of Joint

Slide No. 80
Dislocation: Recognition

• “Sickening” severe pain,

• Difficulty in moving the joint
• Swelling and bruising around the
joint
• Shortening, bending or twisting of
the joint

Slide No. 81
 Dislocation: Management
• Advise the casualty to keep still.
• Support the injured part
• Immobilize the injured part
• Check the circulation beyond the bandages every 10 minutes
• Seek medical assistance.
• Do not try to reposition a dislocated bone into its socket
• Do not move the casualty until the injured part is secured and
supported

Slide No. 82
Fractures
A fracture is a broken bone, the same as a crack or a
break. A bone may be completely fractured or partially
fractured in any number of ways (crosswise, lengthwise,
in multiple pieces).
Open and Close fracture
Cause
oTrauma - A fall, motor vehicle accident, or tackle during
a football game can all result in fractures.
oOsteoporosis - This disorder weakens bones and makes
them more likely to break.
oOveruse - Repetitive motion can tire muscles and place
more force on bone. This can result in stress fractures.
Stress fractures are more common in athletes.

Slide No. 83
Fractures: Recognition
• Deformity, swelling and bruising
• Pain and difficulty in moving the
area
• Shortening, bending or twisting of a
limb
• Coarse grating (crepitus)
• Signs of shock
• Difficulty in moving a limb normally
• A wound, possibly with bone end
protruding.

Slide No. 84
Fractures
Stable Fracture:
• the broken bone ends do not move, either because they are
incompletely broken or they are jammed together. This is common
at the wrist, shoulder, ankle, and hip

Unstable Fracture:
• the broken bone ends can easily move out of position. As a result,
there is a risk that they may cause damage to blood vessels, nerves
and organs.

Slide No. 85
Open Fracture: Management
• Put on gloves, loosely cover the wound with a
dressing/gauze.
• Carefully place clean padding over and around the
dressing
• Secure the dressing and padding with a bandage
• Immobilize above and below the fracture site.
• Treat for shock if necessary, monitor and record
vital signs: Breathing, pulse, level of
consciousness
• Seek medical assistance

Slide No. 86
 Closed Fracture: Management

• Advise the casualty to keep still. Support the

injured part
• For firmer support, bandage the injured part to
an unaffected part of body
• Monitor vital signs
• Seek medical assistance

Slide No. 87
Practical:Immobilization

Slide No. 88
Practical:Immobilization

Slide No. 89
Burns
Burns
Causes:
Heat
Chemicals
Electricity
Extreme Cold
Radiation

Slide No. 91
 Burns
Burns are tissue damage brought on by heat, chemicals,
electricity, radiation or the sun
First-degree burns are mild (like most sunburns). The top
layer of skin (epidermis) turns red and is painful but doesn’t
typically blister.
Second-degree burns affect skin’s top and lower layers
(dermis). You may experience pain, redness, swelling and
blistering.
Third-degree burns affect all three skin layers: epidermis,
dermis and fat. The burn also destroys hair follicles and
sweat glands. Because third-degree burns damage nerve
endings, you probably won’t feel pain in the area of the
burn itself, rather adjacent to it. Burned skin may be black,
white or red with a leathery appearance.
Burn Surface Area
Rule of Nine Palm of hundred
Palm of hundreds

Rule of nine

Slide No. 93
 First Aid Burns
COOLING DOWN
10 Minutes
Do Not touch the affected area
Do Not break the blister
Do Not apply creams and lotion before cooling it
down
Dry chemical burns should be swept/brushed
gently before washing them under running water.
All electrical burns are dangerous. It can interfere
with our hearts electrical activity. Be prepared to
perform CPR if needed.

Slide No. 94
Heat Stroke
 a form of hyperthermia (abnormally elevated
body temperature) with accompanying
physical and neurological symptoms.
 Unlike heat cramps and heat exhaustion, two
less-severe forms of hyperthermia, heat
stroke is a true medical emergency that can
be fatal if not properly and promptly treated.
Signs and Symptoms
 Feeling weak, faint or dizzy with accompanying headache or nausea
 Cold, clammy skin with ashen pallor
 Dry tongue & thirsty
 Severe muscle fatigue
 Loss of appetite
 Profuse sweating
 Physical collapse, with muscle fatigue & sometimes cramping
 Treatment
2 Basic Steps
 Replenish the body’s lost fluid; &
 Cool the body’s temperature
 Move the person into a cool place out of the sun
 Loosen any tight fitting clothing & remove extra layers of
clothing
 Offer the person fluids – water, fruit/vegetable juices, sports
drinks
 Don’t offer drinks with alcohol or caffeine
 Help the person cool off
 Sponging with cool water/Applying cool, wet cloths
Be careful if you eat RED LOBSTERS
A young woman was having a meal at the restaurant and suddenly began to experience intense
chest pains.

Nothing her friends or the restaurant personnel did would relieve the pain.

'911' was called and an ambulance was sent and the women was transported to a nearby
hospital where doctors removed the women's blouse.

As soon as this was done, emergency room personnel were able to properly diagnose the cause
of the pain:
Be careful if you eat RED LOBSTERS
Slide No. 103
 Thank you!!!!

“your health is my concern”

“your health is my concern”