Basic life support

Basic life support (BLS) is a level of medical care which is used for patients with life-threatening condition of cardiac arrest until they can be given full medical care by advanced life support providers (paramedics, certain nurses and physicians, or any trained general personnel). It can be provided by trained medical personnel, such as emergency medical technicians, qualified bystanders and anybody who is trained for providing basic and/or advanced life support.

The International Liaison Committee on Resuscitation (ILCOR) was formed in 1992 to coordinate the efforts of resuscitation worldwide. The ILCOR representatives come from various countries such as the United States, Canada, Australia, New Zealand, and from the European, Asian, and African continents. In 2000, the committee published the first resuscitation guideline. In 2005, the committee published International Consensus on Cardiopulmonary resuscitation (CPR) and Emergency Cardiovascular Care (ECC) Science with Treatment Recommendations. Since 2010, the committee has provided materials for regional resuscitation providers such as European Resuscitation Council and American Heart Association to write their own guidelines. Since 2015, ILCOR has used a new methodology called Consensus on Science with Treatment Recommendations (COSTR) to evaluate the quality of latest evidence available and to reach a conclusion on the best treatments available in resuscitation. Using the COSTR methodology, ILCOR also started to conduct yearly reviews and published updates on the latest evidence in resuscitation, changing it from the previous 5-yearly review on resuscitation.

CPR provided in the field increases the time available for higher medical responders to arrive and provide ALS care. An important advance in providing BLS is the availability of the automated external defibrillator or AED. This improves survival outcomes in cardiac arrest cases.

One of the first checks done in emergency response is to assess the situation for any danger. If the person does not remove themselves or others from the danger then they are liable to become a patient and require emergency assistance themselves or become unable to render assistance for the other patient. Some examples of dangerous situations which should cease before BLS is administered are electrocutions, assault, drowning, and burns.

Checking for response is the next step in emergency situations as continuing with other forceful methods of BLS could exacerbate the patient's condition and can be seen as assault. AVPU (Alert, Verbal, Pain, Unconscious) is the commonly used acronym for quickly assessing the level of consciousness in a patient. Pain stimulus in particular should be used with caution as many methods if done incorrectly can leave bruises (sternal rub for example). Commonly used methods for central stimulus are the trapezius squeeze and for peripheral stimulus it is squeezing the side of the finger.

Sending for help allows much more assistance to be rendered upon the patient and increases their chances of receiving ALS.

Opening of the airway via the jaw-thrust maneuver is the preferred method as the head-tilt maneuver is thought to be more risky for people with suspected spinal injury. If the person is in danger of pulmonary aspiration, then they should be placed in the recovery position, or more advanced airway management should be used.

Once the airway has been opened, checking for breathing should begin, if the respiratory rate is below 12-20 breaths per minute then reassess for responsiveness and pulse, however if the patient is breathing normally then the rescuer should place them in the recovery position and summon an ambulance.