BLS (DRSABCD)

Amplified
Checklist

BLS (DRSABCD) - Amplified

Overview

Basic Life Support is the foundation of all resuscitation. Done well, it provides cerebral oxygenation until definitive care arrives. Every healthcare worker must be able to perform high-quality CPR.

D - Danger

Check scene is safe for self and patient

Look up, look down, look around. Common hazards: traffic, electricity, violence, chemicals, infection risk. You cannot help if you become a victim.

Don gloves if available

In healthcare settings, gloves should always be available. In the community, bare-handed CPR is better than no CPR - infection risk to rescuer is extremely low.

R - Response

Shake shoulders, "Are you okay?"

Shake firmly at the shoulders (not the head - c-spine). Speak loudly in both ears. A response can be verbal, a groan, or movement. If no response, they're unresponsive.

Shout for help

You need help regardless of what you find. In hospital: MET call / Code Blue. In community: call 000, send someone for AED. Early defibrillation is the intervention that saves lives in VF arrest.

S - Send for Help

Call 000 or MET/Code Blue

In Australia: 000 (or 112 from mobile). In hospital, activate the emergency response - usually 2222 or a specific MET number. Know your hospital's system.

Get AED (defibrillator)

Early defibrillation dramatically improves survival in shockable rhythms. Most public places now have AEDs. In hospital, the resus trolley should arrive with the team.

A - Airway

Head tilt / chin lift

One hand on forehead, two fingers under bony chin (not soft tissue). Tilt head back to lift tongue off posterior pharynx. This simple manoeuvre opens the airway in most cases.

Look for obstructions

Quickly look in the mouth. Only remove visible solid obstructions. Don't do blind finger sweeps - you may push objects deeper.

B - Breathing

Look, listen, feel for 10 seconds max

  • Look: chest rise
  • Listen: breath sounds at nose/mouth
  • Feel: air on your cheek

Agonal gasps (irregular, gasping breaths) are NOT normal breathing. If in doubt, start CPR.

C - CPR

30 compressions : 2 breaths

The ratio is 30:2 for all adult patients (single or two rescuers). This provides adequate coronary and cerebral perfusion while minimising interruptions.

Rate: 100-120/min

Use a metronome or song (Stayin' Alive, Another One Bites the Dust). Too slow = inadequate output. Too fast = incomplete recoil.

Depth: at least 5cm

Push hard. Adequate depth is more important than worrying about rib fractures. In-hospital arrests often have inadequate compression depth.

Full recoil between compressions

Don't lean on the chest. Full recoil allows the heart to refill. Leaning reduces cardiac output by 25%.

D - Defibrillation

Apply pads (right clavicle, left lateral)

One pad below right clavicle beside sternum. One pad on left side, mid-axillary line, over the apex of the heart. Avoid placing directly over implanted devices.

Follow AED prompts

Modern AEDs are designed for minimal training. They analyse the rhythm and tell you exactly what to do. Trust the machine.

Resume CPR immediately after shock

Don't check pulse. Don't check rhythm. Immediately resume compressions. The rhythm check happens after 2 minutes of CPR, not after each shock.

High-Quality CPR Principles

  • Minimise interruptions (<10 sec for any reason)
  • Push hard, push fast, full recoil
  • Avoid hyperventilation (12 breaths/min max)
  • Rotate compressors every 2 minutes
  • Real-time feedback devices improve quality