BLS 2010: What is new?

The new ACLS guidelines release somewhere in the mid 2010. There is a multiple changes in the BLS guidelines that i would like to bring in today so that we would see the changes in managing patient with cardiac arrest

The main changes in BLS in the new ACLS 2010 is the change in sequence from the old - Airway-Breathing-Circulation approach to the NEW early Compression and early Defibrillation approach. They had eliminate the look-listen-feel followed by two rescue breath to early initiation of compression.

Let us see how the BLS was done:-

1. Check for RESPONSIVENESS -check for abnormal breathing/no breathing (5-10sec)
2. Activate he EMS - to get the AED
3. Circulation - check for carotid pulse (5-10sec) pulseless --> CPR (30:2)
4. Defibrillation - the emergent use of AED with immediate CPR after each shock

therefore we can see how the airway in BLS is only after the 30compression done.

The ACLS guidelines shows how important the compression should be done, therefore the good quality CPR is repeatedly stressed in the ACLS management and those are:-

1. Compress the centre of the chest (lower half of the sternum) and fast with AT LEAST 100bpm
2. Depth AT LEAST 2 inch (adult)
3. Allow COMPLETE CHEST RECOIL
4. Minimizing interruption during CPR
5. Switch provider every 2min *1cycle - if present
6. Avoid excessive ventilation

Pulse check should be done only after completed 5 cycles of CPR (30:2)

Kindly noted if patient is not breathing but pulse present (RESPIRATORY ARREST), the approach is to restore the respiration therefore to give rescue breath every 5-6 seconds (10-12 bpm) and to recheck pulse every 2min (+resp effort)

In the BLS survey patient who is not intubated will receive 2 breath after 30 chest compression.