Overview of Basic Life Support (BLS) and Cardiopulmonary Resuscitation (CPR)
📌 The primary goal of BLS is to explain the anatomy/physiology of the cardiorespiratory and cerebral systems, manage airway obstruction, and detail the Chain of Survival.
💔 Cardiac arrest is a major cause of death; WHO reported 17 million cardiovascular deaths in 2004, projected to rise to 23.6 million by 2030, especially in Southeast Asia.
⏱️ Successful BLS intervention must occur within the first 5 minutes of cardiac arrest, involving uninterrupted observation and action known as the Chain of Survival.

Anatomy, Physiology, and Primary Survey
🫁 The respiratory system comprises upper (mouth, nose, pharynx, larynx) and lower (trachea, bronchi) sections, with respiration aiming to bring $\text{O}_2$ into the blood and expel $\text{CO}_2$.
❤️ The cardiovascular system includes four chambers (two atria, two ventricles) with valves ensuring unidirectional blood flow; deoxygenated blood enters the right side and oxygenated blood returns via the pulmonary veins to the left side.
🧠 The brain is highly dependent on oxygen; cardiac or circulatory dysfunction significantly impacts brain function, making it the most vulnerable organ during arrest.

The Chain of Survival (CoS)
🏥 In-Hospital CoS (6 Links): Early recognition/prevention, activating the emergency response team (Code Blue), high-quality CPR, rapid defibrillation, post-cardiac arrest care, and recovery.
🛣️ Out-of-Hospital CoS: Recognizing cardiac arrest, activating emergency services (ambulance), immediate high-quality CPR, rapid $\text{AED}$ application, effective advanced cardiac care, post-cardiac arrest care, and recovery.
⚡ The use of an Automated External Defibrillator ($\text{AED}$) is critical, especially as ventricular fibrillation ($\text{VF}$) is the most common rhythm outside the hospital, and its success rate decreases over time.

BLS Procedures for Adults
✋ Primary Survey Steps (C-A-B): Check environment safety, check responsiveness (tap shoulder firmly but gently), activate the emergency system (call 119 or Code Blue), check pulse/breathing simultaneously (max 5-10 seconds).
🫁 Chest Compressions: If no pulse/breathing, position the victim on a hard surface; compress the lower half of the sternum with a rate of 100–120 per minute to a depth of 5–6 cm, allowing full chest recoil.
🌬️ Airway and Breathing: After 30 compressions, open the airway using the head-tilt/chin-lift (or jaw-thrust if trauma suspected) followed by 2 effective breaths (mouth-to-mouth or using barrier devices) lasting 1 second each, aiming for chest rise.

Special Circumstances and Modifications
🌡️ Hypothermia: Assessment of pulse/breathing may take 30–45 seconds; defibrillation may be postponed until the patient is rewarmed to $\geq 30^\circ\text{C}$.
🤰 Pregnancy: A primary intervention is performing a left uterine displacement maneuver to shift the uterus off the vena cava, optimizing circulation.
😷 COVID-19: Use full $\text{PPE}$, minimize personnel, use a $\text{bag-valve mask}$ device with a tight seal and filter for rescue breaths, and continue CPR if the pulse rate remains $<60$ per minute or perfusion is poor.

Foreign Body Airway Obstruction (FBAO)
🗣️ Mild/Moderate Obstruction: Encourage the victim to cough forcefully; if coughing is ineffective, proceed to severe obstruction management.
🚨 Severe Obstruction (Conscious Adult): Perform 5 abdominal thrusts (Heimlich maneuver); if unconscious, begin CPR starting with chest compressions.
👶 Infants (Unwitnessed Arrest): For conscious infants with ineffective coughing, deliver 5 back blows followed by 5 chest thrusts; if unconscious, initiate CPR immediately.

Key Points & Insights
➡️ Prioritize High-Quality CPR: Ensure deep, fast compressions (100–120/min, 5–6 cm depth) with minimal interruptions, as this maintains cerebral blood supply.
➡️ Two-Rescuer Pediatric CPR Ratio: When two rescuers are present for a child (1–8 years old), switch to a 15:2 compression-to-ventilation ratio.
➡️ Airway Management in COVID-19: When providing ventilations in suspected COVID-19 cases, always use barriers like a $\text{bag-valve mask}$ with a filter and ensure a tight seal.
➡️ Decision to Terminate Resuscitation: Consideration for stopping efforts includes asystole persisting for $>10$ minutes in unwitnessed arrests, though exceptions exist for young victims, hypothermia, or overdose cases.

📸 Video summarized with SummaryTube.com on Nov 28, 2025, 01:33 UTC