Adult Basic Life Support

The above algorithm illustrates the important steps in assessing and delivering CPR to a player in cardiac arrest. Of particular importance is the early call for help, ensuring help is on its way and a call for emergency medical services (EMS)/ambulance after recognising a player is not breathing.

In a non-traumatic collapse, the assessment of breathing is achieved by opening the airway with a head tilt, chin lift manoeuvre and looking, listening and feeling for 10 ten seconds.

  • Head tilt, Chin lift
  • If cervical spine injury suspected: jaw thrust
  • Look for chest movement
  • Listen for breath sounds
  • Feel for expired air
  • Assess for 10 seconds

When a healthcare professional is in attendance, a combined airway and pulse check can be performed. This allows for the identification of a respiratory only arrest, where a pulse is present. In this scenario ventilations should be administered to the patient using a pocket mask or bag valve mask at a rate of 10–12 per minute, ensuring regular pulse checks are performed at least every minute.

If on assessing the patient there are no breath sounds and no pulse, then chest compressions should be commenced immediately, after ensuring emergency aid is on the way.

Chest compressions should be delivered in the centre of the chest, at a depth of 5-6 cm in adults and at a rate of 100 – 120 per minute. After 30 chest compressions, 2 ventilations should be delivered. These are delivered using the following steps:

  • Blow steadily (1 sec) into pocket mask or use a bag valve mask.
  • Allow chest to fall (1 sec)
  • Repeat breath/ventilation in (1 sec)
  • Allow chest to fall (1 sec)
  • Total for two breathes is 4 -5 secs
  • Minimal interruption to CPR
  • Watch for the chest to rise
  • Maintain the chin lift / jaw thrust
  • Watch the chest fall

The key to this is ensuring the patient’s airway is open to deliver the breaths/ventilations and ensure no longer than 4-5 seconds are spent delivering the ventilation in order to reduce the interruption to chest compressions, maintaining coronary artery perfusion pressure.

Thereafter 30 compressions should be delivered before each 2 breaths/ventilations are delivered.

If there is a reluctance to perform mouth-to-mouth/mouth to mask/bag valve mask ventilation, then chest compressions alone are better than no CPR.

CPR should be continued until help arrives and someone takes over, the victim starts breathing adequately for themselves or the rescuers become exhausted.

Please see the Appendix at the end of this chapter for a variation example from the American Heart Association.