Basic Life Support with Fast Response April 18th, 2014.

Basic Life Support (BLS) for Healthcare Provider is a foundation course offered by American Heart Association (AHA) for anyone works in medical field. It is the second highest level course by AHA, only   below ACLS (Advanced Cardiovascular Life Support) and PALS (Pediatric Advanced Life Support). As stated in my ACLS review earlier, solid BLS is the basis of any ACLS treatment. I have been BLS certified since 2011, but my card was expired earlier this year;, thus I have to retake this course to keep my certification. Once again I choose Fast Response in Berkeley. The lead instructor today was Michael, a new instructor who is doing intern for AHA program. Everyone in the class was, except for me, a medical professional, including one local Search and Rescue member.

 

AHA’s BLS program basically breaks down into several topics: CPR for adult, for children, and for infant; Basic operation for AED (automatic external defibrillator); and Identify and treatment of choke.

 

Human brain will suffer irreversible damage without oxygen in about 4 minutes. Hence immediate CPR is essential to keep patient alive until Advanced Life Support (ALS) such as an ACLS trained provider and equipment arrive. This is also why the class was called Basic Life Support, since we are there to support patient’s vital organs. In a cardiac arrest situation, CPR alone rarely achieves a “spontaneous circulation” (means patient regained heart beat by him/herself, less than 1%) This is why early use of AED is as important as CPR, and is included in the AHA Chain of Survival. An AED would defibrillate fibrillation in the heart, thus “reboots” it and try to bring it back to normal. It does not work on patient with an asystole (flatline) or PEA (Pulseless electrical activity). The identification of heart rhythm is beyond the scope of BLS course, and is taught in ACLS or other ALS trainings.

 

The main difference between adult and child/infant CPR is the rate of rescue breathing when multiple rescuers were present. Since younger patients have higher metabolism, they demands more oxygen then adult counterparts. If more than one rescuer were present, the ratio of chest compression and rescue breathing should be 15:2 instead adult ratio of 30:2. Another difference is the single rescuer with unwitnessed arrest patient. On an adult patient, the single rescuer should immediately seek help and find an AED before starting CPR. But on a child/infant, the rescuer should do five cycles of CPR before leaving the patient to seek help and AED (in reality, it might be more feasible to carry the child/infant with the rescuer if no c-spine injury was suspected). Most AED today were deigned as “fool proof”, that is, anyone could operate them even without prior trainings. They would guide operators through both text and voice messages. Some more advanced models have ALS options to override the setting or have ECG display.

 

In general, this class was good refreshment for my previous training. And it was designed for anyone, with or without other medical training.