Basic Life Support (BLS)
Basic life support (BLS) is the immediate treatment of one of the three life-threatening emergencies found during your primary survey. Its purpose is to provide temporary support to keep the patient alive while a secondary survey is conducted and/or until advanced treatment is available.
The simplest way to begin a primary survey is to ask the patient, “How are you?” If he answers, you know that his airway is not obstructed (A), his heart is beating (B & C), and his brain is functioning (D). If the patient does not respond or responds in an unusual way, you will need to look more closely.
Airway:
Airway problems result from an obstruction to the pharynx or larynx, which can be complete or partial. A complete obstruction is rapidly fatal, but it can be effectively and dramatically treated by clearing the airway. There are various ways an airway can become obstructed, such as vomit, a foreign object, swelling caused by trauma, an irritant, or an allergic reaction. It is imperative that you clear the airway, but you must do so without causing any additional harm to the patient.
Breathing:
A person can have an open airway yet still experience difficulty breathing. This may result from an injury to the brain, spinal cord, or diaphragm. The method for assisting a patient with breathing when more advanced medical care is unavailable is known as positive pressure ventilation or artificial respiration (mouth-to-mouth). The inflation rate should be around 12 breaths per minute or one every 5 seconds, with each breath lasting about 1 to 1.5 seconds. Rapid breaths can push air into the stomach, potentially leading to vomiting.
Bleeding & Circulation:
Uninterrupted blood circulation is essential for survival. There are two primary types of disruptions to blood circulation that a first responder can address: cardiac arrest and bleeding. Cardiac arrest occurs when the heart stops beating. During your primary survey, if you discover that the patient has no pulse, it indicates that her heart has stopped beating, and she is in cardiac arrest. It's important to note that in adverse situations, or if the patient is in shock, finding a pulse can be challenging. The carotid pulse is the strongest and easiest to access; it is located on either side of the larynx in the neck. If there is no carotid pulse, the heart is not beating. CPR (cardiopulmonary resuscitation) is the only treatment for cardiac arrest. Even with hands-on training, it has limited potential to restore and sustain life.
The second type of disruption to circulation results from significant blood loss. Controlling blood loss is essential as part of BLS. Bleeding can be internal, which is often difficult to identify and stop, or external, though it may not always be obvious. Addressing internal bleeding goes beyond the scope of this article and the capabilities of most first responders in the field. External bleeding is managed by applying direct pressure to the bleeding site with your hand, ideally using a cloth or bandage. This application is not intended to absorb the blood; instead, it provides uniform pressure across the wound. Prepare to maintain direct pressure for ten minutes or more. If the bleeding does not stop, remove the bandage to locate the source of the blood and then reposition your hand.
There is no easy rule for determining when bleeding is severe. A rule of thumb is that if it looks like a lot of blood, it probably is. However, severe bleeding can be missed if the patient is wearing a lot of clothing or the blood is absorbed into the ground around the patient.
Conclusion: