First Aid - basic support

| In Articles | 30th March 2020

Basic life support (First aid) represents a sequence of procedures performed on victims to restore the circulation of oxygenated blood after a sudden pulmonary and/or cardiac arrest. It includes chest compressions and pulmonary ventilation performed by anyone with basic life support knowledge, anywhere, immediately, without any equipment.

A pulmonary arrest refers to the absence of breathing for a long period of time.

A cardiac arrest is when the heart stops pumping blood through the body.

The correct life saving steps when giving first aid are:

  • Approach the victim safely!
  • Check for the victim's response - shake or tap the person gently
  • Shout for help
  • Open airway
    • Head tilt/chin lift maneuver: tilting the head backwards by applying pressure to the forehead and chin
    • Jaw thrust maneuver: place the index and middle fingers to push the posterior part of the lower jaw upwards while the thumbs are pushing down to open the mouth. This procedure stops the tongue from obstructing the airway
    • Finger sweep maneuver: if an object is obstructing the airway. Avoid pushing the object further down!
  • Check breathing: look, listen and feel
    • Normal breathing: 12 to 20 breaths per minute for an adult
    • Agonal breathing: shortly after the heart stops in 40% of cardiac arrests. It is described as barely, heavy, noisy or gasping type of breathing. Recognise as a sign of cardiac arrest!
  • Telephone for an ambulance
  • Start chest compressions: place the heel of one of the hands in the centre of the chest, the lower half of the sternum - place the other hand on top - interlock fingers - arms straight - compress the chest at the rate of approximately 100 chest compressions per minute and 5-6 cm in depth. There should be a perfect balance between compression and relaxation. No pressure on the ribs!
  • If possible swap with another person who has first aid / basic life support knowledge, every 2 minutes!
  • Rescue breaths: pinch the victim's nose
  • take a normal breath
  • seal your lips over the victim's mouth
  • blow until the victim's chest rises
  • allow the chest to fall
  • repeat
mouth-to-mouth resuscitation applied in first aid support to help the victim start breathing

Continue with cycles of 30 chest compressions followed by 2 rescue breaths until the victim recovers or the ambulance arrives!

  • Use a defibrillator - if available - a device used to control heart activity by applying an electric current to the chest wall and heart.
    • defibrillation = a controlled electric shock
    • attach defibrillator pads to the casualty's bare chest
    • do not touch the victim while the defibrillator is analysing the heart rhythm
    • if the defibrillator indicates that it is appropriate, stand clear and deliver the shock
    • each defibrillator comes with clear, easy to follow voice instructions

If the victim starts to breathe normally place them in the recovery position - the body placed downwards and slightly to the left side, supported by bending the lower limbs.

How to give First aid and restore breathing in case of foreign body airway obstruction

Asphyxiation or choking means severe difficulty in breathing due to a constricted or obstructed throat. It happens when a foreign body such as food, an object or liquid blocks the throat. It causes mild or severe difficulty in breathing due to the obstruction of the airways.

If the obstruction is mild, the victim is conscious and can breathe, speak or cough. The first aider should encourage the person to cough, continue to check for deterioration to ineffective cough or until obstruction is relieved.

In case of severe obstruction the victim may be conscious or unconscious. If conscious they may be unable to speak or breathe normally, have silent attempts to cough and sound wheezy.

There are 3 first aid maneuvers the first aider needs to use if the victim is conscious:

  • Stand behind the victim, slightly to one side, supporting their chest with one hand and leaning them forward to enable the object obstructing the airway to come out.
  • Give 5 back blows: the first aider stands slightly behind the victim with one arm diagonally across the chest, bending them at the waist until the upper airway is parallel to the ground. A back blow is a firm strike with the heel of the other hand between the victim's shoulder blades.
Back blows - method applied in first air to remove obstructions and allow breathing
  • Give 5 abdominal thrusts - Heimlich Maneuver: the first aider stands behind the victim with their arms around their waist, bending them forward. One fist needs to be clenched and placed above their belly button while the other hand is placed on top of their fist to pull sharply inwards and upwards.

If the first aid maneuvers fail and the victim becomes unconscious, begin cardiopulmonary resuscitation.