General Concepts of Basic Life Support


Heart disease remains the leading cause of death in the United States, with over 600,000 deaths annually. However, life-saving techniques have improved through ongoing research, and these techniques have been organized into a systematic response called the Chain of Survival. If the heart stops, blood flow stops, causing the person to become unconscious. Without blood flow, the heart and brain rapidly become damaged due to a lack of oxygen. The actions performed during BLS aim to prevent or slow down this damage until the root cause of the problem can be addressed.

Basic Life Support (BLS) is a crucial component of emergency medical care that focuses on providing immediate life-saving techniques, including airway management, breathing support, and circulation. By following the general concepts of BLS, healthcare professionals, and trained bystanders can initiate the chain of survival, increasing the patient's chances of survival.


What are the essential components of Basic Life Support?

  • Quickly initiating the Chain of Survival
  • Providing high-quality chest compressions
  • Understanding the use of an Automated External Defibrillator (AED)
  • Administering rescue breathing
  • Working effectively with other rescuers as part of a team
  • Knowing how to treat choking


Initiating Chain of Survival

Initiating the Chain of Survival is a critical component of Basic Life Support (BLS) that aims to improve a person's chances of survival during a medical emergency. The Chain of Survival is a systematic response that consists of a sequence of events that increase the likelihood of a person surviving a cardiac arrest.

The Chain of Survival includes 6 essential components that must occur in a specific order:

in hospital cardiac arrest chai of survival
out of hospital cardiac arrest chain of survival
pediatric chain of survival

The cause of emergencies in children is usually unrelated to the heart. In fact, breathing problems are the most common cause of cardiac arrest in this population. Thus, prevention is a crucial step in the Pediatric Chain of Survival.


  1. Early recognition and activation of the emergency response system: Recognizing the emergency and calling for help immediately is the first step in the Chain of Survival.
  2. Early CPR: Beginning CPR as soon as possible can help maintain circulation and oxygenation until advanced care arrives.
  3. Rapid defibrillation: Defibrillation is the most effective treatment for ventricular fibrillation, a type of abnormal heart rhythm that can lead to cardiac arrest.
  4. Early advanced care: Advanced care, including medications, advanced airway management, and other interventions, can improve the patient's chance of survival.
  5. Integrated post-cardiac arrest care: Post-cardiac arrest care includes a range of treatments and interventions to improve the patient's recovery and prevent further complications.
  6. Recovery: The additional link in the Chain of Survival includes long-term care and support for patients who have suffered a cardiac arrest or other medical emergencies.


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How important is early recognition and response to an emergency situation regarding Basic Life Support?

Timely recognition of a medical emergency can mean the difference between life and death, as it is the first step in the Chain of Survival. Prompt activation of the emergency response system will ensure that help arrives quickly, allowing for prompt initiation of CPR and other interventions that could save a person's life.


What is the role of bystanders in basic life support, and how can they effectively contribute to the chain of survival?

The role of bystanders in Basic Life Support (BLS) is critical regarding the Chain of Survival. Bystanders can provide a number of important interventions during an emergency situation, including calling for help, initiating CPR, and providing emotional support. In addition, they can begin assessing the situation and provide vital information to EMS personnel when they arrive. Bystanders should be trained in basic life support skills to ensure they are prepared to act in an emergency.


2020 BLS Guideline Changes

The American Heart Association released the 2020 BLS guidelines, which included several changes to the general concepts of BLS. The ILCOR updates the guidelines for CPR and Emergency Cardiac Care every five years.

The 2020 BLS Guidelines emphasize the importance of providing high-quality CPR, early defibrillation, advanced care, and integrated post-cardiac arrest care in order to improve the chances of survival for victims. Here are some of the key changes:


  1. Emphasizing the importance of early initiation of CPR by lay rescuers, as the risk of harm to the patient is low if the patient is not in cardiac arrest.
  2. The Chains of Survival have been updated to include a sixth link, Recovery.
  3. After ROSC, patient care should prioritize oxygenation, blood pressure regulation, percutaneous coronary intervention assessment, targeted temperature management, and multimodal neuro prognostication.
  4. It is recommended that patients who have experienced cardiac arrest receive a thorough evaluation and assistance for their physical, cognitive, and psychosocial needs, as these needs may extend beyond their initial hospital stay.
  5. Debriefing sessions are available for EMS, rescuers, and healthcare workers to support their mental health and well-being following resuscitation.
  6. During a cardiac arrest in pregnancy, it is crucial to prioritize resuscitating the mother and consider performing an early perimortem cesarean delivery if necessary.


The 2020 BLS Guidelines also recommend using real-time feedback for CPR quality. Real-time feedback can help rescuers adjust their technique and improve the effectiveness of their chest compressions. It includes visual, auditory, or tactile cues that provide immediate feedback on the depth, rate, recoil, and release of chest compressions.

In addition to providing guidance for CPR, the 2020 BLS Guidelines also recommend using advanced airway management techniques, such as a supraglottic airway device, to improve the chances of successful resuscitation.

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How have the 2020 BLS guideline changes affected how healthcare providers are trained to administer basic life support?

The 2020 BLS guideline changes have impacted how healthcare providers are trained to administer basic life support. Healthcare providers are now being trained to prioritize early recognition and activation of the emergency response system, as well as rapid defibrillation and high-quality CPR. They are also being taught to use quantitative waveform capnography to confirm and monitor the position of an advanced airway and to use supraglottic airways as an alternative to endotracheal intubation in certain situations.

The 2020 BLS guidelines emphasize the importance of teamwork, communication, and coordination among healthcare providers during cardiac arrest events. Healthcare providers are being trained to work together effectively to provide high-quality care and improve outcomes for patients in emergency situations.

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