Indian Journal of Critical Care Medicine

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 10 , ISSUE 2 ( April, 2006 ) > List of Articles


Adult basic life support

H. Sarin, D. Kapoor

Keywords : Basic life support, cardiopulmonary resuscitation, foreign body airway obstruction, recovery position

Citation Information : Sarin H, Kapoor D. Adult basic life support. Indian J Crit Care Med 2006; 10 (2):95-104.

DOI: 10.4103/0972-5229.25922

License: CC BY-ND 3.0

Published Online: 01-07-2010

Copyright Statement:  Copyright © 2006; The Author(s).


Prompt and skilful resuscitation during cardiac arrest can make a significant difference between life and death. There have been important advances in the science of resuscitation and various international resuscitation committees have formulated evidence-based recommendations for the performance of basic life support. The revised guidelines published in the year 2005 have been designed to simplify cardiopulmonary resuscitation. In this article, we have summarized basic life support guidelines for adult victims.

PDF Share
  1. Guidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care - An international consensus on science. Resuscitation 2000;46:1-448.
  2. International Liaison Committee on Resuscitation. 2005 International Consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Resuscitation 2005;67:181-341.
  3. Handley AJ, Koster R, Monseiurs K, Perkins GD, Davies S, Bossaert L. European Resuscitation Council Guidelines for Resuscitation 2005. Resuscitation 2005;67:7-23.
  4. ECC Committee, Subcommittees and Task Forces of the American Heart Association. 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2005;112:IV1-203.
  5. Chambless L, Keil U, Dobson A, Mahoonen M, Kuulasmaa K, Rajakangas AM, et al, for the WHO MONICA Project. Population versus clinical view of case fatality from acute coronary heart disease: Results from the WHO MONICA Project 1985-1990. Circulation 1997;96:3849-59.
  6. Weston CF, Stephens MR. An audit of cardiac arrest management by extended trained ambulance crew. Resuscitation 1992;23:207-16.
  7. Vaillancourt C, Stiell IG. Cardiac arrest care and emergency medical services in Canada. Can J Cardiol 2004;20:1081-90.
  8. Rea TD, Eisenberg MS, Sinibaldi G, White RD. Incidence of EMS-treated out-of-hospital cardiac arrest in the United States. Resuscitation 2004;63:17-24.
  9. Larsen MP, Eisenberg MS, Cummins RO, Hallstrom AP. Predicting survival from out-of-hospital cardiac arrest: A graphic model. Ann Emerg Med 1993;22:1652-8.
  10. Valenzuela TD, Roe DJ, Cretin S, Spaite DW, Larsen MP. Estimating effectiveness of cardiac arrest interventions: A logistic regression survival model. Circulation 1997;96:3308-13.
  11. Weaver WD, Cobb LA, Dennis D, Ray R, Hallstrom AP, Copass MK. Amplitude of ventricular fibrillation waveform and outcome after cardiac arrest. Ann Int Med 1985;102:53-5.
  12. Weaver WD, Hill D, Fahrenbruch CE, Copass MK, Martin JS, Cobb LA, et al. Use of the automatic external defibrillator in the management of out-of-hospital cardiac arrest. N Engl J Med 1988;319:661-6.
  13. White RD, Bunch TJ, Hankins DG. Evolution of a community-wide early defibrillation programme experience over 13 years using police/fire personnel and paramedics as responders. Resuscitation 2005;65:279-83.
  14. Cobb LA, Fahrenbruch CE, Walsh TR, Copass MK, Olsufka M, Breskin M, et al. Influence of cardiopulmonary resuscitation prior to defibrillation in patients with out-of-hospital ventricular fibrillation. JAMA 1999;281:1182-8.
  15. Wik L, Hansen TB, Fylling F, Steen T, Vaagenes P, Auestad BH, et al. Delaying defibrillation to give basic cardiopulmonary resuscitation to patients with out-of-hospital ventricular fibrillation: A randomized trial. JAMA 2003;289:1389-95.
  16. Carpenter J, Rea TD, Murray JA, Kudenchuk PJ, Eisenberg MS. Defibrillation waveform and post-shock rhythm in out-of-hospital ventricular fibrillation cardiac arrest. Resuscitation 2003;59:189-96.
  17. White RD, Russell JK. Refibrillation, resuscitation and survival in out-of-hospital sudden cardiac arrest victims treated with biphasic automated external defibrillators. Resuscitation 2002;55:17-23.
  18. Cummins RO, Ornato JP, Thies WH, Pepe PE. Improving survival from sudden cardiac arrest: The “chain of survival” concept. A statement for health professionals from the Advanced Cardiac Life Support Subcommittee and the Emergency Cardiac Care Committee, American Heart Association. Circulation 1991;83:1832-47.
  19. Sun D, Bennett RB, Archibald DW. Risk of acquiring AIDS from salivary exchange through cardiopulmonary resuscitation courses and mouth-to-mouth resuscitation. Semin Dermatol 1995;14:205-11.
  20. Bierens JJ, Berden HJ. Basic CPR and AIDS: Are volunteer life savers prepared for a storm? Resuscitation 1996;32:185-91.
  21. Hendricks AA, Shapiro EP. Primary herpes simplex infection following mouth-to-mouth resuscitation. JAMA 1980;243:257-8.
  22. Finkelhor RS, Lampman JH. Herpes simplex infection following cardiopulmonary resuscitation [Letter]. JAMA 1980;243:650.
  23. Guildner CW. Resuscitation: Opening the airway. A comparative study of techniques for opening an airway obstructed by the tongue. JACEP 1976;5:588-90.
  24. Greene DG, Elam JO, Dobkin AB, Studley CL. Cinefluorographic study of hyperextension of the neck and upper airway patency. JAMA 1961;176:570-3.
  25. Hackl W, Hausberger K, Sailer R, Ulmer H, Gassner R. Prevalence of cervical spine injuries in patients with facial trauma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;92:370-6.
  26. Demetriades D, Charalambides K, Chahwan S, Hanpeter D, Alo K, Velmahos G, et al. Cervical spine injuries: Epidemiology and diagnostic pitfalls. J Trauma 2000;48:724-7.
  27. Majernick TG, Bieniek R, Houston JB, Hughes HG. Cervical spine movement during orotracheal intubation. Ann Emerg Med 1986;15:417-20.
  28. Lennarson PJ, Smith DW, Sawin PD, Todd MM, Sato Y, Traynelis VC. Cervical spinal motion during intubation: Efficacy of stabilization maneuvers in the setting of complete segmental instability. J Neurosurg Spine 2001;94:265-70.
  29. Davies G, Deakin C, Wilson A. The effect of rigid collar on intra cranial pressure. Injury 1996;27:647-9.
  30. Kolb JC, Summers RL, Galli RL. Cervical collar-induced changes in intracranial pressure. Am J Emerg Med 1999;17:135-7.
  31. Ruppert M, Reith MW, Widmann JH, Lackner CK, Kerkmann R, Schweiberer L, et al. Checking for breathing: Evaluation of the diagnostic capability of emergency medical services personnel, physicians, medical students and medical laypersons. Ann Emerg Med 1999;34:720-9.
  32. Perkins GD, Stephenson, Hulme J, Monsieurs KG. Birmingham assessment of breathing study (BABS). Resuscitation 2005;64:109-13.
  33. Safar P, Escarraga LA, Chang F. Upper airway obstruction in the unconscious patient. J Appl Physiol 1959;14:760-4.
  34. Clark JJ, Larsen MP, Culley LL, Graves JR, Eisenberg MS. Incidence of agonal respirations in sudden cardiac arrest. Ann Emerg Med 1992;21:1464-7.
  35. Aufderheide TP, Sigurdsson G, Pirrallo RG, Yannopoulos D, McKnite S, von Briesen C, et al. Hyperventilation-induced hypotension during cardiopulmonary resuscitation. Circulation 2004;109:1960-5.
  36. Garnett AR, Ornato JP, Gonzalez ER, Johnson EB. End-tidal carbon dioxide monitoring during cardiopulmonary resuscitation. JAMA 1987;257:512-5.
  37. Baskett P, Nolan J, Parr M. Tidal volumes which are perceived to be adequate for resuscitation. Resuscitation 1996;31:231-4.
  38. Davis K Jr, Johannigman JA, Johnson RC Jr, Branson RD. Lung compliance following cardiac arrest [published correction appears in Acad Emerg Med 1995;2:1115]. Acad Emerg Med 1995;2:874-8.
  39. Paradis NA, Martin GB, Goetting MG, Rosenberg JM, Rivers EP, Appleton TJ, et al. Simultaneous aortic, jugular bulb and right atrial pressures during cardiopulmonary resuscitation in humans: Insights into mechanisms. Circulation 1989;80:361-8.
  40. Idris A, Wenzel V, Banner MJ, Melker RJ. Smaller tidal volumes minimize gastric inflation during CPR with an unprotected airway [abstract]. Circulation 1995;92:759.
  41. Winkler M, Mauritz W, Hackl W, Gilly H, Weindlmayr-Goettel M, Steinbereithner K, et al. Effects of half the tidal volume during cardiopulmonary resuscitation on acid-base balance and haemodynamics in pigs. Eur J Emerg Med 1998 5:201-6.
  42. Kern KB, Hilwig RW, Berg RA, Sanders AB, Ewy GA. Importance of continuous chest compressions during cardiopulmonary resuscitation: Improved outcome during a simulated single lay-rescuer scenario. Circulation 2002;105:645-9.
  43. Locke CJ, Berg RA, Sanders AB, Davis MF, Milander MM, Kern KB, et al. Bystander cardiopulmonary resuscitation: Concerns about mouth-to-mouth contact. Arch Intern Med 1995;155:938-43.
  44. Ornato JP, Hallagan LF, McMahan SB, Peeples EH, Rostafinski AG. Attitudes of BCLS instructors about mouth-to-mouth resuscitation during the AIDS epidemic. Ann Emerg Med 1990;19:151-6.
  45. Chandra NC, Gruben Kg, Tsitlik JE, Brower R, Guerci AD, Halperin HH, et al. Observations of ventilation during resuscitation in a canine model. Circulation 1994;90:3070-5.
  46. Bahr J, Klingler H, Panzer W, Rode H, Kettler D. Skills of lay people in checking the carotid pulse. Resuscitation 1997;35:23-6.
  47. Eberle B, Dick WF, Schneider T, Wisser G, Doetsch S, Tzanova I. Checking the carotid pulse check: Diagnostic accuracy of first responders in patients with and without a pulse. Resuscitation 1996;33:107-16.
  48. Moule P. Checking the carotid pulse: Diagnostic accuracy in students of the healthcare professions. Resuscitation 2000;44:195-201.
  49. Kouwenhoven WB, Jude JR, Knickerbocker GG. Closed-chest cardiac massage. JAMA 1960;173:1064-7.
  50. Abella BS, Alvarado JP, Myklebust H, Edelson DP, Barry A, O′Hearn N, et al. Quality of cardiopulmonary resuscitation during in-hospital cardiac arrest. JAMA 2005;293:305-10.
  51. Aufderheide TP, Pirrallo RG, Yannopoulos D, Klein JP, von Briesen C, Sparks CW, et al. Incomplete chest wall decompression: A clinical evaluation of CPR performance by EMS personnel and assessment of alternative manual chest compression-decompression techniques. Resuscitation 2005;64:353-62.
  52. Yannopoulos D, McKnite S, Aufderheide TP, Sigurdsson G, Pirrallo RG, Benditt D, et al. Effects of incomplete chest wall decompression during cardiopulmonary resuscitation on coronary and cerebral perfusion pressures in a porcine model of cardiac arrest. Resuscitation 2005;64:363-72.
  53. Swenson RD, Weaver WD, Niskanen RA, Martin J, Dahlberg S. Hemodynamics in humans during conventional and experimental methods of cardiopulmonary resuscitation. Circulation 1988;78:630-9.
  54. Wik L, Kramer-Johansen J, Myklebust H, Sorebo H, Svensson L, Fellows B, et al. Quality of cardiopulmonary resuscitation during out-of-hospital cardiac arrest. JAMA 2005;293:299-304.
  55. Kern KB, Sanders AB, Raife J, Milander MM, Otto CW, Ewy GA. A study of chest compression rates during cardiopulmonary resuscitation in humans: The importance of rate-directed chest compressions. Arch Intern Med 1992;152:145-9.
  56. Dorph E, Wik L, Stromme Ta, Eriksen M, Steen PA. Oxygen delivery and return of spontaneous circulation with ventilation: Compression ratio 2:30 versus chest compressions only in pigs. Resuscitation 2004;60:309-18.
  57. Babbs CF, Kern KB. Optimum compression to ventilation ratios in CPR under realistic, practical conditions: A physiological and mathematical analysis. Resuscitation 2002;54:147-57.
  58. Greingor JL. Quality of cardiac massage with ratio compression-ventilation 5/1 and 15/2. Resuscitation 2002;55:263-7.
  59. Niemann JT, Rosborough JP, Niskanen RA, Alferness C, Criley JM. Mechanical “cough” cardiopulmonary resuscitation during cardiac arrest in dogs. Am J Cardiol 1985;55:199-204.
  60. Criley JM, Blaufuss AH, Kissel GL. Cough-induced cardiac compression: Self-administered from of cardiopulmonary resuscitation. JAMA 1976;236:1246-50.
  61. Miller B, Cohen A, Serio A, Bettock D. Hemodynamics of cough cardiopulmonary resuscitation in a patient with sustained torsades de pointes/ventricular flutter. J Emerg Med 1994;12:627-32.
  62. Tobias JD, Mencio GA, Atwood R, Gurwitz GS. Intraoperative cardiopulmonary resuscitation in the prone position. J Pediatr Surg 1994;29:1537-8.
  63. Brown J, Rogers J, Soar J. Cardiac arrest during surgery and ventilation in the prone position: A case report and systematic review. Resuscitation 2001;50:233-8.
  64. Voorhees WD, Niebauer MJ, Babbs CF. Improved oxygen delivery during cardiopulmonary resuscitation with interposed abdominal compressions. Ann Emerg Med 1983;12:128-35.
  65. Sack JB, Kesselbrenner MB, Jarrad A. Interposed abdominal compression-cardiopulmonary resuscitation and resuscitation outcome during asystole and electromechanical dissociation. Circulation 1992;86:1692-700.
  66. Sack JB, Kesselbrenner MB, Bregman D. Survival from in-hospital cardiac arrest with interposed abdominal counterpulsation during cardiopulmonary resuscitation. JAMA 1992;267:379-85.
  67. The Public Access Defibrillation Trial Investigators. Public-access defibrillation and survival after out-of-hospital cardiac arrest. N Engl J Med 2004;351:637-46.
  68. Priori SB, Chamberlain D, Napolitano C, Arntz HR, Koster R, Monsieurs K, et al. Policy Statement: ESC-ERC recommendations for the use of AED′s in Europe. Eur Heart J 2004;25:437-45.
  69. Becker L, Eisenberg M, Fahrenbruch C, Cobb L. Public locations of cardiac arrest: Implications for public access defibrillation. Circulation 1998;97:2106-9.
  70. Mossesso Jr VN, Davis EA, Auble TE, Paris PM, Yealy DM. Use of automated external defibrillators by police officers for treatment of out of hospital cardiac arrest. Ann Emerg Med 1998;32:200-7.
  71. Anonymous. Guidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care - An international consensus on science. Resuscitation 2000;46:1-447.
  72. Ingalls TH. Heimlich versus a slap on the back. N Engl J Med 1979;300:990.
  73. Heimlich HJ. A life-saving maneuver to prevent food choking. JAMA 1975;234:398-401.
  74. Heimlich HJ. Death from food-choking prevented by a new life-saving maneuver. Heart Lung 1976;5:755-8.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.