🚨 Collapsed & Unresponsive Patient
➡️ Check safety ⚠️ → Shout for help 📢 → Open airway 🤲
➡️ Not breathing normally? Call 999 / Arrest Team 📞
➡️ Start CPR immediately: 30 compressions : 2 breaths ❤️‍🔥
➡️ Send for AED / Defib ⚡

🔄 Basic Life Support (BLS) Overview

BLS aims to maintain cerebral and coronary perfusion until definitive care arrives.
Early CPR + early defibrillation = strongest predictors of survival.
Delays in compressions rapidly worsen neurological outcome.
Do not wait for senior review before initiating CPR.

🩺 Primary Survey: ABCDE Approach

All deteriorating or collapsed patients should be assessed systematically using ABCDE. This prevents missed life-threatening pathology and structures escalation.

Component	Assessment	Immediate Action
🛫 Airway	Patency, obstruction, secretions	Open airway, suction, adjuncts
🫁 Breathing	Rate, effort, sats, symmetry	Oxygen, ventilation, escalate
❤️ Circulation	Pulse, BP, perfusion	CPR, fluids, IV access
🧠 Disability	AVPU/GCS, glucose	Treat hypoglycaemia, protect airway
🧍 Exposure	Full examination	Prevent heat loss

👀 Initial Recognition and Safety

⚠️ Ensure scene safety (traffic, electricity, water, chemicals).
🤝 Shake shoulders and shout: “Are you alright?”
👁️ Look for purposeful movement or speech.
❌ No response = medical emergency.
📞 Activate emergency response early.

🛫 AIRWAY: Assessment and Management

Loss of airway tone is common in unconscious patients. Tongue obstruction is the most frequent cause of airway compromise.

🤲 Perform head-tilt / chin-lift.
🦷 Remove visible vomit, blood, or foreign bodies.
🪥 Leave dentures unless loose.
📢 Use jaw thrust if cervical injury suspected.
🧪 Insert oral/nasal airway if trained.

🚫 Signs of Airway Obstruction
Stridor, choking, wheeze Snoring, gurgling Inability to speak Paradoxical breathing Central cyanosis Falling oxygen saturations
🩺 Management
High-flow oxygen (15 L/min) Airway manoeuvres Suction Adjuncts Adrenaline for anaphylaxis Prepare for intubation Emergency cricothyrotomy (rare)

🫁 BREATHING: Assessment and Support

Hypoxia is the most rapidly reversible cause of cardiac arrest. Always assume hypoxia until proven otherwise.

👁️ Look: chest movement, accessory muscles.
👂 Listen: breath sounds, stridor.
🤚 Feel: airflow.
⏱️ Assess for ≤10 seconds.
⚠️ Agonal gasps = arrest.

💨 Give high-flow oxygen.
🫁 Assist ventilation if inadequate.
📞 Call for senior/ICU support early.

Common Causes of Acute Breathlessness
Pulmonary oedema Pulmonary embolism Pneumonia Pneumothorax Asthma/COPD DKA Sepsis

❤️ CIRCULATION: Perfusion and CPR

Loss of effective circulation leads to irreversible brain injury within 3–5 minutes. High-quality compressions are therefore critical.

✋ Check carotid/femoral pulse.
⏱️ Do not spend >10s checking.
❌ No pulse = CPR.

Hands centre of chest.
Depth 5–6 cm.
Rate 100–120/min.
Allow full recoil.
Minimise interruptions.

💋 Rescue Breaths (30:2)

Open airway.
Pinch nose.
Seal mouth.
Blow for 1 second.
Observe chest rise.
Two effective breaths only.

✋ Compression-Only CPR

If untrained or unwilling to ventilate:

Continuous compressions.
100–120/min.
No unnecessary pauses.

🩸 Causes of Circulatory Collapse
Massive PE Haemorrhage Sepsis Anaphylaxis Arrhythmias Cardiogenic shock Tamponade Tension pneumothorax

🧠 DISABILITY: Neurological Status

A – Awake
V – Voice
P – Pain
U – Unresponsive

🧪 Check glucose early.
💉 Treat hypoglycaemia immediately.
💊 Consider opioid overdose → Naloxone.
🫁 GCS < 9 = airway risk → anaesthetic review.
🧠 Consider CT head when stabilised.

🧍 EXPOSURE: Full Assessment

Undress respectfully.
Inspect for trauma, rash, bleeding.
Check drains/catheters.
Prevent hypothermia.
Re-cover patient promptly.

📸 Practical Illustrations

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Resuscitation - Basic Life Support ABCDE