Resuscitation Council (UK)
FAQs Adult Basic Life Support

Frequently asked questions (FAQs)

Adult Basic Life Support

It may be difficult to carry out abdominal thrusts in a choking victim who is very obese. If you are unable to encircle the victim's abdomen, the BLS/AED Subcommittee of the Resuscitation Council (UK) recommends that you stand behind the victim, as for abdominal thrusts, but position your hands somewhat higher, over the lower end of the sternum (breastbone). Pull hard into the chest with quick thrusts.

January 2014

Yes, it is safe to defibrillate a victim who is lying on a metallic or wet surface. If the self-adhesive pads are applied correctly, and provided there is no direct contact between the user and the victim when the shock is delivered, there is no direct pathway that electricity could take that would cause the user to experience shock.

If the victim is wet, his/her chest should be dried so that the self-adhesive AED pads will stick properly. As with any attempt at defibrillation, particular care should be taken to ensure that no one is touching the victim when a shock is delivered.

The initial shout for help has been removed as a separate step for simplicity and to reduce delay in starting CPR and getting an AED - a key evidence-based intervention linked to the Chain of Survival. 

A bystander may shout for help at any stage during the initial assessment and subsequent resuscitation attempt. Most (80%) of cardiac arrests occur in the home and the rescuer is likely to know if others are present and whether a shout for help is indicated. Observational data report that in most of out-of-hospital cardiac arrests in the home only a single bystander is present.

Whenever possible the call to emergency services should be made from the patient’s side to allow a real-time assessment of the patient’s status by the dispatch operator and for them to provide CPR instruction if required.

There has been no change in who should deliver the full paediatric BLS sequence with Guidelines 2015. The full paediatric BLS sequence of 15:2 is still aimed at healthcare professionals with a duty to respond to paediatric emergencies (e.g. Emergency Department staff, paediatric doctors and nurses, paramedics). These people usually work in teams of two or more rescuers.

Lay people should be taught the adult BLS sequence of 30 compressions : 2 ventilations.

Cardiorespiratory arrest occurs less frequently in children and many children do not receive resuscitation because potential rescuers fear causing harm. This fear is unfounded; it is far better to use the adult BLS sequence for resuscitation of a child than to do nothing. Guidelines 2015 reiterate this approach and promote the delivery of BLS by the general public and the use of the same sequence on children who are not responsive and not breathing normally. 

Lay people with responsibility for the care of children (e.g. teachers, lifeguards) should be taught the adult BLS sequence of 30:2 with the following modification that makes it more suitable for use on children:

  • Give 5 initial breaths before starting chest compression.
  • If on your own, perform CPR for approximately 1 minute before going for help.
  • Compress the chest by one-third of its depth, approximately 4 cm for an infant and approximately 5 cm for an older child. Use two fingers for an infant under 1 year; use one or two hands for a child over 1 year to achieve an adequate depth of compression.
There are other potential rescuers such as dentists, general practitioners, health visitors, and school nurses who are healthcare professionals working with children, but they often work alone. Although they may have to resuscitate a child, this would be a very unusual event and they are more likely to have to resuscitate a parent or grandparent. It would be sufficient to teach these groups the adult sequence of 30:2 with the paediatric modifiers unless they expressed a particular wish or interest to learn the full paediatric sequence.

October 2015

The scientific evidence underpinning the management of choking was first reviewed by the International Liaison Committee on Resuscitation (ILCOR) in 2005, and subsequently reviewed by the European Resuscitation Council in 2010 and 2015. This evidence supports the Resuscitation Council (UK) 2015 guidelines for choking.
Our recommendations focus on encouraging the conscious victim to cough, followed by the administration of back slaps and abdominal thrusts if coughing is ineffective. If the victim becomes unconscious, CPR should be started without delay. These recommendations can be initiated promptly and effectively without the requirement for any equipment.
To date, there has been insufficient evidence on the safety or effectiveness of novel airway clearance devices for us to recommend their use.

July 2016

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