1. european
resuscitation
council
Basic Life Support &
Automated External Defibrillation
Check response
Shake gently
Ask loudly: “Are you all right?”
If not responsive
Open airway & check for breathing
If not breathing normally
If breathing normally
or not breathing
Call 112, find & bring an AED
Start CPR immediately *
Turn into recovery position
Place your hands in the centre of the chest • Call 112
Deliver 30 chest compressions: • Continue to assess that breathing
remains normal
• Press firmly at least 5 cm deep
at a rate of at least 100/min
• Seal your lips around the mouth
• Blow steadily until the chest rises
• Give next breath when the chest falls
• Continue CPR
CPR 30:2
Switch on the AED & attach pads
Follow the voice prompts immediately
Attach one pad below the left armpit
Attach the other pad below the right collar bone, next to the breastbone
If more than one rescuer: don’t interrupt CPR
Stand clear & deliver shock
Nobody should touch the victim
- during analysis
- during shock delivery
If the victim starts to wake up: to move, to open eyes and to breathe normally, stop CPR.
If still unconscious, turn him into the recovery position*.
www.erc.edu | info@erc.edu
Published October 2010 by European Resuscitation Council Secretariat vzw, Drie Eikenstraat 661, 2650 Edegem, Belgium
Product reference: Poster_10_BLSAED_01_01_ENG Copyright European Resuscitation Council

2. european
resuscitation
council
In-hospital Resuscitation
Collapsed/sick patient
Shout for HELP
& assess patient
If NO signs of life If signs of life
Call resuscitation team
Assess ABCDE
Recognise & treat
CPR 30:2 Oxygen, monitoring, iv access
with oxygen and airway adjuncts
Call resuscitation team
If appropriate
Apply pads/monitor Handover to
resuscitation team
Attempt defibrillation
if appropriate
Advanced Life Support
when resuscitation team arrives
www.erc.edu | info@erc.edu
Published October 2010 by European Resuscitation Council Secretariat vzw, Drie Eikenstraat 661, 2650 Edegem, Belgium
Product reference: Poster_10_IHBLS_01_01_ENG Copyright European Resuscitation Council

3. european
resuscitation
council
In-hospital Resuscitation
Collapsed/sick patient
Shout for HELP & assess patient
No Signs of life? Yes
Call resuscitation team
Assess ABCDE
Recognise & treat
Oxygen, monitoring, iv access
CPR 30:2
with oxygen and airway adjuncts
Call resuscitation team
Apply pads/monitor If appropriate
Attempt defibrillation if appropriate
Advanced Life Support
Handover to resuscitation team
when resuscitation team arrives
www.erc.edu | info@erc.edu | Published October 2010 by European Resuscitation Council Secretariat vzw, Drie Eikenstraat 661, 2650 Edegem, Belgium | Product reference: Poster_10_IHBLS-A_01_01_ENG Copyright European Resuscitation Council

4. european
resuscitation
council
Advanced Life Support
Universal Algorithm
Unresponsive?
Not breathing or only occasional gasps
Call
Resuscitation Team
CPR 30:2
Attach defibrillator/monitor
Minimise interruptions
Assess
rhythm
Shockable Non-shockable
(VF/Pulseless VT) (PEA/Asystole)
Return of
1 Shock spontaneous
circulation
Immediately resume: Immediate post cardiac Immediately resume:
arrest treatment
CPR for 2 min CPR for 2 min
• Use ABCDE approach
Minimise interruptions • Controlled oxygenation and Minimise interruptions
ventilation
• 12-lead ECG
• Treat precipitating cause
• Temperature control /
therapeutic hypothermia
During CPR Reversible causes
• Ensure high-quality CPR: rate, depth, recoil • Hypoxia
• Plan actions before interrupting CPR • Hypovolaemia
• Give oxygen • Hypo-/hyperkalaemia/metabolic
• Consider advanced airway and capnography • Hypothermia
• Continuous chest compressions when advanced airway in place
• Thrombosis
• Vascular access (intravenous, intraosseous)
• Tamponade - cardiac
• Give adrenaline every 3-5 min
• Toxins
• Correct reversible causes
• Tension pneumothorax
www.erc.edu | info@erc.edu
Published October 2010 by European Resuscitation Council Secretariat vzw, Drie Eikenstraat 661, 2650 Edegem, Belgium
Product reference: Poster_10_ALS_01_01_ENG Copyright European Resuscitation Council

5. european
resuscitation
council
Advanced Life Support
Bradycardia Algorithm
• Assess using the ABCDE approach
• Ensure oxygen given and obtain IV access
• Monitor ECG, BP, SpO2, record 12 lead ECG
• Identify and treat reversible causes (e.g. electrolyte abnormalities)
Assess for evidence of adverse signs:
1 Shock
Yes 2 Syncope No
3 Myocardial ischaemia
4 Heart failure
Atropine
500 mcg IV
Satisfactory
Yes
Response?
No Risk of asystole?
• Recent asystole
Yes • Möbitz II AV block
• Complete heart block with broad QRS
• Ventricular pause > 3s
Interim measures:
• Atropine 500 mcg IV
repeat to maximum of 3 mg
No
• Isoprenaline 5 mcg min-1
• Adrenaline 2-10 mcg min-1
• Alternative drugs*
OR
• Transcutaneous pacing
Seek expert help Observe
Arrange transvenous pacing
* Alternatives include:
• Aminophylline
• Dopamine
• Glucagon (if beta-blocker or calcium channel
blocker overdose)
• Glycopyrrolate can be used instead of atropine
www.erc.edu | info@erc.edu
Published October 2010 by European Resuscitation Council Secretariat vzw, Drie Eikenstraat 661, 2650 Edegem, Belgium
Product reference: Poster_10_ALS-BRAD_01_01_ENG Copyright European Resuscitation Council

6. european
resuscitation
council
Advanced Life Support
Tachycardia Algorithm
• Assess using the ABCDE approach
• Ensure oxygen given and obtain IV access
• Monitor ECG, BP, SpO2 , record 12 lead ECG
• Identify and treat reversible causes (e.g. electrolyte abnormalities)
Assess for evidence of adverse signs
Synchronised DC Shock* Unstable 1. Shock 2. Syncope Stable Is QRS narrow (< 0.12 sec)?
Up to 3 attempts
3. Myocardial ischaemia 4. Heart failure
• Amiodarone 300 mg IV over
10-20 min and repeat shock; Broad Narrow
followed by:
• Amiodarone 900 mg over 24 h
Broad QRS Narrow QRS
Irregular Regular Regular Irregular
Is QRS regular? Is rhythm regular?
Seek expert help • Use vagal manoeuvres Irregular Narrow Complex
• Adenosine 6 mg rapid IV bolus; Tachycardia
if unsuccessful give 12 mg; Probable atrial fibrillation
if unsuccessful give further 12 mg. Control rate with:
• Monitor ECG continuously • ß-Blocker or diltiazem
• Consider digoxin or amiodarone
if evidence of heart failure
Anticoagulate if duration > 48h
Possibilities include: If Ventricular Tachycardia Normal sinus rhythm restored? No Seek expert help
• AF with bundle branch block (or uncertain rhythm):
treat as for narrow complex • Amiodarone 300 mg IV over
• Pre-excited AF 20-60 min; then 900 mg over 24 h
Yes
consider amiodarone
• Polymorphic VT If previously confirmed
(e.g. torsades de pointes - SVT with bundle branch block:
give magnesium 2 g over 10 min) • Give adenosine as for regular
narrow complex tachycardia
Probable re-entry PSVT: Possible atrial flutter
• Record 12-lead ECG in sinus rhythm • Control rate (e.g. ß-Blocker)
• If recurs, give adenosine again &
consider choice of anti-arrhythmic
*Attempted electrical cardioversion is always undertaken under sedation or general anaesthesia prophylaxis
www.erc.edu | info@erc.edu | Published October 2010 by European Resuscitation Council Secretariat vzw, Drie Eikenstraat 661, 2650 Edegem, Belgium | Product reference: Poster_10_ALS-TACH_01_01_ENG Copyright European Resuscitation Council

7. european
resuscitation
council
Paediatric Basic Life support
Health professionals with a duty to respond
UNRESPONSIVE?
Shout for help
Open airway
NOT BREATHING NORMALLY?
5 rescue breaths
NO SIGNS OF LIFE?
15 chest compressions
2 rescue breaths
15 compressions
After 1 minute of CPR call national emergency number (or 112)
or cardiac arrest team
www.erc.edu | info@erc.edu
Published October 2010 by European Resuscitation Council Secretariat vzw, Drie Eikenstraat 661, 2650 Edegem, Belgium
Product reference: Poster_10_PaedBLS_01_01_ENG Copyright European Resuscitation Council

8. european
resuscitation
council
Paediatric Life Support
Advanced Life Support
Unresponsive?
Not breathing or only occasional gasps
CPR (5 initial breaths then 15:2) Call Resuscitation
Attach defibrillator/monitor Team
Minimise interruptions (1 min CPR first, if alone)
Assess
rhythm
Shockable Non-shockable
(VF/Pulseless VT) (PEA/Asystole)
Return of
1 Shock 4 J/Kg spontaneous
circulation
Immediately resume: Immediate post cardiac Immediately resume:
arrest treatment
CPR for 2 min CPR for 2 min
• Use ABCDE approach
Minimise interruptions • Controlled oxygenation and Minimise interruptions
ventilation
• Investigations
• Treat precipitating cause
• Temperature control
• Therapeutic hypothermia?
During CPR Reversible causes
• Ensure high-quality CPR: rate, depth, recoil • Hypoxia
• Plan actions before interrupting CPR • Hypovolaemia
• Give oxygen • Hypo-/hyperkalaemia/metabolic
• Vascular access (intravenous, intraosseous) • Hypothermia
• Give adrenaline every 3-5 min
• Tension pneumothorax
• Consider advanced airway and capnography
• Toxins
• Continuous chest compressions when advanced airway in place
• Tamponade - cardiac
• Correct reversible causes
• Thromboembolism
www.erc.edu | info@erc.edu
Published October 2010 by European Resuscitation Council Secretariat vzw, Drie Eikenstraat 661, 2650 Edegem, Belgium
Product reference: Poster_10_PALS_01_01_ENG Copyright European Resuscitation Council

9. european
resuscitation
council
At all stages ask: Do you need HELP? Newborn Life Support
Dry the baby Birth
Remove any wet towels and cover
Start the clock or note the time
Assess (tone), 30 sec
breathing and heart rate
If gasping or not breathing
Open the airway
Give 5 inflation breaths
Consider SpO2 monitoring 60 sec
Re-assess
If no increase in heart rate
Look for chest movement
If chest not moving Acceptable
pre-ductal SpO2
Recheck head position
2 min: 60%
Consider two-person airway control
3 min: 70%
or other airway manoeuvres
4 min: 80%
Repeat inflation breaths
Consider SpO2 monitoring 5 min: 85%
Look for a response 10 min: 90%
If no increase in heart rate
Look for chest movement
When the chest is moving
If the heart rate is not detectable or slow (< 60)
Start chest compressions
3 compressions to each breath
Reassess heart rate
every 30 seconds
If the heart rate is not detectable or slow (< 60)
Consider venous access and drugs
www.erc.edu | info@erc.edu
Published October 2010 by European Resuscitation Council Secretariat vzw, Drie Eikenstraat 661, 2650 Edegem, Belgium
Product reference: Poster_10_NLS_01_01_ENG Copyright European Resuscitation Council