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    Basic Life Support for Healthcare Providers

    Dr. Mary Williams, RN, DC

    About the author

    Dr. Mary Williams, RN, DC
     

    Dr. Mary Williams, R.N., D.C is a Doctor of Chiropractic with an extensive background as a Registered Nurse and experienced Core Instructor for the American Heart Association. She has over 30 years of hands-on medical and instructional experience.

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    Many people who work in the healthcare field—or who may be the first on the scene of an accident—need a higher level of CPR training for healthcare providers.

    The American Heart Association, the Red Cross, and many other providers offer CPR training at this level—and it’s often called “BLS” rather than “CPR” training. That’s because this level of training is more in-depth, and includes CPR but may not be limited to it.

    However, some providers continue to refer to these classes as CPR training for healthcare professionals—which can lead to some confusion.

    What is basic life support?

    There’s a bit of confusion surrounding what we call CPR certification for healthcare providers, rather than the lay public.

    The term “basic life support” is typically used to refer to a range of non-invasive emergency measures taken to save a patient’s life. These include but are not limited to CPR, stabilizing bone fractures, immobilization of the spine, bleeding control, and basic first aid. So that’s confusing.

    Another confusing factor is that in the UK, the term “BLS” is used to refer to CPR training much more generally—not just to a level reserved for healthcare providers.

    No matter what it’s called, though, these classes for healthcare providers focus on training professional medical providers to deliver emergency care for cardiac and respiratory crises in adults, children, and infants.

    These are some of the most deadly sudden health crises a patient can face. And at the healthcare-provider level, classes focus on a team-based response, critical thinking and problem solving in emergency situations, and real-life, case-based scenarios to help students understand how to deliver this care both inside and outside the hospital.

    What does “for healthcare providers” mean?

    It doesn’t matter whether the course you’re considering taking is called CPR or BLS—as long as it teaches you the skills you need to deliver CPR on a professional level.

    BLS programs for healthcare providers teach the same skills you’d learn in a CPR class, but at a deeper level. They also focus more on delivering care as part of a team, rather than working on your own. Some of the things you can expect to learn include:

    • CPR (delivered singly and as part of a team)
    • Use of an AED
    • How to conduct a primary assessment
    • Advanced airway management
    • How to use an Ambu Bag
    • First aid for choking in conscious and unconscious victims
    • Child and infant CPR

    Not every program is the same—there is no national regulatory or certifying body that governs CPR and BLS classes. However, classes that follow the American Heart Association guidelines should offer similar content. 

    What are the steps for basic life support?

    When you’re responding to a medical emergency, you may find yourself treating a victim of heart attack, cardiac arrest, respiratory issues, drug overdose, a major accident, or any other illness or injury. 

    Many aspects of basic life support are appropriate for some situations and not others—but there are some high-level steps that should be performed in almost any emergency situation. These include:

    • Perform a primary assessment of the scene

    It’s crucial, as an emergency rescuer, that you have the ability to size up a situation quickly and effectively. Things you should take into account include:

    • Unsafe conditions. Do you see downed electrical lines? Traffic? Is anything on fire? Are there any other immediate dangers?
    • What you’re wearing. Do you have any personal protective equipment? Goggles? Rubber gloves? Are you risking exposure to pathogens?
    • Number and state of the patients. How many people are sick or injured? Do they look sick? Is there bleeding? Is anyone unconscious?
    • Other people on the scene. Is there anyone else on the scene who can help? A layperson or someone with medical knowledge? Do you need them to call 911?
    • Assess the patient

    Once you understand the general situation, you’ll need to assess the patient’s health. While your actions may vary depending on the nature of the illness or injury, most assessments start with these steps:

    • Check the patient’s consciousness. Are they alert, confused, or completely unconscious?
    • Check their breathing and pulse.
    • Provide emergency care

    This is where your training comes in. With BLS training, you may find yourself delivering CPR either alone or with a team, providing rescue breaths, using an AED, or dealing with an obstructed airway. Some BLS courses also provide in-depth first aid training.

    What other topics may be covered?

    In addition to in-depth rescuer CPR for adults, children and infants, a BLS certification course for healthcare providers may include some other detailed topics not present in your typical CPR course. Here’s an overview of what you can expect to learn.

    Personal Protective Equipment

    Personal Protective Equipment (PPE) is equipment and clothing that protects you from coming into contact with infectious materials and bodily fluids.

    PPE may include eye protection, gowns, masks, aprons, lab coats, clinic jacket, gloves, and other items. Rules for using PPE effectively include:

    • All PPE must be suited to the task.
    • You should use PPE every time you are in a situation where you may be exposed to pathogens.
    • Before donning PPE, always double check for damage.
    • Take off your PPE before leaving your work area.
    • Be surse to remove it in the right order: first your gown and other clothing, then your gloves.

    Universal Standard Precautions

    Some online BLS certification courses include bloodborne pathogens certification (ours does). As part of this training, you may learn the Universal Standard Precautions for dealing with bloodborne pathogens.

    These are a simple set of practices that protect both healthcare employees and patients from various pathogens, in an environment where exposure is possible. Some of the important components of Universal Standard Precautions include:

    • Washing your hands with soap and water for 40-60 seconds after having direct contact with patients.
    • Rub alcohol-based disinfectant into your hands for 20-30 seconds at the point of care, if you have the supplies.
    • These two steps both fall under “hand hygiene.” Hand hygiene should be performed both before and after patient contact, whether you’re wearing gloves or not.
    • Needles and sharps should be properly collected and stored.
    • Always wear gloves when expecting to come into contact with broken skin, bodily fluids or mucus membranes.
    • Always wear PPE such as mask, gown and eye protection if you are in a situation where you might be splashed by blood or other bodily fluids.
    • Cover cuts and abrasions with a waterproof dressing.
    • Always clean up spills of blood and other bodily fluids promptly and according to disinfecting guidelines.
    • Use a safe and effective system to manage and dispose of hospital waste.

    Allergic Reactions

    Many BLS courses for healthcare providers teach students to deal with severe allergic reactions. Mild allergic reactions can be managed with medication or simply removing or getting away from the allergen, but even a mild allergic reaction can suddenly and unexpectedly turn severe.

    Severe allergy reactions include difficulty breathing, swelling around the face and tongue, and classic signs of shock: a rapid pulse and cold, sweaty, pale skin.

    Most people who have a serious allergy carry an EpiPen with them at all times. This can be injected through clothing into the outer thigh, about halfway between hip and knee.

    Here’s how to administer an EpiPen:

    • Remove the safety cap on the pen and follow any instructions.
    • Hold the EpiPen in the middle without touching it at either end. One side will have a needle.
    • Push the needle side hard into the person’s thigh, through cloth or bare skin.
    • Hold in place for 10 seconds, then pull it straight out of the patient’s leg.
    • Rub the injection site for 15 seconds. Take note of the time you gave the injection.

    The EpiPen should kick in within 15 seconds to a few minutes. If the first dose doesn't have an effect, try a second dose. Call for emergency help.

    First Aid for a Heart Attack

    Many BLS certification programs include emergency treatment for heart attacks. Signs include:

    • Chest pain that lasts more than a few minutes, or that goes in and out. The feeling of pain or discomfort may include sensations of pressure, fullness, or squeezing.
    • Cold sweats, light-headedness and nausea.
    • Discomfort in the shoulder, jaw, neck, or upper back.

    If you suspect a heart attack, it’s important to call an ambulance right away. Stay with the person while rescuers arrive, keep them calm and encourage them to sit or lie down. In the absence of bleeding disorders, aspirin allergies or symptoms of stroke, you can offer the person one or two low-dose aspirins and have them chew it.

    Signs of Stroke

    As a BLS-certified healthcare provider, you may be called upon to treat someone with a stroke. Strokes happen when the blood flow to the brain is interrupted, due to a blocked or bleeding blood vessel.

    It’s crucial that a patient experiencing a stroke receives help within the first hour. Some key signs of stroke include: 

    • Sudden weakness or a numb feeling in the arm, leg or face, particularly concentrated on one side
    • Cognitive confusion; trouble speaking or understanding
    • Sudden difficulty seeing in one or both eyes
    • Dizziness, loss of balance and coordination
    • Sudden severe headache

    How to Treat a Seizure

    Seizures involve abnormal electrical activity in the brain. Most last only a few seconds to a few minutes, but some can last longer.

    Epilepsy, head injury, heat stroke, certain poisons, and low blood sugar may all be causes of seizure. If you see a person experiencing a seizure, you should:

    • Ensure the scene is safe
    • Move furniture and other hard objects away from the patient.
    • Do not stick your fingers into the patient’s mouth.
    • Call or have someone call emergency services.
    • Note the time, onset and duration of the seizure. 

    After the seizure, stay with the person and help them recover. Offer water if needed. If there is no head, neck or spine injury and they are vomiting or have increased saliva, help them roll onto their side to recover.

    Who needs BLS certification for healthcare providers?

    You probably don’t need this level of training if you’re a layperson. You need it if you’re going to use CPR in a professional setting.

    The professions that most commonly need BLS for healthcare providers include:

    • Doctors, nurses, and medical personnel
    • Emergency responders
    • Firefighters
    • Police officers
    • Lifeguards
    • Nursing home employees

    However, we’re also starting to see other employers requiring their employees to have a higher level of CPR certification. If you’re in one of the following professions, your employer might also want you to get this type of certification:

    • Teachers and coaches
    • Daycare providers
    • Camp counselors
    • Bus drivers
    • Safety managers
    • Anyone who works in a high-risk environment

     The bottom line is that, depending on the provider, the class you need may be called CPR or BLS. But if you’re in the United States, “BLS” is more likely to be used for a higher-level class, while “CPR” may be used more generally for both.

    When in doubt, go with the BLS certification—as chances are it’s the more in-depth option. You’ll never get penalized by your employer for having a higher level of certification than they need. If you don’t want to leave it to chance, however, it’s a good idea to call the provider to find out what’s taught in the class you’re considering.

    Our BLS certification course provides training in the advanced CPR techniques you need to know as a healthcare provider—as well as training in topics such as basic life support for stroke, shock, drowning, and drug overdoses; comprehensive first aid; and reducing the risk of bloodborne pathogen exposure.

    Click here /courses/bls-certification for more information or to sign up.


    Sources

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