What is Basic life support?


Basic life support (BLS) is the provision of initial care for an illness or injury, commonly known as first aid. First aid is usually performed by a non-expert person to a sick or injured person until definitive medical treatment can be accessed. Certain self-limiting illnesses or minor injuries may not require further medical care past the first aid intervention. First aid generally consists of a series of simple and in some cases, potentially life-saving techniques that an individual can be trained to perform with minimal equipment.



Why do we provide initial care for illness or injury?


The key aims of first aid can be summarized in three key points:

  • Preserve life - the overriding aim of all medical care, including first aid, is to save lives
  • Prevent further harm - also sometimes called prevent the condition from worsening, this covers both external factors, such as moving a patient away from any cause of harm, and applying first aid techniques to prevent worsening of the condition, such as applying pressure to stop a bleed becoming dangerous.
  • Promote recovery - first aid also involves trying to start the recovery process from the illness or injury, and in some cases might involve completing a treatment, such as in the case of applying a plaster to a small wound

Do you require any skills to perform BLS?

Yes. However you don’t have to go to the medical school to know these skills. Any person can be trained and perform these skills. Certain skills are considered essential to the provision of first aid and are taught ubiquitously. Particularly the "ABC"s of Cardiopulmonary resuscitation (CPR), which focuses on critical life-saving intervention, must be rendered before treatment of less serious injuries. ABC stands for Airway, Breathing, and Circulation. In other school of thought there is an addition of fourth step of "D" for Deadly bleeding or Defibrillation, while others consider this as part of the Circulation step. Variations on techniques to evaluate and maintain the ABCs depend on the skill level of the first aider. Once the ABCs are secured, first aiders can begin additional treatments, as required.

What is CPR?

CPR stands for cardiopulmonary resuscitation (cardio- means heart, pulmonary means lungs), is an emergency procedure which is attempted in an effort to return life to a person in cardiac arrest (cessation of normal circulation of the blood due to failure of the heart to contract effectively). It is indicated in those who are unresponsive with no breathing or only gasps. It may be attempted both in and outside of a hospital.

CPR involves chest compressions at a rate of at least 100 per minute in an effort to create artificial circulation by manually pumping blood to the heart, brain and other vital organs. In addition the rescuer may provide breaths by either exhaling into their mouth (mouth-to-mouth breathing) or utilizing a device (mouth piece) that pushes air into the lungs. The process of externally providing ventilation is termed artificial respiration. Mouth-to-mouth breathing is a quick, effective way to provide oxygen to the victim.

Current recommendations place emphasis on high quality chest compressions over artificial respirations and a method involving only chest compressions is recommended for untrained rescuers. The victim should be laid on a hard surface for maximum efficiency of chest compressions. Compression-ventilation ratio for the lone rescue should be 30 compressions to 2 breaths.

Two rescuers should use a ratio of 15 compressions to 2 breaths for both adults and infants.

If the victim becomes responsive, s/he should be laid on recovery position.

Besides provision of basic life support to unresponsive victim, there are other conditions which require first aid. These include Choking, Bleeding, Fever, Burns, Snake /poisonous bites and fractures.

What is chocking?

Chocking occurs when there is a foreign-body airway obstruction. Early recognition of airway obstruction is the key to successful outcome. The signs of airway obstruction may range from weak ineffective cough, high-pitched noise, increased respiratory difficulty, unable to speak and unable to move air. The public should use the universal sign to indicate the need for help when chocking and this involves clutching the neck with the thumb and fingers.

Relief of chocking involves the use of abdominal thrusts commonly known as the Heimlich maneuver.

This can be used in both adults and children. However the Heimlich maneuver is not used to relieve choking in infants. The relief of chocking in infants is done by back slaps and chest thrust as shown in the figure below.

If the chocking individual becomes unresponsive, the rescuer should perform CPR.

What is bleeding and its first aid?

Bleeding occurs when there is loss of certain amount of blood. Severe bleeding refers when there is large volume of blood lost. Bleeding can be caused by many things, for instance cuts, injuries like scalp wound, tooth extraction, accidents/falls etc.

The first aid for a bleeding person, depending on the type and site of bleeding, involves resting/lying down, slightly elevate legs, if possible elevate the affected area, remove any visible debris and using a clean cloth, apply a direct pressure on the wound/bleeding site. Apply pressure continuously for about 20 minutes and seek medical attention.

What are burns?

Burns can result from dry heat (fire), moist heat (steam, hot liquids), electricity, chemicals, or from radiation, including sunlight. The longer the skin is exposed to the burn source, the worse the burn can be.

Classification of burns

First-degree burns affect only the outer skin layer. The skin area appears dry, red, and mildly swollen. First-degree burns are painful and sensitive to touch. They should feel better in 1 to 2 days. They heal in about a week.

Second-degree burns affect the skin's outer and lower layers. The skin is painful, swollen, red, and has blisters. The skin also has a weepy, watery surface.


Third-degree burns affect the outer and deeper skin layers and organs below the skin. The skin appears black-and-white and charred. It swells. Tissue under the skin is often exposed. Third-degree burns may have less pain than first-degree or second-degree burns. Why? No pain is felt where nerve endings are destroyed. Pain may be felt around the margin of the burn, though.

For Severe Burns before Emergency Care
Remove the person from the source of heat. Keep the person's airway open. Remove hot or burned clothes that come off easily, not if they are stuck to the skin. Cover the burns loosely with clean cloths. Use direct pressure to control bleeding. Don't rub.


For First-Degree and Second-Degree Burns
Use cold water or cloths soaked in cold water on burned areas for 15 minutes or until the pain subsides. Do not use ice at all. Doing this could result in frostbite.

Cover the area loosely with a dry clean cloth, such as sterile gauze. Hold it in place by taping only the edges of the gauze. Don't use ointments. Aloe vera can be applied over closed skin 3 to 4 times a day. Don't break blisters. If they break on their own, apply an antibacterial spray or ointment or treatment prescribed by your doctor. Keep the area loosely covered with a sterile dressing.

Snake / poisonous bites

There are different types of snakes poisons which depend on the toxins released from different types

of snakes. Snake venoms are either hemotoxic (causing damage to blood and other tissues)

or neurotoxic (causing damage to nerves).

The pit vipers, with the exception of some Mojave rattlesnakes, have hemotoxic venom.

The extremely potent venom of the Mojave rattlesnake has neurotoxic activity.

Coral snakes and black mamba also have neurotoxin venom.

Symptoms of snake bites are dependent upon the type and size of the snake, the location of the bite on the body,

 and the age, size, and health of the victim.


Children are more likely to have severe symptoms because they receive a larger concentration

of venom due to their smaller body size. Also, not all snake bites involve the discharge of venom into

the victim (known as evenomation). At least 25% of poisonous snake bites do not result in evenomation.

Intense pain usually results at the site within five minutes of the bite, and swelling is common.

Other symptoms that may result from pit viper hemotoxin include: weakness, rapid pulse, numbness, tingling

Sensation, bruising, vomiting, paralysis, decrease in reflex,confusion and an unusual metallic taste.

Bites from snakes such as coral snakes and their exotic relatives whose venom is neurotoxic may result in

minimal pain and no visible marks on the skin. Instead of pain and swelling, these bites often cause

local numbness as well.

If someone is bitten by a poisonous snake, the bitten area should be immobilized and the victim transported to a hospital as quickly as possible. The bitten area should be washed with soap and water. A wide constriction bandage (tourniquet) may be applied two to four inches upstream of the bitten area (if on an extremity) so long as the pressure is not too tight (one or two fingers should be able to slide under the band). Overly tight tourniquets should never be used as these can block arterial blood flow to the affected area and worsen tissue damage.

Incising (cutting) and suctioning the bite area has not been shown to be beneficial, but a venom extractor (found in commercial snake bite kits) may be helpful if it is applied to the area within five minutes of the bite and left in place for 30 minutes. Ice or cooling packs should never be applied to the area as these may result in greater harm, and incisions of the bitten area are also potentially harmful and have no benefit.

Most importantly, any victim of a venomous snake bite should be evaluated in an emergency medical care facility as soon as possible.

What is fever and its first aid?

Fever means a state of higher-than-normal body temperature. The normal body temperature is 37.0ºC. Fever indicates abnormal process in the body and when it is high, it can be life threatening, requiring more attention. Fever can be confirmed by the use of thermometer although sometimes feeling ones temperature by use of the hand can be applied. Causes of fever can be bacterial and viral infections, dehydration, childhood immunization etc. In most of the areas in Tanzania, the term ‘fever’ is misunderstood and used synonymously to mean malaria disease.

Although there are medications which usually lower the fever, there are other measures there can be taken so as reduce the body temperature of the victim. These include removing the excess clothing on the victim, sponging the body by luke warm water and provision of plenty of drinking fluids.








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