Basic Life Support- Adult

BLS Adult Opener

This module describes how to resuscitate an adult patient in cardiac arrest using a simple algorithmic approach.


  1. Unresponsive patient

  1. None for the assessing the patient, but whether to proceed with resuscitation may be subject to patient consent directives

In unresponsive patients, consent is generally implied.

(DNR) orders, “Not For Max” orders, or living wills that specify that no resuscitation may be performed take precedence.


Basic Life Support is an emergency procedure. Always:

  1. If outside the hospital, carry gloves and a CPR protective device you can use in an emergency.
  2. In public places such as airports and malls, look out for AEDs and first aid stations attached to walls.
  3. Memorise emergency phone numbers, or keep them on your cell phone, so you can call for help.
  4. In the hospital, be aware of where the defibrillators and red trolleys are kept. Know the staff in the department. Keep your seniors’ contact details close at hand.
  5. Keep unstable patients in resuscitation bays with continuous monitoring.

The patient should be lying flat on their back on a

. There should be space behind the head of the bed for staff to stand. Staff performing chest compressions should stand on a step or kneel on the bed.


Use medical asepsis with non-sterile gloves.

I don’t have a CPR protective device for mouth-to-mouth breaths.

Give hands-only CPR (continuous compressions without breaths) until equipment such as a BVM resuscitator arrives.

I’m unsure about the quality of my chest compressions.

Check the following:

  1. Centre compressions on the lower half of the sternum, compressing ⅓ of the depth of the chest.
  2. Ensure good chest recoil (don’t lean on the chest between compressions).
  3. Your shoulders should be directly above your hands, elbows straight.
  4. Stand on a step or kneel on the bed so that your hips are higher than the patient’s chest.
  5. Minimise interruptions.
  6. Change chest compressors every 2 min to avoid fatigue.

I’m unsure about the quality of my rescue breaths.

Ensure correct head position. Consider using an oropharyngeal or nasopharyngeal airway. Ensure that you are pulling the face into the mask using an EC grip, rather than leaning on the patient’s face. Continuously monitor chest rise.

My patient is moving but I still can’t find a pulse.

Patients in cardiac arrest may have movements such as twitching or writhing. If there is no pulse and the patient is not responding to your prompts, continue CPR.

I heard something crack under my hands.

Rib and sternal fractures are not uncommon. Continue CPR, but ensure your hand placement is correct.


  1. Unsuccessful CPR
  2. Bruising
  3. Rib/sternal fractures
  4. Pneumothorax
  5. Defibrillator burns
  6. Healthcare worker exposure to infectious substances

  1. Resuscitation Council of Southern Africa. Basic Life Support Algorithm. 2021.
  2. McQuoid-Mason DJ. Emergency medical treatment and 'do not resuscitate' orders: when can they be used?. S Afr Med J. 2013;103(4):223-225. Published 2013 Jan 23. doi:10.7196/samj.6672