Crisis Nursing: Using BLS in the Workplace to Save Lives

In the fast-paced world of healthcare, every second counts, especially during a crisis. Basic Life Support (BLS) is a critical skill set that nurses must master to provide immediate care and increase the chances of survival for patients in life-threatening situations. This blog delves into the significance of BLS in the workplace, illustrating its vital role through real-life scenarios, detailed instructions, and tips for effective implementation.

Understanding Basic Life Support (BLS)

Basic Life Support (BLS) is a foundational medical skill set designed to provide immediate assistance to individuals experiencing cardiac arrest, respiratory distress, or airway obstruction. BLS involves several key components:

• Chest Compressions: These are performed to manually pump the heart, maintaining circulation of blood to the brain and vital organs.

• Rescue Breathing: Also known as mouth-to-mouth resuscitation, this technique provides oxygen to the lungs of the person who has stopped breathing.

• Automated External Defibrillator (AED) Use: AEDs are used to deliver an electric shock to the heart, helping to restore a normal heart rhythm in cases of cardiac arrest.

The effectiveness of BLS is maximized when these components are executed promptly and correctly, forming what is known as the Chain of Survival. This chain includes early recognition of the emergency, immediate activation of emergency medical services (EMS), early CPR, rapid defibrillation, effective advanced life support, and integrated post-cardiac arrest care.

Real-Life Scenarios Where BLS is Crucial

BLS is not just a theoretical concept; it is a lifesaving practice that has proven its worth in countless real-life scenarios. Here are some examples:

• Hospital Emergency Room: A nurse in an ER setting witnesses a patient collapse due to sudden cardiac arrest. The nurse immediately initiates BLS, performing chest compressions and using an AED until the arrival of the advanced cardiac life support (ACLS) team, significantly increasing the patient’s chances of survival.

• Nursing Home: An elderly resident chokes on food during dinner. Quick intervention by a trained nurse who performs abdominal thrusts and rescue breathing prevents the situation from escalating to a full-blown cardiac arrest.

• Pediatric Clinic: A child experiencing a severe asthma attack stops breathing. The quick actions of the clinic nurse, who performs rescue breathing and chest compressions, keep the child stable until emergency services arrive.

These scenarios highlight the importance of BLS skills across various healthcare settings, demonstrating how immediate and effective response can make the difference between life and death.

Steps to Perform BLS in the Workplace

Performing BLS requires precision and calmness under pressure. Here are the detailed steps for performing BLS on adults, children, and infants:

• For Adults:

1. Check Responsiveness: Shake the person and shout to see if they respond.
2. Call for Help: If there is no response, call for emergency medical services and get an AED if available.
3. Check Breathing and Pulse: Look for normal breathing and check for a pulse for no more than 10 seconds.
4. Start Chest Compressions: If no pulse is detected, start chest compressions at a rate of 100-120 compressions per minute, pressing down at least 2 inches deep on the center of the chest.
5. Provide Rescue Breaths: After 30 compressions, give 2 rescue breaths by tilting the head back, lifting the chin, and blowing into the mouth while pinching the nose.
6. Use an AED: As soon as the AED arrives, turn it on and follow the voice prompts. Continue CPR until EMS takes over or the person shows signs of life.

• For Children (1 to Puberty):

1. Check Responsiveness: Tap the child and shout to get a response.
2. Call for Help: If unresponsive, call for emergency medical services and get an AED.
3. Check Breathing and Pulse: Check for normal breathing and a pulse for no more than 10 seconds.
4. Start Chest Compressions: If no pulse or if the pulse is less than 60 beats per minute with signs of poor perfusion, start chest compressions. Use one hand for smaller children and compress at least one-third the depth of the chest, at a rate of 100-120 compressions per minute.
5. Provide Rescue Breaths: After 30 compressions, give 2 breaths using the head-tilt/chin-lift technique.
6. Use an AED: Apply the AED as soon as it arrives, using pediatric pads if available.

• For Infants (0 to 12 Months):

1. Check Responsiveness: Gently tap the infant’s foot and look for a response.
2. Call for Help: If there is no response, call for emergency medical services.
3. Check Breathing and Pulse: Check for breathing and feel for the brachial pulse on the inside of the upper arm for no more than 10 seconds.
4. Start Chest Compressions: If no pulse or if the pulse is less than 60 beats per minute, begin chest compressions using two fingers, compressing about 1.5 inches deep at a rate of 100-120 compressions per minute.
5. Provide Rescue Breaths: After 30 compressions, give 2 gentle breaths, covering the infant’s mouth and nose with your mouth.
6. Use an AED: If an AED is available, use it with pediatric settings and pads.

Training and Certification for Nurses

Training and certification in BLS are essential for nurses to ensure they can respond effectively in emergencies. Here’s what you need to know about BLS certification:

• Certification Process:

1. Enroll in a BLS Course: Nurses can find BLS courses through hospitals, local health organizations, or online platforms like Medicus Training.
2. Complete the Training: The course typically includes a mix of theoretical lessons and hands-on practice. Nurses will learn how to perform chest compressions, use an AED, and provide rescue breaths.
3. Pass the Exam: After completing the training, participants must pass a written exam and a skills test to demonstrate their competence.
4. Receive Certification: Upon successful completion, nurses receive a BLS certification card, valid for two years.

• Recertification:

1. BLS certification needs to be renewed every two years to ensure skills remain current and aligned with the latest guidelines.
2. Recertification courses are often shorter than the initial certification and focus on updating knowledge and skills based on recent changes in BLS guidelines.

• Resources for BLS Training:

1. Medicus Training: Offers comprehensive BLS courses with flexible online and in-person options.
2. American Heart Association (AHA): Provides accredited BLS courses and certification.
3. Local Health Institutions: Many hospitals and clinics offer BLS training sessions for their staff.

Regular training and certification not only ensure that nurses are prepared to handle emergencies but also boost their confidence in performing BLS effectively.

Challenges and Tips for Performing BLS in Crisis Situations

Performing BLS in a crisis can be challenging due to the high-stress environment. Here are some common challenges and tips for overcoming them:

• Challenges:

1. High Stress and Pressure: The urgency of the situation can cause stress, potentially leading to mistakes.
2. Physical Demands: Performing continuous chest compressions can be physically exhausting, especially in extended resuscitation efforts.
3. Emotional Impact: Witnessing a person in critical condition can be emotionally overwhelming.

• Tips for Overcoming Challenges:

1. Practice Regularly: Regular practice through simulations and drills can help nurses maintain their skills and stay prepared.
2. Work as a Team: Effective communication and teamwork can distribute the workload and ensure all steps are performed accurately.
3. Stay Calm: Taking deep breaths and focusing on the task at hand can help manage stress.
4. Use Proper Techniques: Ensuring proper body mechanics and compression techniques can reduce physical strain.
5. Debrief After Incidents: Discussing the event with colleagues and seeking support can help manage emotional impact and improve future performance.

By addressing these challenges proactively, nurses can enhance their ability to perform BLS effectively, even in the most stressful situations.

Mental and Emotional Aspects of Performing BLS

The mental and emotional toll of performing BLS can be significant, especially in critical and high-stress situations. Here’s how nurses can manage these aspects:

• Mental Preparation:

1. Training and Simulation: Regular training sessions and simulations can mentally prepare nurses for real-life scenarios, reducing anxiety when faced with actual emergencies.
2. Mindfulness and Stress-Reduction Techniques: Practices such as mindfulness, deep breathing exercises, and meditation can help nurses maintain mental clarity and focus during emergencies.

• Emotional Support:

1. Peer Support: Engaging with colleagues for support and sharing experiences can provide emotional relief and foster a supportive work environment.
2. Professional Counseling: Access to professional counseling services can help nurses process their experiences and manage the emotional impact of performing BLS.
3. Self-Care: Nurses should prioritize self-care activities such as exercise, hobbies, and adequate rest to maintain emotional well-being.

By addressing the mental and emotional aspects, nurses can enhance their resilience and ability to perform BLS under pressure, ensuring they provide the best possible care to their patients.

Regulatory Changes and Compliance in BLS

Keeping up with regulatory changes and compliance is crucial for maintaining effective BLS practices in the workplace. Here’s what nurses need to know:

• Updates in Guidelines:

1. 2020 BLS Guidelines Changes: The International Liaison Committee on Resuscitation (ILCOR) updates BLS guidelines approximately every five years. The 2020 guidelines emphasize early initiation of CPR, the addition of a sixth link (recovery) in the Chains of Survival, and the importance of post-resuscitation care .
2. Specific Changes: Increased focus on the importance of high-quality CPR, the addition of recovery as a vital component, and updated practices for managing cardiac arrest in pregnant women.

• Compliance Requirements:

1. Certification and Recertification: Nurses must stay up-to-date with their BLS certification and recertification, ensuring they are trained according to the latest guidelines.
2. Documentation and Record-Keeping: Proper documentation of BLS training, certification, and recertification is essential for compliance with healthcare regulations and institutional policies.

Staying informed about regulatory changes and maintaining compliance ensures that nurses are equipped with the latest knowledge and skills to provide the best possible care.

Emerging Technologies in BLS

Technology continues to evolve, enhancing the effectiveness of BLS. Here are some emerging technologies that are transforming BLS training and practice:

• Simulation-Based Training:

1. High-Fidelity Manikins: Advanced manikins simulate realistic scenarios, providing nurses with hands-on practice in a controlled environment.
2. Virtual Reality (VR): VR platforms offer immersive training experiences, allowing nurses to practice BLS in various simulated settings.

• Automated External Defibrillators (AEDs):

1. Smart AEDs: Modern AEDs come equipped with features like real-time feedback, voice prompts, and data recording, improving the efficiency and effectiveness of defibrillation.
2. Mobile AED Apps: Apps that locate the nearest AED and provide step-by-step instructions for use are becoming more common, ensuring quick access and proper use of these devices.

• Mobile Applications and Digital Resources:

1. BLS Training Apps: Apps like Medicode and CertAlert+ provide easy access to BLS algorithms, reminders for certification renewal, and other valuable resources.
2. Online Learning Platforms: Digital platforms offer flexible BLS training and recertification options, making it easier for nurses to stay current with their skills.

Embracing these technologies can significantly enhance BLS training and practice, ensuring that nurses are always prepared to respond effectively in emergencies.

Inspiring Stories and Successes in BLS

Real-life stories of nurses successfully performing BLS can inspire and motivate others in the profession. Here are a few inspiring anecdotes:

• Nurse Saves Colleague:

During a busy shift, a nurse noticed a colleague collapse due to a sudden cardiac arrest. Thanks to her BLS training, she quickly performed CPR and used an AED, reviving her colleague before the EMS team arrived. This incident underscored the importance of being prepared to save lives at any moment.

• Child’s Life Saved at School:

A school nurse performed BLS on a student who suffered a severe asthma attack and stopped breathing. Her prompt action and adherence to BLS protocols ensured the child was stabilized and transported to the hospital for further care.

• Community Hero:

A nurse out for a jog came across a jogger who had collapsed. Without hesitation, she performed chest compressions and rescue breathing until help arrived. Her quick thinking and BLS skills made all the difference in saving a life outside the hospital setting.

These stories highlight the real-world impact of BLS training and the difference it can make in various settings. They also serve as a reminder of the profound responsibility and potential that comes with being a healthcare professional.

To Summarize

Basic Life Support (BLS) is an essential skill that every nurse must master to provide immediate, life-saving care in emergencies. From understanding the fundamental components of BLS to staying updated with the latest guidelines and embracing new technologies, nurses play a crucial role in the Chain of Survival. By sharing inspiring stories and practical tips, we can continue to motivate and equip nurses to perform BLS effectively, ultimately saving more lives in the workplace.