Which Survey Should You Use?

For unconscious patients in cardiac or respiratory arrest, start with the BLS survey before beginning the ACLS survey

BLS Survey

1. Check for responsiveness and breathing
   1. Shake and shout, “Are you okay?”
2. Get help
   1. Use your cell phone if you have one to call 911/EMS
   2. Get others to help, have them get Automated External Defibrillator (AED)
   3. If you are alone with no cell phone, leave victim to activate EMS
3. Check breathing and pulse
   1. Scan chest for 5-10 seconds for chest rise
   2. Agonalor shallow short breathing is ABNORMAL!!!!
   3. Check carotid pulse for no more than 10 seconds
   4. Both pulse and breath checks can be done simultaneously within 10 seconds
   5. If no pulse, start chest compressions
   6. If pulse, start rescue breathing

ACLS Survey

1. Airway
2. Breathing
3. Circulation
4. Defibrillation
5. Exposure

Airway

• Keep the airway open
• Use head tilt-chin lift (or jaw thrust if there is suspected neck injury)
• Use bag valve mask when available
• Use advanced airways as needed
• Remember to verify the placement of advanced airways and secure them in place

Breathing

• Monitor quality of ventilation and oxygenation
  • Use waveform capnography when available
  • Check chest rise and avoid cyanosis
• Give supplemental oxygen
  • Cardiac arrest patients: give 100% oxygen
  • Goal for other patients: keep pulse oximetry ≥94%
• Avoid excessive ventilation

Circulation

• Monitor CPR quality of ventilation and oxygenation
  • Use waveform capnography when available
    • If end-tidal CO₂<10 mmHg, CPR is inadequate
  • Use arterial linewhen available
• Give supplemental oxygen
  • Cardiac arrest patients: give 100% oxygen
  • Goal for other patients: keep pulse oximetry ≥94%

• Obtain IV/IO access for drug administration

Disability

• Check brain function
  • Alert
  • Voice
  • Painful
  • Unresponsive

Exposure

• Remove clothing
• Look for obvious trauma/bleeding/burn