Three Protocol Changes You Might See in Your BLS Class

Posted On: 2/22/2011 | By: Shannon Fern

If you are already certified in basic life support, or are thinking of taking a BLS class, you need to keep up to date with ongoing changes in basic life support (BLS) protocol. Every five years, the American Heart Association reviews and updates its standards for emergency care. Here are three key changes regarding BLS that have been made in the most recent round of revisions.

A-B-C to C-A-B

The “ABC’s of CPR” is a phrase previously used to note the recommended steps for CPR – airway, breathing and compression. The 2010 revisions for CPR suggest that a trained rescuer performing CPR on an adult or child victim should do chest compressions first, followed by opening the airway and rescue breathing.

The switch from A-B-C to C-A-B is due to the fact that chest compressions are the most critical part of CPR for victims of cardiac arrest. This change also makes it more likely that a bystander will be comfortable performing CPR, as opening the airway and performing rescue breathing are more difficult.

Frequency and depth of compression

Chest compressions help circulate blood, and therefore oxygen, to the brain and heart of a victim undergoing CPR. Protocol recommendations have been updated to ensure better chest compression technique.

It was previously recommended that a trained rescuer performing CPR do approximately 100 compressions per minute. The 2010 recommendations suggest that a rescuer do at least 100 compressions a minute. According to research, a higher compression rate typically leads to a higher survival rate of victims.

The new recommendations also suggest that chest compression depth should be at least two inches when performing CPR on an adult victim. This recommendation is due to the fact that CPR is often not performed with enough force to be effective.

Protocol for untrained bystanders

Previous BLS guidelines did not provide guidance on situations regarding untrained rescuers. The 2010 revisions have included recommendations for EMS dispatchers regarding how to direct a bystander to perform CPR.

According to the 2010 guidelines, if a bystander is not trained in CPR, he or she can provide compression-only CPR for an adult cardiac arrest victim, as directed by an EMS dispatcher.

In cases of asphyxia arrest, EMS dispatchers should provide instructions for an untrained rescuer to perform conventional CPR rather than compression-only.

Health Education Solutions provides BLS classes

Health Education Solutions (HES) offers training courses targeting professional healthcare providers, including an online BLS class, as well as ACLS, PALS, first aid, CPR and AED certification courses. If you also need to complete an ACLS exam or PALS exam for certifications, visit

Topics:  2010 Guidelines  |  BLS  |  Certifications  |