Medical First Aid Guide


Basic life support comprises the ‘‘A-B-C” steps which concern the airway, breathing, and circulation respectively.

Basic life support is indicated for:

  • Airway obstruction
  • Breathing (respiratory) arrest
  • Circulatory or cardiac arrest.

Any inadequacy or absence of breathing or circulation must be determined immediately.

Assessment of breathing

  • Tilt the head firmly backwards with one hand while lifting the neck with the other hand to relieve obstructed breathing.
  • Pull the tongue forward.
  • Suck or swab out excess secretions.
  • Clean any vomit from the mouth and back of the throat. Remove any loose dentures.
  • Listen and feel for any movement of air, because the chest and abdomen may move in the presence of an obstructed airway, without moving air. The rescuer’s face should be placed close to the casualty’s nose and mouth so that any exhaled air may be felt against the cheek. Also the rise and fall of the chest can be observed and the exhaled breath heard.
  • Look, listen and feel for five seconds before deciding that breathing is absent.

Listen for breathing

Assessment of heart function

  • Check for a pulse. The best pulse to feel in an emergency is the carotid. Feel for five seconds before deciding it is absent. If it cannot be felt or is feeble, there is insufficient circulation.

Check for pulse

Full advice on CPR: see appendix 2.

Signs and symptoms Treatment
Breathing, heart is beating, unconscious
  • Place casualty in the recovery position. Recovery position
  • Remove any loose dentures.
  • Clean any vomit from the mouth and back of the throat.
Further advice on the unconscious casualty: see table 4.
  • Once a clear and open airway is established, insert a Guedel airway: see appendix 3. Guedel airway insertion
Not breathing but heart is beating
  • Begin artificial respiration; mouth-to-mouth or mouth-to-nose respiration Mouth-to-nose respiration
  • Give four quick breaths and continue at a rate of 12 inflations per minute.
  • Chest should rise and fall. If it does not, check to make sure the casualty’s airway is clear and open. Chest rise and fall
  • Do not use mouth-to-mouth respiration if the casualty was exposed to cyanides, organophosphates or radiation to prevent rescuer from being exposed. Respiration mask Meanwhile, install bag-valve-mask and oxygen supply for continued controlled ventilation. Give oxygen unless there is a danger of fire or explosion. Bag valve mask
Further advice on the oxygen administration: see table 3.
Breathing and heart have stopped
  • Begin CPR immediately. If possible, use two rescuers.
    Don’t delay. One rescuer can do the job.
    • Locate the pressure point (lower half of breast bone: about 4 cm from the tip of the breast bone).
    • Depress breast bone 4 to 5 cm (80 to 100 times per minute). Breast bone If one rescuer:
      15 heart compressions and 2 very quick lung inflations.
      If two rescuers:
      5 heart compressions and 1 lung inflation.

Table 1: Rescue

Table 3: Oxygen administration and controlled ventilation