Resuscitation Council (UK)
RESUSCITATION GUIDELINES 2005
Adult Basic Life Support
This section contains the guidelines for out-of-hospital, single rescuer, adult basic
life support (BLS). Like the other guidelines in this publication, it is based on the
document 2005 International Consensus on Cardiopulmonary Resuscitation and
Emergency Cardiovascular Care Science with Treatment Recommendations
(CoSTR), which was published in November 2005. Basic life support implies that
no equipment is employed other than a protective device.
There are two main underlying themes in the BLS section of CoSTR: the need to
increase the number of chest compressions given to a victim of cardiac arrest,
and the importance of simplifying guidelines to aid acquisition and retention of
BLS skills, particularly for laypersons.
It is well documented that interruptions in chest compression are common1 and
are associated with a reduced chance of survival for the victim.2 The ‘perfect’
solution is to deliver continuous compressions whilst giving ventilations
independently. This is possible when the victim has an advanced airway in
place, and is discussed in the adult advanced life support (ALS) section. Chest-
compression-only CPR is another way to increase the number of compressions
given and will, by definition, eliminate pauses. It is effective for a limited period
only (about 5 min) 3 and is not recommended as standard management of out-of-
hospital cardiac arrest.
The following changes in the BLS guidelines have been made to reflect the
greater importance placed on chest compression, and to attempt to reduce the
number and duration of pauses:
1) Make a diagnosis of cardiac arrest if a victim is unresponsive and not
2) Teach rescuers to place their hands in the centre of the chest, rather than to
spend more time using the ‘rib margin’ method.
3) Give each rescue breath over 1 sec rather than 2 sec.
4) Use a ratio of compressi