Basic life support modifications

• Basic life support (BLS) should be initiated according to the guidelines (described in Chapter 5).

• Hypothermia slows breathing and causes peripheral vasoconstriction. For this reason breathing may be shallow and the pulse difficult to feel. It may be necessary to assess breathing and pulse for a period of 30-45 seconds to confirm arrest (AHA & ILCOR 2000).

• The ventilation : compression ratio (15: 2) should be the same as for casualties with a normal temperature. Hypothermia can make the chest wall feel stiff and ventilation and compressions more difficult. The lungs should be ventilated with enough volume to cause the chest to rise visibly. The rescuer should aim to achieve a compression depth of 4-5cm.

• BLS should continue until the casualty has been rewarmed.

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