Cardio PulmonaryResuscitation

AHA New Guidelines 2010 for CPR

C.P.R.

•CARDIO = Heart•PULMONARY = Lung•RESUSCITATION = Revival

sudden cardiac arrest• EMS treats nearly 300,000 out of hospital

cardiac arrest each year in the U.S.• Less than 8 percent of people who suffer

cardiac arrest outside of the hospital survive to make it home from the hospital.

• Nationally, only 20 % get bystander help• Locally, 50 % receive help

CPR facts• 500,000 deaths a year due to cardiac arrest• 250,000 will die before they reach the hospital• 50% show up by private car to the hospital• Avg. person waits 2 hours before seeking help – are

more likely to go into cardiac arrest within the 1st hour• Effective bystander CPR provided immediately after

sudden cardiac arrest, can double or triple a victim’s chance of survival.

• 13 million people worldwide are trained in CPR.

CPR Facts• Best place to have a heart attack?

• Las Vegas• Worst Place?

*Detroit Michigan – 0%*Washington DC – 5%

Seattle/King Co. – 50%Are over 250 AED’s at SeaTac

Airport

Most Common TIMESCPR is Needed

Heart AttackDrug Overdose

DrowningSmoke InhalationElectrical Shock

Choking

AHA Adult chain of survival

• 1. Immediate recognition of cardiac arrest and activation of the emergency response.

• 2. Early CPR with emphasis on chest compressions.

• 3. Rapid defibrillation• 4. Effective advanced life support• 5. Integrated post-cardiac arrest care.

HEART ATTACK

•“Death of part of the heart muscle due to inadequate supply of blood and oxygen.”

•Signs of a heart attack: • Severe chest pain or pressure• Sweating, nausea, shortness of breath,

weakness, fainting, heartburn, back pain*Signs may last for several minutes

Sudden Cardiac Arrest• Cardiac arrest is present when the heart

stops pumping.• The most common cause of cardiac

arrest in adults is an abnormal heart rhythm called ventricular fibrillation (VF)• In VF the heart quivers uselessly and does

not pump blood.• VF requires an immediate electric shock

– defibrillation – to the heart to allow the normal heart rhythm to resume

Sudden Cardiac Arrest

• The best chance for survival depends on early CPR and early defibrillation

• For every minute that passes without defibrillation, the victim’s chances of survival falls by 7 – 10 % (unless CPR is provided)

• 4 minutes: Brain damage begins• 10-12 minutes: Chance of survival is

small unless CPR is provided

Time is CrucialOnce breathing has stopped, brain cells begin to

die.CPR Started in Chance of Recovery

1 minute 90%

4 – 6 minutes 50%

7+ minutes 10%

New Steps to CPR

Aed AND PERSONNEL• One Rescuer

• Unresponsiveness – Call 911 and get the AED

• BEGIN COMPRESSIONS AND BREATHING• Attach AED

• Two Rescuer• #1 – Call 911/Perform CPR• #2 – Attach AED

*If an AED is on site – don’t start CPR*If no AED on site – start CPR and continue

until an AED arrives

Tap and shout

•Tap and Shout to check for unresponsiveness.

• 10% of victims have seizures while in cardiac arrest. Are often found laying down so often people “leave them alone.” Have to roll them over to check.

Yell for help. Send someone to phone 911 an get an aed

• When calling 9-1-1…• Give the specific location• Phone # of where they can reach you• Nature/Extent of the emergency• Advise that AED is on the scene or NOT• Don’t hang up until the dispatcher

advises

Infant, child, adult CPR

Infant Child Adult30:2 30:2 30:22 fingers 1 Hand 2 HandsAbout 1 ½ inches

At least 2 inches

At least 2 inches

100 X a min. 100 X a min. 100 X a min.1 yr. or younger

Age 1 - 8 8 and older

Guideline for Chest Compressions

• Position victim on a hard surface on their back• Remove clothing from chest• Locate correct hand position on the center of the chest and on

the lower half of the breastbone, right between the nipples.• Place the heel of one hand on the sternum and place the other

hand on top.• Depress sternum 2 inches• Provided 30 chest compressions at a rate of at least100 x per

minute. Make sure to have complete chest recoil!• Give 30 compressions, (if trained and proficient give 2 breaths

lasting one second each)• Count out loud…”One and two…” to the beat of “Staying Alive”

“Open AIRWAY”

• Airway can be blocked by the tongue• Position victim• Open the airway• Head tilt-chin lift (or jaw thrust)

Suspected Neck Injury

•If a neck (spinal) injury is suspected, use the jaw thrust. Position yourself at the victim's side and without tilting the head, lift the jaw.

BREATHING

• While holding the airway open, pinch the nose closed.

• Take a breath. Cover the person’s mouth with your mouth.

• Give 2 full breaths (1 second each) Watch for the chest to begin to rise as you give each breath.

AGoNOL BREATHING• Sometimes the victim will sound like

they are snoring. This is not an indication of true breathing. Agonal breathing is an indication that CPR needs to be started.

Special considerations

•Is victim lying in water?•Is victim less than 8 years old?•Is victim wearing a transdermal

medication patch on his/her chest?

•Does the victim have a pacemaker or implanted defibrillator?

Effectiveness of pads

•Sweaty Chest•Dry with a towel•Do not use alcohol

•Hairy Chest•Shaving may be needed

aeddefibrillation

•Right Electrode Pad•To the right of the breastbone•Below the collarbone above the

nipple•Left Electrode Pad

•Outside the left nipple, upper edge of the pad several inches below the armpit

choking

•The choking sign is holding the neck with one or both hands.

•“There are more than 3000 deaths per year in the US due to choking.”

Signs of choking• Mild signs include: Can make sounds or

can cough loudly. You should: Stand by and let him/her cough.

• Severe signs may include: Cannot breathe or has a cough that has no sound or cannot talk or make a sound or makes the choking sign. You should: Act quickly and follow the steps to help a choking adult.

Action to help a choking conscious adult

• If you think someone is choking, ask, “Are you choking?” If victim nods yes, tell them you are going to help.

• Get behind him/her. Wrap your arms around him/her so that your hands are in front.

• Make a fist with 1 hand.

• Put the thumb side of your fist slightly above the belly button and well below the breastbone.

• Grasp the fist with your other hand and give quick upward thrusts into abdomen.

• Give thrusts until the object is forced out and the victim can breather, cough, or talk, or until victim stops responding.

Special circumstances• If someone is choking and is in the late

stages of pregnancy or is a very large person, give thrusts on the chest instead of thrusts on the abdomen.

• Put your arms under the armpits and your hands on the lower half of the breastbone. Pull straight back to give the chest thrusts.

How to help a choking child

• If you think the child is choking, ask “Are you choking?” If victim nods yes, tell him you are going to help.

• Get behind the victim. Wrap your arms around him/her so that your hands are in front.

• Make a fist with 1 hand.

• Put the thumb side of your fist slightly above the belly button and well below the breastbone.

• Grasp the fist with your other hand and give quick upward thrusts into the abdomen.

• Give thrusts until the object is forced out and he can breathe, cough, or talk, or until victim stops responding.

How to help a choking infant

• Hold the infant facedown on your forearm. Support he infant’s head and jaw with your hand.

• Give up to 5 back slaps with the heel of your other hand between the infant’s shoulder blades.

• Give up to 5 chest thrusts using 2 fingers of your other hand to push on the chest in the same place you push for CPR.

• Repeat giving 5 back slaps and 5 chest thrusts until the infant can breathe, cough, or cry or until he stops responding.

If the Choking victim becomes unconscious

Immediately call 9-1-1 and start the CPR sequence until help arrives.When completing the ventilations, look for a foreign object. If seen, remove it. If not, continue CPR.Continue until help arrives.