Bacic cpr

BasicBasic CPRCPR

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The lecture of Assistant Professor Ann Kakabadze

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What is the difference between clinical death and biological death?

When the heart stops pumping the lungs stop breathing, the person is in a state of clinical death. Usually, this is measured from the moment the cessation of heart and lung functions begin.

Most often the time table is 0 to 4 minutes. In this instance, remaining oxygen in the blood can still supply the brain with enough oxygen without brain damage. However after 4 minutes, the oxygen remaining in the blood will be used up and there is already the possibility that brain damage will occur. At this point in time, the person is said to be in the state of biological death.

To summarized:

CLINICAL DEATH (0-4 minutes) - occurs from the time the person stops breathing and the heart stops pumping.

BIOLOGICAL DEATH (4 minutes onwards) - brain damage may occur at this point.

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signs of clinical death are-

1.respiratory arrest.2.cardiac arrest.3.coma

signs of biological death are-1.rhomboid eyes2.cold temperature of the body3.body becomes stiff4.foul smell of the body

The stepsThe steps

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Above allAbove all

Safety first

to you

to other

to the casualty

• make sure that no one elso gets hurt. You will not be able to

help if you are also a casualty• only proceed if it is safe to do

so.

Securing the sceneSecuring the scene

1. Electrical hazards1. Electrical hazards 2. Chemical hazards2. Chemical hazards 3. Noxious & Toxic gases3. Noxious & Toxic gases 4. Ground hazards4. Ground hazards 5. Fire5. Fire 6. Unstable equipment6. Unstable equipment

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Bef ore performin g any Bef ore performin g any F irst Aid, F irst Aid,

Check for :Check for :

Step 2Step 2

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Check consciousness

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RESPOND-

is the casualty consious?

• Gently shake the casualty and ask : 'Can you hear me?' , 'What is your name?'

• If the casualty is conscious,check for and manage bleeding and other injuries

• If the casualty is unconscious,he/she should be turned on the side.

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Unconsciousness is when a person is unable to respond to people and activities. Often, this is called a coma or being in a comatose state. Unconsciousness or any other sudden change in mental status must be treated as a medical emergency.

Causes

Unconsciousness can be caused by nearly any major illness or injury, as well as substance abuse and alcohol use. Brief unconsciousness (or fainting) is often caused by dehydration, low blood sugar, or temporary low blood pressure. However, it can also be caused by serious heart or nervous system problems.

http://www.nlm.nih.gov/medlineplus/ency/article/001945.htm




Check consciousnessCheck consciousness

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Verbal

Painfull

Call for help

Step 3Step 3

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AIRWAY

AIRWAYAIRWAY

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Remove secretions

base tongue of FallingExtend head

Elevate jaw

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The main aim of checking the The main aim of checking the airway is to ensure that there is airway is to ensure that there is nothing lodged that can nothing lodged that can prevent the casualty from prevent the casualty from breathing.breathing.

The first step is to check the The first step is to check the airway by opening the mouth airway by opening the mouth and look for any objects in the and look for any objects in the

mouthmouth..These objects could These objects could

include food, blood, vomit, include food, blood, vomit, teeth or tongueteeth or tongue..

Causes for chocking and ApneaCauses for chocking and Apnea

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I. Foreign object

II. Aspiration

III. Relaxed tongue base

IV. Allergic reaction

Choking & aspiration

Brain death

Airway obstruction

Cardiac standstill

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Obstructed airway (choking) Partially obstructed airway with good air exchange: Partially obstructed airway with good air exchange:

victim can make some sounds; may be able to speak and cough

Partially obstructed airway with poor exchange: Partially obstructed airway with poor exchange: victim cannot speak, may be wheezing or coughing weakly

Fully obstructed airway: Fully obstructed airway: victim cannot make any sounds

The most common cause of an airway obstruction in a conscious person is food or a foreign object.

The most common cause of an airway obstruction in an unconscious person is the tongue.

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• Adult choking - The Heimlich maneuver Adult choking - The Heimlich maneuver

1. Ask the victim: : “Are you choking?”

2. If the victim nods yes, ask them “Would you like my help?”

3. If they say “NO”, do not help them. If they say yes, you may help them.

4. Position yourself by placing one of your legs between the legs of your victim. Give 5 abdominal thrusts and continue as needed.

5. For a pregnant or obese person, perform chest thrusts.

6. Repeat thrusts until the object is expelled and the obstruction is relieved OR the victim becomes unresponsive/unconscious.

Step 4Step 4

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Breathing

BREATHINGBREATHINGCheck breathingCheck breathing

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LookListenFeel

+-

Keep Airway open,

Observe

2 Breaths

Check Carotid pulse

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BREATHING

• look for the chest rising and falling.

•listen for the sound of breathing

if the casualty is breathing , ensure that he/she is in a stable side position. Check for and managed bleeding and other injuries. if the casualty is not breathing . turn onto the back and commence EAR (expired air resuscitation) , giving 5 full breaths in 10 seconds.

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EAR (mouth-to-mouth resuscitation)

• Knee beside the casualty.• Keep the casualty's head tilted back.• Pinch the casualty's nostrils with your fingers or seal with your cheek.• Lift the jaw forward with your other hand.• Take a deep breath and open your mouth wide.• Place your mouth firmly over the casualty's mouth making an airtight

seal.• Breath into the casualty's mouth.• Remove your mouth and turn your head to observe the chest fall and

listen or feel for exhaled air.• If the chest does not rise and fall , check head tilt position first , then

check for and clear foreign objects in the airway.• Give 5 full breaths in 10 seconds , then check the carotid (neck) pulse

for 5 seconds. If pulse is present, continue EAR at the rate of 15 breaths per minute.

Stage 5Stage 5

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Circulation

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CIRCULATION

•feel the pulse at the neck (carotid pulse)

•if pulse is present , continue EAR at the rate of 15 breaths per minute. Check breathing anf the pulse after 1 minute, then after every 2 minutes

•if pulse is not present, commence CPR (cardiopulmonary resuscitation)

•check breathing and the pulse after 1 minute , then after every2 minutes. If the pulse returns, continue EAR. If breathing returns , turn the casualty to a stable side position. Check for and manage shock, bleeding and other injuries

•seek medical aid.

CirculationCirculation

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Check for pulse

-

Begin C.P.R

Check pulse every 2-3 min

2 Ventilations

15 Chest compressions

““spot “ Finding the : Adultsspot “ Finding the : Adults

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1. Find the rib cage

2. Then find the Xyphoid


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3. Place the palm of hand two fingers above Xyphoid

4. Place second hand over first, lock elbows


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Locked elbows

Locked fingers

Body 90 degrees

ADULT C.P.R.ADULT C.P.R.summarysummary

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Check consciousness

Call for help

Verbal

Pain

A - Extend head, open mouth, remove secretions

(-)

ADULT C.P.R.ADULT C.P.R. summarysummary

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B - Check for breathing

-+

2 Full Breaths

Keep Airway open

ADULT C.P.R.ADULT C.P.R. summarysummary

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C - Check pulse

-+

2:151:5

Infant and ChildInfant and Child

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Infant and ChildInfant and Child

Incidents involving infants or children Incidents involving infants or children

may havemay have two patients...two patients...

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...an ill or injured...an ill or injured childchild and an and an emotional and upsetemotional and upset parent.parent.

Newborn:Newborn:

The term for a pediatric patient from birth to The term for a pediatric patient from birth to 1 month of age.1 month of age.

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Newborn

Infant:Infant:

A pediatric patient greater than 1 month A pediatric patient greater than 1 month of age, but less than a year.of age, but less than a year.

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Infant

Adult vs Child Respiratory AnatomyAdult vs Child Respiratory Anatomy

� Proportionately larger tongue than Proportionately larger tongue than in adultin adult

� Narrower and shorter tracheaNarrower and shorter tracheaTrachea easily kinked by improper positioningTrachea easily kinked by improper positioning

� Chest wall very pliableChest wall very pliable� Larynx more anteriorLarynx more anterior� Weaker intercostal musclesWeaker intercostal muscles

Requires more use of diaphragmRequires more use of diaphragm

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Comparison of

the diameter of

the child’s

trachea versus

the adult’s.

Adult (20 mm)

Infant(4 mm)

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Infants under the age of

2 months are obligate

nose-breathers.

Infant C.P.R Infant C.P.R (0 to 1 year old)(0 to 1 year old)

The same scheme, with some differencesThe same scheme, with some differencesCheck consciousnessCheck consciousnessAA irway openingirway openingBBreathing(1:3)reathing(1:3)CCirculation(1:5)irculation(1:5)

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Airway openingAirway opening

NO HEAD EXTENTION!NO HEAD EXTENTION!““Sniffing Position”Sniffing Position”

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BreathingBreathing

Breaths to mouth Breaths to mouth andand nose noseUntil the chest risesUntil the chest rises

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Check the brachial pulse in infants.Check the brachial pulse in infants.

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““spot “ Finding the : Infantsspot “ Finding the : Infants One finger below the One finger below the

nipple linenipple line Compressions: with Compressions: with

two fingerstwo fingers 120 per minute120 per minute

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Chest compressionsChest compressions

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1 Ventilation

5 Chest compressions

Child C.P.RChild C.P.R(1 to 8 years old)(1 to 8 years old)

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Check consciousnessCheck consciousness

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AirwayAirway

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BreathingBreathing Breaths to mouth and Breaths to mouth and

nose, nose, if possibleif possible Until chest risesUntil chest rises 1:51:5

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““spot “ Finding the : Childrenspot “ Finding the : Children One finger above XyfoidOne finger above Xyfoid

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CirculationCirculation Chest compressions Chest compressions

with one palmwith one palm 2:152:15

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QUESTIONS

Bacic cpr

Education

Transcript of Bacic cpr