Cardiopulmonary Resuscitation Cardiopulmonary Resuscitation CPR CPR

First Aid Course First Aid Course

ByBy

Dr. Hanan Said AliDr. Hanan Said Ali

Learning Objectives:Learning Objectives:**** Define CPRDefine CPR**** State causes of CPR State causes of CPR**** List the clinical manifestation of List the clinical manifestation of respiratory andrespiratory and cardiac arrest cardiac arrest**** Perform CPR for adult arrested person Perform CPR for adult arrested person**** Perform CPR for arrested child Perform CPR for arrested child **** Perform CPR for arrested infant Perform CPR for arrested infant ** ** Identify Precautions for RescuersIdentify Precautions for Rescuers**** List Complications of CPR List Complications of CPR

What Is CPR? Cardio means "of the heart" and pulmonary means "of the lungs." Resuscitation is a medical word that means "to revive" — or bring back to life.

Sometimes CPR can help a person who has stopped breathing, and whose heart may have stopped beating, to stay alive.

Cardiopulmonary resuscitation Cardiopulmonary resuscitation (CPR)(CPR) Is a lifesaving technique in many Is a lifesaving technique in many emergencies, CPR involves emergencies, CPR involves a combination of a combination of mouth-to-mouth rescue breathing and chest mouth-to-mouth rescue breathing and chest compressioncompression that keeps that keeps oxygenated blood oxygenated blood flowing to the brain and other vital organs flowing to the brain and other vital organs until more definitive medical treatment can until more definitive medical treatment can restore a normal heart rhythm.restore a normal heart rhythm.

When the heart stops, the absence of When the heart stops, the absence of oxygenated blood can cause irreparable oxygenated blood can cause irreparable brain damage in only a few minutes.brain damage in only a few minutes.

** Death will occur within Death will occur within eighteight toto ten ten minutesminutes. . Time is critical when you're Time is critical when you're helping an unconscious person who isn't helping an unconscious person who isn't breathing.breathing.

Someone can stop breathing Someone can stop breathing and/or have cardiac arrest from:and/or have cardiac arrest from:

** Heart attacks Heart attacks ** Strokes (when the blood flow to a part of the Strokes (when the blood flow to a part of the brain suddenly stops) brain suddenly stops) ** Choking on something that blocks the entireChoking on something that blocks the entire airway airway ** Near-drowning incidents (when someone isNear-drowning incidents (when someone is under water for too long and stops breathing) under water for too long and stops breathing)

** A very bad neck, head, or back injury A very bad neck, head, or back injury

** Severe electrical shocks (like from touching aSevere electrical shocks (like from touching a power line) power line)

** Being very sick from a serious infection Being very sick from a serious infection

** Too much bleeding Too much bleeding

**Severe Severe allergic reactions reactions

Clinical Manifestation Of Clinical Manifestation Of Cardiopulmonary Arrest:Cardiopulmonary Arrest:

11-- Loss of consciousness .Loss of consciousness .22-Stopage of breathing.-Stopage of breathing.33-Stopage of heart beats.-Stopage of heart beats.44-Dilated pupils.-Dilated pupils.55- Pale and cyanotic skin.- Pale and cyanotic skin.

Before you beginBefore you begin** Assess the situation before Assess the situation before starting CPR:starting CPR:----Is the person conscious orIs the person conscious or unconscious? unconscious?

If the person appears unconscious If the person appears unconscious tap or shake his or hertap or shake his or her shoulder and ask loudly, shoulder and ask loudly, "Are you OK?" "Are you OK?"

If the person doesn't respond: If the person doesn't respond: call ambulance (or your local call ambulance (or your local

emergency number), or have emergency number), or have someone else do it. someone else do it. If you're alone and the victim is If you're alone and the victim is an infantan infant or a child age 1 to 8 who or a child age 1 to 8 who needs CPR:needs CPR:

perform two minutes of perform two minutes of CPR before calling for help. CPR before calling for help.

Steps Of CPR Include the ABCsSteps Of CPR Include the ABCs

AIR WAY

CIRCULATIONBREATHIG

A-AIRWAY: Clear the airwayA-AIRWAY: Clear the airway* * Put the person on his or her back on a firm Put the person on his or her back on a firm surface. surface.

** Kneel next to the person's neck and shoulders. Kneel next to the person's neck and shoulders.

** Open the person's airway using the head tilt-chin Open the person's airway using the head tilt-chin

lift.lift.

** Put your palm on the person's forehead andPut your palm on the person's forehead and gently push down. gently push down.

** Then with the other hand, gently lift Then with the other hand, gently lift the chin forward to open the airway. the chin forward to open the airway.

** Check for normal breathing, taking no more Check for normal breathing, taking no more than 10 seconds: Look for chest motion, listen than 10 seconds: Look for chest motion, listen for breath sounds, and feel for the person's for breath sounds, and feel for the person's breath on your cheek and ear. breath on your cheek and ear.

Do not consider gasping to be normal breathing. If the person isn't breathing normally or you

aren't sure, begin mouth-to-mouth breathing.

B-BREATHING: Breathe for the person• Rescue breathing can be mouth-to-mouth breathing or mouth-to-nose breathing if the mouth is seriously injured or can't be opened.

* With the airway open (using the head tilt-chin lift), pinch the nostrils shut for mouth-to-mouth breathing and cover the person's mouth with yours, making a seal.

** Prepare to give two rescue breaths. Give the Prepare to give two rescue breaths. Give the first rescue breath — lasting one second — and first rescue breath — lasting one second — and watch to see if the chest rises.watch to see if the chest rises.

** If it does rise, give the second breath. If it does rise, give the second breath.

** If the chest doesn't rise, repeat the head tilt- If the chest doesn't rise, repeat the head tilt-chin lift and thchin lift and then give the second breath. en give the second breath.

C-CIRCULATION: Restore blood C-CIRCULATION: Restore blood circulation.circulation.

**Check the pulse on carotid arteryCheck the pulse on carotid artery

C-CIRCULATION: Restore blood C-CIRCULATION: Restore blood circulation (Cont.)circulation (Cont.)** Place the heel of one hand over the centre Place the heel of one hand over the centre of the person's chest between the nipples. of the person's chest between the nipples. Place your other hand on top of the first Place your other hand on top of the first hand.hand.

** Keep your elbows straight and position Keep your elbows straight and position your shoulders directly above your hands.your shoulders directly above your hands.

*

Use your upper body weight (not just your arms) as you push straight down on (compress) the chest 3 to 5 cm. Push hard and push fast — give two compressions per second, or about 100 compressions per minute.

** After 30 compressions, tilt the head backAfter 30 compressions, tilt the head back and lift the chin up to open the airway. and lift the chin up to open the airway.

* * Prepare to give two rescue breaths.Prepare to give two rescue breaths.

* Release the pressure without removing your Hands from his chest.

* Pinch the nose shut and breathe into the mouth for one second.

* If the chest rises, give a second rescue breath.

* If the chest doesn’t rise, repeat the head tilt-chin lift and then give the second rescue breath

Instead of doing mouth-to-mouth rescue breathing, professional rescuers — such as paramedics — will provide artificial breathing for someone by using a mask with a special hand pump connected to an oxygen tank.

To perform CPR on a child:To perform CPR on a child:

The procedure for giving CPR to a The procedure for giving CPR to a child age 1 through 8 is child age 1 through 8 is essentially the same as that for an essentially the same as that for an adult. The differences are as adult. The differences are as follows:follows:

** Perform five cycles of compressions Perform five cycles of compressions and breaths on the child , this should and breaths on the child , this should take about two minutes before calling take about two minutes before calling ambulance or the local emergency ambulance or the local emergency number, unless someone else can call number, unless someone else can call while you attend to the child.while you attend to the child.

** Use only one hand to perform heartUse only one hand to perform heart compressions at the deep of (2.5-3cm) compressions at the deep of (2.5-3cm)

** Breathe more gently. Breathe more gently.

** Use the same compression/breath rate as is Use the same compression/breath rate as is used for adults: 30 compressions followed by used for adults: 30 compressions followed by two breaths. This is one cycle. Continue until the two breaths. This is one cycle. Continue until the victim moves or help arrives. victim moves or help arrives.

To perform CPR on a baby:To perform CPR on a baby: 1. 1. Shout and Tap Shout and gently tap the Shout and Tap Shout and gently tap the child on the shoulder. If there is no child on the shoulder. If there is no response, position the infant on his or her response, position the infant on his or her back back

2. 2. Open The Airway Open the Open The Airway Open the airway using a head tilt lifting of airway using a head tilt lifting of chin. Do not tilt the head too far chin. Do not tilt the head too far back back

3. 3. Give 2 Gentle BreathsGive 2 Gentle Breaths If the baby is NOT breathing give 2 small If the baby is NOT breathing give 2 small gentle breaths. Cover the baby's mouth and nose gentle breaths. Cover the baby's mouth and nose with your mouth. Each breath should be 1 with your mouth. Each breath should be 1 second long. You should see the baby's chest rise second long. You should see the baby's chest rise with each breath.with each breath.

4. 4. Give 30 CompressionsGive 30 Compressions Give 30 gentle chest compressions at the rate of Give 30 gentle chest compressions at the rate of 100 per minute (100 per minute (Give two breaths after every Give two breaths after every 30 chest compressions30 chest compressions)). Use two or three . Use two or three fingers in the centre of the chest just below the fingers in the centre of the chest just below the nipples. Press down approximately 1.5-2.5 cm nipples. Press down approximately 1.5-2.5 cm depth of the chest.depth of the chest.

5. 5. Repeat with 2 breath and 30 Repeat with 2 breath and 30 compressions. After two minutes compressions. After two minutes of repeated cycles call ambulance of repeated cycles call ambulance and continue giving breaths and and continue giving breaths and compressionscompressions

Precautions for Rescuers ** Do not give chest compressions if the victim has a pulse. (cause the heart to stop beating).

** Do not give the victim anything to eat or drink.

** Avoid moving the victim's head or neck if spinal injury is a possibility.

** The person should be left as found if breathing freely. ** Do not slap the victim's face, or throw water on the face, to try and revive the person.

** Do not place a pillow under the victim's head.

Precautions for Rescuers cont..

Complications of CPRComplications of CPR

** Gastric distention due to artificial Gastric distention due to artificial ventilation by mouth to mouth ventilation by mouth to mouth** Fracture ribs Fracture ribs** Hemothorax Hemothorax ** Penumothorax Penumothorax ** Abdominal organs lacerationAbdominal organs laceration