Chapter 5

CPR

Heart Attack and Cardiac Arrest

• Heart attack occurs when heart muscle tissue dies because its blood supply is severely reduced or stopped.

• Cardiac arrest results when the heart stops beating.

Caring for Cardiac ArrestThe Chain of Survival

Five events that must occur rapidly and in an integrated manner during cardiac arrest:

• Recognition and action• Cardiopulmonary resuscitation (CPR)• Defibrillation• Advanced care• Post-arrest care

Purpose of CPR

• CPR moves blood to the heart and brain by giving chest compressions.

• CPR provides periodic breaths to place oxygen into the victim’s lungs.

Performing CPRAge Classifications

• Adults: Puberty and older

• Children: 1 year to puberty

• Infants: Younger than 1 year

Performing CPR Check for Responsiveness and Breathing (1 of 2)

• Tap the victim’s shoulder and ask if he or she is okay.

• At the same time, look to see if the victim is breathing.

• Have a bystander call 9-1-1.

Performing CPRCheck for Responsiveness and Breathing (2 of 2)

• If alone, call 9-1-1 unless the victim is a child or infant.

• For children and infants, give 30 compressions and 2 breaths before calling 9-1-1.

Performing CPRGive Chest Compressions (1 of 3)

• Perform on a firm, flat surface whenever possible.

• Use two hands on adults.

• Use one hand on children.

• Use two fingers on infants.

Performing CPRGive Chest Compressions (2 of 3)

• Compress hard and fast.• Compress at least 2 inches

on an adult’s and child’s chest.

• Compress an infant’s chest about 1½ inches.

• Place hands in the center of the chest at the lower half of the breast bone.

Performing CPR Give Chest Compressions (3 of 3)

• Give 30 compressions per 18 seconds.

• Give 2 rescue breaths.

Performing CPRContinue CPR Until…

• An automated external defibrillator (AED) is available.

• Victim shows signs of life.

• Emergency medical services (EMS) personnel take over.

• You become too tired to continue.

Performing CPRGive Rescue Breaths (1 of 3)

• Tilt the victim’s head back and lift the chin to open the airway.

• Pinch the victim’s nose and make a tight seal over the victim’s mouth with your mouth.

Performing CPRGive Rescue Breaths (2 of 3)

• Give one breath lasting 1 second, take a breath, and then give another 1-second breath.

• Each breath should make the victim’s chest rise.

Performing CPRGive Rescue Breaths (3 of 3)

Methods of Rescue Breathing

• Mouth-to-breathing device

• Mouth-to-nose method

• Mouth-to-stoma method

Mouth-to-Breathing Device

• A breathing device is placed in or over the victim’s mouth and nose as a precaution against disease transmission.

Mouth-to-Nose Method

• Used when:• you cannot open the victim’s mouth. • the victim’s mouth is severely injured. • you cannot make a good seal with the

victim’s mouth.

• Tilt the head back, and push up on the victim’s chin to close the mouth.

• Seal your mouth over the victim’s nose and provide rescue breaths.

Mouth-to-Stoma Method

• A small, permanent opening in the neck is a stoma.

• Close the victim’s mouth and nose and breathe through the opening in the neck.

Adult CPR (1 of 2)

1. Check for responsiveness and breathing.

2. Have a bystander call 9-1-1 or call yourself if alone.

© Berta A. Daniels, 2010

© Berta A. Daniels, 2010

Adult CPR (2 of 2)

3. If unresponsive and not breathing, provide 30 chest compressions hard and fast.

4. Provide two rescue breaths. Repeat compression and breath cycles until an AED is available or EMS personnel arrive.

© Berta A. Daniels, 2010

© Berta A. Daniels, 2010

Child CPR (1 of 2)

1. Check for responsiveness and breathing.

2. Have a bystander call 9-1-1. If alone, give five cycles of CPR first, and then call.

3. Give 30 chest compressions using one or two hands.

Child CPR (2 of 2)

4. Give two rescue breaths.

5. Repeat the compression and breath cycles until an AED is available or EMS personnel arrive.

Infant CPR (1 of 2)

1. Check for responsiveness and breathing.

2. Have a bystander call 9-1-1. If alone, give five cycles of CPR first, and then call.

3. Give 30 chest compressions using two fingers.

Infant CPR (2 of 2)

4. Give two rescue breaths.

5. Repeat the compression and breath cycles until an AED is available or EMS personnel arrive.

Airway Obstruction

An object lodged in the airway can cause a mild or severe airway obstruction.

Mild Airway Obstruction

• Good air exchange present

• Victim can make forceful coughing efforts.

• Victim should be encouraged to cough.

Severe Airway Obstruction

• Poor air exchange

• Breathing becomes more difficult.

• Weak and ineffective cough

• Inability to speak or breathe

• Skin, fingernail beds, and inside of mouth appear bluish gray.

Airway Obstruction in a Responsive Adult or Child (1 of 4)

• Check the victim for choking.

• Ask, “Are you okay?”

Airway Obstruction in a Responsive Adult or Child (2 of 4)

• Perform the Heimlich maneuver by moving behind the victim.

• Reach around the victim’s waist with both arms and locate the navel.

Airway Obstruction in a Responsive Adult or Child (3 of 4)

• Place a fist with the thumb side against the victim’s abdomen, just above the navel.

Airway Obstruction in a Responsive Adult or Child (4 of 4)

• Grasp the fist with your other hand.

• Press into the abdomen with quick, inward and upward thrusts.

• Continue until the object is removed or the victim becomes unresponsive.

Airway Obstruction in Responsive Infants (1 of 2)

• Support the infant’s head and neck.

• Lay the infant face down on the forearm.

• Lower the arm to the leg. • Give five back blows

between the shoulder blades with the heel of the hand.

Airway Obstruction in Responsive Infants (2 of 2)

• Roll the infant face up.• Give five chest

compressions on the infant’s sternum using two fingers.

• Repeat until the object is removed or the infant becomes unresponsive.

If a Victim Becomes Unresponsive…

• Immediately call 9-1-1.

• Begin CPR.

• Look for an object in the victim’s mouth during CPR.