CPRCPR

IntroductionIntroduction

– Basic Life Support needed for patient whose Basic Life Support needed for patient whose breathing or heart has stoppedbreathing or heart has stopped

– Ventilations are given to oxygenate blood when Ventilations are given to oxygenate blood when breathing is inadequate or has stoppedbreathing is inadequate or has stopped

– If heart has stopped, chest compressions are If heart has stopped, chest compressions are given to circulate blood to vital organsgiven to circulate blood to vital organs

– Ventilation combined with chest compressions is Ventilation combined with chest compressions is called cardiopulmonary resuscitation (CPR)called cardiopulmonary resuscitation (CPR)

– CPR is commonly given to patients in cardiac CPR is commonly given to patients in cardiac arrest as a result of heart attackarrest as a result of heart attack

CPR Saves LivesCPR Saves Lives

– CPR and defibrillation within 3-5 minutes can save CPR and defibrillation within 3-5 minutes can save over 50% of cardiac arrest victimsover 50% of cardiac arrest victims

– CPR followed by AED saves thousands of lives CPR followed by AED saves thousands of lives each yeareach year

– In most cases CPR helps keep victim alive until In most cases CPR helps keep victim alive until EMS or AED arrivesEMS or AED arrives

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Circulatory SystemCirculatory System

• Circulatory system consists of heart, blood, and Circulatory system consists of heart, blood, and blood vessels. blood vessels.

• Transports blood to lungsTransports blood to lungs• Delivers carbon dioxide and picks up oxygenDelivers carbon dioxide and picks up oxygen• Transports oxygen and nutrients to all parts of Transports oxygen and nutrients to all parts of

bodybody• Helps regulate body temperatureHelps regulate body temperature• Helps maintain body’s fluid balanceHelps maintain body’s fluid balance

Anatomy of the HeartAnatomy of the Heart

Coronary ArteriesCoronary Arteries

Major ArteriesMajor Arteries

Circulatory System EmergenciesCirculatory System Emergencies

• Any condition that affects respiration reduces Any condition that affects respiration reduces ability to deliver oxygenability to deliver oxygen

• Severe bleedingSevere bleeding• ShockShock• StrokeStroke• Heart conditions Heart conditions

Cardiac ArrestCardiac Arrest

• Heart may stop (cardiac arrest) as a result of Heart may stop (cardiac arrest) as a result of heart attack heart attack

• Brain damage begins 4 - 6 minutes after Brain damage begins 4 - 6 minutes after cardiac arrestcardiac arrest

• Brain damage becomes irreversible in 8 - 10 Brain damage becomes irreversible in 8 - 10 minutesminutes

• Dysrhythmia, an abnormal heartbeat, may Dysrhythmia, an abnormal heartbeat, may also reduce heart’s pumping effectivenessalso reduce heart’s pumping effectiveness

Causes of Cardiac ArrestCauses of Cardiac Arrest

– Heart attackHeart attack– DrowningDrowning– SuffocationSuffocation– StrokeStroke– Allergic reactionAllergic reaction– Diabetic emergencyDiabetic emergency– Prolonged seizuresProlonged seizures– Drug overdoseDrug overdose– Electric shockElectric shock– Certain injuriesCertain injuries

Chain of SurvivalChain of Survival

• Early Access Early Access • Early CPR Early CPR • Early Defibrillation Early Defibrillation • Early Advanced CareEarly Advanced Care

Cardiopulmonary Resuscitation (CPR)Cardiopulmonary Resuscitation (CPR)

– CPR helps keep patient alive by circulating some CPR helps keep patient alive by circulating some oxygenated blood to vital organsoxygenated blood to vital organs

– Ventilations move oxygen into lungs where it is Ventilations move oxygen into lungs where it is picked up by bloodpicked up by blood

– Compressions on sternum increase pressure Compressions on sternum increase pressure inside chest, moving some blood to brain/other inside chest, moving some blood to brain/other tissuestissues

– Blood circulation resulting from chest Blood circulation resulting from chest compressions are not as strong as circulation from compressions are not as strong as circulation from heartbeat heartbeat

– Can help keep brain/other tissues alive until Can help keep brain/other tissues alive until normal heart rhythm restorednormal heart rhythm restored

– Often electric shock from AED is needed to Often electric shock from AED is needed to restore a heartbeat—and CPR can keep patient restore a heartbeat—and CPR can keep patient viable until then viable until then

– CPR effective only for a short time CPR effective only for a short time

– CPR should be started as soon as possibleCPR should be started as soon as possible

– In some instances, the heart may start again In some instances, the heart may start again spontaneously with CPRspontaneously with CPR

Overview of Initial BLS Steps

1.1. Assess the victim for responseAssess the victim for response and look for normal or abnormal breathing. If there is no response and no breathing, or no normal breathing (i.e. only gasping), shout for help.

2. If you are alone, activate the emergency activate the emergency response system and get an AEDresponse system and get an AED (or defibrillator) if available and return to the victim.

3. Check the victim’s pulseCheck the victim’s pulse (take at least 5 seconds but no more than 10 seconds).

4. If you do not definitely feel a pulse within 10 seconds, perform 5 cycles of compressions perform 5 cycles of compressions and breaths (30:2 ratio),and breaths (30:2 ratio), starting with compressions (C-A-B sequence)

CPR SequenceCPR Sequence• Check the sceneCheck the scene• Check for responseCheck for response• Call for helpCall for help• Open the airway using the head tilt/chin liftOpen the airway using the head tilt/chin lift• Give two breaths Give two breaths • Check for pulse (carotid) 5-10 secondsCheck for pulse (carotid) 5-10 seconds• Give 30 chest compressions Give 30 chest compressions • Open the airway using the head tilt/chin liftOpen the airway using the head tilt/chin lift• Give two breaths Give two breaths • Continue cycle 30 chest Continue cycle 30 chest compressions/ 2 breaths at a rate of 100 per minutecompressions/ 2 breaths at a rate of 100 per minute

Chest Compressions AlertChest Compressions Alert– Be careful with your hand position Be careful with your hand position – For adults/children, keep your fingers off patient’s For adults/children, keep your fingers off patient’s

chest chest – Do not give compressions over bottom tip of Do not give compressions over bottom tip of

breastbone breastbone – When compressing, keep elbows straight and hands When compressing, keep elbows straight and hands

in contact with patient’s chest at all times in contact with patient’s chest at all times – Compress chest hard and fast, but let chest recoil Compress chest hard and fast, but let chest recoil

completely between compressions. completely between compressions. – Minimize amount of time used giving ventilations Minimize amount of time used giving ventilations

between sets of compressions.between sets of compressions.

CPR CPR ReviewReview

• What is the rate for performing chest What is the rate for performing chest compressions for a victim of any age?compressions for a victim of any age?

100 per minute

Describe a way you can allow the chest to recoil Describe a way you can allow the chest to recoil completely after each chest compression.completely after each chest compression.

Allow the chest to expand completely between each compression.

After you open the airway and pinch the nose of After you open the airway and pinch the nose of an unresponsive adult or child, what is the an unresponsive adult or child, what is the bestbest way to give mouth-to-mouth breaths? way to give mouth-to-mouth breaths?

Seal your mouth over the victims mouth and give 2 breaths, watching for the chest to rise

What is the What is the bestbest way for a rescuer to know that way for a rescuer to know that a rescue breath is effective?a rescue breath is effective?

The chest will rise with each breath.

You must check adequate breathing before You must check adequate breathing before giving breaths to an unresponsive adult giving breaths to an unresponsive adult victim. You do this by looking for chest rise victim. You do this by looking for chest rise and feeling for airflow through the victim's and feeling for airflow through the victim's nose or mouth. What nose or mouth. What otherother sign should you sign should you assess?assess?

Listen for airflow from the victim’s nose or mouth

When you do not suspect a cervical spine injury, When you do not suspect a cervical spine injury, what is the what is the bestbest way to open an unresponsive way to open an unresponsive victim's airway?victim's airway?

The head tilt / chin lift technique

What should be the next step when you find an What should be the next step when you find an unresponsive victim who has agonal gasps and unresponsive victim who has agonal gasps and you have sent someone to activate the you have sent someone to activate the emergency response system?emergency response system?

• Open the airway and give 2 breaths

How do you know when to start cycles of chest How do you know when to start cycles of chest compressions with breaths for an adult?compressions with breaths for an adult?

The victims is unresponsive, is not breathing, and does not have a pulse.

Why it is important to give early defibrillation to Why it is important to give early defibrillation to an adult?an adult?

The most effective treatment for sudden cardiac arrest is synchronized cardioversion

What are the steps common to the operation of What are the steps common to the operation of all AED's in the correct order?all AED's in the correct order?

Power on, attach pads, clear & analyze, clear & deliver shock if advised

After you power on an AED and attach the pads After you power on an AED and attach the pads to the victim, what is the next step you should to the victim, what is the next step you should do?do?

Clear the victim so the AED can analyze the heart rhythm

What might happen if you touch the victim What might happen if you touch the victim while the AED is delivering a shock?while the AED is delivering a shock?

The AED could shock you while it is shocking the victim.

You are using an AED on an adult victim, and the You are using an AED on an adult victim, and the AED gives a "no shock indicated" (or "no shock AED gives a "no shock indicated" (or "no shock advised") message. Until advanced care advised") message. Until advanced care personnel arrive, what should you do next?personnel arrive, what should you do next?

Leave the pads in place and continue CPR

What is the What is the bestbest way to relieve severe choking way to relieve severe choking in a responsive adult?in a responsive adult?

Perform abdominal thrusts

A choking adult becomes unresponsive while A choking adult becomes unresponsive while you are doing abdominal thrusts for severe you are doing abdominal thrusts for severe choking. You ease the victim to the floor and choking. You ease the victim to the floor and send someone to activate your emergency send someone to activate your emergency response system. What should you do next?response system. What should you do next?

Begin CPR, when you open the airway, look for and remove the object if seen, before giving breaths

• Which of the following statements Which of the following statements best best describes why you should minimize describes why you should minimize interruptions when giving chest compressions interruptions when giving chest compressions to any victim of cardiac arrest?to any victim of cardiac arrest?

If you minimize interruptions, you increase the victims chance of survival.

Breathing stops but the heart still continues for Breathing stops but the heart still continues for 2-3 minutes. What is this called?2-3 minutes. What is this called?

Respiratory arrest.

You find a victim lying on his right side. He is not You find a victim lying on his right side. He is not breathing but has a pulse. What should you breathing but has a pulse. What should you do?do?

Give a rescue breath every 5 seconds.

What happens during a cardiac arrest?What happens during a cardiac arrest?

The heart and breathing stop without warning.

Before starting chest compressions, you need to Before starting chest compressions, you need to check for a pulse. What pulse site should you check for a pulse. What pulse site should you use?use?

Carotid

A person shows signs of circulation after CPR A person shows signs of circulation after CPR was started. What should you do?was started. What should you do?

Place the victim in the recovery position, lying on their side.

The purpose of the recovery position is to:The purpose of the recovery position is to:

Prevent aspiration.