aboali sena balkhi hospital 9/23/2018 12:27 AM Mazar-e- Sharif Abu Ali Sena Balkhi Hospital, Power Point ® Lecture Slides prepared by dr Kh Noor M Faiz, cardio pulmonary Resuscitation(CPR) Date:10.05.1395

Cardiopulmonary Resuscitation with Automated External Defibrillator

At the end of this seminar participants should be able to demonstrate: How to assess the collapsed victim How to perform chest compression and rescue breathing (CPR) How to operate an automated external defibrillator safely How to place an unconscious breathing victim in the recovery position

Cardiopulmonary resuscitation (CPR) is a set of actions that should be done if a person stops breathing, or if their heart stops. The goal of CPR is to force blood and oxygen to keep flowing through the body. Every part of the body needs blood and oxygen to survive.

CPR does not start a person's heart again CPR does not start a person's heart again. However, it can keep pushing blood and oxygen around the body long enough that sometimes, it can keep the body from getting damaged by not having enough oxygen.

Check the scene for immediate danger Check the scene for immediate danger. Make sure you're not putting yourself in harm's way by administering CPR to someone unconscious. Is there a fire? Is the person lying on a roadway? Do whatever is necessary to move yourself and the other person to safety.

If there is anything that could endanger you or the victim, see whether there is something you can do to counteract it. Open a window, turn off the stove, or put out the fire, if possible. However, if there is nothing you can do to counteract the danger, move the victim. The best way to move the victim is by placing a blanket or coat underneath their back and dragging it.

In 2010, the American Heart Association made a radical change to the recommended CPR process for victims of cardiac arrest after studies showed that compression-only CPR (no mouth-to-mouth breathing) is as effective as the traditional approach.

Approach safely Check response Shout for help Open airway Check breathing Call emergency code no 30 chest compressions 2 rescue breaths

Approach safely Approach safely Check response Shout for help Open airway Check breathing Call 112 30 chest compressions 2 rescue breaths

Check response Approach safely Approach safely Check response Shout for help Open airway Check breathing Call 112 30 chest compressions 2 rescue breaths

Check response Shake shoulders gently Ask “Are you all right?” If he responds Leave as you find him. Find out what is wrong. Reassess regularly.

If the victim does not respond, continue with the following steps. Check response . If he or she responds agreement "Yeah" or Bali, CPR is not required. Instead, undertake basic first aid and take measures to prevent or treat shock, and assess whether you need to contact emergency services. If the victim does not respond, continue with the following steps.

Shout for help Approach safely Approach safely Check response Open airway Check breathing Call 112 30 chest compressions 2 rescue breaths

Open airway Approach safely Approach safely Check response Shout for help Open airway Check breathing Call 112 30 chest compressions 2 rescue breaths

Check breathing Approach safely Approach safely Check response Shout for help Open airway Check breathing Call 112 30 chest compressions 2 rescue breaths

Check breathing Look, listen and feel for NORMAL breathing

Abnormal breathing Check for breathing. And, make sure that the airway is not blocked. If the mouth is closed, press with your thumb and forefinger on both cheeks at the end of the teeth and then look inside. Remove any visible obstacle that is in your reach but never push your fingers inside too far. Put your ear close to the victim's nose and mouth, and listen for slight breathing. Do abdominal thrusts (the Heimlich maneuver). If the victim is coughing or breathing normally, do not perform CPR.

Abnormal breathing Occurs shortly after the heart stops in up to 40% of cardiac arrests Described as barely, heavy, noisy or gasping breathing Recognise as a sign of cardiac arrest

Call 112 Approach safely Approach safely Check response Shout for help Open airway Check breathing Call 112 30 chest compressions 2 rescue breaths

30 Chest compressions Approach safely Approach safely Check response Shout for help Open airway Check breathing Call 112 30 chest compressions 2 rescue breaths

Chest compressions Place the heel of one hand in the centre of the chest Place other hand on top Interlock fingers or avoid putting pressure on the side of the chest Compress the chest Rate 100 – 120 min-1 Depth 5 – 6 cm Equal compression : relaxation When possible change CPR operator every 2 min

2 Rescue breaths Approach safety Approach safely Check response Shout for help Open airway Check breathing Call 112 30 chest compressions 2 rescue breaths

Rescue breaths Pinch the nose Take a normal breath Place lips over mouth Blow until the chest rises Take about 1 second Allow chest to fall Repeat

Continue CPR 30 2

Continue CPR Position your body directly over your hands, so that your arms are straight and somewhat rigid. Don't flex the arms to push, but sort of lock your elbows, and use your upper body strength to push.

Approach safely Check response Shout for help Open airway Check breathing Call 112 30 chest compressions 2 rescue breaths

Approach safely Chest compressions are more critical for correcting abnormal heart rhythms (ventricular fibrillation or pulseless ventricular tachycardia, heart rapidly quivering instead of beating). Check response Shout for help Open airway Call 112

Do the compressions in a relatively fast rhythm Do the compressions in a relatively fast rhythm. Some agencies recommend doing compressions to the beat of the chorus of "Stayin' Alive," a 1970s disco hit, or at roughly 100 beats per minute.

Defibrillation

Approach safely Check response Shout for help Open airway Check breathing Call 112 Attach AED Follow voice prompts

Switch on AED Some AEDs will automatically switch themselves on when the lid is opened

Attach pads to victims bare chest

Analysing Rhythm: Do not touch victim

Shock indicated Stand clear Deliver shock

Shock delivered: Follow AED instructions 30 2

If victim starts to breathe normally place in recovery position

CPR in children Adult CPR techniques can be used on children Compressions at least 1/3 of the depth of the chest

AED in children Age > 8 years use adult AED Age 1-8 years use paediatric pads / settings if available (otherwise use adult mode) Age < 1 year use only if manufacturer instructions indicate it is safe

CPR Quiz 1. Victim responsiveness is checked by: a.) Shaking and shouting at the victim b.) Patting gently on shoulder asking if they are alright c.) Checking pulse 2. If victim is unresponsive, you should: a.) Dial 9-1-1 before starting CPR b.) Start CPR before dialing 9-1-1 c.) Dial 9-1-1 and wait for the arrival B A

3. To check if victim is breathing, you should: a.) Listen for exhaled air b.) Feel for exhaled air c.) Watch rise and fall of chest d.) All of the above The most common airway obstruction is: a.) Dentures b.) Food c.) Tongue d.) none of these D b

5. The technique used to clear the victim’s airway is: a.) Lift chin up, tilt head back b.) Push chin down, tilt head forward c.) lift chin up, turn head sideways 6. When ventilating an unconscious victim: a.) Pinch the victim’s nose closed. b.) Do not over-inflate the victim’s lungs c.) Allow the victim exhale on his own d.) All of the above. A d

7. When administering compressions, the rule to remember is: a.) 1 hand, 1 inch for children b.)1/2 hand, ½ inch for infants c.)2 hands, 2 inches for adults d.) All of the above Answers: b,a,d,b,a,d,d

Any questions?

Approach safely Approach safely Check response Check response Shout for help Shout for help Open airway Open airway Check breathing Check breathing Call 112 Call 112 30 chest compressions Attach AED 2 rescue breaths Follow voice prompts