1 One-Man Adult CPR

2 Remember: CPR can save lives. Do it well. Do it right. And the victim gets a chance at life.

3 Learning Objectives Able to recognise: Unresponsiveness Breathlessness Pulselessness Perform one-man adult CPR proficiently

4 Scope of Lesson Introduction Explanation on CPR Procedure Practical Training When to Stop CPR Conclusion

5 Look out for unsafe environment, e.g.:-. electrical current, fire, possible explosion, construction works, or poisonous gas D : Danger

6 R: Response Tap victims shoulder and shout: Hello! Hello! Are you OK?

7 No Response Help! Call Ambulance 995.

8 Position the Victim For CPR to be effective, the victim must be lying flat on his / or her back and on a firm, flat surface If the victim is lying face down on his side, you will need to roll the victim over as a unit onto his back. Do take care that the head, neck and body are supported and turned simultaneously during repositioning.

9 Head tilt/Chin lift Push chin down. Check victims mouth. Clear foreign body if seen. A : Airway

10 Place your hand that is nearest victims head on victims forehead and apply backward pressure to tilt head back, place 2 fingers of your other hand under the bony part of jaw near chin and lift, avoid pressing on soft tissues under jaw, tilt head backward without closing victims mouth Head tilt/Chin lift is to open the airway. The most common cause of airway obstruction in the unconscious victim is occlusion of the airway by the Tongue.

11 Check Breathing: Look, Listen and Feel for breathing up to 10 seconds. Place your ear and cheek over the victims mouth and nose while maintaining an open airway. Assess for breathing up to 10 seconds. Look for the chest to rise and fall Listen for air escaping during exhalation Feel for the flow of air If no breathing, give 2 ventilations…. B : Breathing

12 Give 2 fast & effective breaths (each 1 sec & between 400 – 600 cc) Pinch the nose with your thumb and index finger to prevent air from escaping through the victims nose. Take a deep breath and seal your lips around the victims mouth. Give 2 fast & effective breaths until you see the chest rise. Release the nostrils after each breath. The duration for each breath is 1 second. Ventilation volume should be between 400 to 600 cc.

13 Check Carotid Pulse for up to 10 seconds. Maintain head tilt with your hand nearest the victims head on forehead Locate Adams apple or the centre of the neck (female) with the pulp of 2 fingers of hand nearer victims feet Slide your fingers down into groove of neck on side closest to you Do not use your thumb because you may feel your own pulse C: Circulation

14 If there is no pulse, commence CPR: 30 chest compressions : 2 ventilations for 5 cycles.

15 No Pulse Start CPR Locate end of sternum using the middle finger

16 Place middle finger on the xiphoid process and index finger next to it.

17 Put heel of the palm on sternum next to index finger.

18 Perform 30 Compressions (Depth of 4-5 cm, Rate of approximately 100 per minute) Interlace the fingers of both hands and lift the fingers off the chest wall Straighten both elbows and lock them in position Position your shoulder directly over the victims chest Use your body weight to compress the victims chest 4-5 cm Bouncing compressions, jerky movements, improper hand position and leaning on the chest can decrease the effectiveness of resuscitation and are more likely to cause injuries Do not lift the hands from the chest or change position, otherwise correct hand position may be lost

19 Count loudly as you compress: 1 and 2 and 3 and 4 and 5 and 1 and 2 and 3 and 4 and 10 and 1 and 2 and 3 and 4 and 15 1 and 2 and 3 and 4 and 5 and 1 and 2 and 3 and 4 and 10 and 1 and 2 and 3 and 4 and 30

20 Landmark for proper chest compressions

21 Perform 5 cycles of 30 compressions : 2 breaths in 2 minutes and then reassess CPR cycle

22 Reassessment After 5 cycles, ending with the 2 breaths, check the pulse. If there is no pulse, continue with CPR until victim revives, paramedic arrives or you are completely exhausted. If pulse has returned, check breathing. If victim is not breathing, perform rescue breathing at 12 times/minute (one breath every 5 seconds) by counting after each breath: 2-a-thousand, 3-a-thousand, 4-a-thousand, 5-a-thousand If both pulse/circulation and breathing have returned, place the victim in the recovery position and maintain an open airway Continue to monitor for breathing and pulse every few (5) minutes as these can stop suddenly.

23 If pulse and breathing have returned, place victim into Recovery Position.

24 The victim revives (regains pulse and breathing). Though revival is hoped for, most victims also require advanced cardiac procedures before ever regaining their heart and lung functions. You are replaced by either another trained rescuer or paramedic. A physician tells you to stop. You are too exhausted to continue. The scene becomes unsafe for you to continue. When to stop CPR

25 Conclusion What should you do when you come across someone lying on the ground? Show the correct method to check the pulse. Show the method of locating proper hand position for chest compression After how many cycles should you reassess the victim? What should you do after you confirm that the victim has no breathing? When pulse is present but breathing is not present, what should you do? What should you do next when both pulse and breathing of victim is present?