CPR

Introduction Basic Life Support needed for patient whose breathing or heart has stopped Ventilations are given to oxygenate blood when breathing is inadequate or has stopped     If heart has stopped, chest compressions are given to circulate blood to vital organs Ventilation combined with chest compressions is called cardiopulmonary resuscitation (CPR) CPR is commonly given to patients in cardiac arrest as a result of heart attack

CPR Saves Lives CPR and defibrillation within 3-5 minutes can save over 50% of cardiac arrest victims CPR followed by AED saves thousands of lives each year In most cases CPR helps keep victim alive until EMS or AED arrives  

Circulatory System Circulatory system consists of heart, blood, and blood vessels. Transports blood to lungs Delivers carbon dioxide and picks up oxygen Transports oxygen and nutrients to all parts of body Helps regulate body temperature Helps maintain body’s fluid balance  

Anatomy of the Heart

Coronary Arteries

Major Arteries

Circulatory System Emergencies Any condition that affects respiration reduces ability to deliver oxygen Severe bleeding Shock Stroke Heart conditions

Cardiac Arrest Heart may stop (cardiac arrest) as a result of heart attack Brain damage begins 4 - 6 minutes after cardiac arrest Brain damage becomes irreversible in 8 - 10 minutes Dysrhythmia, an abnormal heartbeat, may also reduce heart’s pumping effectiveness

Causes of Cardiac Arrest Heart attack Drowning Suffocation Stroke Allergic reaction Diabetic emergency Prolonged seizures Drug overdose Electric shock Certain injuries

Chain of Survival Early Access Early CPR Early Defibrillation Early Advanced Care Integrated post-cardiac arrest care

Cardiopulmonary Resuscitation (CPR) CPR helps keep patient alive by circulating some oxygenated blood to vital organs Ventilations move oxygen into lungs where it is picked up by blood Compressions on sternum increase pressure inside chest, moving some blood to brain/other tissues

Blood circulation resulting from chest compressions are not as strong as circulation from heartbeat Can help keep brain/other tissues alive until normal heart rhythm restored Often electric shock from AED is needed to restore a heartbeat—and CPR can keep patient viable until then

CPR effective only for a short time CPR should be started as soon as possible In some instances, the heart may start again spontaneously with CPR

CPR Sequence C A B Check the scene Assess & Activate EMS Check the pulse (carotid) Give 30 chest compressions Continue cycle 30 chest compressions/ 2 breaths at a rate of 100 per minute (C A B sequence)

Chest Compressions Alert Be careful with your hand position For adults/children, keep your fingers off patient’s chest Do not give compressions over bottom tip of breastbone (xiphoid process) When compressing, keep elbows straight and hands in contact with patient’s chest at all times Compress chest hard and fast, but let chest recoil completely between compressions. Minimize amount of time used giving ventilations between sets of compressions.

CPR Review

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

What happens during a cardiac arrest?

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

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

The purpose of the recovery position is to: