Adult Basic Life Support for the Health Care Worker Philippine Heart Association, Inc. Council on Cardio Pulmonary Resuscitation - CPR Philippine Heart Association, Inc. Council on Cardio Pulmonary Resuscitation - CPR

Chain of Survival Concept The Links in the Chain of Survival The Links in the Chain of Survival  Early access  Early CPR  Early defibrillation  Early ACLS

 A well-informed person - key in the early access link. the early access link.  Recognition of heart attack and respiratory failure  Call for help immediately if needed  Activate the EMS System The First Link--Early Access

 CPR - Cardio-Pulmonary Resuscitation  Life saving technique for cardiac & respiratory arrest respiratory arrest  Rescue breathing & chest compressions  Lay persons and medical personnel Second Link - Early CPR

Why The Need For CPR Training?

CPR is the best treatment for cardiac arrest until the arrival of an AED and advanced cardiovascular (ACLS) care.

Why the need for early CPR?  prevents VF from deteriorating to asystole  may increase the chance of defibrillation  contributes to preservation of heart and brain function  significantly improves survival

Brain (Cerebral) Heart (Cardiac (Cardiac ) Lungs (Pulmonary/ Respiratory Respiratory ) Normal Anatomy Anatomy

How does CPR work?  All the living cells of our body need a steady supply of oxygen to keep us alive.  CPR works because you can breathe air into the victim’s lungs to provide oxygen into the blood. When you press on the chest, you move oxygen - carrying blood through the body.

When will you do CPR? CPR must be started as soon as possible after the heart stops beating or if breathing either stops or is ineffective. Any delay in starting CPR reduces the chances of survival. CPR must be started as soon as possible after the heart stops beating or if breathing either stops or is ineffective. Any delay in starting CPR reduces the chances of survival. In addition, the brain cells begin to die after 4-6 minutes without oxygen.

CARDIOVASCULAR RISK FACTORS Non-modifiable  Hereditary  Gender  Race  Age Modifiable  Cigarette smoking  Hypertension  Elevated Cholesterol & triglyceride levels  Lack of exercise  Obesity  Stress  Diabetes mellitus

EARLY WARNING SIGNS OF HEART ATTACK  prolonged compressing pain or unusual discomfort in the center of the chest, behind the breast bone  pain may radiate to shoulder, arm, neck or jaw, usually on the left side  may be accompanied by sweating, nausea, vomiting and shortness of breath

EARLY WARNING SIGNS OF RESPIRATORY FAILURE  unable to speak, breath or cough  clutches neck (universal distress signal)  bluish color of skin and lips

The ABC’s of CPR After determining unconsciousness, you should evaluate the condition of the body’s two most vital systems-- respiratory and circulatory system. This is done by checking the ABC’s.

The ABC’s of CPR A. Airway Does the victim have an open airway (air passage that allows the victim to breathe)? B. Breathing Is the victim breathing? C. Circulation Does the victim have a pulse?

You find a person lying on the ground, not moving. You should survey the scene to see if it is safe and to get some idea of what happened. Then begin doing a primary survey by checking for unresponsiveness.

TO CHECK FOR UNRESPONSIVENESS  Tap or gently shake the victim  Rescuer shouts “Are you OK?”  If the victim is unconscious, rescuer shouts “HELP”  He should activate the EMS System  He then proceeds to do CPR

Airway obstruction by epiglottis

A - AIRWAY Open the Airway: Use the head tilt/chin Use the head tilt/chin lift method lift method  Place one hand on the victim’s forehead  Place fingers of other hand under the bony part of lower jaw near chin  Tilt head and lift jaw-- avoid closing victim’s mouth

Jaw Thrust  Jaw is lifted without tilting the head  Suspected victims of cervical spine injury

Check for Breathlessness  Maintain open airway  Place your ear over victim’s mouth and nose  (LLF) Look at chest, Listen and Feel for breathing for 10 sec.  Victims may either be breathing or not  Counting for 10 Sec. thousand-one, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, thousand-ten

B - BREATHING Give 2 full breaths  Maintain airway  Pinch nose shut  Open your mouth wide, take a deep breath, and make a tight seal around outside of victim’s mouth  Give 2 slow breaths (1 1/2-2 sec/min)  Observe chest rise & fall; listen & feel for escaping air

C - Circulation  Maintain open airway  LLF: Look at chest, Listen and Feel for breathing for 10 sec.  THIS TIME, FEEL FOR THE CAROTID PULSE INSTEAD OF SUPPORTING THE CHIN  Counting: thousand-one, 1002, 1003, 1004, 1005, 1006, 1007, 1008, 1009, thousand-ten

Continue Rescue Breathing  Give one breath every 5 sec (about 12 breaths/min)  Counting: (Blow) thousand-one, 1002, 1003, 1004, TWO (2 nd blow) If with pulse but is not breathing

C - Circulation  Immediately begin chest compression If without signs of circulation and normal breathing

C -CIRCULATION Locate Compression Area  Kneel facing victim’s chest  With middle & index fingers of hand nearest victim’s legs, locate lower edge of victim’s rib cage on side closest to you  Follow rib cage to “notch” at lower end of breastbone

. Place heel of hand nearest victim’s head on breastbone next to index finger of hand used to find “notch” Place heel of handPlace heel of hand used to locate used to locate “notch” directly on “notch” directly on top of heel of other top of heel of other hand hand Keep fingers offKeep fingers off victim’s chest victim’s chest

 Position shoulders over hands with elbows locked and arms straight

Give 30 Compressions  Compress breastbone 1 1/2 to 2 in. (30 compressions should take sec)  Count aloud “1, 2, 3, 4, 5,6,7,8,9,10,11,12,13,1 4,15,16,17,18,19,20,21,22,23,24,25,26,27,28, 29, ONE (Push down as you say the number and come up as you await chest recoil)

 Compress down and release pressure smoothly, keeping hand contact with chest at all times

If the victim is breathing  the unresponsive victim with spontaneous respirations should be placed in the recovery position if no cervical trauma is suspected  placement in this position consists of rolling the victim onto his or her side to help protect the airway Maintain open airway & position the victim

1.Survey the scene – the scene is SAFE 2.Tap the shoulder. “Hey hey are you OK? PX IS UNRESPONSIVE CALL FOR HELP– Help!” 3.CHECK BREATHING: LLF POSITION ”Thousand –one, 1002…10010” 4.SCENARIO: (-)BREATHING - I will give 2 full breaths – BREATHE 2X 5.CHECK BREATHING AND PULSE: LLF and pulse check – ”Thousand one… SCENARIO: (-) BREATHING, (+) PULSE – RESCUE BREATHING Breathe. 1001, 1002…….1004 – TWO (2 ND breath) Breathe. 1001, 1002…….1004 – TWELVE (12 TH Breath) 7.CHECK BREATHING & PULSE (same as #5) 8.SCENARIO: (-) BREATHING, (-) PULSE – I will do CPR (30:2) 1, 2, 3, 4, …….20, 1, 2….9 – ONE (1 ST Breath 2X) 1, 2, 3, 4 …….. 20, 1, 2…9 – FIVE (5 TH Breath 2X) 9. CHECK BREATHING & PULSE: (+) BREATHING, (+) PULSE – PX IS REVIVED 10. RECOVERY POSITION