Dr.Dhananjaya Bulathwatta

Importance

Importance CPR TIME LINE  0-4 mins. brain damage unlikely  4-6 mins. brain damage possible  6-10 mins. brain damage probable  >10 mins. probable brain death

Urgency

Background The best chance of long term neurologically intact survival occurs if:  The victim’s collapse is witnessed  CPR is commenced immediately  The cardiac rhythm is VF or pulse less VT

 Check for Response - “touch and talk”  Shout – “HELP”  Call Emergency No.[s]  Airway  Breathing  Circulation  Disability

HHead tilt- Chin lift

 Jaw Thrust with Support

for rise and fall of the chest. for breath sounds. for the exhaled air

 2 Resque breaths within 2-4 seconds Make the chest rise

PushPush down on the chest 11/2 to 2 inches 30 times right between the nipples. Pump at the rate of 100/minute, faster than once per second. Minimize interruptions to 10 seconds or less.

 Pulse less than 60 bpm  2 Rescuer CPR -Concider as poor perfusion -15 : 2

 Brachial Pulse less than 60 bpm  Just below the nipple line on breast bone  2 Rescuer CPR -Consider as poor perfusion -2 fingers -15 : 2

IIntubation CCardiac Monitor PPrecordial Thumb

 Pulseless VT  Asystole  VF  E.M.D.

 Defibrillation (one shock J biphasic or 360 J monophasic).  Immediately resume chest compressions (30:2) without reassessing the rhythm or feeling for a pulse.  Continue CPR for 2 min, then pause briefly to check the monitor.  If VF/VT persists give adrenaline 1 mg IV [every 3-5 min] followed immediately by a shock.

 CPR 30:2 till pt. becomes shockable  Give adrenaline 1 mg IV as soon as intravascular access is achieved and every 3-5 min (alternate loops).  Give atropine 3 mg IV

 CPR  Give further adrenaline 1 mg IV every 3-5 min (alternate loops)

AdultChildInfant 1 Response, Shout for help, Emergency Call 2 Head tilt, Chin lift [Suspected trauma: Jaw thrust] 3 Look, Listen, Feel for breathing 5-10 seconds 4 2 Rescue Breaths. [1 second each] 5 No carotid Pulse No brachial Pulse start CPRor <60 with signs of poor perfusion start CPR 6 Center of the breast boneJust below the nipple between two nipplesline on breast bone 7 With both hands [interlaced fingers]2 Fingers Inches1/3 - 1/2 of thedepth of chest per minute for 230 for2 [1 Resquer], 15 for 2 [2 Resquer]