Chapter 8 Circulation Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ.

Topics The Circulatory System Cardiopulmonary Resuscitation
Briefly review the topics with the students Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

The Circulatory System
Delivers oxygen and removes waste throughout the body Consists of heart, blood vessels, and blood Advise the students that the circulatory system not only circulates blood, but is also responsible for the transport of nutrients and wastes throughout the body Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

Heart Hollow, muscular organ Located left lower, left central region of chest 4 chambers Atria Ventricles Advise the students that the heart has four chambers, the two chambers on the right side that receive blood from the body and pump blood to the lungs, and the two chambers on the left side that receive blood from the lungs and pump blood throughout the body Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

Advise the students that the heart has four chambers, the two chambers on the right side that receive blood from the body and pump blood to the lungs, and the two chambers on the left side that receive blood from the lungs and pump blood throughout the body Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

Blood vessels Arteries transport blood throughout the body Capillaries exchange gas, nutrients, and waste with cells Veins return blood to the heart Review how the blood is transported throughout the body Advise the students that the arteries are under high pressure Advise the students that the veins are under lower pressure, and therefore require valves to assist in returning blood to the heart Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

How the heart works 2-sided pump Left side pumps blood throughout the body Right side pumps blood to the lungs and left side of heart Contractions of heart create pulses Review with the students how the two sides of the heart work to pump blood throughout the body Advise the students that the contractions of the heart create a pulse Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

When the heart stops Clinical death Both respiratory and cardiac arrest Cardiopulmonary resuscitation Chain of survival Buys time until other life-saving treatments Review the concept of clinical death with the students Explain to the students the importance of rapid intervention if a patient goes into cardiac arrest Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

When the heart stops Chain of survival Early Access Early CPR Early Defibrillation Early Advanced Care Review the AHA Chain of Survival with the students Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

Cardiopulmonary Resuscitation
Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

Requires an unresponsive, breathless, pulseless patient Support ventilations and circulation Steps preceding CPR CPR for adults CPR for infants and children Briefly review the topics with the students Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

Steps preceding CPR Determine responsiveness Open airway with head-tilt/chin-lift Look, listen, and feel breathing Administer positive pressure ventilations Feel for a carotid pulse Make sure the students understand the importance of following the steps above Remind the students that, as with their patient assessment, they will be checking the airway first, then breathing, then circulation Advise the students that they must work to correct one life-threat prior to moving on to the next part of their assessment Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

Steps preceding CPR If patient has a pulse Do not initiate CPR If patient does not have a pulse Place patient on a firm, flat surface Begin CPR Remind the students that they should not perform CPR if the patient has a pulse, is breathing normally, or coughing and moving Advise the students that they must place the patient on a firm, flat surface if their compressions are to be effective Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

CPR for adults Chest compressions (1 of 2) Position the patient Uncover the chest Get in position Locate the compression site Advise the students that they must expose the patient’s chest prior to beginning CPR Advise the students of the proper location for chest compressions Warn the students that compressions in the wrong location can actually cause more harm than good Warn the students of the risk for rib and sternum fractures even when CPR is properly performed Advise the students that they should know where the xyphoid process is, but that the compressions should be performed on the lower 1/3 of the sternum on the nipple line Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

CPR for adults Chest compressions (2 of 2) Position your hands and shoulders Perform chest compressions Completely release pressure after each compression Count as you compress Advise the students that they must completely release pressure to help with the heart refilling Stress the importance of keeping your elbows locked with your shoulders directly above your wrists, and using your entire upper body to perform the compressions as a way to reduce rescuer fatigue Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

CPR for adults Chest compressions Perform compression at a rate of 100/min Provides some blood flow until defibrillation Ensure an adequate depth with each compression Stress the importance of performing compression in a rapid, controlled fashion Make sure the students know the correct depth for performing chest compressions Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

CPR for adults One-rescuer adult CPR (1 of 2) Obtain defibrillator Open airway Administer 2 breaths Check for pulse Advise the students that they should call and obtain a defibrillator if available prior to performing CPR if they are alone Review the procedure for performing one-rescuer CPR with the students Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

CPR for adults One-rescuer adult CPR (2 of 2) Perform 30 compressions Open airway and provide 2 ventilations Check for pulse every 2 minutes Advise the students that they should perform cycles of 30 compressions and 2 ventilations Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

CPR for adults Two-rescuer adult CPR (1 of 2) If the patient is unresponsive, breathless, and pulseless Perform 30 compressions (1st rescuer) Open airway and provide 2 ventilations (2nd rescuer) Insert oropharyngeal airway if available Check for a pulse every 2 minutes Review the procedure for performing two-rescuer CPR, stressing that one rescuer will be responsible for compressions while the other rescuer will be responsible for airway management and ventilation Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

CPR for adults Two-rescuer adult CPR (2 of 2) When the compression rescuer tires Call for switch during compressions Rescuer 2 administers ventilations Rescuer 1 moves to head and performs pulse check Should occur every 2–3 minutes Review the procedure for rotating the rescuer performing compressions to the airway position Advise the students this should occur every few minutes as rescuer fatigue reduces the effectiveness of compressions before the resuer feels tired Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

CPR for adults Assisting advanced providers Once patient is intubated Ventilations every 6–8 seconds Compressions continuous at rate of 100/min Performed asynchronously Advise the students that, once the airway is secured with an advanced airway device, they can perform ventilations and compressions asynchronously Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

CPR for adults Monitoring the patient Ensures rescue efforts are successful Feel for pulse during compressions Pulse check after 1 minute and every 2–3 minutes thereafter Do not interrupt CPR for more than 10 seconds Advise the students that they can monitor the effectiveness of the resuscitative efforts by checking for a pulse during compressions Advise the students that they should not interrupt compressions for more than 10 seconds unless performing defibrillations with an AED Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

CPR for adults Signs of successful CPR Pulse present during compressions Chest rise and fall with ventilations Spontaneous pulse returns Spontaneous gasps Patient swallows Review the methods of determining the effectiveness of CPR with the students Advise the students that after a spontaneous pulse returns, the patient may take occasional, gasping breaths or may begin to swallow Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

CPR for adults Mistakes in performing CPR Ventilations Inadequate head-tilt/chin-lift Poor mask seal Not allowing for exhalation Ventilations too shallow Ventilations too rapid or forceful Review the common mistakes that occur while performing positive pressure ventilation Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

CPR for adults Mistakes in performing CPR Compressions Failing to keep elbows straight Poor hand placement Inadequate compression depth Compressions too slow Review the mistakes commonly made while performing chest compressions Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

CPR for adults Complications caused by CPR Fractures to ribs or sternum Pneumothorax Hemothorax Liver lacerations Review the common complications associated with performing CPR Warn the students that these can occur even when CPR is properly performed Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

CPR for infants and children Infant: birth to 1 year Child: 1 year to onset of puberty Cardiac arrest usually due to respiratory problem Review the age breakdown that separates infants, children, and adults Advise the students that cardiac arrest in infants and children is typically caused by respiratory compromise Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

CPR for infants and children Infants: brachial Children: carotid pulse Begin CPR if heart rate < 60/min Review the locations for pulse checks in the infant and child Advise the students that they can also check a child’s radial or femoral pulse Stress the need to begin CPR if the infant or child has a heart rate < 60 beats per minute Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

CPR for infants and children Performing infant or child CPR Position the patient Locate the compression site Perform chest compressions 1/3 the depth of the chest 30:2 for one- rescuer CPR 15:2 for two- rescuer CPR Check for pulse 2 minutes Review the procedure for performing CPR on the infant and child Stress the importance on the compression depth with the students Remind the students that the compression to ventilation ratio changes when a second rescuer arrives for the infant or child in cardiac arrest Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

CPR for infants and children Alternative techniques for newborns Two-rescuer CPR Thumbs on compression location Wrap hands around chest Compress with thumbs and fingers Review the change in hand position for infants and newborns with the students Advise the students that it creates more effective compressions and helps to maintain the airway in the proper position throughout CPR Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

CPR for infants and children Signs of successful infant or child CPR Spontaneous heartbeat Spontaneous breathing Responsiveness Review the signs of successful CPR with the students Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

Summary Know the components of the circulatory system and how they work Ensure that the patient is unresponsive, breathless, and pulseless prior to beginning CPR Make sure the airway is patent throughout the resuscitation Rotate rescuers frequently to ensure adequate compressions and the appropriate rate Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ

Chapter 8 Circulation Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ.

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Chapter 8 Circulation Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ.

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Presentation on theme: "Chapter 8 Circulation Limmer, First Responder: A Skills Approach, 7th ed. © 2007 by Pearson Education, Inc. Upper Saddle River, NJ."— Presentation transcript:

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