1. Basic Life Support C.P.R.

2. CPR Training Precautions u Do not practice on a person u Clean faces properly after each use u Alcohol u Bleach wash

3. Do Not Use A Manikin If: u Cold or sore throat u Known positive hepatitis B or C u Infected by HIV or AIDS u You have an infection

4. CPR u Combines rescue breathing and chest compressions u Revives heart (cardio) and lung (pulmonary) functioning u Use when there is no breathing and no pulse u Provides O2 to the brain until ACLS arrives

5. How CPR Works u Effective CPR provides 1/4 to 1/3 normal blood flow u Rescue breaths contain 16% oxygen (21%)

6. Start CPR Immediately u Better chance of survival u Brain damage starts in 4-6 minutes u Brain damage is certain after 10 minutes without CPR

7. Do Not Move the Victim Until CPR is Given and Qualified Help Arrives… u unless the scene dictates otherwise u threat of fire or explosion u victim must be on a hard surface u Place victim level or head slightly lower than body

8. Even With Successful CPR, Most Won’t Survive Without ACLS u ACLS (Advanced Cardiac Life Support) u ACLS includes defibrillation, oxygen, drug therapy

9. Survey The Scene, then: RAP u R - Responsiveness u Tap shoulder and shout “Are you ok?”

10. RAP u A - Activate EMS ( if unresponsive) u YOU - call 911 – come back and let me know what they said (another can stay by the phone) u You may have to make the call

11. RAP u P - Position on back u All body parts rolled over at the same time u Always be aware of head and spinal cord injuries u Support neck and spinal column

12. ABCD u Airway u Breathing u Circulation - Bleeding u Disability (keep this in mind from the beginning) u If victim is unconscious but does display vital signs, place on left side

13. Checking Vital Signs u A – Airway u Open the airway u Head tilt chin lift

14. B – Check For Breathing u Look, listen and feel for breathing u No longer than 10 seconds seconds

15. Breathing Breathing u If the victim is not breathing, give two breaths (1 second or longer) u Pinch the nose u Seal the mouth with yours u If the first two don’t go in, re- tilt and give two more breaths (if breaths still do not go in, suspect choking)

16. Breathing: Mouth To Nose (when to use) u Can’t open mouth u Can’t make a good seal u Severely injured mouth u Stomach distension u Mouth to stoma (tracheotomy)

17. Compressions u After giving breaths… u Locate proper hand position for chest compressions u Place heel of one hand on center of chest between the nipples

18. Compressions u Using both hands, give 30 chest compressions u Count 1, 2, 3 … u Depth of compressions: 1.5 to 2 inches u For children: ½ to 1/3 of chest depth and use 1 or 2 hands (keep one hand on forehead if possible)

19. CPR u After 30 chest compressions give: u 2 slow breaths u Continue until help arrives or victim recovers u If the victim starts moving: check breathing

20. When Can I Stop CPR? u Victim revives u Trained help arrives u Too exhausted to continue u Unsafe scene u Physician directed (do not resuscitate orders) u Cardiac arrest of longer than 30 minutes u (controversial)

21. Two Partner CPR u Rescuer 1: u RAPAB u Rescuer 2: u place hands for compressions u Compression rate: 30:2 u Switch off when tired u 1 and 2…..4 and change

22. Checking for CPR Effectiveness u Does chest rise and fall with rescue breaths? u Have a second rescuer check pulse while you give compressions

23. Why CPR May Fail u Delay in starting u Improper procedures (ex. Forget to pinch nose) u No ACLS follow-up and delay in defibrillation u Only 15% who receive CPR live to go home u Improper techniques u Terminal disease or unmanageable disease (massive heart attack)

24. Injuries Related to CPR u Rib fractures u Laceration related to the tip of the sternum u Liver, lung, spleen

25. Complications of CPR u Vomiting u Aspiration u Place victim on left side u Wipe vomit from mouth with fingers wrapped in a cloth u Reposition and resume CPR

26. Stomach Distension u Air in the stomach u Creates pressure against the lungs u Prevention of Stomach Distension u Don’t blow too hard u Slow rescue breathing u Re-tilt the head to make sure the airway is open u Use mouth to nose method

27. Mouth to Mouth Barrier Devices u Masks u Shields

28. If You Are Afraid to Perform CPR u Call EMS u Open the airway u Give chest compressions

29. Choking u The tongue is the most common obstruction in the unconscious victim (head tilt- chin lift) u Vomit u Foreign body u Balloons u Foods u Swelling (allergic reactions/ irritants) u Spasm (water is inhaled suddenly)

30. How To Recognize Choking u Can you hear breathing or coughing sounds? u High pitched breathing sounds? u Is the cough strong or weak? u Can’t speak, breathe or cough u Universal distress signal (clutches neck) u Turning blue

31. Recognizing Choking #2 u A partial airway obstruction with poor air exchange should be treated as if it were a complete airway blockage. u If victim is coughing strongly, do not intervene

32. Conscious Choking ( Adult Foreign Body Airway Obstruction ) u Give 5 abdominal thrusts (Heimlich maneuver) u Place fist just above the umbilicus (normal size) u Give 5 upward and inward thrusts u Pregnant or obese? 5 chest thrusts u Fists on sternum u If unsuccessful, support chest with one hand and give back blows with the other u Continue until successful or victim becomes unconscious

33. If You Are Choking And You Are Alone u Use fist u Use corner of furniture u Be creative

34. If Victim Becomes Unconscious After Giving Thrusts u Call 911 u Try to support victim with your knees while lowering victim to the floor u Assess u Begin CPR u After chest compressions, check for object before giving breaths breaths

35. You Enter An Empty Room And Find An Unconscious Victim On The Floor u What do you do? u Assess the victim (RAPABC) u Give CPR if needed u After giving compressions: u look for object in throat u then give breaths

36. CPR for Infants (Under 1 Year of Age) u Same procedures (RAPAB) except: u Seal nose and mouth or nose only u Give shallow “puffs” u

37. CPR: Infants u RAPAB u Give CPR u Press sternum 1/2 to 1/3 depth of the chest u Use middle and ring finger u 30 compressions to 2 u If alone, resuscitate for 2 minutes then call 911

38. Choking: Conscious Infants u Position with head downward u 5 back blows (check for expelled object) u 5 chest thrusts (check for expelled object) u Repeat

39. Choking: Unconscious Infants u If infant becomes unconscious: u RAPAB u When the first breaths don’t go in, check for object in throat then try 2 more breaths. u If neither set of breaths goes in, suspect choking u Begin 30 compressions u Check for object in throat (no blind finger sweep) u Give 2 breaths

40. SIDS u 5000 per year u Affects more males than females u No know cause u No indication of problem u Usually occurs during the sleep during first 6 months of life u Place baby on back (now, side) u Avoid “fluffy” blankets etc.