1. CARDIOPULMONARY RESUSCITATION CPR
Done by: MS.Salmah Awad

2. Out line: Introduction What is CPR The heart and pulmonary system
Why you Start CPR Immediately?
Sequence of CPR
Main stages of resuscitation ( A,B,C)
Check responsiveness
When Can I Stop CPR?
Injuries Related to CPR
Choking( definition, causes, signs of choking)
Rescue action in choking

3. Introduction
For the life to continue, the body requires an adequate supply of oxygen . If a casualty is deprived of oxygen, the brain begins to fail, after 3 or 4 minutes without oxygen, casualty will lose consciousness  the heart & breathing will stop  death will result.

4. What is CPR?
It is a sequence of techniques used to sustain life in the absence of spontaneous breathing and heart beat
Together chest compressions and rescue breath are called cardiopulmonary resuscitation
The aim of CPR is to maintain victim's breathing and circulation until emergency aid arrives.

6. Why Start CPR Immediately
Life threatening .
Brain damage starts in 4-6 minutes
Brain damage occur after 10 minutes without CPR

7. Sequence of CPR: Call for help
Check responsiveness
Call for help
Correctly place the victim and ensure the open airway
Check the presence of spontaneous respiration
Check pulse
Start CPR

8. Main stages of resuscitation
A (Airway) – ensure open airway by preventing the falling back of tongue
B (Breathing) – start artificial ventilation of lungs
C (Circulation) – restore the circulation by external cardiac compression

9. Check responsiveness:
Tap shoulder and shout “Are you ok?”

10. A – Airway Open the airway
-Head tilt chin lift Place one hand over the forehead and tilt the head back.
Pick out any obvious obstruction from the mouth.

11. B – Check For Breathing Look, listen and feel for breathing
No longer than 10 seconds second
-If the victim is breathing:
Place in recovery position
-If the victim is NOT breathing:
Ask for help and Give 2 rescue breaths for fife times then check for signs of circulation

12. Mouth to Mouth Barrier Devices
Masks
Shields

13. B (Breathing) Make sure that airway is open.
Pinch the nose & open the victim’s mouth.
If you have a face shield or pocket mask place it over the victim’s mouth.
Take a breath and place your lips over around the victim’s mouth.
Blow steadily into the victim’s mouth until the chest rises
Maintaining open airway, take your mouth off and see if chest falls.

14. How to check for circulation:
Maintain a head tilt with one hand on the victim’s forehead
Locate the trachea with 2 or 3 fingers of the other hand
Slide these fingers where you can feel the carotid pulse
Palpate for at least 5 seconds and no more than 10 seconds

15. If signs of circulation exist:
Continue rescue give 1 breath every 3 seconds, every 2 minutes recheck pulse.
If victim start to breath turn him into recovery position
If signs of circulation are absent:
Begin giving chest compressions ( start CPR )

16. Compressions Make sure the victim is lying on his back on hard surface
Make sure the victim is lying on his back on hard surface   
Put the heel of one hand on the center of the victim’s bare chest between the nipples
Put the heel of your other hand on top of the first hand.
Straighten your arms & position your shoulders directly over your hands.

17. Chest compression continue:
Push hard and fast 1.5 to 2 inches with each compression
At the end of each compression, allow the chest to recoil completely
Deliver compression at a rate of 100 compression per minute

18. Rate of compression to breathing:
Compression rate for adult :
30:2

19. When Can I Stop CPR? Victim survive Trained help arrives
Cardiac arrest longer than 30 minutes

20. How to place in recovery position

21. Injuries Related to CPR
Rib fractures
Laceration related to the tip of the sternum
(Liver, lung, spleen)

22. Choking
Obstruction of the air way by foreign body( food , object….)

23. causes of Choking:
The tongue is the most common obstruction in the unconscious victim
Foreign body
Foods
Swelling (allergic reactions/ irritants)
Spasm (water is inhaled suddenly)

24. Signs of choking Poor or no air exchange
Week, ineffective cough or no cough at all
High pitch noise while inhaling or no noise at all
Increased respiratory difficulty
Possible cyanosis
Unable to speak
Clutching the neck with the thump and fingers, ,making the universal choking sign
unable to move air.

25. Standing or sitting responsive adult:
  Activate the emergency response system.
Stand behind the victim and wrap your arms around the victim’s waist.
  Make a fist with one hand 
Place the thumb side of your fist against the victim’s abdomen, in the midline.
Grasp your fist with the other hand and press into the abdomen with a quick upward thrust
Repeat until object expelled or victim’s become unresponsive.

26. Lying down responsive adult:
If you find a responsive adult lying down, perform abdominal thrusts with the victim lying down

27. Pregnant and obese victims;
Instead of abdominal thrusts Perform chest thrusts

28. References:
BLS for health care providers, Student manual .American heart association AHA 2006
Fundamentals Of Nursing Procedures Book Second year Nursing,2008
First Aid Manual .

29. Thank you