1. CPR

2. Introduction – Basic Life Support needed for patient whose breathing or heart has stopped – Ventilations are given to oxygenate blood when breathing is inadequate or has stopped – If heart has stopped, chest compressions are given to circulate blood to vital organs – Ventilation combined with chest compressions is called cardiopulmonary resuscitation (CPR) – CPR is commonly given to patients in cardiac arrest as a result of heart attack

3. CPR Saves Lives – CPR and defibrillation within 3-5 minutes can save over 50% of cardiac arrest victims – CPR followed by AED saves thousands of lives each year – In most cases CPR helps keep victim alive until EMS or AED arrives

4. Circulatory System Circulatory system consists of heart, blood, and blood vessels. Circulatory system consists of heart, blood, and blood vessels. Transports blood to lungs Transports blood to lungs Delivers carbon dioxide and picks up oxygen Delivers carbon dioxide and picks up oxygen Transports oxygen and nutrients to all parts of body Transports oxygen and nutrients to all parts of body Helps regulate body temperature Helps regulate body temperature Helps maintain body’s fluid balance Helps maintain body’s fluid balance

5. Anatomy of the Heart

6. Coronary Arteries

7. Major Arteries

8. Circulatory System Emergencies Any condition that affects respiration reduces ability to deliver oxygen Any condition that affects respiration reduces ability to deliver oxygen Severe bleeding Severe bleeding Shock Shock Stroke Stroke Heart conditions Heart conditions

9. Cardiac Arrest Heart may stop (cardiac arrest) as a result of heart attack Heart may stop (cardiac arrest) as a result of heart attack Brain damage begins 4 - 6 minutes after cardiac arrest Brain damage begins 4 - 6 minutes after cardiac arrest Brain damage becomes irreversible in 8 - 10 minutes Brain damage becomes irreversible in 8 - 10 minutes Dysrhythmia, an abnormal heartbeat, may also reduce heart’s pumping effectiveness Dysrhythmia, an abnormal heartbeat, may also reduce heart’s pumping effectiveness

10. Causes of Cardiac Arrest – Heart attack – Drowning – Suffocation – Stroke – Allergic reaction – Diabetic emergency – Prolonged seizures – Drug overdose – Electric shock – Certain injuries

11. Chain of Survival Early Access Early Access Early CPR Early CPR Early Defibrillation Early Defibrillation Early Advanced Care Early Advanced Care

12. Cardiopulmonary Resuscitation (CPR) – CPR helps keep patient alive by circulating some oxygenated blood to vital organs – Ventilations move oxygen into lungs where it is picked up by blood – Compressions on sternum increase pressure inside chest, moving some blood to brain/other tissues

13. – Blood circulation resulting from chest compressions are not as strong as circulation from heartbeat – Can help keep brain/other tissues alive until normal heart rhythm restored – Often electric shock from AED is needed to restore a heartbeat—and CPR can keep patient viable until then

14. – CPR effective only for a short time – CPR should be started as soon as possible – In some instances, the heart may start again spontaneously with CPR

15. Basic Skills

16. Rescue Breathing The risk of infection from CPR is extremely low but the US Occupational Safety and Health Administration requires that healthcare workers use standard precautions in the workplace, including CPR face maskbag-mask Standard Precautions include using barrier devices such as a face mask or bag-mask device when giving breaths.

17. Head Tilt-Chin Lift Place one hand on the victim’s forehead and push with your palm to tilt the head back. Place the fingers of the other hand under the bony part of the lower jaw near the chin. Lift the jaw to bring the chin forward.

18. Mouth to Mouth Breathing Position yourself at the victim’s side Perform the head tilt / chin lift Pinch the victim’s nose and cover his mouth with yours Deliver air over 1 second to make the chest rise

19. Mouth to Mask Breathing Position yourself at the victim’s side. Place the mask on the victim’s face, using the bridge of the nose as a guide. Seal the mask against the face. Perform the head tilt / chin lift Deliver air over 1 second to make the chest rise

20. Chest Compressions

21. Chest Compressions Basics Position yourself at the victim’s side Make sure the victim is lying face up on a firm surface If you suspect a head or neck injury, try to keep the head, neck, and torso in one line when turning

22. Hand Placement Put the heel of one hand on the center of the victim’s chest on the lower half of the sternum Put the heel of your other hand on top of the first hand Straighten your arms and position your shoulders directly over your hands

23. Rate and Depth Push hard and fast. Press straight down at least 2 inches Deliver compressions in a smooth fashion at a rate of at least 100/min.

24. Overview of Initial BLS Steps

25. 1.Assess the victim for response 1.Assess the victim for response and look for normal or abnormal breathing. If there is no response and no breathing, or no normal breathing (i.e. only gasping), shout for help. Tap and shout, “Are you OK?”

26. activate the emergency response system and get an AED 2. If you are alone, activate the emergency response system and get an AED (or defibrillator) if available and return to the victim.

27. 3. Check the victim’s pulse 3. Check the victim’s pulse (take at least 5 seconds but no more than 10 seconds).

28. perform 5 cycles of compressions and breaths (30:2 ratio), 4. If you do not definitely feel a pulse within 10 seconds, perform 5 cycles of compressions and breaths (30:2 ratio), starting with compressions (C-A-B sequence)

29. CPR Sequence Check the scene Check the scene Check for response Check for response Call for help Call for help Open the airway using the head tilt/chin lift Open the airway using the head tilt/chin lift Give two breaths Give two breaths Check for pulse (carotid) 5-10 seconds Check for pulse (carotid) 5-10 seconds Give 30 chest compressions Give 30 chest compressions Open the airway using the head tilt/chin lift Open the airway using the head tilt/chin lift Give two breaths Give two breaths Continue cycle 30 chest Continue cycle 30 chest compressions/ 2 breaths at a rate of 100 per minute compressions/ 2 breaths at a rate of 100 per minute

30. Chest Compressions Alert – Be careful with your hand position – For adults/children, keep your fingers off patient’s chest – Do not give compressions over bottom tip of breastbone – When compressing, keep elbows straight and hands in contact with patient’s chest at all times – Compress chest hard and fast, but let chest recoil completely between compressions. – Minimize amount of time used giving ventilations between sets of compressions.

31. CPRReview

32. What is the rate for performing chest compressions for a victim of any age? What is the rate for performing chest compressions for a victim of any age? 100 per minute

33. Describe a way you can allow the chest to recoil completely after each chest compression. Allow the chest to expand completely between each compression.

34. After you open the airway and pinch the nose of an unresponsive adult or child, what is the best way to give mouth-to-mouth breaths? Seal your mouth over the victims mouth and give 2 breaths, watching for the chest to rise

35. What is the best way for a rescuer to know that a rescue breath is effective? The chest will rise with each breath.

36. You must check adequate breathing before giving breaths to an unresponsive adult victim. You do this by looking for chest rise and feeling for airflow through the victim's nose or mouth. What other sign should you assess? Listen for airflow from the victim’s nose or mouth

37. When you do not suspect a cervical spine injury, what is the best way to open an unresponsive victim's airway? The head tilt / chin lift technique

38. What should be the next step when you find an unresponsive victim who has agonal gasps and you have sent someone to activate the emergency response system? Open the airway and give 2 breaths

39. How do you know when to start cycles of chest compressions with breaths for an adult? The victims is unresponsive, is not breathing, and does not have a pulse.

40. Why it is important to give early defibrillation to an adult? The most effective treatment for sudden cardiac arrest is synchronized cardioversion

41. What are the steps common to the operation of all AED's in the correct order? Power on, attach pads, clear & analyze, clear & deliver shock if advised

42. After you power on an AED and attach the pads to the victim, what is the next step you should do? Clear the victim so the AED can analyze the heart rhythm

43. What might happen if you touch the victim while the AED is delivering a shock? The AED could shock you while it is shocking the victim.

44. You are using an AED on an adult victim, and the AED gives a "no shock indicated" (or "no shock advised") message. Until advanced care personnel arrive, what should you do next? Leave the pads in place and continue CPR

45. What is the best way to relieve severe choking in a responsive adult? Perform abdominal thrusts

46. A choking adult becomes unresponsive while you are doing abdominal thrusts for severe choking. You ease the victim to the floor and send someone to activate your emergency response system. What should you do next? Begin CPR, when you open the airway, look for and remove the object if seen, before giving breaths

47. Which of the following statements best describes why you should minimize interruptions when giving chest compressions to any victim of cardiac arrest? Which of the following statements best describes why you should minimize interruptions when giving chest compressions to any victim of cardiac arrest? If you minimize interruptions, you increase the victims chance of survival.

48. Breathing stops but the heart still continues for 2-3 minutes. What is this called? Respiratory arrest.

49. You find a victim lying on his right side. He is not breathing but has a pulse. What should you do? Give a rescue breath every 5 seconds.

50. What happens during a cardiac arrest? The heart and breathing stop without warning.

51. Before starting chest compressions, you need to check for a pulse. What pulse site should you use? Carotid

52. A person shows signs of circulation after CPR was started. What should you do? Place the victim in the recovery position, lying on their side.

53. The purpose of the recovery position is to: Prevent aspiration.