1. AHA New Guidelines 2010 for CPR

2. C.P.R. CARDIO= HeartCARDIO= Heart PULMONARY = LungPULMONARY = Lung RESUSCITATION = RevivalRESUSCITATION = Revival

3. sudden cardiac arrest EMS treats nearly 300,000 out of hospital cardiac arrest each year in the U.S.EMS treats nearly 300,000 out of hospital cardiac arrest each year in the U.S. Less than 8 percent of people who suffer cardiac arrest outside of the hospital survive to make it home from the hospital.Less than 8 percent of people who suffer cardiac arrest outside of the hospital survive to make it home from the hospital. Nationally, only 20 % get bystander helpNationally, only 20 % get bystander help Locally, 50 % receive helpLocally, 50 % receive help

4. CPR facts 500,000 deaths a year due to cardiac arrest500,000 deaths a year due to cardiac arrest 250,000 will die before they reach the hospital250,000 will die before they reach the hospital 50% show up by private car to the hospital50% show up by private car to the hospital Avg. person waits 2 hours before seeking help – are more likely to go into cardiac arrest within the 1 st hourAvg. person waits 2 hours before seeking help – are more likely to go into cardiac arrest within the 1 st hour Effective bystander CPR provided immediately after sudden cardiac arrest, can double or triple a victim’s chance of survival.Effective bystander CPR provided immediately after sudden cardiac arrest, can double or triple a victim’s chance of survival. 13 million people worldwide are trained in CPR.13 million people worldwide are trained in CPR.

5. CPR Facts Best place to have a heart attack?Best place to have a heart attack? Las VegasLas Vegas Worst Place?Worst Place? *Detroit Michigan – 0% *Washington DC – 5% Seattle/King Co. – 50% Are over 250 AED’s at SeaTac Airport

6. Most Common TIMES CPR is Needed Heart Attack Drug Overdose Drowning Smoke Inhalation Electrical Shock Choking

7. AHA Adult chain of survival 1. Immediate recognition of cardiac arrest and activation of the emergency response.1. Immediate recognition of cardiac arrest and activation of the emergency response. 2. Early CPR with emphasis on chest compressions.2. Early CPR with emphasis on chest compressions. 3. Rapid defibrillation3. Rapid defibrillation 4. Effective advanced life support4. Effective advanced life support 5. Integrated post-cardiac arrest care.5. Integrated post-cardiac arrest care.

8. HEART ATTACK “Death of part of the heart muscle due to inadequate supply of blood and oxygen.”“Death of part of the heart muscle due to inadequate supply of blood and oxygen.” Signs of a heart attack:Signs of a heart attack: Severe chest pain or pressureSevere chest pain or pressure Sweating, nausea, shortness of breath, weakness, fainting, heartburn, back painSweating, nausea, shortness of breath, weakness, fainting, heartburn, back pain *Signs may last for several minutes

9. Sudden Cardiac Arrest Cardiac arrest is present when the heart stops pumping.Cardiac arrest is present when the heart stops pumping. The most common cause of cardiac arrest in adults is an abnormal heart rhythm called ventricular fibrillation (VF)The most common cause of cardiac arrest in adults is an abnormal heart rhythm called ventricular fibrillation (VF) In VF the heart quivers uselessly and does not pump blood.In VF the heart quivers uselessly and does not pump blood. VF requires an immediate electric shock – defibrillation – to the heart to allow the normal heart rhythm to resumeVF requires an immediate electric shock – defibrillation – to the heart to allow the normal heart rhythm to resume

10. Sudden Cardiac Arrest The best chance for survival depends on early CPR and early defibrillationThe best chance for survival depends on early CPR and early defibrillation For every minute that passes without defibrillation, the victim’s chances of survival falls by 7 – 10 % (unless CPR is provided)For every minute that passes without defibrillation, the victim’s chances of survival falls by 7 – 10 % (unless CPR is provided) 4 minutes: Brain damage begins4 minutes: Brain damage begins 10-12 minutes: Chance of survival is small unless CPR is provided10-12 minutes: Chance of survival is small unless CPR is provided

11. Time is Crucial Once breathing has stopped, brain cells begin to die. CPR Started inChance of Recovery 1 minute90% 4 – 6 minutes50% 7+ minutes10%

12. New Steps to CPR

13. Aed AND PERSONNEL One RescuerOne Rescuer Unresponsiveness – Call 911 and get the AEDUnresponsiveness – Call 911 and get the AED BEGIN COMPRESSIONS AND BREATHINGBEGIN COMPRESSIONS AND BREATHING Attach AEDAttach AED Two RescuerTwo Rescuer #1 – Call 911/Perform CPR#1 – Call 911/Perform CPR #2 – Attach AED#2 – Attach AED *If an AED is on site – don’t start CPR *If no AED on site – start CPR and continue until an AED arrives

14. Tap and shout Tap and Shout to check for unresponsiveness. Tap and Shout to check for unresponsiveness. 10% of victims have seizures while in cardiac arrest. Are often found laying down so often people “leave them alone.” Have to roll them over to check.10% of victims have seizures while in cardiac arrest. Are often found laying down so often people “leave them alone.” Have to roll them over to check.

15. Yell for help. Send someone to phone 911 an get an aed When calling 9-1-1…When calling 9-1-1… Give the specific locationGive the specific location Phone # of where they can reach youPhone # of where they can reach you Nature/Extent of the emergencyNature/Extent of the emergency Advise that AED is on the scene or NOTAdvise that AED is on the scene or NOT Don’t hang up until the dispatcher advisesDon’t hang up until the dispatcher advises

16. Infant, child, adult CPR InfantChildAdult 30:2 2 fingers1 Hand2 Hands About 1 ½ inchesAt least 2 inches 100 X a min. 1 yr. or youngerAge 1 - 88 and older

17. Guideline for Chest Compressions Position victim on a hard surface on their backPosition victim on a hard surface on their back Remove clothing from chestRemove clothing from chest Locate correct hand position on the center of the chest and on the lower half of the breastbone, right between the nipples.Locate correct hand position on the center of the chest and on the lower half of the breastbone, right between the nipples. Place the heel of one hand on the sternum and place the other hand on top.Place the heel of one hand on the sternum and place the other hand on top. Depress sternum 2 inchesDepress sternum 2 inches Provided 30 chest compressions at a rate of at least100 x per minute. Make sure to have complete chest recoil!Provided 30 chest compressions at a rate of at least100 x per minute. Make sure to have complete chest recoil! Give 30 compressions, (if trained and proficient give 2 breaths lasting one second each)Give 30 compressions, (if trained and proficient give 2 breaths lasting one second each) Count out loud…”One and two…” to the beat of “Staying Alive”Count out loud…”One and two…” to the beat of “Staying Alive”

18. “Open AIRWAY” Airway can be blocked by the tongueAirway can be blocked by the tongue Position victimPosition victim Open the airwayOpen the airway Head tilt-chin lift (or jaw thrust)Head tilt-chin lift (or jaw thrust)

19. Suspected Neck Injury If a neck (spinal) injury is suspected, use the jaw thrust. Position yourself at the victim's side and without tilting the head, lift the jaw.If a neck (spinal) injury is suspected, use the jaw thrust. Position yourself at the victim's side and without tilting the head, lift the jaw.

20. BREATHING While holding the airway open, pinch the nose closed. While holding the airway open, pinch the nose closed. Take a breath. Cover the person’s mouth with your mouth. Take a breath. Cover the person’s mouth with your mouth. Give 2 full breaths (1 second each) Watch for the chest to begin to rise as you give each breath. Give 2 full breaths (1 second each) Watch for the chest to begin to rise as you give each breath.

21. AGoNOL BREATHING Sometimes the victim will sound like they are snoring. This is not an indication of true breathing. Agonal breathing is an indication that CPR needs to be started.Sometimes the victim will sound like they are snoring. This is not an indication of true breathing. Agonal breathing is an indication that CPR needs to be started.

22. Special considerations Is victim lying in water?Is victim lying in water? Is victim less than 8 years old?Is victim less than 8 years old? Is victim wearing a transdermal medication patch on his/her chest?Is victim wearing a transdermal medication patch on his/her chest? Does the victim have a pacemaker or implanted defibrillator?Does the victim have a pacemaker or implanted defibrillator?

23. Effectiveness of pads

24. aed defibrillation Right Electrode PadRight Electrode Pad To the right of the breastboneTo the right of the breastbone Below the collarbone above the nippleBelow the collarbone above the nipple Left Electrode PadLeft Electrode Pad Outside the left nipple, upper edge of the pad several inches below the armpitOutside the left nipple, upper edge of the pad several inches below the armpit

25. choking The choking sign is holding the neck with one or both hands. The choking sign is holding the neck with one or both hands. “There are more than 3000 deaths per year in the US due to choking.” “There are more than 3000 deaths per year in the US due to choking.”

26. Signs of choking Mild signs include: Can make sounds or can cough loudly. You should: Stand by and let him/her cough. Mild signs include: Can make sounds or can cough loudly. You should: Stand by and let him/her cough. Severe signs may include: Cannot breathe or has a cough that has no sound or cannot talk or make a sound or makes the choking sign. You should: Act quickly and follow the steps to help a choking adult. Severe signs may include: Cannot breathe or has a cough that has no sound or cannot talk or make a sound or makes the choking sign. You should: Act quickly and follow the steps to help a choking adult.

27. Action to help a choking conscious adult If you think someone is choking, ask, “Are you choking?” If victim nods yes, tell them you are going to help. If you think someone is choking, ask, “Are you choking?” If victim nods yes, tell them you are going to help. Get behind him/her. Wrap your arms around him/her so that your hands are in front. Get behind him/her. Wrap your arms around him/her so that your hands are in front. Make a fist with 1 hand. Make a fist with 1 hand. Put the thumb side of your fist slightly above the belly button and well below the breastbone. Put the thumb side of your fist slightly above the belly button and well below the breastbone. Grasp the fist with your other hand and give quick upward thrusts into abdomen. Grasp the fist with your other hand and give quick upward thrusts into abdomen. Give thrusts until the object is forced out and the victim can breather, cough, or talk, or until victim stops responding. Give thrusts until the object is forced out and the victim can breather, cough, or talk, or until victim stops responding.

28. Special circumstances If someone is choking and is in the late stages of pregnancy or is a very large person, give thrusts on the chest instead of thrusts on the abdomen. If someone is choking and is in the late stages of pregnancy or is a very large person, give thrusts on the chest instead of thrusts on the abdomen. Put your arms under the armpits and your hands on the lower half of the breastbone. Pull straight back to give the chest thrusts. Put your arms under the armpits and your hands on the lower half of the breastbone. Pull straight back to give the chest thrusts.

29. How to help a choking child If you think the child is choking, ask “Are you choking?” If victim nods yes, tell him you are going to help. If you think the child is choking, ask “Are you choking?” If victim nods yes, tell him you are going to help. Get behind the victim. Wrap your arms around him/her so that your hands are in front. Get behind the victim. Wrap your arms around him/her so that your hands are in front. Make a fist with 1 hand. Make a fist with 1 hand. Put the thumb side of your fist slightly above the belly button and well below the breastbone. Put the thumb side of your fist slightly above the belly button and well below the breastbone. Grasp the fist with your other hand and give quick upward thrusts into the abdomen. Grasp the fist with your other hand and give quick upward thrusts into the abdomen. Give thrusts until the object is forced out and he can breathe, cough, or talk, or until victim stops responding. Give thrusts until the object is forced out and he can breathe, cough, or talk, or until victim stops responding.

30. How to help a choking infant Hold the infant facedown on your forearm. Support he infant’s head and jaw with your hand. Hold the infant facedown on your forearm. Support he infant’s head and jaw with your hand. Give up to 5 back slaps with the heel of your other hand between the infant’s shoulder blades. Give up to 5 back slaps with the heel of your other hand between the infant’s shoulder blades. Give up to 5 chest thrusts using 2 fingers of your other hand to push on the chest in the same place you push for CPR. Give up to 5 chest thrusts using 2 fingers of your other hand to push on the chest in the same place you push for CPR. Repeat giving 5 back slaps and 5 chest thrusts until the infant can breathe, cough, or cry or until he stops responding. Repeat giving 5 back slaps and 5 chest thrusts until the infant can breathe, cough, or cry or until he stops responding.

31. If the Choking victim becomes unconscious Immediately call 9-1-1 and start the CPR sequence until help arrives. When completing the ventilations, look for a foreign object. If seen, remove it. If not, continue CPR. Continue until help arrives.