3. ECC Mission Statement ECC Mission Statement The mission of the American Heart Association Emergency Cardiovascular Care Programs is to reduce disability and death from cardiovascular emergencies and stroke by improving the Chain of Survival in every community

4. AHA Impact Goal Reduce coronary heart disease, stroke and risk by 25%

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

10. New Fifth Link to the Chain Post- Cardiac Care Victim Transport and Hospitalization

11. C.P.R. Cardiopulmonary Resuscitation (CPR) consists of mouth-to-mouth respirations and chest compressions. CPR allows oxygenated blood to circulate to vital organs such as the brain and heart. CPR can keep a person alive until more advanced procedures (such as defibrillation - an electric shock to the chest) can treat the cardiac arrest. CPR started by a bystander doubles the likelihood of survival for victims of cardiac arrest.

12. CPR CPR AGE CATEGORIES ADULT Puberty and Higher CHILD 1-Onset of Puberty INFANT0-1

13. ADULT CPR IN THREE SIMPLE STEPS 1. Secure the scene for safety. Check the victim for unresponsiveness. If there is no response, immediately call 911 or point to someone to call 911. In most locations the emergency dispatcher can assist you with CPR instructions. unresponsiveness

14. ADULT CPR IN THREE SIMPLE STEPS 2. Compress Chest If the victim is still not breathing normally, coughing or moving, begin chest compressions.

15. PushPush down on the chest at least 2 inches 30 times right between the nipples. Pump at the rate of 100- 120/minute.

16. ADULT CPR IN THREE SIMPLE STEPS 3. Airway and Breathing Tilt the head back, lift the chin, pinch nose and cover the mouth with yours and blow until you see the chest rise. Give 2 breaths. Each breath should take 1 second.

17. ADULT CPR IN THREE SIMPLE STEPS CONTINUE WITH 30 COMPRESSIONS AND 2 BREATHS UNTIL HELP ARRIVES NOTE: This ratio is for one-person & two- person CPR. In two- person CPR the person pumping the chest stops while the other gives mouth-to-mouth breathing.

18. CHILD CPR CPR for Children CPR for children is similar to performing for adults. There are, however, 3 differences. 1) If you are alone with the child give two minutes (5 cycles) of CPR before calling 911 2) Use the heel of one hand for chest compressions 3) Compress at a depth of about 2 inches.

19. INFANT CPR CPR for Infants (Age <1) Shout and gently tap the infant on the foot. If there is no response, position the infant on his or her back

20. INFANT CPR Give 30 Compressions Give thirty gentle chest compressions at the rate of 100-120 per minute. Position your 3rd and 4th fingers in the center of the chest half an inch below the nipples. Press down approximately 1/2 inches.

21. INFANT CPR Open The Airway Open the airway using a head tilt lifting of chin. Do not tilt the head too far back. Give 2 Gentle Puffs If the baby is NOT breathing give 2 small gentle puffs. Cover the baby's mouth and nose with your mouth. Each breath should be 1. second long. You should see the baby's chest rise with each breath.

22. Repeat Repeat with 2 breaths and 30 compressions. After two minutes (5 cycles) of repeated cycles call 911 and continue giving breaths and compressions.

23. C. P. R. Terminology Unresponsiveness During cardiac arrest, the heart stops pumping blood, the blood pressure falls to zero and the pulse disappears. Within 10 seconds of cardiac arrest the person loses consciousness and becomes unresponsive. If you shake or shout at the victim, there will be no response. Sometimes a person in cardiac arrest may make grunting, gasping or snoring type breathing sounds for a couple of minutes. Do not be confused by this abnormal type of breathing. If a person is unresponsive (doesn't respond to shouts or shakes) and not breathing (or breathing abnormally) then call 911 and begin CPR.

24. C. P. R. Terminology Abnormal Breathing Remember a person in cardiac arrest may have abnormal breathing for a couple of minutes. This abnormal breathing is called "agonal respiration" and is the result of the brain's breathing center sending out signals even though circulation has ceased. The key point is that the abnormal breathing may sound like grunting, gasping or snoring. It disappears in 2-3 minutes. If you see this type of breathing DO NOT delay CPR. The person desperately needs air and only you can provide it.

25. C. P. R. Terminology Pushing on the Chest In general the chest should be pushed down about 2 inches. Sometimes you may hear a cracking sound. Do not be alarmed. The sound is caused by cartilage or ribs cracking. Even if this occurs the damage is not serious. The risk of delaying CPR or not doing CPR is far greater than the risk of a broken rib.

26. C. P. R.

43. Objectives How the heart functions What a heart attack is Heart attack warning signs The importance of rapid treatment for a heart attack What to do if warning signs happen How to reduce your risk of heart disease By the end of this session you will be better informed about:

44. Heart Disease: Major Problem in the United States Heart disease #1 killer Coronary heart disease –Major form –Affects about 12 million Americans Heart attack –1.1 million affected each year – 460,000 deaths – Half occur before reaching hospital

45. How Your Heart Functions The heart pumps blood throughout the body. Blood carries oxygen and nutrients. Coronary arteries carry oxygenated blood to the heart muscle.

46. What Is a Heart Attack? Blood flow through one of the coronary arteries becomes blocked. Heart disease, which can lead to a heart attack, develops over time as fatty deposits narrow coronary arteries, restricting blood flow to the heart.

47. How Does a Heart Attack Happen? Coronary artery becomes blocked— usually by a clot. Blood flow is closed off and a heart attack begins. If blockage continues, parts of the heart muscle start to die. Heart may stop beating.

48. What Stops a Heart Attack? Quick action and medical treatment restore blood flow and save heart muscle. Dead heart muscle cannot be restored.

49. Importance of Rapid Treatment “Clot-busting” drugs break up clots, restoring blood flow. Angioplasty opens artery, restoring blood flow. –Balloon –Stent

50. Importance of Rapid Treatment Ideally, treatments should be given within 1 hour after symptoms start. The more heart muscle that is saved, the better the chance of survival.

51. Heart Attack Warning Signs Chest discomfort—pressure, squeezing, fullness, or pain in center of chest Discomfort in one or both arms, back, neck, jaw, or stomach Shortness of breath, may come before or with chest discomfort Breaking out in a cold sweat Nausea Light-headedness

52. What People Expect a Heart Attack to be Like Crushing chest pain Sudden, intense, falls to the floor—like in the movies

53. What Is a Heart Attack Really Like? Heart attacks often begin with vague symptoms that slowly intensify. Pain or discomfort can be relatively mild. Symptoms may come and go. Variety of symptoms may signal danger.

54. Reaction to a Heart Attack May not be sure it is a heart attack May confuse with symptoms of other diseases or conditions May not want to believe risk May ignore symptoms or take a wait-and- see approach

55. Delay Can Be Deadly Patient delay is the biggest cause of not getting care fast. Do not wait more than a few minutes— 5 at the most—to call 9-1-1. 9-1-1

56. Why People Delay Think symptoms are due to something else Afraid or unwilling to admit symptoms are serious Embarrassed about: –“Causing a scene” –Having a false alarm Do not understand need for getting to hospital fast

57. Why People Do Not Call 9-1-1 Think symptoms are not bad enough Unaware of benefits of using 9-1-1 Think transporting self is faster Concern about embarrassment

58. Heart Attacks in Women Women are as vulnerable as men. Half of all heart attack deaths are in women. Tend to delay longer than men in seeking help.

59. Heart Attacks in Women Like men, may feel pain or discomfort Somewhat more likely to experience: –Shortness of breath –Nausea/vomiting –Back or jaw pain Tend to delay telling others about symptoms to avoid causing bother or worry

60. Advantages of Calling 9-1-1 Brings emergency personnel who can— Arrive fast and start medical care Send information to hospital emergency department before the patient’s arrival Restart or shock the heart if patient goes into cardiac arrest 9-1-1

61. Seven Steps to Survival 1.Learn heart attack warning signs. 2.Think through your steps if warning signs occur. 3.Talk with family and friends about warning signs and calling 9-1-1. 4.Talk to your doctor about heart attack risk.

62. Seven Steps to Survival 5.Talk to doctor about what to do if warning signs occur. 6.Gather important information to take to hospital. 7.Call insurance plan to check on coverage.

63. Controllable Risk Factors Cigarette smoking Diabetes High blood cholesterol High blood pressure Overweight/obesity Physical inactivity

64. Non-Controllable Risk Factors Age Family history of early heart disease Previous heart attack or other signs of heart disease