American Heart Association (AHA)

1. American Heart Association (AHA) CPR

2. CPR CARDIOPULMONARY RESUSCITATION Heart/Lungs “To bring back”

3. ABC’S OR CAB’S??? BIG change in CPR guidelines: no more ABC’s but rather…CAB’s C= Circulation A= Airway B= Breathing The CAB’s are your priority management steps to life-saving

4. Why the change? 1.In the ABC sequence, chest compressions were often delayed while the responder opened the airway to give mouth to mouth breaths, etc. By changing the sequence to CAB, chest compressions will be initiated sooner.

5. Why the change?? 2. Most victims out of hospital do not receive any bystander CPR because in the ABC sequence, the starting procedures were airway and mouth to mouth breathing which most rescuers found difficult. Starting with chest compressions might encourage more rescuers to begin CPR.

7. WHEN DO YOU DO CPR??? Based on signs of unresponsiveness with no breathing or no normal breathing (ie. Victim is gasping!)

8. When do you do CPR??? Loss of circulation: Heart attack Drowning Allergic Reaction Stroke

9. Loss of Breathing Heart attack Choking Drowning Drug OD

10. STEPS FOR CPR Make sure scene is safe Put hand on forehead…Shake the victim’s shoulder and SHOUT to see if they respond If the victim does NOT respond, and the victim is not breathing or gasping for air, yell for someone to call 911 and get an AED Start CPR

11. STEPS FOR CPR If you are alone, call 911 and get an AED if available. Follow the AED’s voice prompting. If no AED is available, immediately start CPR, beginning with compressions. SO WHAT IS AN AED ANYWAY?????

12. AED AUTOMATIC EXTERNAL DEFIBRILLATOR A device that electrically jolts the heart to bring it back to a normal rhythm. Remember…in a cardiac arrest the heart has stopped beating!

15. (AED) Automated External Defibrillator • When AED arrives, place it at the victims side, next to the responder using it. • POWER – POWER on the AED. • ATTACH – ATTACH the pads to the victim, then attach to AED. • ANALYZE – Clear the victim and ANALYZE the rhythm, by pressing the analyze button. • SHOCK – If the AED advises a shock, Clear the victim and press the SHOCK button. • CPR – After AED gives the shock, begin CPR beginning with chest compressions. • RE-ANALYZE – After 2 minutes of CPR, press ANALYZE on AED • Special situations. • Un-witnessed out of hospital cardiac arrest in children, perform 5 cycles (2 mins) of CPR before using the AED. • Use adult pads on victims aged 8 and Older. • Use specialized pediatric pads on victims aged 1 to 8. • Currently no evidence to recommend for AED use on infants aged 1 or less. • If victim is an adult and a victim because of drowning, give 5 cycles of CPR (2 mins) before activating EMS and using the AED.

16. STEPS FOR CPR Make sure scene is safe Put hand on forehead…Shake the victim’s shoulder and SHOUT to see if they respond If the victim does NOT respond, and the victim is not breathing or gasping for air, yell for someone to call 911 and get an AED Start CPR

17. So…let’s look at CAB Compressions: (C) Push hard and fast on the center of the chest 30 times at a rate of at least 100 compressions/minute. Push down at least 2 inches with each compression and allow each compression to “recoil” before the next compression.

19. AIRWAY Airway- (A) Open airway by head tilt-chin-lift

21. BREATHING Breathing(B) Pinch victim’s nose closed. Take a normal breath a cover the victim’s mouth with your mouth, creating an airtight seal. Give 2 breaths (1 second each). Watch for the chest to rise as you give the breath.

23. CPR STEPS: Keep giving sets of 30 compressions and 2 breaths until the AED arrives or paramedics come Push hard/fast AT LEAST 100 times a minute and AT LEAST 2 inches depth

24. 1 Rescuer CPR for Infants • 1 – Check for scene safety. • 2 – Check for responsiveness. • 3 – If no response SHOUT for help, send someone to ACTIVATE EMS and get an AED. • A – Open the Airway (head-tilt-chin-lift or jaw thrust) Look, Listen, Feel for breath (5 – 10 secs). The head is in a SNIFFING position. • B – Give 2 breaths (give enough breath to make the chest rise).***remember to place your mouth around the nose and mouth. • Start CPR 30 compressions and 2 breaths at a rate of 100 compressions per min. • After 5 cycles of 30:2 if alone ACTIVATE the EMS and get the AED

27. Relief of Choking in the Adult and Child • Ask the victim “Are you choking?” if the victim nods yes • Ask the victim “Can I Help?” if the victim nods yes • Position yourself behind the victim (standing for adult, knelling for child) place one fist turned up with the thumb against the abdomen. The other hand clasping the first fist. • Thrust inward and upward with enough force to expel the object. • Continue to thrust until the object is expelled or the victim becomes unresponsive. • If the object is expelled have the victim see a healthcare professional for further evaluation. • If the Adult victim becomes unresponsive, ACTIVATE the EMS get an AED. Open the airway and remove the object if you see it, then begin CPR. Check the Airway every time before giving breaths during CPR. • If the Child victim becomes unresponsive, Open the airway, remove the object if you see it, and begin CPR. After 5 cycles (2 min) ACTIVATE the EMS and get an AED. Check the Airway every time before giving breaths during CPR.

30. Relief of Choking in the Infant. • Signs of Severe Airway Obstruction • poor / no air exchange. • weak ineffective cough / no cough at all. • turning blue around mouth. • Knell / sit with infant in your lap • 5 back thrusts, 5 chest thrusts, continue until object is expelled or infant becomes unresponsive. • If object is expelled take infant to a Healthcare provider for further evaluation. • If object is not expelled and infant becomes unresponsive, Open the airway, remove the object if you see it, and begin CPR. After 5 cycles (2 mins) ACTIVATE the EMS. Check the Airway every time before giving breaths during CPR.