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Unit 7 CPR

Unit 7 CPR. PRESENTED BY: REVIEWED BY: Ms. Pavithra K Mr. Jobin Lecturer, MSN dept Asst. Professor, MSN dept. LEARNING OBJECTIVES. At the end of the class students will be able to Define CPR Explain the goals of CPR Describe the steps of CPR.

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Unit 7 CPR

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  1. Unit 7CPR PRESENTED BY: REVIEWED BY: Ms. Pavithra K Mr. Jobin Lecturer, MSN dept Asst. Professor, MSN dept

  2. LEARNING OBJECTIVES At the end of the class students will be able to • Define CPR • Explain the goals of CPR • Describe the steps of CPR

  3. CPR is an attempt to restore spontaneous circulation • It is essential to act immediately as irreversible damage can occur in a short time.

  4. Cardiopulmonary resuscitation (CPR) is an emergency procedure which is attempted in an effort to return life to a person in cardiac arrest

  5. Current recommendations place emphasis on high quality chest compressions over artificial respirations • method involving only chest compressions is recommended for untrained rescuers.

  6. Purposes: • To restore the flow of oxygenated blood to the brain and heart. • It may avoid tissue death • opportunity for a successful resuscitation without permanent brain damage. • CPR may induce a shockable rhythm.

  7. Indications • cardiac arrest. • respiratory arrest • Unconsciousness • In cases of pulseless electrical activity, asystole, pulseless bradycardia.

  8. Guidelines According to AHA • Universal compression – 30:2 • Instead of assessing for carotid pulse, take the absence of normal breathing as the key indicator for commencing CPR

  9. STEPS OF CPR • Components C - Circulation A – Airway B – Breathing • Survey • R - Responsiveness • A - Activate EMS • P - Position on back

  10. “R”–“A”–“P” R – Responsiveness Tap or gently shake shoulder and Shout, “Are you OK?”

  11. 1. Determining Unresponsiveness: • BLS begins when a victim is found unresponsive and not moving. • unconscious • he or she should first look for any obvious head or neck injuries.

  12. Whatever the location, the victim’s level of consciousness should be assessed quickly by checking for signs of life like movement and breathing. • The rescuer should call for help and activate the EMS system if the patient is found unresponsive.

  13. “R”–“A”–“P” • A - Activate EMS(Emergency Medical Services) Call to the local emergency number (if unresponsive);

  14. “R”–“A”–“P” • P - Position on back • All body parts rolled over at the same time. • Support neck and spinal column

  15. C • A • B • D- defibrillation

  16. Restoring Circulation: Determining pulselessness: • In adults and children older than 1 year the carotid artery in the neck should be palpated. • If the patient has a pulse but no breathing, ventilation must be started immediately, at the appropriate rate of 8 to 10 breaths/min. • If no pulse, external chest compression must be started

  17. Providing Chest Compressions: • The rescuer manually compresses the lower half of the sternum at a rate of 100 compressions/minute. • Identify the lower half of the victim’s sternum in centre of the chest between the nipples. • Compress the sternum 1.5 to 2 inches at a rate of 100/min.

  18. Hand position for chest compressions • Place heel of one hand on center of chest between the nipples Or • Two fingers above the xiphoid-

  19. Lock arms • Keep Elbows straight. • Position shoulders directly over hands • Depress victim’s sternum (1 ½ to 2 in) • Allow chest to rebound to normal position after each compression.

  20. AIRWAY: • The rescuer should try to open the victim’s airway. • If spinal trauma is suspected, the neck must be carefully positioned in a neutral line position. • If a victim is found lying on his or her side or stomach, he or she should be moved to a supine position, before airway procedures are begun.

  21. The rescuer must ensure that the victim is positioned on a hard, flat surface. • The head tilt/ chin lift method is the primary procedure recommended for the lay person when spinal trauma is suspected. • The jaw thrust is used mainly by trained clinicians when spinal neck injuries are suspected

  22. AIRWAY Head-Tilt/Chin-Lift

  23. JAW THRUST

  24. Breathing : • Before attempting to provide artificial ventilation, the rescuer should assess for the presence of breathing. • Scan for the chest movements • This should not take longer than 3 to 5 seconds

  25. If Yes • Continue to protect airway. • Place victim in recovery position.

  26. Providing artificial ventilation: • During respiratory arrest the victim must be provided with oxygen within 4 to 6 minutes • The rescuer can restore an oxygen supply to the victim’s lung into the victim’s mouth, nose or tracheal stoma.

  27. Mouth- to-Mouth ventilation: • Mouth -to -Nose ventilation: • Mouth –to- Stoma ventilation:

  28. BREATHING Give two slow Mouth to Mouth Rescue breaths. • Pinch the nose • Seal the victim’s mouth • Give slow breaths

  29. Mouth-to-Nose Rescue Breathing • Can’t open mouth • Can’t make a good seal • Severely injured mouth • Stomach distension Mouth-to-Stoma Rescue Breathing • In case of tracheotomy

  30. Mouth to Mouth Barrier Devices

  31. One Vs Two rescuer • When performing CPR alone the rescuer must remember to give 30 compressions to 2 breaths until AED arrives. • When 2 rescuers are available, one rescuer ventilates and the other performs the compression. • The compression ventilation ratio is same as that of single rescuer. 30:2

  32. When 2 people provide support, • one person -30 compressions • other person can administer 2 ventilations. • the rescuers should change positions every 5 cycles.

  33. Defribillation • Shockable rhythm • After 5 cycles

  34. Hazards and Complications: • Worsening of existing neck or spine injuries. • Gastric inflation and vomiting • Trauma to internal structures during chest compressions like rib fracture.

  35. Contraindications of CPR • CPR is stopped when patient is obviously biologically dead (rigor motis) • “Do not resuscitate” order

  36. EVALUATION • What is CPR? • What are the goals of CPR • Explain the steps of CPR • What are the complications of CPR

  37. REFERENCE • Smeltzer – Brunner & Suddharth Textbook of Medical Surgical Nursing, Wolterskluwer publishers, 12th edition 2009. • Black – Medical Surgical Nursing, Elsevier publishers, 8th edition 2009. • Nettina – Lippincott manual of Nursing Practice, Wolterskluwer publishers, 7th edition 2014. • Lewis – Medical Surgical Nursing, Elsevier publishers, 10th edition, 2017

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