(Cardiopulmonary Resuscitation )

1. (Cardiopulmonary Resuscitation)

2. Why do CPR? • To keep blood flowing to the heart, brain and other vital organs • Provide oxygen to the victim • 70% of cardiac arrest pts are in V-fib. CPR keeps oxygenated blood flow to the vital organs until defibrillation and advanced care can arrive • Earlier defibrillation=higher survival rate

3. Distress vs. Arrest Cardiac Distress • Occurs when the heart is having problems pumping Cardiac Arrest • Occurs when the heart • stops contracting • No blood is pumped • through the blood • vessels.

4. Causes of Cardiac Arrest • Cardiac related causes—ex. heart attack, CHF, arrythmias • Stroke • Untreated respiratory arrest • Medical emergencies (eg, electrical shock, • epilepsy, poisoning) • Drowning • Suffocation • Trauma or shock from massive blood loss

5. SX of MI (myocardial infarction) • Chest discomfort—lasts more than 15-20 minutes—not relieved with rest or nitroglycerin • Some describe pain as intense but not everyone • Feeling of weakness • Other signs may include sweating, nausea, vomiting or shortness of breath

6. Providing Care for MI • Recognize Sx of MI • Convince victim to stop activity • Help them rest comfortably • Administer O2 • Call for more advanced personnel • Assist w/ medications • Monitor vitals • Prepare to give CPR • Advanced Cardiac Life Support (ACLS)

7. Symptoms of CVA (stroke) • Sudden numbness or weakness, especially on one side • Sudden confusion, trouble speaking • Sudden trouble seeing in one eye or both eyes • Sudden trouble walking, dizziness • Sudden severe headache with no known cause

8. Adult CPR • Adult CPR • 1. Check victim’s responsiveness • 2. Call 9-1-1 and get AED • 3. Open airway (head tilt-chin lift) • 4. Check breathing (look, listen, & feel) 5-10 sec • 5. If no adequate breathing give 2 breaths • 5. Check circulation • 6. Perform chest compressions (30 compressions hard and fast) Rate of 100 per minute • 7. Cycles of 30 compressions and 2 breaths • 8. Recheck circulation after approx 2 minute

9. Establish Unresponsiveness • Tap victim on shoulder and ask “Are you OK?”

10. Activate EMS • If victim is unresponsive, activate EMS immediately • Instruct a bystander to call • If you are alone, you must activate EMS before performing any other step • If unresponsive & victim is breathing, place in recovery position

11. Opening the Airway • Head tilt – Chin lift • Remove any visible objects from mouth • If victim has possible spinal injury, use jaw thrust without a head tilt

12. Check for Breathing • Look, Listen and Feel for Breathing (for at least 5 seconds and not more than 10)

13. Agonal Gasps • Sometimes patients may experience gasps in the first few minutes after sudden cardiac arrest • These gasps are not adequate breathing and you must give the victim breaths

14. Give 2 Breaths • Pinch the nose closed with your thumb and index finger • Take a regular breath and seal your lips around the victim’s mouth, creating an airtight seal • Slowly breath air into victim’s mouth until victim’s chest rises • Remove your mouth to let the air come out • Repeat one more breath

15. Check Pulse • Check carotid pulse • Check for 5-10 seconds • If you are not sure if the victim has a pulse, start CPR • Unnecessary CPR is less harmful than not performing CPR that is needed

16. Hand Placement for Chest Compression • Place the heel of one hand in the center of the victim’s bare chest between the nipples • Put the heel of your other hand on the top of your first hand • Straighten your arms and position your shoulders directly over your hands

17. Chest Compressions • Push hard and fast—rate of 100 per min • Press down 1 ½- 2 inches with each compression • For each compression press straight down • At the end of the compression allow the chest to recoil or re-expand completely

18. Recheck Circulation • Cycle=30 compressions and 2 breaths • Recheck pulse after 5 cycles

19. When to Stop CPR • Victim is revived • Replaced by another equally trained person or physician assumes responsibility • Exhaustion • Scene becomes unsafe • Physician direction to stop

20. Differences in Adult, Child, Infant

21. Child CPR • Steps very similar to adult except you do 5 cycles of CPR before calling 911 if you are alone • If pulse <60 with signs of poor perfusion, start CPR • Also you may only use one hand if child is smaller • Compress 1/3 to ½ the depth of the chest • If you have 2 rescuers, you switch to 15:2 ratio

22. Infant CPR • Place 2-3 fingers in center of chest just below nipple line • Ration 30:2 for single rescuer • Ratio 15:2 for two rescuer • Check brachial pulse in upper arm

23. 2 Rescuer Infant CPR • Switch to 2 thumb-encircling hands technique

24. AED (Automated External Defibrillator) • Most common rhythm is sudden cardiac arrest is ventricular fibrillation • Earlier defibrillation= increased survival rates

25. Steps to Use an AED • Power on AED • Attach electrode pads to patient (Must be correct size—Do not use child pads for victims 8 years or older • “Clear” the victim and ANALYZE the rhythm • If the AED advises a shock, “CLEAR” THE VICTIM • Press the SHOCK button • After shock, start CPR and after 2 minutes of CPR, repeat steps 3 and 4

26. Special AED Situations • Hairy chest—either shave chest or use AED pads to remove hair then use 2nd set of AED pads • Water—dry victim’s chest • Implanted defibrillator or pacemaker—place the AED electrode pad at least 1 inch to side of device • Transdermal Medication Patches—remove the patch and wipe the area clean

27. Rescue Breathing • Adults: 1 breath every 5 to 6 (10-12 breaths per minute) • Child: 1 breath every 3 to 5 seconds (12- 20 breaths per minute) • Infant: 1 breath every 3 to 5 seconds (12- 20 breaths per minute)

28. Relief of Choking • Adults and children– Abdominal Thrusts until relieved or unconscious– once unconscious, CPR but check airway before giving breaths

29. Infant Choking • Infants: Back blows and chest thrusts until relieved or becomes unconscious