310 likes | 1.08k Views
CARDIOPULMONARY RESUSCITATION. CPR. Cardiopulmonary Resuscitation (CPR). CPR is a proven technique to administer basic life support to a patient whose heart has stopped beating.
E N D
Cardiopulmonary Resuscitation (CPR) • CPR is a proven technique to administer basic life support to a patient whose heart has stopped beating. • CPR consists of artificial respiration which supplies oxygen to the blood and heart compressions which supply blood to the body.
Automated External Defibrillator (AED) • Device that generates an electric shock • AED analyses the patient’s heart rhythm and indicates if an electric shock would be beneficial • While in an abnormal rhythm, the heart does not effectively pump blood throughout the body • CPR and early defibrillation give the best chance of survival
Pulse Check in CPR • Carotid Artery - Adult/Child • Brachial Artery- Infant • Pulse check is only taught to trained responders If the patient is unresponsive and not breathing, and you don’t find a pulse after 10 sec, you must conclude the patient is in cardiac arrest. You should immediately begin CPR and AED without further delay.
Landmarking-Adult • With the hand closest to the head, place the heel of that hand on the sternum in the centre of the chest. Make sure it is not on the xiphoid process. • Place the heel of the other hand on top of the first hand. • Interlace the fingers to keep them off the chest. • Landmark every time you remove your hands from an adult patient’s chest.
Landmarking-Child • Place the heel of one hand on the sternum in the centre of the chest. Make sure it is not on the xiphoid process. • Only the heel of the hand should be in contact with the chest. • For the child, you administer cardiac compressions with one or two hands - as needed • Subsequent landmarking is done visually.
Landmarking-Infant • Place two fingers in the middle of the infant's chest between the nipples • Slide your fingers to just below the nipple line • Administer chest compressions with the two fingers
Depth of Compressions Adult, Child and Infant: Compress the chest down one third to one half it’s depth
One Rescuer CPR, Adult • Scene survey • Establish unresponsiveness • Activate EMS • Open airway • Check for breathing • If absent, check pulse • If absent, landmark • 30 compressions + 2 breaths • 100 compressions per minute • repeat 5 sets of 30:2, reassess
Two Rescuer CPR - Adult or Child • Survey the scene • Rescuer 1 is performing CPR • Rescuer 2 will identify him/her self & checks that EMS has been activated • Rescuer 1 complete 30:2 cycle then reassess vitals - no more than 10 sec. • Rescuer 2 co-operates with Rescuer 1 with reassessment • if no visible signs: • One rescuer now performs chest compressions • The other now administer rescue breaths • Rescuer 1 and 2 will change positions with little interruption every few minutes
Scene survey • Establish unresponsiveness • Activate EMS (if alone, do 2 min of CPR before EMS) • Open airway • Check for breathing, • if absent, check for pulse • if absent, landmark • 30 compressions + 2 breaths • 100 compressions per minute • repeat 5 sets of 30:2 reassess One Rescuer CPR - Child
Scene survey • Establish unresponsiveness • Activate EMS (if alone - 2 min of CPR before EMS) • Open airway • Check for breathing, • if absent, check for pulse • if absent, landmark • 30 compressions + 2 breaths • 100+ compressions per minute • Repeat 5 sets of 30:2, reassess One Rescuer CPR - Infant
Do Not Resuscitate (DNR) • Decapitated • In Rigor Mortis • Incinerated • Eviscerated • Decayed • Prolonged submersion (days of decomposition) • Ordered not to by a physician or police officer
Key Points • Use an even squeezing motion when doing the compressions • CPR should never be interrupted for more than 10 seconds • Always release pressure between compressions • Maintain contact with the skin at all times • For adults/child • interlace fingers of both hands or extend them straight out to give a straight, downward pressure on the sternum
Key Points • Expect some damage to the patient’s chest while doing CPR. • Injuries to the chest area can be life-threatening if they result in damage to either the heart or lungs, or cause severe internal bleeding. Responders may require CISM support after performing CPR
Chain of Survival • Healthy Choices • Recognition of Warning Signs • Early Access to the Emergency Medical Services (EMS) System • Early CPR • Early Defibrillation • Early Advanced Care • Early Rehabilitation
Health Care Provider Level (HCP) • EMS activation: if the patient is suffering respiratory arrest, if alone the HCP should do 5 cycles of CPR before calling EMS • HCP would do two breaths before compressions are started • Two rescuer CPR on children or infants will be done at rate of 15:2 when using a BVM
Health Care Provider Level (HCP) • Aged guidelines are: • Infant: up to one year of age • Child: 1 yr to puberty • Adult: after puberty • Infant compressions may be delivered using the two thumbs with hands encircling the chest