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(Cardiopulmonary Resuscitation ). 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 - PowerPoint PPT Presentation
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(Cardiopulmonary Resuscitation)
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
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.
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
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
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)
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
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
Establish Unresponsiveness
• Tap victim on shoulder and ask “Are you OK?”
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
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
Check for Breathing
• Look, Listen and Feel for Breathing (for at least 5 seconds and not more than 10)
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
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
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
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
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
Recheck Circulation
• Cycle=30 compressions and 2 breaths• Recheck pulse
after 5 cycles
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
Differences in Adult, Child, InfantCalling Pulse Hand Hand
postitionRatio
Adult Call 911 once pt is determined unresponsive
Carotid—if no pulse start CPR
Two hands Center of breastbone between the nipples
30:2 1 or 2 rescuer
Child Call after 5 cycles of CPR
Carotid pulse– if no pulse or <60 with sx start CPR
One or two hands
Center of breastbone between the nipples
30:2 for 1 rescuer15:2 for 2 rescuer
Infant Call after 5 cycles of CPR
Brachial pulse-if no pulse or <60 with sx start CPR
2 fingers or two thumbs
Just below nipple line on breastbone
30:2 for 1 rescuer15:2 for 2 rescuer
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
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
2 Rescuer Infant CPR
• Switch to 2 thumb-encircling hands technique
AED (Automated External Defibrillator)
• Most common rhythm is sudden cardiac arrest is ventricular fibrillation
• Earlier defibrillation= increased survival rates
Steps to Use an AED1. Power on AED2. Attach electrode pads to patient (Must be
correct size—Do not use child pads for victims 8 years or older
3. “Clear” the victim and ANALYZE the rhythm4. If the AED advises a shock, “CLEAR” THE VICTIM5. Press the SHOCK button6. After shock, start CPR and after 2 minutes of
CPR, repeat steps 3 and 4
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
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)
Relief of Choking
• Adults and children– Abdominal Thrusts until relieved or unconscious– once unconscious, CPR but check airway before giving breaths
Infant Choking
• Infants: Back blows and chest thrusts until relieved or becomes unconscious