Docstoc

CPR and First Aid Basics_

Document Sample
CPR and First Aid Basics_ Powered By Docstoc
					  Unit 21 Cardiac Arrest and
Cardiopulmonary Resuscitation



                   韩明华
              山东省泰安卫生学校
      Review

 What are the most common causes of upper gastrointestinal
  hemorrhage?
  Peptic ulcer disease; erosive gastritis; esophageal varices
 Upper GI hemorrhage is characteristically manifested by:
  Hematemesis and melena
 If the blood loss is more than 40% of the total blood volume,
  it may cause:

  Hypovolemic shock, with pallor, cool clammy skin,
  hypotension and tachycardia
               Learning Objectives


 Tell all the steps of the chain of survival and
  present the importance of each step
 Know how to perform one rescuer CPR and two
  rescuer CPR in adults
 Use AED correctly and proficiently
                        BACKGROUND

 Approximately 540,000 people die of cardiac arrest per year
  in China
 Survival to hospital discharge presently approximately 5-10%
 Typically <20% of bystanders can perform CPR before
  arrival of emergency services
 Early resuscitation and prompt defibrillation (within 1-2
  minutes) can result in >60% survival
What is Cardiac Arrest?
Causes of Cardiac Arrest
 Trauma
 Drowning
 Electrical shock
 Hypersensitivity reactions
 Drug overdose
 Cardiac dysrhythmias: ventricular fibrillation
 CAD/AMI
Patient Symptoms of Cardiac Arrest

 Unconsciousness
 No breathing
 No heart sounds
 No major pulse (carotid or
  femoral)
 Dilation of pupils


 Resulting in…

No Oxygen to the Brain or Body
Organs
Start CPR Immediately
 Better chance of survival
 Brain damage starts in 4-6 minutes
 Brain damage is certain after 10 minutes
 without CPR
CPR-Cardiopulmonary Resuscitation
 CPR is the care given to a
  victim who is not breathing and
  does not have a pulse.
 Revives heart (cardio) and
  lung (pulmonary)
  functioning
 Keeps blood that contains
  oxygen flowing to the brain and
  vital organs until ACLS arrives.
How CPR Works
 Effective CPR provides 1/4 to 1/3 normal
  blood flow
 Rescue breaths contain 16% oxygen
Chain of Survival




   Early    Early       Early
                        Early         Early
  Access    CPR     Defibrillation
                    Defibrillation   Advanced
                                      Care


   FAST SPEED IS THE KEY TO SUCCESS
Cardiac Chain of Survival
 Early recognition and quick call to 1-2-0
 Begin CPR right away
 Use AED quickly
 EMS get victim to hospital ASAP



 Best chance of survival if these things are done
 QUICKLY!!!
Check the scene for safety:
 Make sure there is nothing around that will
   cause you harm before approaching the victim,
   such as spilled chemicals, traffic, fire, and other
   hazardous items.
Survey The Scene, then: RAP
 R - Responsiveness       Are you
                            okay?




Tap shoulder and shout loudly
  RAP
 A - Activate EMS
 ( if unresponsive)
  Call 120 or the local
  emergency number (If there
  are other people at the scene,
  ask them to call for help!)
  Make sure you give the 120
  operator the correct
  information!
 RAP
 P - Position on back
   On a hard, flat surface
     Always be aware of head and spinal cord injuries
     Support neck and spinal column
Steps of CPR


               Call
ABC
 Airway
 Breathing
 Circulation




           SAVING A LIFE IS EASY
Checking Vital Signs
 A – Airway
  Open the airway and maintain the
   airway open
  Head tilt chin lift
   B – Check For Breathing
 Look, listen and feel
 for normal breathing
  No longer than 10
   seconds
     Breathing
 If the victim is not
  breathing, give two breaths
   Pinch the nose
   Seal the mouth with yours
   Watch the chest rise
 Check for choking
   Clear the airway
 Mouth to mouth devices
   Masks /Shields
  Compressions
 If no signs of life, start chest compression…
 Using both hands, give 30 chest compressions at a
 rate of 100 per minute
    Count 1, 2, 3 …




                  push hard and push fast
                               Land mark




                                  press down on the
                                sternum 1 ½ to 2 inches




Place the heel of one hand in                      Place the heel of your other
the centre of the victim’s chest.                 hand on top of the first hand.
                                30 : 2




After 30 compressions open the airway again using head tilt and chin lift give

2 breaths while watching the chest rise.
    CPR
 After 30 chest compressions give:
 2 slow breaths
 Continue compressions and breaths at a ratio
 of 30:2 until help arrives or victim recovers
 If the victim starts moving: check
 breathing
Two Partner CPR
 Rescuer 1:
   RAPAB
 Rescuer 2:
   place hands for
   compressions
 Compression rate: 30:2
 Switch off when tired
Checking for CPR Effectiveness
 Does chest rise and fall with rescue breaths?
 Have a second rescuer check pulse while
 you give compressions
When Can I Stop CPR?
 Victim revives
 Trained help arrives
 Too exhausted to continue
 Unsafe scene
 Physician directed (do not resuscitate orders)
 Cardiac arrest of longer than 30 minutes
   (controversial)
 Why CPR May Fail

 Delay in starting
 Improper procedures (ex. Forget to pinch nose)
 No ACLS follow-up and delay in defibrillation
   Only 15% who receive CPR live to go home
 Terminal disease or unmanageable disease
 (massive heart attack)
Complications of CPR
 Rib fractures
 Laceration of liver, spleen or lungs
 Vomiting
 Stomach distension
Here are some Key points you NEED to remember!
 Check the person for consciousness
 Call for help!
 Open the airway and look, listen, and feel for signs of life
 Give 30 chest compressions with both hands then open the
 airway and give 2 rescue breaths.
 Continue the 30 to 2 ratio until EMS arrives.
This Video is from the American Heart Association. It will
take you through the important steps of CPR for an adult!

                Click to watch the video!
    Even With Successful CPR, Most Won’t
    Survive Without ACLS

 ACLS (Advanced Cardiac
  Life Support)
 ACLS includes defibrillation
  (AED), oxygen, drug
  therapy
            AED
Automated External Defibrillator
AED
Public access AED
Home AED
   What does an AED do?

 The AED is programmed to analyze the heart’s electrical
  activity, and decide whether the electrical shock would help.
  It then builds up an electric charge and deliver to the patient
  when you push the button. If a victim truly has no pulse, the
  AED is the only thing that will bring the victim back to life.
  CPR only keeps blood and oxygen flowing through the body.
  CPR alone does NOT restart the heart!
•   CPR (only) ……………………… 0-2%

• EMS/ER …………………… 5-15%
• CPR+AED…….. 30-75%
 Electrode placement

 Remove electrodes from package
 Apply to victims :upper right chest
                   left lower side of chest
 Wet victims should be toweled dry.
 Hairy chest may need shaving.
SWITCH ON AED




        Some AEDs will automatically
         switch themselves on when the
         lid is opened
ATTACH PADS TO CASUALTY’S BARE
CHEST
ANALYSING RHYTHM
DO NOT TOUCH VICTIM
SHOCK INDICATED




          Stand clear
          Deliver shock
• Don’t Touch Patient During Analysis
• Keep Clear of the Victim
 While Delivering Shock
                                   Trainning Section
     SHOCK DELIVERED
     FOLLOW AED INSTRUCTIONS




30                       2
IF VICTIM STARTS TO BREATHE NORMALLY
PLACE IN RECOVERY POSITION
        Key Points of Using AED

•   Turn on AED
•   Wipe chest dry; Shave chest hair
•   Attach pads
•   Analyze rhythm
•   Deliver shock

• WHAT TO DO NEXT-
• After shock, give about 2 minutes of CPR.
               AED-Video
This Video is from the European Resuscitation Council.
      American Heart Association (AHA)
Resuscitation Training Center of Caritas Medical Center
Basic Life Support for Healthcare Providers
         CPR & AED Program (Adult)
Two rescuer CPR Practice
CPR-Infant
Cardiac Arrest
How to perform CRP
Chain of survival
How to use AED!
  Classroom Exercises
                                    100
 Chest compression rate is about _______ per minute
 The new ratio of compressions to breaths in adult, child
                  30 : 2
  and infant is _______
                              1.5-2 inches
 Press down on the sternum __________ in adults
 Tell the chain of survival:
   Access-CPR-AED-EMS------Fast Speed
 Steps of CPR:
   Airway, Breathing, Circulation
Assignments
 One rescuer CPR practice in adults
 Two rescuer CPR practice
 Recite the steps of using AED
 CPR+AED practice in pairs
?

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:34
posted:2/14/2012
language:English
pages:58