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CPR

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					CPR
              Introduction
– Basic Life Support needed for patient whose
  breathing or heart has stopped
– Ventilations are given to oxygenate blood when
  breathing is inadequate or has stopped
–  If heart has stopped, chest compressions are
  given to circulate blood to vital organs
– Ventilation combined with chest compressions is
  called cardiopulmonary resuscitation (CPR)
– CPR is commonly given to patients in cardiac
  arrest as a result of heart attack
                CPR Saves Lives
    – CPR and defibrillation within 3-5 minutes can save
      over 50% of cardiac arrest victims

    – CPR followed by AED saves thousands of lives
      each year

    – In most cases CPR helps keep victim alive until
      EMS or AED arrives
•
            Circulatory System
• Circulatory system consists of heart, blood, and
  blood vessels.
• Transports blood to lungs
• Delivers carbon dioxide and picks up oxygen
• Transports oxygen and nutrients to all parts of
  body
• Helps regulate body temperature
• Helps maintain body’s fluid balance
Anatomy of the Heart
Coronary Arteries
Major Arteries
  Circulatory System Emergencies
• Any condition that affects respiration reduces
  ability to deliver oxygen
• Severe bleeding
• Shock
• Stroke
• Heart conditions
               Cardiac Arrest
• Heart may stop (cardiac arrest) as a result of
  heart attack
• Brain damage begins 4 - 6 minutes after
  cardiac arrest
• Brain damage becomes irreversible in 8 - 10
  minutes
• Dysrhythmia, an abnormal heartbeat, may
  also reduce heart’s pumping effectiveness
      Causes of Cardiac Arrest
– Heart attack
– Drowning
– Suffocation
– Stroke
– Allergic reaction
– Diabetic emergency
– Prolonged seizures
– Drug overdose
– Electric shock
– Certain injuries
              Chain of Survival
•   Early Access
•   Early CPR
•   Early Defibrillation
•   Early Advanced Care
Cardiopulmonary Resuscitation (CPR)
 – CPR helps keep patient alive by circulating some
   oxygenated blood to vital organs

 – Ventilations move oxygen into lungs where it is
   picked up by blood

 – Compressions on sternum increase pressure
   inside chest, moving some blood to brain/other
   tissues
– Blood circulation resulting from chest
  compressions are not as strong as circulation from
  heartbeat

– Can help keep brain/other tissues alive until
  normal heart rhythm restored

– Often electric shock from AED is needed to restore
  a heartbeat—and CPR can keep patient viable
  until then
– CPR effective only for a short time

– CPR should be started as soon as possible

– In some instances, the heart may start again
  spontaneously with CPR
     Overview of Initial BLS Steps
1. Assess the victim for response and look for
   normal or abnormal breathing. If there is no
   response and no breathing, or no normal
   breathing (i.e. only gasping), shout for help.
2. If you are alone, activate the emergency
   response system and get an AED (or
   defibrillator) if available and return to the
   victim.
3. Check the victim’s pulse (take at least 5
     seconds but no more than 10 seconds).
4. If you do not definitely feel a pulse within 10
     seconds, perform 5 cycles of compressions
     and breaths (30:2 ratio), starting with
     compressions (C-A-B sequence)
                  CPR Sequence
•   Check the scene
•   Check for response
•   Call for help
•   Open the airway using the head tilt/chin lift
•   Give two breaths
•   Check for pulse (carotid) 5-10 seconds
•   Give 30 chest compressions
•   Open the airway using the head tilt/chin lift
•   Give two breaths
•   Continue cycle 30 chest
    compressions/ 2 breaths at a rate of 100 per minute
    Chest Compressions Alert
– Be careful with your hand position
– For adults/children, keep your fingers off patient’s
  chest
– Do not give compressions over bottom tip of
  breastbone
– When compressing, keep elbows straight and hands in
  contact with patient’s chest at all times
– Compress chest hard and fast, but let chest recoil
  completely between compressions.
– Minimize amount of time used giving ventilations
  between sets of compressions.
 CPR
Review
• What is the rate for performing chest
  compressions for a victim of any age?



 100 per minute
Describe a way you can allow the chest to recoil
 completely after each chest compression.



 Allow the chest to expand
 completely between each
 compression.
After you open the airway and pinch the nose of
  an unresponsive adult or child, what is the
  best way to give mouth-to-mouth breaths?



 Seal your mouth over the victims
 mouth and give 2 breaths, watching
 for the chest to rise
What is the best way for a rescuer to know that
 a rescue breath is effective?




 The chest will rise with each breath.
You must check adequate breathing before
  giving breaths to an unresponsive adult
  victim. You do this by looking for chest rise
  and feeling for airflow through the victim's
  nose or mouth. What other sign should you
  assess?

  Listen for airflow from the victim’s
  nose or mouth
When you do not suspect a cervical spine injury,
 what is the best way to open an unresponsive
 victim's airway?



 The head tilt / chin lift technique
What should be the next step when you find an
 unresponsive victim who has agonal gasps and
 you have sent someone to activate the
 emergency response system?

• Open the airway and give 2 breaths
How do you know when to start cycles of chest
 compressions with breaths for an adult?




 The victims is unresponsive, is not
 breathing, and does not have a
 pulse.
Why it is important to give early defibrillation to
 an adult?




 The most effective treatment for
 sudden cardiac arrest is
 synchronized cardioversion
What are the steps common to the operation of
 all AED's in the correct order?




 Power on, attach pads, clear &
 analyze, clear & deliver shock if
 advised
After you power on an AED and attach the pads
  to the victim, what is the next step you should
  do?



 Clear the victim so the AED can
 analyze the heart rhythm
What might happen if you touch the victim
 while the AED is delivering a shock?




 The AED could shock you while it is
 shocking the victim.
You are using an AED on an adult victim, and the
  AED gives a "no shock indicated" (or "no shock
  advised") message. Until advanced care
  personnel arrive, what should you do next?

 Leave the pads in place and
 continue CPR
What is the best way to relieve severe choking in
 a responsive adult?




 Perform abdominal thrusts
A choking adult becomes unresponsive while
  you are doing abdominal thrusts for severe
  choking. You ease the victim to the floor and
  send someone to activate your emergency
  response system. What should you do next?

 Begin CPR, when you open the
 airway, look for and remove the
 object if seen, before giving breaths
• Which of the following statements best
  describes why you should minimize
  interruptions when giving chest compressions
  to any victim of cardiac arrest?

 If you minimize interruptions, you
 increase the victims chance of
 survival.
Breathing stops but the heart still continues for
  2-3 minutes. What is this called?




 Respiratory arrest.
You find a victim lying on his right side. He is not
  breathing but has a pulse. What should you
  do?



 Give a rescue breath every 5
 seconds.
What happens during a cardiac arrest?




 The heart and breathing stop
 without warning.
Before starting chest compressions, you need to
  check for a pulse. What pulse site should you
  use?



 Carotid
A person shows signs of circulation after CPR
  was started. What should you do?




 Place the victim in the recovery
 position, lying on their side.
The purpose of the recovery position is to:




 Prevent aspiration.

				
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posted:7/31/2012
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