Chest Compressions
Advertisement 1. Indications 1. Newborn Resucitation 2. Pediatric Resuscitation 3. Adult Resuscitation 2. Technique: Newborns 1. Sternal Compressions 1. General 1. Depress one third chest depth 2. Do not lift fingers from chest between compressions 2. Technique 1: Thumbs depress sternum 1. Hands encircle torso 2. Fingers support spine 3. Preferred (less tiring) 3. Technique 2: Two fingers depress sternum 1. Use Index, Middle Finger placed below nipple level 2. Preferred for larger newborns 2. Compression rate >90 times per minute 3. Compression to ventilation ratio: 3 to 1 4. Sequence (2 sec): One and Two and Three and Breath 3. Technique: Infants (age under 1 year) 1. Sternal Compressions 1. Use Index, Middle Finger placed below nipple level 2. Depress 1/2 to 1 inch (1/3-1/2 chest depth) 2. Compression rate > 100 times/minute 3. Compression to Ventilation Ratio = 30:2 (one or two rescuer) 4. Technique: Children (1 to 8 years) 1. Sternal Compressions 1. Use heel of one hand placed above center of chest (superior to xiphoid) 2. Depress 1 to 1 and 1/2 inch (1/3-1/2 chest depth) 2. Compression rate = 100 times/minute 3. Compression to Ventilation Ratio = 30:2 (one or two rescuer) 5. Technique: Adults 1. Sternal Compressions 1. Use heel of two hands placed above center of chest (superior to xiphoid) 2. Depress 1.5 to 2 inches (1/3-1/2 chest depth) 2. Compression rate = 100 times/minute 3. Compression to Ventilation Ratio = 30:2 (one or two rescuer) 6. Prognosis: Adults after CPR 1. Criteria 1. Witnessed arrest
2. Initial rhythm 1. Ventricular Tachycardia or 2. Ventricular Fibrillation 3. Pulse regained in first 10 minutes of compression 2. Interpretation: Any of three criteria above met 1. Predicts survival to hospital discharge 3. References 1. van Walraven (2001) JAMA 285:1602