Cardio Pulmonary Resuscitation

CPR
 Cardiopulmonary resuscitation (CPR) is a

lifesaving technique useful in many emergencies,
including a heart attack or near drowning, in
which someone's breathing or heartbeat has
stopped. The American Heart Association
recommends that everyone — untrained
bystanders and medical personnel alike — begin
CPR with chest compressions.
 It's far better to do something than to do nothing
at all if you're fearful that your knowledge or
abilities aren't 100 percent complete. Remember,
the difference between your doing something
and doing nothing could be someone's life.
 CPR – or Cardiopulmonary Resuscitation – is
an emergency lifesaving procedure performed
when the heart stops beating. Immediate CPR
can double or triple chances of survival after
cardiac arrest.
 Keeping the blood flow active – even partially
– extends the opportunity for a successful
resuscitation once trained medical staff arrive
on site.
 CPR can keep oxygenated blood flowing to
the brain and other vital organs until more
definitive medical treatment can restore a
normal heart rhythm.
 When the heart stops, the lack of oxygenated
blood can cause brain damage in only a few
minutes. A person may die within eight to 10
minutes.
 refers to a series of actions that, properly
executed, reduce the mortality associated
with sudden cardiac arrest.
 The four interdependent links in the chain of
survival are early access, early CPR, early
defibrillation, and early advanced cardiac life
support.
 CPR is a critical step in the AHA’s Chain of Survival.
The term Chain of Survival provides a useful
metaphor for the elements of the ECC (emergency
cardio vascular care) systems concept.
 The 5 links in the adult out-of-hospital Chain of
Survival are:
◦ 1. Recognition of cardiac arrest and activation of the
emergency response system (calling 9-1-1 in the US)
◦ 2. Early CPR with an emphasis on chest compressions
◦ 3. Rapid defibrillation
◦ 4. Basic and advanced emergency medical services
◦ 5. Advanced life support and post-cardiac arrest care
 A strong Chain of Survival can improve chances of
survival and recovery for victims of cardiac arrest.
 There are two commonly known versions of CPR:
1. For healthcare providers and those trained:
conventional CPR using chest compressions and
mouth-to-mouth breathing at a ratio of 30:2
compressions-to-breaths. In adult victims of
cardiac arrest, it is reasonable for rescuers to
perform chest compressions at a rate of 100 to
120/min and to a depth of at least 2 inches (5 cm)
for an average adult, while avoiding excessive chest
compression depths (greater than 2.4 inches [6
cm]).
 2. For the general public or bystanders who
witness an adult suddenly collapse:
compression-only CPR, or Hands-Only CPR.
Hands-Only CPR is CPR without mouth-to-
mouth breaths. It is recommended for use by
people who see a teen or adult suddenly
collapse in an out-of-hospital setting (such
as at home, at work, or in a park).
 1. Call 9-1-1 (or send someone to do that)
 2. Push hard and fast in the center of the
chest
 High-quality CPR should be performed by
anyone - including bystanders. There are five
critical components:
 1. Minimize interruptions in chest
compressions
 2. Provide compressions of adequate rate and
depth
 3. Avoid leaning on the victim between
compressions
 4. Ensure proper hand placement
 5. Avoid excessive ventilation
 Untrained. If you're not trained in CPR, then provide
hands-only CPR. That means uninterrupted chest
compressions of 100 to 120 a minute until paramedics
arrive. You don't need to try rescue breathing.
 Trained and ready to go. If you're well-trained and
confident in your ability, check to see if there is a pulse
and breathing. If there is no breathing or a pulse within 10
seconds, begin chest compressions. Start CPR with 30
chest compressions before giving two rescue breaths.
 Trained but rusty. If you've previously received CPR
training but you're not confident in your abilities, then just
do chest compressions at a rate of 100 to 120 a minute
 The above advice applies to adults, children and infants
needing CPR, but not newborns (infants up to 4 weeks
old).
 Before starting CPR, check:
 Is the environment safe for the person?
 Is the person conscious or unconscious?
 If the person appears unconscious, tap or shake his or her
shoulder and ask loudly, "Are you OK?"
 If the person doesn't respond and two people are
available, have one person call 911 or the local emergency
number and get the AED, if one is available, and have the
other person begin CPR.
 If you are alone and have immediate access to a telephone,
call 911 or your local emergency number before beginning
CPR. Get the AED, if one is available.
 As soon as an AED is available, deliver one shock if
instructed by the device, then begin CPR.
 Chest compressions
 Open the airway
 Rescue breathing
 The American Heart Association uses the
letters C-A-B — compressions, airway,
breathing — to help people remember the
order to perform the steps of CPR.
1. Put the person on his or her back on a firm surface.
2. Kneel next to the person's neck and shoulders.
3. Place the heel of one hand over the center of the person's chest,
between the nipples. Place your other hand on top of the first hand.
Keep your elbows straight and position your shoulders directly
above your hands.
4. Use your upper body weight (not just your arms) as you push
straight down on (compress) the chest at least 2 inches (approximately 5
centimeters) but not greater than 2.4 inches (approximately 6
centimeters). Push hard at a rate of 100 to 120 compressions a minute.
5. If you haven't been trained in CPR, continue chest compressions until
there
are signs of movement or until emergency medical personnel take over.
If
you have been trained in CPR, go on to opening the airway and rescue
breathing.
 If you're trained in CPR and you've performed
30 chest compressions, open the person's
airway using the head-tilt, chin-lift
maneuver. Put your palm on the person's
forehead and gently tilt the head back. Then
with the other hand, gently lift the chin
forward to open the airway.
 Rescue breathing can be mouth-to-mouth breathing or mouth-to-nose breathing if the mouth is seriously
injured or can't be opened.
1. With the airway open (using the head-tilt, chin-lift maneuver), pinch the nostrils shut for
mouth-to-mouth breathing and cover the person's mouth with yours, making a seal.
2. Prepare to give two rescue breaths. Give the first rescue breath — lasting one second —
and watch to see if the chest rises. If it does rise, give the second breath. If the chest
doesn't rise, repeat the head-tilt, chin-lift maneuver and then give the second breath.
Thirty chest compressions followed by two rescue breaths is considered one cycle. Be
careful not to provide too many breaths or to breathe with too much force.
3. Resume chest compressions to restore circulation.
4. As soon as an automated external defibrillator (AED) is available, apply it and follow the
prompts. Administer one shock, then resume CPR — starting with chest compressions —
for two more minutes before administering a second shock. If you're not trained to use
an AED, a 911 or other emergency medical operator may be able to guide you in its use. If
an AED isn't available, go to step 5 below.
4. Continue CPR until there are signs of movement or emergency medical personnel take
over.
 Information
- According to the American College of
Emergency Physicians, the following are
warning signs of a medical emergency:
 Bleeding that will not stop
 Breathing problems (difficulty breathing,
shortness of breath)
 Change in mental status (such as unusual
behavior, confusion, difficulty arousing)
 Chest pain
 Choking
 Coughing up or vomiting blood
 Fainting or loss of consciousness
 Feeling of committing suicide or murder
 Head or spine injury
 Severe or persistent vomiting
 Sudden injury due to a motor vehicle
accident, burns or smoke inhalation, near
drowning, deep or large wound, or other
injuries
 Sudden, severe pain anywhere in the body
 Sudden dizziness, weakness, or change in
vision
 Swallowing a poisonous substance
 Severe abdominal pain or pressure
 Determine the location and quickest route to the
nearest emergency department before an emergency
happens.
 Keep emergency phone numbers posted in your
home where you can easily access them. Also enter
the numbers into your cell phone. Everyone in your
household, including children, should know when and
how to call these numbers. These numbers
include: fire department, police department, poison
control center, ambulance center, your doctors'
phone numbers, contact numbers of neighbors or
nearby friends or relatives, and work phone numbers.
 Know at which hospital(s) your doctor practices and,
if practical, go there in an emergency.
 Wear a medical identification tag if you have a
chronic condition or look for one on a person
who has any of the symptoms mentioned.
 Get a personal emergency response system if
you're an older adult, especially if you live
alone.
 Stay calm, and call your local emergency
number (such as 911).
 Start CPR (cardiopulmonary resuscitation) or
rescue breathing, if necessary and if you
know the proper technique.
 Place a semiconscious or unconscious person
in the recovery position until the ambulance
arrives. DO NOT move the person, however, if
there has been or may have been a neck
injury.
 Upon arriving at an emergency room, the
person will be evaluated right away. Life- or
limb-threatening conditions will be treated
first. People with conditions that are not life-
or limb-threatening may have to wait.
 The person's condition is life threatening (for
example, the person is having a heart
attack or severe allergic reaction)
 The person's condition could become life
threatening on the way to the hospital
 Moving the person could cause further injury (for
example, in case of a neck injury or motor
vehicle accident)
 The person needs the skills or equipment of
paramedics
 Traffic conditions or distance might cause a delay
in getting the person to the hospital
 Most cardiac arrests in babies occur from lack
of oxygen, such as from drowning or
choking. If you know the baby has an airway
obstruction, perform first aid for choking. If
you don't know why the baby isn't breathing,
perform CPR.
 To begin, examine the situation. Stroke the baby and
watch for a response, such as movement, but don't
shake the baby.
 If there's no response, follow the C-A-B procedures
below for a baby under age 1 (except newborns,
which includes babies up to 4 weeks old) and time
the call for help as follows:
◦ 1. If you're the only rescuer and you didn't see the baby
collapse, do CPR for two minutes — about five cycles —
before calling 911 or your local emergency number and
getting the AED. If you did see the baby collapse, call 911
or your local emergency number and get the AED, if one is
available, before beginning CPR.
◦ 2. If another person is available, have that person call for
help immediately and get the AED while you attend to the
baby.
 Place the baby on his or her back on a firm,
flat surface, such as a table. The floor or
ground also will do.
 Imagine a horizontal line drawn between the
baby's nipples. Place two fingers of one hand
just below this line, in the center of the chest.
 Gently compress the chest about 1.5 inches
(about 4 centimeters).
 Count aloud as you pump in a fairly rapid
rhythm. You should pump at a rate of 100 to
120 compressions a minute.
 After 30 compressions, gently tip the head
back by lifting the chin with one hand and
pushing down on the forehead with the other
hand.
 Cover the baby's mouth and nose with your mouth.
 Prepare to give two rescue breaths. Use the strength of your
cheeks to deliver gentle puffs of air (instead of deep breaths
from your lungs) to slowly breathe into the baby's mouth one
time, taking one second for the breath. Watch to see if the baby's
chest rises. If it does, give a second rescue breath. If the chest
does not rise, repeat the head-tilt, chin-lift maneuver and then
give the second breath.
 If the baby's chest still doesn't rise, continue chest
compressions.
 Give two breaths after every 30 chest compressions. If two
people are conducting CPR, give two breaths after every 15 chest
compressions.
 Perform CPR for about two minutes before calling for help unless
someone else can make the call while you attend to the infant.
 Continue CPR until you see signs of life or until medical
personnel arrive.

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CPR

 Cardiopulmonary resuscitation (CPR) is a

3. Resume chest compressions to restore circulation.

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