The New CPR

1
The New CPR

• Based on recent research, International agreement
  and simplicity of teaching and practice

2
The Chain Of Survival

• Early Access D Hazards, Risks, Safety
• R Signs of
  Life? Not moving unresponsive, unconscious
  and.(get help-000, 112) Toe tapCOWS
• Open the airway using backward tilt and chin lift
• 
  A Not breathing normally (look, listen
  , feel
• Early CPR B 2 effective rescue
  breaths
• C 30 rapid
  effective compressions
• (Repeat 230 at least 5 cycles in 2 minutes,
  switch operators every 2 minutes or so,continue
  with oxygen assistance as available)
• Early Defibrillation D Apply pads during CPR,
  series of three shocks if advised with 2 minutes
  CPR between each one
• Early Emergency Care (E)

3

• Prepare for a whole new set of CPR protocols
  based on current research and Internationally
  agreed upon ways to educate people to apply the
  principles important in saving lives.
• Forget about trying to feel for a pulse, look
  for signs of life instead- movement,
  responsiveness, consciousness (CgtOgtWgtSgt),
  breathing normally
• Forget about giving 5 breaths and EAR- 2
  Rescue Breaths are enough to maintain
  satisfactory oxygen levels but maintaining
  correct head tilt remains vital.
• Forget about methods for finding the
  compression point on the chest- just put the
  hand(s) in the right place (centrally) and go for
  it
• Forget all the measures for compression depth-
  just try to go about one third the depth of the
  chest on any patient
• Forget absolutely accurate timings and all the
  suggested rates . Just go. Go . Go for 2 rescue
  breaths and 30 compressions to finish 5 cycles in
  at least 2 minutes,
• Forget about 2 person CPR. Its all one person
  with a second operator (if available) ready to
  change with you after the 2 minutes.Stop as
  little as possible.
• Dont forget to call for help AS SOON AS YOU
  HAVE AN UNRESPONSIVE patient
• Only use lateral position for immersions or
  choking casualties at the start of your
  assessment, otherwise straight on the back. Place
  in Recovery after signs of life return or
  patient is unconscious and breathing normally
• Make sure the Chain of Survival Early
  Access- Early CPR- Early Defibrillation- Early
  evacuation to Critical Care happens
  quickly.Wasted minutes mean wasted lives.

4
New guidelines

• One third chest depth
• Two hand, One or two, Two finger or one hand
  compressions
• Backward head tilt and chin lift for all except
  infants
• Compress centre of the chest, below the nipple
  and above the xyphiod process
• Only check airways in lateral position for
  immersion or choking victims
• Keep up the 230 rhythm with as few pauses as
  possible, ensuring all breaths cause effective
  chest inflation and aim for at least 5 cycles in
  2 minutes
• Ensure help, seek a defibrillator and operator
  and rotate at about 2 minute intervals to reduce
  fatigue
• The resting operator could assist in
  maintaining the airway and application of
  resuscitation mask- work as a team and
  communicate

5
Special Considerations

• Adult airway obstruction- encourage coughing if
  conscious, if blue or unresponsive call 000/112,
  place unconscious casualty in lateral position,
  administer 4 solid back blows, upwards from
  between the shoulder blades.
• Child Airway Obstruction-As above but place
  casualty across the knees, try to remove by
  finger sweeps, administer 4 firm back blows if
  necessary, 4 lateral chest thrusts if blockage
  persists
• (Check signs of life after each attempt and act
  accordingly
• Obvious Pregnancy Apply left lateral tilt by
  padding the right buttock to give an obvious
  pelvic tilt to the left
• If you hear a crack whilst performing CPR,
  recheck hand position and continue, treat
  regurgitation by rolling into lateral position,
  clearing airways and rechecking for signs of life.