CPR

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CPR
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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

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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
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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 bodys fluid balance
•  

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Anatomy of the Heart
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Coronary Arteries
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Major Arteries
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Circulatory System Emergencies

• Any condition that affects respiration reduces
  ability to deliver oxygen
• Severe bleeding
• Shock
• Stroke
• Heart conditions

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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 hearts pumping effectiveness

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Causes of Cardiac Arrest

• Heart attack
• Drowning
• Suffocation
• Stroke
• Allergic reaction
• Diabetic emergency
• Prolonged seizures
• Drug overdose
• Electric shock
• Certain injuries

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Chain of Survival

• Early Access
• Early CPR
• Early Defibrillation
• Early Advanced Care
• Integrated post-cardiac arrest care

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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

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• 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 heartbeatand CPR can keep patient
  viable until then

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• 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

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CPR Sequence C A B

• Check the scene
• Assess Activate EMS
• Check the pulse (carotid)
• Give 30 chest compressions
• Continue cycle 30 chest compressions/
• 2 breaths at a rate of 100 per minute
• (C A B sequence)

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Chest Compressions Alert

• Be careful with your hand position
• For adults/children, keep your fingers off
  patients chest
• Do not give compressions over bottom tip of
  breastbone (xiphoid process)
• When compressing, keep elbows straight and hands
  in contact with patients 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.

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• CPR
• Review

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• What is the rate for performing chest
  compressions for a victim of any age?

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• Describe a way you can allow the chest to recoil
  completely after each chest compression.

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• 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?

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• What is the best way for a rescuer to know that a
  rescue breath is effective?

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• 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?

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• When you do not suspect a cervical spine injury,
  what is the best way to open an unresponsive
  victim's airway?

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• 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?

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• How do you know when to start cycles of chest
  compressions with breaths for an adult?

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• Why it is important to give early defibrillation
  to an adult?

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• What are the steps common to the operation of all
  AED's in the correct order?

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• After you power on an AED and attach the pads to
  the victim, what is the next step you should do?

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• What might happen if you touch the victim while
  the AED is delivering a shock?

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• 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?

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• What is the best way to relieve severe choking in
  a responsive adult?

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• 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?

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• Which of the following statements best describes
  why you should minimize interruptions when giving
  chest compressions to any victim of cardiac
  arrest?

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• Breathing stops but the heart still continues for
  2-3 minutes.  What is this called?

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

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• What happens during a cardiac arrest?

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• Before starting chest compressions, you need to
  check for a pulse.  What pulse site should you
  use?

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

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• The purpose of the recovery position is to