Cardio Pulmonary Resuscitation Objectives: • Promote willingness to perform CPR by addressing key psychological concerns. • Provide basic physiological knowledge to enhance understanding of CPR. • Demonstrate the simplicity of the CPR process. Vasoconstriction Plaque Blood Clot Arteries Lumen CPR will not undo damage to the heart! : • Heart Attack Signs or Symptoms are: - Severe pain or pressure in the center of the chest. - Pain in the arms, back, neck or jaw. - Denial. Heart Attack Signs or Symptoms: - Nausea and Vomiting. - Cold Sweat. - Shortness of breath with or without discomfort. - Persistent pain around the “stomach” area. • Stroke Signs and Symptoms are: - Sudden numbness or weakness of the: • Face (Droopy or slurred speech). • Arm on one side of body. • Leg on one side of body. Loss of balance. • Stroke Signs or Symptoms: - Sudden confusion, difficulty speaking or understanding. - Trouble seeing out of one or both eyes. - Dizziness. - Sudden severe headache of unknown causes. So…Who receives CPR? • The answer lies with understanding what CPR actually means: - Cardio = Heart - Pulmonary = Breathing - Resuscitation = To revive to a level of consciousness by replacing what’s missing. Answer is… DEAD PEOPLE!!! Time is critical in starting CPR. Age Guidelines for CPR Infant: Birth up to 1 year of age Small Child: Ages 1 to 8 or to Puberty • Child procedures should be performed if they are less mature and less physically developed and extended to age of 12 or 13 Adult: Puberty should be used as a guideline; however Adult Procedures can be used on anyone over 8 years The emergency medical procedure used for reviving the heart and lung functions Cardio: Heart Pulmonary: The Lungs Circulating Oxygen into the Blood Resuscitation: Revive from Apparent Death or Unconsciousness by using the combination of: *Ventilations *Compressions Call the CAB: E:Call 911-EMS or the Emergency Medical Services Phone Number in your Community C: Compressions – Perform 30 Chest Compressions @ 100 cpm A: Airway – Open Airway/Head Tilt – Chin Lift *Look – Listen – Feel for Air Exchange B: Breathing – Give 2 ventilations D: Defibrillation – Add the AED to the rescue if one is available *(Automated External Defibrillator) Simplified Adult BLS Algorithm Travers, A. H. et al. Circulation 2010;122:S676-S684 Copyright ©2010 American Heart Association Three C’s of Emergencies Check: for Responsiveness and signs of Circulation Call:activate the EMS Care: provide First Aid and CPR for the victim Emergency Medical Services What is The EMS? The Emergency Medical Services is a systemized network of community resources and services that responds to medical emergencies. Ideally, all the links of the chain should work together to provide the best possible care to victims of injury or illness. Early arrival of emergency personnel increases the victim's chances of surviving any life-threatening emergencies. Checking for Signs of Circulation: *Scan the Body & Check for Pulse Carotid Pulse on Neck for Child and Adult Brachial Pulse on Bicep for Infants Rule Three Initial Steps Check Responsiveness and Breathing Check Pulse Begin Chest Compressions (Only if pulse is missing) Rule Three Repetitive Steps Compressions (Only if pulse is missing) Airway (Clear the throat) Breathing Circulation C A B The 2010 CPR Standard Not Breathing but the pulse is present Not Breathing and the pulse is missing Airway Adult Child Infant A B C Adult Airway Child Infant (≥ 8 yrs) (1 yr – puberty) (Birth – 1 yr) One breath every 5-6 sec 3-5 sec 3-5 sec Circulation Repeat for 2 minutes 30 compressions And Two Breaths Repeat 5 times w/in 2 minutes Adult CPR • Click on link Infant CPR • Click on link ONLY Circumstances to Discontinue Rescue Efforts More Qualified Help Arrives on the scene and takes over the rescue Victim is Revived or Regains Consciousness Emergency Situation Is Too Dangerous and the Rescuer is Prohibited from Providing any Emergency First Aid or CPR – Example: Victim trapped in burning house or burning car Another type of CPR is…. Hands Only CPR The premise… • Due to arrest, circulation ceases. • In theory, there is unused O2 on the arterial side of the system. • If adequate circulation is created via compressions, perfusion of key organs may be achieved faster. Is applicable when… • The responder is reluctant to perform breathing without a barrier device. • Untrained in CPR. • We do not give bre Automated External Defibrillation Sudden Cardiac Arrest • Two Stages 1. Ventricular Fibrillation (Quivering Heart) 2. Asystole , Agonal (Flat Line) Normal Rhythm Heart Attack Cardiac Arrest VentricularFibrillation Tachycardia Ventricular Asystole /Agonal (i.e. Flat Line) Normal Rhythm Ventricular Fibrillation Asystole /Agonal (i.e. Flat Line) Equipment • The AED Unit • AED Pads • Optional Accessories – – – – – Gloves CPR Barrier Device Scissors Razor Towel • If body jewelry present: – Try to remove but do not invest much time. • If oxygen present: - Close valve or remove from area. AED Configuration • Pad placement is important – Place the pads as shown on the pictures • Do not touch the person during analysis stage or when administering the shock – No shock statement means either * There is a heart beat * Or the heart beat is missing – If no signs of life, start CPR – During reassessment or CPR, the AED Deactivates for two minutes – The AED will continuously reassess and instruct user Pediatric Pads • Used on children under 8 yrs. • Never use on adults: - Not enough electrical current. • Placement varies with manufacturer. Management of the Foreign Body Airway Obstruction (Choking) FBAO Techniques • Works best on solid objects - Candy - Toys - Food The choking person can be in one of two states: 1. Conscious 2. Unconscious The conscious choking person can be in one of two conditions: 1. Partial Obstruction - Good air exchange - Poor air exchange 2. Total Obstruction Partial Obstruction Good Air Exchange Signs and Symptoms • May have a strong cough • May exhibit odd behavior - Universal Sign Solution: Encourage strong coughing! Partial Obstruction Poor Air Exchange Signs and Symptoms • Displays a weak cough or wheezing • May have concerned expression • Change of skin color • May display the Universal Sign or other odd behavior Solution: Encourage coughing or if necessary force them to cough! Unresolved Partial And Total Obstructions Signs and Symptoms • Odd behavior - May display Universal Sign • Wheezing (Unresolved partial) • Concerned expression • Change of skin color Unresolved Partial And Total Obstructions Signs and Symptoms • Unable to speak, cough or breathe Solution: Force them to cough! Unconscious FBAO Solution: • 30 Chest Compressions. • Inspect the airway: - If object visible, remove. • If the patient is not breathing: - Test the airway with breathing. • If first attempt fails: • Readjust the head with the head-tilt chin-lift. • Breath again. • If the second attempt fails: • Resume chest compressions. • Test the airway as appropriate. Infant FBAO Unconscious • 30 Chest compressions. • Two breaths. Recovery Position What is the Recovery Position? First Aid procedure to use if the person is unconscious, breathing and they have a pulse. It is a safe position to put them in while you are waiting for the EMS to arrive; which allows them to breathe easily and prevents them from choking on their tongue or any vomit. Good Samaritan Law Law that protects rescuers from prosecution or civil law suits, unless their actions constitute willful misconduct and negligence. The Rescuer MUST comply with proper emergency first aid and CPR guidelines; acting in good faith by being prudent and responsible in their rescue efforts.