1. Adult CPR Section II

2. Recognizing and Caring for Cardiac Emergencies

3. Signals of Breathing Emergencies Breathing is unusually slow or rapid. Breaths are unusually deep or shallow. Victim is gasping for breath. Victim is wheezing, gurgling, or making high-pitched noises. Victim’s skin is unusually moist. Victim’s skin has a flushed, pale, or bluish appearance. Victim feels short of breath. Victim feels dizzy or light-headed. Victim feels pain in chest or tingling in hands or feet. Apprehensive or fearful feelings. -Respiratory Distress – A condition in which breathing becomes difficult. Can lead to respiratory arrest (breathing stops). If a victim cannot cough, speak or breath, suspect that something is blocking the airway.

4. Conditions That Cause Breathing Emergencies Asthma-a condition that narrows the air passageways. Emphysema-a disease that involves damage to the lung’s air sacs. Worsens over time and shortness of breath. Bronchitis-a condition that causes the bronchial tubes to become swollen and irritated. Inflammation causes mucus buildup and blocks passage of air and air exchange in lungs. Hyperventilation-occurs when a person breathes faster and more shallow than normal. Body does not take in enough oxygen to meet its demands. Allergic Reaction – a severe reaction can cause anaphylactic shock. Air passages may swell and restrict a person’s breathing.

5. conscious choking adult/child

6. Helping a Conscious Choking Victim: 1. Check the scene, then check the victim. 2. Ask the victim if he or she is choking. Call 9 -1 - 1 3. Identify yourself and ask if you can help and obtain consent. 4. Care for victim a. If coughing, encourage to continue. b. If no response, begin 5 back blows striking between the shoulder blades (one arm diagonally across chest and lean victim over) followed by 5 abdominal thrusts.

7. Helping a Conscious Choking Victim Cont: Stand behind the victim with one of your legs between the victim’s legs. Keep your head to the side of the victim’s head. Place the thumb side of your fist against the middle of the victim’s abdomen, just above the belly button. Grasp your fist with your other hand. Give quick, upward thrusts.

8. Repeat back blows and abdominal thrusts until: The object is coughed up. The victim starts to breathe or cough forcefully. The victim becomes unconscious. EMS personnel or another trained person takes over.

9. What should you do if the victim becomes unconscious while performing this skill? Make sure 9-1-1 has been called. Carefully lower the victim to the floor, supporting the head. Open the airway, look for a foreign object and if you see an object, remove it. Care for an Unconscious Choking Adult.

10. Pregnant or Large Victim Give chest thrusts instead. Place fist in the center of victim’s breastbone.

11. Self-choking Lean over any firm object (like a chair) and press abdomen firmly into the object.

12. Practice & Skill Test Conscious Choking Adult

13. The Heart's Electrical System

14. Cardiac Emergencies Key Points Heart Disease is one of the leading causes of death in both men and women. Taking steps to prevent heart disease or to reduce your risk of heart disease is one of the most important things you can do for your health. A person having a heart attack may deny that he or she has any signals.

15. What is a Heart Attack? When a heart muscle is damaged from a lack of oxygen and blood supply by either disease or trauma. A heart attack can eventually lead to cardiac arrest, a condition in which he heart stops functioning altogether. V-fibrillation – Heart’s electrical system stops making sense and causes a quivering of ventricles. Ventricles do not contract and the heart cannot send enough blood through the body. V-Tachycardia – The electrical system tells the ventricles to contract too quickly and as a result, the heart cannot pump properly. Person will show no signs of life. Can be corrected by a shock by an AED.

16. Signals of a Heart Attack Persistent chest pain or pressure that lasts longer than 3-5 minutes or goes away and comes back. Chest pain spreading to the shoulders, neck, jaw or arms. Breathing difficulty (shortness or faster than normal) Nausea or vomiting Dizziness, lightheadedness, or fainting Pale, ashen (grayish) or bluish skin Sweating

17. Care for a Heart Attack Recognize the signals of a heart attack. Call 9-1-1 or the local emergency number immediately for help. Convince the person to stop activity and rest. Try to obtain additional information about the person’s condition. Have the person rest comfortably Assist with medication, if prescribed Offer an aspirin, if appropriate (see p. 33) Monitor the person’s condition. Be prepared to give CPR and to use an AED.

18. If someone is experiencing signals of a heart attack should the responder Call First or Call Fast? Call First 0 minutes – Breathing stops. Heart will soon stop beating 4-6 minutes – Brain damage possible 6-10 minutes – Brain damage likely Over 10 minutes – Irreversible brain damage certain.

19. What is the purpose of CPR? CPR helps circulate blood containing oxygen to the brain and vital organs while the heart is stopped by a combination of chest compressions and rescue breaths. -Pressing down causes the heart’s walls to squeeze together forcing the blood to empty the heart -Coming up releases pressure on the chest and allows the chambers to fill with blood between compressions.

20. The Cardiac Chain of Survival The greatest chance of survival from cardiac arrest occurs when the following sequence of events happens as rapidly as possible. 1. Early recognition and early access. 2. Early CPR. 3. Early Defibrillation. (Each minute it is delayed reduces the chance of survival by almost 10%) 4. Early advanced medical care.

21. CPR- Adult

22. Putting it all Together

23. Adult CPR: 5 cycles in 2 minutes of care 1. Check the scene for safety then check the victim. 2. Tap the victim and shout. 3. Call 9-1-1

24. Adult CPR Cont: Care for the victim. a. Open Airway with head tilt and chin lift. b. Look, Listen and Feel for no more than 10 seconds. c. If no signs of life (movement or breathing) give care with 30 chest compressions

25. Chest Compressions - Locate proper hand position with heel of hand on the breastbone on the person’s sternum, center of chest. -Place your other hand on top by interlacing them or holding them upward. - Position your shoulders over your hands, lock your elbows and keep your fingers off the chest. - Push straight down and give 30 compressions in about 18 seconds. Compress the chest at least 2 inches at a rate of 100 compressions per minute. Release the pressure between compressions while maintaining contact with the chest with your hands. (Count compressions aloud).

26. Chest Compressions Cont: Give 2 rescue breaths The chest should clearly rise. a. tilt head and lift chin, pinch nose shut b. take a breath and make a seal over the person’s mouth c. blow and make the chest rise clearly d. each rescue breath should last 1 second

27. When do you stop CPR? the scene becomes unsafe the person shows signs of life an AED becomes available and is ready to use another trained responder arrives and takes over you are too exhausted to continue

29. Practice & Skill Test Adult CPR

30. Hands Only CPR

31. Hands-Only CPR: If there is a bystander or you are unable for any reason to perform full CPR, give continuous chest compressions after calling 911. Continue this until another trained responder or EMS personnel take over.

32. What is an AED? Automated External Defibrillator An AED is a machine that analyzes the heart’s rhythm and, if necessary, tells the responder to deliver a shock to a victim of sudden cardiac arrest. This shock, called defibrillation, may help the heart re- establish an effective rhythm.

33. Using the AED

34. AED Info EACH MINUTE THAT DEFIBRILLATION IS DELAYED, THE CHANCES OF SURVIVAL ARE REDUCED BY ABOUT 10 PERCENT!!! While certified emergency medical services (EMS) personnel are the preferred users of AEDs under the law, if no EMS personnel are available, untrained persons may use AEDs.

35. AED Cont Anyone who lacks the training but uses an AED in an emergency is immune from suit if he or she uses the device in good faith. The Act defines "good-faith use" as occurring when the user has "a reasonable opinion that the immediacy of the situation is such that the use of an AED should not be postponed until emergency medical services personnel arrive or the person is hospitalized.”

36. AED Precautions Do not touch the victim while the AED is analyzing. Touching or moving the person may affect the analysis. Do not touch the victim while the device is defibrillation. You or others could be shocked. Prior to shocking the person with the AED, make sure no one is touching or in contact with the person or the resuscitation equipment. Do not use alcohol to wipe the victim’s chest dry. Alcohol is flammable. Do not defibrillate someone when around flammable materials, such as gasoline or free flowing oxygen. Do not use an AED on a person who is in contact with water. Move victims away from puddles of water or swimming pools, out of the rain, before defibrillating. Do not use a mobile phone or radio within 6 feet of an AED. This may interrupt analysis. Use appropriate pads for each victim. There are pads for adults and pads for children.

37. Unconscious Choking Adult

38. Helping an unconscious choking victim: If the chest does not rise when you attempt rescue breaths in an unconscious victim, the skill performed is very similar to CPR. After compressions, lift the jaw and tongue and look for a foreign object. If you see a foreign object, finger sweep it out and give 2 rescue breaths. -If they go in, check for signs of life for no more than 10 seconds (be ready to continue CPR if you find no signs of life) If no object is removed give 2 rescue breaths. If they do not go in, repeat cycles of chest compressions, foreign object check and 2 rescue breaths until: oObject is removed and chest clearly rises oThe person starts to breath on their own oEMS personnel arrive oYou are too exhausted to continue oThe scene becomes unsafe

39. Practice & Skill Test Unconscious Choking Adult