2 Cardiopulmonary Resuscitation (CPR) CPR is a proven technique to administer basic life support to a patient whose heart has stopped beating.CPR consists of artificial respiration which supplies oxygen to the blood and heart compressions which supply blood to the body.
3 Automated External Defibrillator (AED) Device that generates an electric shockAED analyses the patient’s heart rhythm and indicates if an electric shock would be beneficialWhile in an abnormal rhythm, the heart does not effectively pump blood throughout the bodyCPR and early defibrillation give the best chance of survival
4 Pulse Check in CPR Carotid Artery - Adult/Child Brachial Artery- InfantPulse check is only taught to trained respondersIf the patient is unresponsive and not breathing, and you don’t find a pulse after 10 sec, you must conclude the patient is in cardiac arrest. You should immediately begin CPR and AED without further delay.
5 Landmarking-AdultWith the hand closest to the head, place the heel of that hand on the sternum in the centre of the chest. Make sure it is not on the xiphoid process.Place the heel of the other hand on top of the first hand.Interlace the fingers to keep them off the chest.Landmark every time you remove yourhands from an adult patient’s chest.
6 Landmarking-ChildPlace the heel of one hand on the sternum in the centre of the chest. Make sure it is not on the xiphoid process.Only the heel of the hand should be in contact with the chest.For the child, you administer cardiac compressions with one or two hands - as neededSubsequent landmarking isdone visually.
7 Landmarking-InfantPlace two fingers in the middle of the infant's chest between the nipplesSlide your fingers to just below the nipple lineAdminister chest compressions with the two fingers
8 Depth of Compressions Adult, Child and Infant: Compress the chest down one third to one half it’s depth
9 Cardiac Compression and Ventilation Ratios Groups (yr.)Single Rescuer CPRTwo Rescuer CPRCompression RatesAdult (>8 yrs)30 comp.2 ventilations100 per minuteChild(1-8 yrs)Infant(<1 yrs)
10 One Rescuer CPR, Adult Scene survey Establish unresponsiveness Activate EMSOpen airwayCheck for breathingIf absent, check pulseIf absent, landmark30 compressions + 2 breaths100 compressions per minuterepeat 5 sets of 30:2, reassessNOTE: use AED ASAP
11 Two Rescuer CPR - Adult or Child Survey the sceneRescuer 1 is performing CPRRescuer 2 will identify him/her self & checks that EMS has been activatedRescuer 1 complete 30:2 cycle then reassess vitals - no more than 10 sec.Rescuer 2 co-operates with Rescuer 1 with reassessmentif no visible signs:One rescuer now performs chest compressionsThe other now administer rescue breathsRescuer 1 and 2 will change positions with little interruption every few minutes
12 One Rescuer CPR - Child Scene survey Establish unresponsiveness Activate EMS (if alone, do 2 min ofCPR before EMS)Open airwayCheck for breathing,if absent, check for pulseif absent, landmark30 compressions + 2 breaths100 compressions per minuterepeat 5 sets of 30:2 reassess
13 One Rescuer CPR - Infant Scene surveyEstablish unresponsivenessActivate EMS (if alone - 2 min ofCPR before EMS)Open airwayCheck for breathing,if absent, check for pulseif absent, landmark30 compressions + 2 breaths100+ compressions per minuteRepeat 5 sets of 30:2, reassess
15 Do Not Resuscitate (DNR) DecapitatedIn Rigor MortisIncineratedEvisceratedDecayedProlonged submersion (days of decomposition)Ordered not to by a physician or police officer
16 Key Points Use an even squeezing motion when doing the compressions CPR should never be interrupted for more than 10 secondsAlways release pressure between compressionsMaintain contact with the skin at all timesFor adults/childinterlace fingers of both hands or extend them straight out to give a straight, downward pressure on the sternum
17 Key Points Expect some damage to the patient’s chest while doing CPR. Injuries to the chest area can be life-threatening if they result in damage to either the heart or lungs, or cause severe internal bleeding.Responders may require CISM support after performing CPR
18 Chain of Survival Healthy Choices Recognition of Warning Signs Early Access to the Emergency Medical Services (EMS) SystemEarly CPREarly DefibrillationEarly Advanced CareEarly Rehabilitation
19 Health Care Provider Level (HCP) EMS activation: if the patient is suffering respiratory arrest, if alone the HCP should do 5 cycles of CPR before calling EMSHCP would do two breaths before compressions are startedTwo rescuer CPR on children or infants will be done at rate of 15:2 when using a BVM
20 Health Care Provider Level (HCP) Aged guidelines are:Infant: up to one year of ageChild: 1 yr to pubertyAdult: after pubertyInfant compressions may be delivered using the two thumbs with hands encircling the chestPuberty is defined as the onset of facial hair in males, and th development of breast tissue in females.
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