 In an emergency, when every second is critical, would you know what to do?  sudden cardiac arrest =  Leading cause of death in America

 Once the heart ceases to function, a healthy human brain may survive without oxygen for:  Up to 4 minutes  typical EMS response =  6, 8, or even 10 minutes

 0-4 mins. brain damage unlikely  4-6 mins. brain damage possible  6-10 mins. brain damage probable  over 10 mins. probable brain death

 provide oxygenated blood to the victim's brain  and the heart  dramatically increase chance of survival

 Learn and perform CPR!

 air we breathe in travels to our lungs  oxygen is picked up by our blood  pumped by the heart to our tissue and organs

 normal beat to an arrhythmic pattern › ventricular fibrillation › ceases to beat altogether  heart failure  Injury › near drowning › Electrocution › severe trauma

 prevents oxygen from circulating throughout the body  kills cells and tissue

 Cardio (heart)  Pulmonary (lung)  Resuscitation (revive, revitalize)  artificial heartbeat  artificial respirator

 CPR may not save  BUT IF  Started within 4 minutes of cardiac arrest  Defibrillation provided within 10 minutes  THEN  40% chance of survival

 Step 1:  dialing 911 may be the most important step you can take to save a life

 Someone besides you  When to call:  If you are alone: › Adult CPR: BEFORE you start › Child CPR: AFTER a minute of CPR

 Provide operator with:  1. Your location  2. Your phone number  3. Type of emergency  4. Victim's condition

 DO NOT leave the victim alone.  DO NOT try make the victim drink water.  DO NOT throw water on the victim's face.  DO NOT prompt the victim into a sitting position.  DO NOT try to revive the victim by slapping his face.

 Don’t act impulsively  Don’t place yourselves in harm's way  Don’t waste time, BUT do  approach the victim after  scene is safe:  check for hazards

 Before rescue efforts  Check responsiveness  Suspect spinal or neck injury  do not move or shake  Otherwise, shake the victim gently and shout "Are you okay?“  Use his name

 911 (AED)  check the victim for circulation

 "C" = CIRCULATION  determine if heart is beating: › two fingertips on carotid artery › depression between windpipe and neck muscles › slight pressure for several seconds

 Proper hand placement important  Locate correct hand position › two fingers find the notch at the spot where the lower ribs meet › put the heel of your other hand next to your fingers, on the sternum (breastbone)

 one hand on top of the other  interlace the fingers  Keep fingers up off chest wall

 Lock your elbows  Use body weight to compress chest  Depth of compressions: at least 2 inches  2 hands, 2 inches

 Count aloud as you compress 30 times  Rate: about 3 compressions every 2 seconds  About 100 compressions per minute.  Think: Staying Alive

 Chest compressions will supply blood flow to the heart and the brain but if victim remains unresponsive you will need to check their airway airway

 Victim is unconscious and unresponsive?  Make sure airway is clear of obstructions

 Victim flat on back  Your hand on his forehead  Other hand under the tip of the chin

 Gently tilt victim's head backward  In this position weight of the tongue will force it to shift away from the back of the throat, opening the airway  Tongue is the most common airway obstruction in an unconscious person

 Place ear over victim’s mouth for no longer than 10 seconds  Listen for breathing

 Gasping for air is not considered normal breathing, so you should proceed with CPR immediately.  If the victim is breathing, roll the person onto his or her side, and wait for emergency personnel to arrive.

 If the person is still not breathing on his own after the airway has been cleared, you will have to assist him breathing breathing

 With victim's airway clear of obstructions  gently support his chin  keep it lifted up and the head tilted back

 Pinch his nose with your fingertips to prevent air from escaping once you begin to ventilate  place your mouth over the victim's, creating a tight seal

 assist the person in breathing  keep an eye on his chest  Try not to over-inflate lungs  It may force air into the stomach  causing him to vomit  If this happens, turn the person's head to the side and sweep any obstructions out of the mouth before proceeding.

 Give two full breaths  Between each breath allow victim's lungs to relax  place your ear near his mouth  listen for air to escape  Watch chest fall as the victim exhales

 In case of an emergency you may be the victim's only chance of survival.  Until an ambulance arrives and professional assistance is available, you can increase that chance by 40%  simply by remembering and effectively administering Cardio Pulmonary Resuscitation.

 1. Check for responsiveness by shouting and shaking the victim. Do not shake or move the victim if you suspect he may have sustained spinal injury.  2. Call 911.  3. Remember C-A-B:

 Circulation: if there is no pulse, perform 30 chest compressions at the rate of at least 100/minute - 2 hands, 2 inches.  Airway: tilt the head back and lift the neck to clear the airway.  Breathing: pinch the victim's nose and give 2 breaths, watching for the chest to rise with each breath.

 Automated External Defibrillator

 Help when a persons heart starts irregular beating pattern that doesn't let the blood circulate properly.  AED puts a shock through the heart so it stops and restarts.  Heart can re-set and pump normally again.

 Can’t be used for heart that has stopped completely.  Irregular beat will show no pulse.  You can’t tell if it is an irregular beat or if the heart has stopped completely.  The AED can tell. It will direct you and deliver the right amount of shock.

 Turn on AED  Press "on" button or open lid, depending on device.  Second rescuer continue CPR until AED is attached.

 Attach AED electrode pads.  Bare victim's chest - make sure it is dry.  Remove adhesive AED electrode pads from package  Attach firmly to chest, as illustrated on the package.

 Very important to place pads correctly so electric current passes through heart.  One pad placed on victim's upper right chest  Other on lower left chest  Thick chest hair removed before pad placement - ensures adequate contact.

 Analyze heart rhythm  Make sure no one is touching victim  Some AEDs analyze heart rhythm automatically.  Other models prompt you to press the analyze button.

 Follow AED's prompt and call out, "Analyzing rhythm, stand clear!"  Make sure no one is touching victim when the AED is analyzing.  If AED indicates "shock advised" go to next step.

 AED indicates victim does not need to be shocked: check pulse again  No pulse - do CPR (ventilations and chest compressions) for one minute  advise “stand clear” -analyze again.  Repeat sequence of CPR/analysis every minute until help arrives.

 If AED determines victim does need to be shocked, it will prompt you to press the shock button  Ensure safety of onlookers: Make sure no one is touching victim.  Call out, "Shock indicated. Stand clear!"  Press shock button.

 Sometimes, victim will be revived after one shock.  After first shock is delivered, immediately analyze again.  If AED advises another shock – press shock button a second time  After second shock delivered, immediately analyze again.

 If AED advises another shock needed, press shock button a third time  If after three shocks –no pulse: do CPR (ventilations and chest compressions) for one minute  If still no pulse, give additional sets of three quick shocks, interspersed with one minute of CPR (3 cycles)  until AED prompts no shock is indicated

 AED will deliver appropriate energy levels for each shock  Continue cycles of one minute of CPR followed by heart rhythm analysis and appropriate shocks until advanced help arrives

 AEDs are very safe and effective when used properly.  Follow operating instructions that come with each AED.  Attach only to victims who are unresponsive: not breathing normally and no pulse

 AEDs, as currently configured, are intended for use among adult victims of sudden cardiac arrest  No children!  less than eight + less than 55 to 65 lbs = do not attach AED

 Safe to use AEDs in all weather conditions, including rain and snow  In wet weather, wipe the chest dry before placing electrodes  If victim lying in water, move to a relatively dry area before attaching AED

 Never place AED electrode pads directly on top of medication patches  Patches should always be removed and skin wiped dry before placing defibrillator pads on the skin  Make sure to wipe your own skin dry if you come in contact with the medication

 If victim has a pacemaker or an internal defibrillator with a battery pack (visible as a lump under the skin about two inches long)  avoid placing pads directly on top of the implanted medical device, if it is possible to do so and still maintain proper pad placement

 If victim is lying on metal surface, such as bleachers or a stretcher, avoid contact of the electrodes with the metal surface.

 Child CPR is for who?  Victims age 1 to  10 or 14  Onset of adolescence

 in children cardiac arrest rarely caused by heart failure  Then what?  Injury › poisoning › smoke inhalation › head trauma  which causes the breathing to stop first

 children are more resilient than adults  they tend to respond to CPR much better  if administered as soon as possible

 Before you call an ambulance  immediately check the victim for responsiveness › gently shake and shout, "Are you okay?" › DO NOT shake the child if you suspect he may have suffered a spinal injury.

 Child is unresponsive  You are alone  Start rescue efforts immediately  Perform CPR for at least 1 to 2 minutes before dialing (5 cycles)

 If the child is clearly unconscious,  remember C-A-B  and immediately assist him with  circulationcirculation

 Check carotid artery for pulse  place two fingertips and apply slight pressure on his carotid artery for 5 to 10 seconds

 If you don't feel a pulse then the victim's heart is not beating, and you will have to perform chest compressions compressions

 When performing chest compressions on a child, proper hand placement is even more crucial than with adults.  Using two fingers locate the victim's sternum at the bottom of the rib cage where the lower ribs meet,  put the heel of your other hand directly on top of your fingers

 Use only the heel of one hand to perform compressions.

 Smaller and more fragile body = less pressure  Depth of compressions for a child: › about 2 inches Feel or hear slight cracking sound?  may be pressing too hard -- apply less pressure as you continue

 Count aloud as you compress 30 times  followed by 2 breaths  Perform 5 cycles of 30 compressions and 2 breaths  before checking the child for breathing and pulse  check victim's carotid artery for pulse as well as any signs of consciousness  DO NOT FORGET TO DIAL 9-1-1

 Keep in mind that children's lungs have much smaller capacity than those of adults.  When ventilating a child, be sure to use shallower breaths and keep an eye on the victim's chest to prevent stomach distention.

 1. Check for responsiveness by shouting and shaking the victim. Do NOT shake the child if he has sustained a spinal injury.  2. Remember C-A-B:  Circulation: if there is no pulse, administer 30 chest compressions of about 2 inches. One hand.  Airway: tilt the head back and lift the neck to clear the airway.  Breathing: pinch the child's nose or cover his mouth and nose with your mouth making a tight seal, and give two breaths, watching for the chest to rise with each breath.  3. Continue to perform CPR for 1 to 2 minutes before dialing

 According to AHA guidelines, Infant CPR is for:  any victim under 12 months  except  newborns in the first hours after birth

 Infants, like children, have a much better chance of survival if  CPR is performed immediately  If you are alone with the infant, do not dial until after you have made an attempt to resuscitate

 Check infant for responsiveness by  patting his feet  gently tapping his chest or shoulders  If he does not react (stirring, crying, etc.) immediately check his circulation circulation