1 Ch. 5-Cardiopulmonary Resuscitation

2 5.2 Basic Life Support Sequence Determining Responsiveness Determining Responsiveness Activating the EMS System Activating the EMS System Opening the Airway Opening the Airway Determining Breathlessness Determining Breathlessness Providing Rescue Breathing Providing Rescue Breathing Determining Pulselessness Determining Pulselessness Deliver Chest Compressions Deliver Chest Compressions Defibrillation Where Available Defibrillation Where Available

3 Vocabulary Cardiac arrest- A condition in which the heart stops beating Defibrillation- The application of electricity to the chest of a victim whose heart has stopped Larynx- The voice box

4 PROGRESS CHECK 1. In cardiac arrest, the heart stops because it is not getting the ____________ it needs. (electrical stimulation/rest/oxygen) 2.CPR consists of opening the airway, providing rescue breathing, and providing ____________. (chest compressions/defibrillation/intrathoracic massage) 3. The key objectives of CPR are to ____________ and circulate the blood. (provide rescue breathing/defibrillate/oxygenate) 4. For each minute a heart is stopped, a victim loses approximately ___________ % from his chance of survival. (5/10/25) 5. A key to survival in cardiac arrest is ___________ CPR. (early/effective/prolonged)

5 Determining Breathlessness Look for the chest to rise and fall Look for the chest to rise and fall Listen for air escaping during exhalation Listen for air escaping during exhalation Feel for the breath against your cheek Feel for the breath against your cheek

6 Determining Pulselessness 1. Maintain the head tilt with one hand on the victim’s forehead, and place the first two fingers of other hand on the larynx (voice box). 2. Locate the carotid artery. 3. Exert only gentle pressure to avoid compressing the carotid artery, and feel for a pulse for as long as 10 seconds. 4. While checking pulse, be alert for other signs of life— including movements, breathing, gasping, or coughing—that could indicate a pulse is present.

7 PROGRESS CHECK 1. The first step in the basic life support sequence is to determine ____________. (responsiveness/breathlessness/pulselessness) 2. If you determine that the victim is unresponsive, you should immediately ____________. (open the airway/start CPR/activate the EMS system) 3. Before you can determine whether the victim is breathing, you need to ____________. (open the airway/provide two rescue breaths/start CPR) 4. Before you can determine whether the heart is beating, you need to ____________. (position the victim/provide two rescue breaths/start CPR)

8 5.3 Chest Compressions Positioning Your Hands Positioning Your Hands Delivering Chest Compressions Delivering Chest Compressions

9 Proper Hand Placement for Adult CPR

10

11

12 Vocabulary Xiphoid process- The lower tip of the sternum Substernal notch- The notch at the spot where the ribs join the sternum Ventricular fibrillation- A chaotic, unorganized beating effort of the heart that is incapable of producing a pulse or circulation

13

14 Performing One-Rescuer Adult CPR 1. Position your hands properly on the victim’s chest as described above. 2. Deliver 15 chest compressions at the rate of about 100 per minute. Count aloud to keep track of the compressions. 3. Remove your hands from the victim’s chest, open the airway, and deliver two rescue breaths

15 Terminating CPR Breathing and heartbeat start again spontaneously (this is unusual; most cases of cardiac arrest require defibrillation and advanced life support procedures) Breathing and heartbeat start again spontaneously (this is unusual; most cases of cardiac arrest require defibrillation and advanced life support procedures) Another trained rescuer, a physician, or an individual or team directed by a physician assumes responsibility for basic life support Another trained rescuer, a physician, or an individual or team directed by a physician assumes responsibility for basic life support A physician tells you to stop A physician tells you to stop The victim is transferred to an appropriate medical care facility The victim is transferred to an appropriate medical care facility You are exhausted and unable to continue life support You are exhausted and unable to continue life support Conditions (such as a fire, noxious fumes, or an unstable Conditions (such as a fire, noxious fumes, or an unstable building) make it unsafe for you to continue building) make it unsafe for you to continue The victim is declared dead by a physician The victim is declared dead by a physician

16 PROGRESS CHECK 1. You must properly position your ____________ during chest compressions, or you can injure the victim. (shoulders/hands/knees) 2. The xiphoid process is the tip of the ___________. (rib/clavicle/sternum) 3. The substernal notch is the notch where the ____________ meet(s) the sternum. (ribs/clavicle/xiphoid) 4. During chest compressions, keep your shoulders straight and your elbows ____________. (bent/locked/aligned) 5. After every two rescue breaths, deliver __________ chest compressions. (10/15/20) 6. Once you start CPR, you must continue it until breathing and pulse return, someone else takes over, or ____________. (you are told to stop/you are too tired to continue/you injure the victim) 7. During two-rescuer CPR, the First Aider at the victim’s side should never ____________. (lift hands off the chest/deliver rescue breaths) 8. If delivering chest compressions to an infant, use ____________. (two fingers/one hand/both hands)

17

Mistakes, Complications, and When to Withhold Complications Caused by CPR Complications Caused by CPR Fracture of the ribs or sternum Fracture of the ribs or sternum Separation of rib cartilage (common in the elderly) Separation of rib cartilage (common in the elderly) Pneumothorax Pneumothorax

19 Withholding CPR There is rigor mortis or other signs of death. There is rigor mortis or other signs of death. The victim is decapitated. The victim is decapitated. The victim has wounds that will certainly cause death. The victim has wounds that will certainly cause death.

Defibrillation Defibrillation is done by automated external defibrillators (AEDs) Defibrillation is done by automated external defibrillators (AEDs) Ventricular fibrillation is a chaotic, unorganized beating of the heart that is incapable of producing a pulse or contraction Ventricular fibrillation is a chaotic, unorganized beating of the heart that is incapable of producing a pulse or contraction Defibrillation literally shocks the heart into the proper organized rhythm Defibrillation literally shocks the heart into the proper organized rhythm

21 Cardiac Arrest in Pediatric Patients In the event of cardiac arrest in pediatric patients 1 year or older, defibrillate with adult pads if pediatric-specific pads or devices are unavailable. Pediatric pads should not be used on adult patients. In the event of cardiac arrest in pediatric patients 1 year or older, defibrillate with adult pads if pediatric-specific pads or devices are unavailable. Pediatric pads should not be used on adult patients.

22 PROGRESS CHECK 1. Ventricular fibrillation is an ________ beating effort of the heart. (accelerated/unorganized/ordinary) 2. If you are alone with a victim in cardiac arrest and you have an AED available, you should perform _________ first. (CPR/defibrillation/a neuro exam) 3. Before analyzing or shocking a victim with an AED you should _______ the victim. (roll/clear/ventilate)