By Tadeh Danielian

The Cardiac Chain of Survival 1. Early recognition of the emergency and early access to EMS 2. Early cardiopulmonary resuscitation (CPR) 3. Early defibrillation 4. Early advanced medical care

Persistent chest discomfort, pain or pressure that lasts longer than 3 to 5 minutes, or goes away and comes back. Discomfort, pain or pressure in either arm, back or stomach. Chest discomfort, pain or pressure that spreads to the shoulder, neck, jaw or arms. Shortness of breath or trouble breathing.

Nausea or vomiting. Dizziness, light-headedness, loss of consciousness or fainting. Pale, ashen, grayish or bluish skin. Sweating—face may be moist or person may be sweating profusely. Denial of signs or symptoms.

Immediately summon advanced medical personnel. Have the victim stop what he or she is doing and rest. Loosen any tight or uncomfortable clothing. Closely monitor the victim until advanced medical personnel arrive. Notice any changes in the victim’s appearance or behavior. Comfort the victim.

What is it and when does it occur? Signs and symptoms:  Unconsciousness  No movement or breathing  No pulse Care:  Early CPR  Early defibrillation

Combination of rescue breaths and chest compressions. Circulates blood containing oxygen to vital organs, increasing victim’s chance of survival, until advanced medical personnel arrive. CPR increases the likelihood that successful defibrillation can be delivered to a victim of sudden cardiac arrest, especially if more than 4 minutes have elapsed since the victim’s collapse. Must be performed on a firm, flat surface.

 1 – Check for responsiveness (tapping the shoulders with both hands while saying “are you ok”).  2 – If no response, yell for help. If someone comes, tell him/her to phone 911 and get an AED. If no one comes, phone 911 immediately and then begin the step of CPR.  3 – Open the Airway (head-tilt-chin-lift or Jaw thrust) Look, Listen, Feel for breath (5 – 10 seconds.)  4 –Perform a “head tilt chin lift” and Give 2 breaths (give enough breath to make the chest rise).***remember to pinch the nose.  Start five cycles of 30 compressions and 2 breaths at a rate of 100 compressions per min. Five cycles of 30 comps and 2 breaths in under 2 minutes.  Remember—if an AED arrives on the scene (for adult CPR) stop CPR and use AED immediately

 1 – Check for responsiveness.  2 – If no response SHOUT for help, send someone to  CALL and get an AED.  3 – Open the Airway (head-tilt-chin-lift or jaw thrust) Look, Listen, Feel for breath (5 – 10 secs).  4 – Give 2 breaths (give enough breath to make the chest rise).***remember to pinch the nose.  Start CPR 30 compressions and 2 breaths at a rate of 100 compressions per min.  Compression is different than adult. One hand on chest and one hand on forehead.  After 5 cycles of 30:2 if alone ACTIVATE the EMS and get the AED.

 1 – Check for responsiveness.  2 – If no response SHOUT for help, send someone to call 911 and Do NOT get an AED.  3– Open the Airway (head-tilt-chin-lift or jaw thrust) Look, Listen, Feel for breath (5 – 10 secs).  4 – Give 2 breaths (give enough breath to make the chest rise).***remember to place your mouth around the nose and mouth.  Start CPR 30 compressions and 2 breaths at a rate of 100 compressions per min.  After 5 cycles of 30:2 if alone call 911 after 5 th cycle

Most cardiac arrests occur away from the hospital. Early CPR can help a cardiac arrest victim. An electrical shock (defibrillation) is needed to correct the problem. The sooner the shock is administered, the greater the victim’s chance of survival. Early defibrillation is the third step in the Cardiac Chain of Survival.

 When AED arrives, place it at the victims side, next to the responder using it.  First  POWER on the AED.  Second  ATTACH the pads to the victim, then attach to AED.  Third,  Clear the victim and ANALYZE the rhythm, by pressing the analyze button.  Fourth  SHOCK – If the AED advises a shock, Clear the victim and press the SHOCK button.  CPR – After AED gives the shock, begin CPR beginning with chest compressions.  RE-ANALYZE – After 2 minutes of CPR, press ANALYZE on AED  Four Special situations:  Take heed of the four special situations (hairy chest, wet/water, pacemaker, and medicine patch) and know what to do  Use adult pads on victims aged 8 and Older.  Use specialized pediatric pads on victims aged 1 to 8.  Currently no evidence to recommend for AED use on infants aged 1 or less.

 American Heart Association,  Sensible Saftey: First Aid/CPR/AED Training,