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Cardiopulmonary Resuscitation
CPR is commonly taught to the general public as these may be the only ones
present in the crucial few minutes before emergency personnel are available.
Each year, CPR helps save thousands of lives in the United States. More than
five million Americans annually receive training in CPR through American Heart
Association and American Red Cross courses.
CPR must be performed within four to six minutes after cessation of breathing so
as to prevent brain damage or death.
CPR is not generally recommended for the chronically or terminally ill or frail
elderly. For these people, it represents a traumatic and not a peaceful end of life.
The medical term for a patient whose heart has stopped is cardiac arrest (also
referred to as cardiorespiratory arrest), in which case CPR is used. If the patient
still has a pulse, but is not breathing, this is called respiratory arrest and in such
cases Rescue breathing is used.
What to do in an emergency
Stay calm and remember, you can only do your best. First, use all your senses to
assess the situation and make sure the area is free of hazards like live electricity
cables,gas,fumes, speedy traffic,falling masonry,firearm, particularly something
that may have been responsible for the casualty you are about to care for, and
ensure that there is no danger either to yourself or the casualty.
Once you have assessed the situation, Then you should quickly check the
casualty's responses by Gently shaking the casualty by the shoulders and ask
loudly "Are you alright?“.
When more than one rescuer is available, one should start resuscitation while
another rescuer goes for help.
A lone rescuer will have to decide whether to start resuscitation or to go for help.
In these circumstances, perform resuscitation for about 1 minute before going for
help.
Then return quickly to the casualty, not leaving the casuality alone more than
three minutes.
PROCEDURE WHEN CASUALTY IS UNRESPONSIVE. .
o With the other hand, slowly lift the chin forward and slightly up.,by placing
. two fingers under the point of the chin
o Move the chin up until the teeth are almost together, but the mouth is still.
slightly open .
o The head tilt and chin lift opens the airway by lifting the tongue and
epiglottis,and stops the tongue from falling back and blocking the throat.
Keep the airway open, and look, listen and feel for normal breathing
To assess breathing,place your ear near the victim’s mouth and nose while
maintaining an open airway. Then, while observing the victim’s chest,
(2) listen for breath sounds as air escapes during exhalation, and
Look, listen, and feel for no more than 10 seconds,If the chest does not rise and fall and
no air is exhaled, the victim is not breathing. In the first few minutes after cardiac arrest, a
casualty may be barely breathing, or taking infrequent, noisy gasps. Do not confuse this
with normal breathing.. If you have any doubt whether breathing is normal, act as if it is
not normal.
If the person is not breathing, give two rescue breaths. This is mouth-to-mouth breathing.
With the head tilted and chin up, pinch the nose and you inhale deeply and give sufficient
air to make the chest rise.you can actually see the chest to rise.When you remove your
mouth from the victim's mouth and break the air seal,
their chest fallsThis takes about two seconds. Allow the air to come out of the casualty’s
mouth, then repeat. There should be a slight pause to ensure that the delivered breath is
sufficient to cause the patient's chest to rise. After you've given the victim two rescue
breaths, you then check whether or not they have a pulse.
Feel for the pulse at the side of the neck.
The easiest pulse to find is the carotid artery. There are two, one running down
each side of the neck. Place two fingers on the centre of the throat and slide
them to one side, finding the groove on the side of the neck. You should press
gently and count out loud for ten seconds on one side of the neck only at a time.
You will recognise a pulse as a throbbing sensation under your fingers (you can
practice finding a major pulse on yourself or another person). Checking for
circulation includes pulse and other signs of life e.g. movement and/or
swallowing.
• After 30 compressions open the airway again using head tilt and chin lift
• Pinch the soft part of the nose closed, using the index finger and thumb of
your hand on the forehead.
• Allow the mouth to open, but maintain chin lift.
• Take a normal breath and place your lips around his mouth, making sure
that you have a good seal.
• Blow steadily into the mouth while watching for the chest to rise, taking
about 1 second as in normal breathing; this is an effective rescue breath.
• Maintaining head tilt and chin lift, take your mouth away from the casualty
and watch for the chest to fall as air passes out
• Take another normal breath and blow into the casualty's mouth once
more, to achieve a total of two effective rescue breaths. Then return your
hands without delay to the correct position on the sternum and give a
further 30 chest compressions.
• Continue with chest compressions and rescue breaths in a ratio of 30:2.
• Stop to recheck the casualty only if he starts breathing normally; otherwise
do not interrupt resuscitation.
• If your initial rescue breath does not make the chest rise as in normal
breathing, then before your next attempt: check the casualty's mouth and
remove any obstruction
• recheck that there is adequate head tilt and chin lift
• do not attempt more than two breaths each time before returning to chest
compressions
• Each rescue breath is given over 1 second rather than 2 seconds(new
guide line 2006).
• Recheck pulse and breathing every minute., better is very less
interruptions should be made, and continue till casuality shows movement
or signs of breathing.