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BASIC LIFE

SUPPORT
CARDIOPULMONARY
RESUSCITATION
Prepared by: BSN - 3

OBJECTIVES:
At the end of this session participants should be
able to:
a.
b.

c.
d.

Define cardiopulmonary resuscitation


Perform correct cardiopulmonary
resuscitation techniques to an adult, child
and infant who are in cardiac arrest
Discuss other alternative forms of CPR
Enumerate the criteria for when to start,
not to start and when to stop CPR

CARDIOPULMONARY
RESUSCITATION (CPR)

is series of assessments and


interventions using techniques and
maneuvers made to bring victims of
cardiac and respiratory arrest back
to life.

CARDIOPULMONARY
RESUSCITATION

WHEN NOT TO START CPR


All victims of cardiac arrest should receive CPR
unless:
1. Patient has a valid DNAR (Do Not Attempt
Resuscitation) order.
2. Patient has signs of irreversible death (Rigor
Mortis, Decapitation, Dependent Lividity).
3. No physiological benefit can be expected
because the vital functions have deteriorated as
in septic or cardiogenic shock.
4. Confirmed gestation of < 23 weeks or birth
weight < 400 grams, anencephaly.
5. Attempts to perform CPR would place the
rescuer at risk of physical injury.

WHEN TO STOP CPR


All rescuers who have started resuscitation
procedures should continue to do so unless:
1. Effective and spontaneous (normal)
breathing and circulation has been restored.
2. Responsibility is assumed by a more senior
emergency medical professional who may
determine unresponsiveness to resuscitation
efforts such as a paramedic arriving on the
scene or a physician in the emergency room.

3. Recognition of reliable criteria indicating


irreversible death (Physician).
4. Rescuer is unable to continue resuscitation
due to exhaustion, the scene is no longer
safe, or when continued resuscitation may
place other lives at risk.
5. Presentation of a valid DNAR order to the
rescuer.

TO START, STOP OR NOT TO


START
When to STOP (Continuation):

S - SPONTANEOUS signs of circulation are


restored
T -TURNED over to medical services or properly
trained and authorized personnel
O - OPERATOR is already exhausted and cannot
continue CPR
P - PHYSICIAN assumes responsibility (declares
death, takes over, etc.)
S SCENE becomes unsafe (such as traffic,
impending or ongoing violencegun fires, etc)
S SIGNED waiver to stop CPR

CARDIAC ARREST

WHAT DO WE DO?
1.
2.
3.
4.
5.

Establish scene safety.


Introduce self to establish authority.
Tap the victims shoulder and Shout, Are you
ok?
No response: Shout Help! Man down! Activate
medical assistance (and bring me an AED)!
If you are alone, you must LEAVE the patient
to call for help (and get an AED). Once this is
accomplished, return to the patient
immediately.

THE C-A-BS
Core concept: Oxygen to the Brain!
In order: Compression-Airway-Breathing
These build on each other.
You cannot breathe for a patient or assess
breathing without first opening the airway.
ALWAYS FOLLOW YOUR CABs!!!

REASON: AHA 2010 GUIDELINES


Early CPR improves the likelihood of survival.
Chest Compressions are the foundations of CPR.
Compressions create blood flow by increasing
intra-thoracic pressure and directly compress the
heart; generate blood flow and oxygen delivery to
the myocardium and brain.

CPR: C- CIRCULATION
CIRCULATION represents a heart that is
actively pumping blood, most often recognized by
the presence of a pulse in the neck
Assume there is no CIRCULATION if the
following exist: Unresponsive, Not breathing, Not
moving and Poor skin color

SIGNS OF CIRCULATION

CPR: CHEST COMPRESSIONS


Place the other hand
over the first (and
interlock your fingers)
You should be on your
knees squarely at the
patients side

Push hard, push fast. Depress the chest 1.5-2 inches at


a rate of 100 times per minute
Do not bounce or bend elbows.
Release pressure after depressing the chest while still
keeping contact with the victims chest.
THIS IS A RATIO.DO THIS 30 TIMES
THEN DELIVER TWO BREATHS (30:2)

CPR: A- OPEN AIRWAY


This must be done to
ensure an open passage
for spontaneous
breathing OR mouth to
mouth during CPR
Head-Tilt/Chin-Lift
Tilt the head back with
your hand and lift up on
the chin
Jaw Thrust Maneuver

Jaw-Thrust Maneuver
is strictly a Healthcare
Provider technique
and not for Lay
Rescuers (if suspected
with cervical trauma)

If

NOT BREATHING: Deliver


TWO quick breaths that make
the chest rise.
Allow

the chest to fall


completely between breaths.
Turn your head towards the
patients chest as you inhale
for the 2nd breath.

CPR: PUTTING IT TOGETHER


Ratio:30

compressions/2 breaths
Rate: Approx: 100 compressions per
minute
Depth: 1.5-2 inches
Cycles: 1 cycle = 30 compressions
and 2 breaths
Five cycles should take no more than
2 minutes

CPR: ALL TOGETHER NOW


1.
2.
3.
4.
5.

Establish scene safety.


Introduce self to establish authority.
Determine unresponsiveness (movement &
breathing)
IF not moving and NO signs of circulation, go
get HELP! Activate EMS.
Pulse check within 10 seconds (for HCP)

6.

Perform 30 Compressions on the chest

7.

A- Airway- Open it! Head/Tilt chin lift

8.

Perform 2 Rescue Breaths

9.

Do this until AED/Defibrillator arrives, ALS


provider takes over, or victim starts to move.