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CPR & AED

Familiarization Programme
For NUS Community

EM Div, OSHE
UHWC & OSA
20 March 2008
CPR & AED Familiarization Programme
Concept of ‘Chain of Survival’

Early  Early 
Recognition  Early CPR Early  Advanced 
and Access Defibrillation Care
CPR & AED Familiarization Programme

How do you know it is a Heart Attack?


 Chest discomfort or pain

 Other symptoms – any or all may appear
• Sweating
• Nausea
• Shortness of breath
• Weakness
 Symptoms may appear suddenly & 
    victim does not realize it is a heart attack; 
    may think it is indigestion
What commonly causes “Sudden Collapse”?
Heart Attack
Foreign Body Airway Obstruction
Suffocation
Drowning
Stroke
Drug Overdose
Smoke Inhalation
Electrocution
Severe Allergic Reactions
Severe Trauma, e.g.. an accident

Heart Attack death can be prevented?


‘Only if’
Prompt help by someone applying CPR
until medical help arrives
CPR & AED Familiarization Programme
One-Man CPR Techniques

Step 1: Assessment – Determine responsiveness


“Hello! Hello! 
Are you Ok?”
 Check site for danger, e.g. chemical
spill, exposed electrical wire, falling
items, fire, leaked fuel & gas 

 Check casualty responsiveness


 tap shoulders gently
 call out loud
“Hello! Hello! Are you Ok?”

 No response – you have a casualty!


One-Man CPR Techniques

Step 2 : Activate Emergency Service

 Call loudly for ‘help’… “Call 995 for ambulance. 


Get the AED here.” 

 Call 995 or campus


security @ 6874 1616
for help

 Get someone to call for


help & get an AED,
if available
One-Man CPR Techniques

Step 3 : Position the Casualty

 Casualty must be lying


flat on his/her back on a
firm ground

Place casualty in correct


position (flat on back)
One-Man CPR Techniques

Step 4: Open Airway


  Place one hand on forehead & apply firm backward pressure    
with palm to tilt head back
  Place finger on the chin bone and lift the jaw forward (jaw trust)
  Open mouth gently and remove any obvious obstructing foreign 
body, e.g.. food, loose denture or secretions (finger sweep)

‘Head Tilt – Chin Lift’


One-Man CPR Techniques

Step 5 : Check Breathing


 Do the ‘head tilt-chin lift’ to open
airway

 Place own ear & cheek over


casualty’s mouth & nose for:

 Look – for chest rise and fall

 Listen – air escaping during


exhalation

 Feel - for the flow of air from


casualty’s nose
One-Man CPR Techniques

Step 6 : Mouth-to-Mouth Breathing


 Maintain ‘head tilt-chin lift’
to open airway

 Pinch nose with thumb &


index finger

 Cover mouth-to-mouth fully

 Give 2 short breaths (1 sec


each) & watch chest rise

 Ventilation volume between Use resuscitation mask / face mask for


400 to 600mls mouth-to-mouth resuscitation, if possible
One-Man CPR Techniques

Step 7 : Check for Circulation / Pulse


 Maintain the head tilt-chin lift to open airway
 Use index finger centre of throat & slide into the groove to locate
the carotid pulse
 Feel for pulse for about 10 secs & look for Signs of Circulation

Look for
Signs of Circulation
(CCMB)
• Consciousness
• Coughing
• Movement
• Breathing
One-Man CPR Techniques

Step 8 : Locate Hand position for Chest Compressions


 Run finger from rib cage to reach the sternal notch
 Place index finger next to center finger
 Place heel of the hand next to the index finger

Step 1 Step 2 Step 3


One-Man CPR Techniques

Step 9 : Perform Chest Compression


 Place the other hand on top of the hand on the sternum &
interlock the fingers
 Straighten both elbows and lock in position
 Position shoulder directly over the casualty’s chest
 Use body weight to compress chest about 4-5cm

• Ratio of CPR is 30 compression 
plus 2 ventilation
Step 1 Step 2 • Compression rate @ 100/min
• Perform 3 cycles of CPR
One-Man CPR Techniques

Step 10 : Reassessment
 Check for Pulse or Signs of Circulation (CCMB)

 If No - Continue CPR 30 : 2

 If Yes - Check for external injuries;


- Place casualty in recovery position
and maintain open airway

 Monitor casualty every few minutes until help


arrives
One-Man CPR Techniques

Recovery Position
Step 1 : Position the Casualty

(c) Tuck hand nearer to you,


arm straight & palm
upwards under thigh

(e) Bring arm from across &


place back of the hand
against cheek

(g) Bend the far knee to


90 degree angle
Recovery Position

Step 2 : Roll casualty towards the 
rescuer

• Place palm on palm of 
casualty hand on cheek & 
hold far hip and roll till lying 
on the side

• Use knee to support to 
prevent rolling too far 
forward
Recovery Position

Step 3 : Final Recovery Position

• Head (cheek) lie on the back 
of his palm

• Other hand lying free along 
side of body 

• The former far leg should be 
bent at 90 degree
Two­Man CPR+AED Techniques
MEDICAL PROTOCAL
Verify
Cardiac Arrest
Check Response (No) SHOCK ADVISED
Call 995 / 6874 1616 / AED
No Yes
Check Breathing (No)
Analyze Analyze
Check Pulse /  AED Deliver 
2 Ventilations Shock or 
Sign of Circulation
Press to shock
Check Pulse /
Signs of Circulation (No) Resume CPR 
Absent Present (30:2) & follow AED
Start CPR (30:2) until  voice prompt
AED is attached Resume CPR 
(30:2) & follow AED Recovery Position &
voice prompt Monitor Pulse & Signs
Prepare Chest  Every 05 mins
* AED should remain connected until casualty is
Operate AED handed over to medical personnel
THANK YOU