Cardio-Pulmonary Resuscitation BLS PDF

Cardio-Pulmonary resuscitation Dr / Mohammed Fawzy Tantawy MD, EgFEM Consultant of Emergency & Critical Care Medicine Lecturer at The Faculty of Medicine Menoufia University Cardiopulmonary resuscitation, commonly known as CPR, is an emer...

Cardio-Pulmonary resuscitation Dr / Mohammed Fawzy Tantawy MD, EgFEM Consultant of Emergency & Critical Care Medicine Lecturer at The Faculty of Medicine Menoufia University Cardiopulmonary resuscitation, commonly known as CPR, is an emergency procedure performed in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person who is in cardiac arrest. CPR alone is unlikely to restart the heart. Its main purpose is to restore partial flow of oxygenated blood to the brain and heart. The objective is to delay tissue death and to extend the brief window of opportunity for a successful resuscitation without permanent brain damage.  Check Response and Scan for Breathings ADULT PEDIATRIC 6  Check PULSE Feel for a pulse for at least 5 but no more than 10 seconds. If you don’t definitely feel a pulse , begin CPR. 8  Activate Emergency Response System & get AED If another rescuer is present , ask him to activate the ERS & get the AED ( Defibrillator ) if available. 9 If you are alone , will you prefer to Call ERS & get AED Or you will start to deal with the victim ???  CPR The 2010 AHA guidelines for CPR changed the sequence from A-B-C to C-A-B in adults , children & infants In the A-B-C sequence , chest compressions were often delayed while the rescuer open the airway to give mouth- to-mouth breaths & by changing the sequence to C-A-B , rescuers can start Chest compressions sooner which always give bitter results.  Start Chest Compressions  Begin cycles of 30 chest compressions & 2 breaths  Position yourself at the Victim’s side  Make sure the victim is lying face-up on a firm flat surface  Put the heal of one hand on the center of the victims chest on the lower half of the sternum  Straighten your arms & position your shoulders directly over your hands  Try to give high quality CPR 14  High quality CPR I. START within 10 sec. of arrest recognition. II. PUSH FAST: Compression rate AT LEAST 100/ min. III. PUSH HARD: Compression depth AT LEAST 5 cm in adults, (5 cm in children and 4 cm in infants or 1/3 of the AP chest diameter). IV. ALLOW COMPLETE CHEST RECOIL. V. Minimize interruptions. Chest compressions in children Chest compressions in infants  Opening the Airway  There are two methods for opening the airway to provide breaths.  The first method is Head tilt–Chin lift & the second is Jaw thrust.  Jaw thrust is the safe method if you suspect head & neck injury while Head tilt-Chin lift is contraindicated.  If Jaw thrust is no adequate switch to Head tilt-Chin lift method whatever the contraindications.  Place one hand on the victim’s forehead & push with your palm to tilt the head back.  Place the fingers of the other hand under the bony part of the lower jaw near the chin.  Lift the jaw to brig the chin forward.  This maneuver will lift the tongue relieving the airway obstruction.  Place one hand on each side of the victim’s head resting your elbows on the surface on which the victim is lying.  Place your fingers under the angle of the victim’s lower jaw & lift with both hands displacing the jaw forward.  Push the lower lip with your thumb to open the mouth.  How to give breaths Mouth to Mouth breathing. Mouth to Mask breathing. Bag & Mask breathing. Mouth to mouth breathing Mouth to Mask breathing Bag & Mask breathing Bag & Mask breathing Advantage of Bag-Mask ventilation :-  Avoids direct person to person contact  Allows oxygen supplementation – up to 85% with reservoir  Can be used with facemask or tracheal tube Automated External Defibrillator  The interval from collapse to defibrillation is one of the most important factors of survival from sudden cardiac arrest with Ventricular fibrillation & pulseless ventricular tachycardia.  AEDs are computerized devices that can identify cardiac rhythms that need a shock & they can deliver the shock.  They are simple operate allowing any healthcare provider to attempt defibrillation safely.  When ventricular fibrillation is present , the heart muscle fibers just quiver & don’t contract together to pump blood.  The Defibrillator delivers an electric shock to stop the quivering of the heart muscle fibers.  This allows the muscle fibers to reset so that they can begin to contract at the same time & once an organized rhythm occurs the heart muscle may begin to contract effectively & generate Pulse  This process is called Return Of Spontaneous  Power on the AED.  Attach AED pads to the victims bare chest. - Self adhesive pads - Place one AED pad on the upper right chest - place the other one to the side of the left nipple below the armpit  Attach the AED connecting cables to the AED box.  Clear the victim & Analyze rhythm. - it may take about 5-15 sec to analyze the rhythm - There will be two possibilities …………..  If the AED advises a SHOCK , it will till you to clear the victim. - be sure nobody is touching the victim - loudly state a “ clear the victim “ massage such as “ everybody clear - press the shock button - the shock will produce a sudden contraction of the victims muscles - immediately resume CPR *****  If no shock is needed , start CPR.  The AED will automatically reanalyzes the rhythm after 2 min or 5 cycles.  Special situations Hairy Chest Water 37  Special situations Transdermal Drugs Implanted PM & ICDs 38 Take Home Massage Every medical personnel must be BLS certified Any Questions ??????