Cardio-Pulmonary Resuscitation (CPR) PDF

Cardio-Pulmonary Resuscitation 26-Jan-18 (CPR) 1  OBJECTIVES  Define BLS 2  Explain steps & components of BLS  Explain chain of survival  Explain about defibrillator ...

Cardio-Pulmonary Resuscitation 26-Jan-18 (CPR) 1  OBJECTIVES  Define BLS 2  Explain steps & components of BLS  Explain chain of survival  Explain about defibrillator  Definition of CPR: An emergency procedure consisting of external cardiac message ,and artificial respiration ; the first treatment for 3 person who has collapsed and has no pulse and has stopped breathing. Attempt to restore circulation of blood and maintain breathing and prevent brain damage due to lack of oxygen that lead to death  Indication of CPR: 4 1-Cardiac arrest 2-Respiratory arrest  1-Cardiac arrest Occur when heart stops beating or beats ineffectively to circulate blood to the brain and other vital organ 5 When heart stops beating properly ;the body can not survive ;breathing will soon stop. Brain damage can begin in about 4 to 6 minutes and damage can be irreversible after about 10 minute  Cardiovascular disease is the primary cause of cardiac arrest in adult  1-Cardiac arrest Cause of cardiac arrest 1-Failure to fill heart: 6 A-sever bradycardia B-great blood vessels obstruction 2- Failure to empty the heart A-Hypoxia B-Hyperkalemia C-Heart disease D-Hypothermia E-Halothane F- Heavy pulmonary embolism  2-Respiratory arrest: 7 A breathing emergency is any respiratory problem that can threaten person's life. when air cannot travel freely and easily into the lungs, respiratory distress, and respiratory arrest  2-Respiratory arrest: Causes of respiratory arrest: 8 A-Airway obstruction B-Drowning C-Suffocation D-coma  General Manifestation Of Cardiopulmonary Arrest A-abrupt and arrest:-complete unconsciousness 9 B-absence of pulse in major vessels as carotid C-apnea with or without cyanosis D-dilation of pupil Warning signs of arrest Chest pain or discomfort Heart palpitations 1 Rapid or irregular heartbeats 0 Unexplained wheezing Shortness of breath Fainting or near fainting Lightheadedness or dizziness Level of skills  Basic life support:-  Advanced life support:-  Level of skills 1. Basic life support:- Simple first responder technique or emergency medical technique (variety of noninvasive emergency procedures to assist in the immediate survival of patient) And don not involve use of 1 2 hsophisticated medical equipment 2. Advanced life support:- Is set of life –saving protocols and skills that extend basic life support to further support the circulation and provide open airway and adequate ventilation used in hospitals as use of intubation kit Technique Of Basic Life Support 1 3 CPR  14 1-Ensure Safety  Safety of self  Safety of patient  Movement of a trauma victim – only when absolutely necessary [Unstable cervical spine – injured spinal cord]  15 2-Check for responsiveness Tapand shout Ask the person “Are you ok ?” For infant 'you may flick the bottom of foot  If the client responds reassess regularly from head to toes  if no response call EMS (Emergency Medical Services).  EMS IS network of professional linked together to provide the best care for all people in all types of emergencies o If you are alone leave the victim, call for an ambulance and back as quickly as possible o If two , one should call emergency number for help while the other perform CPR  3- (C)CIRCULATION check carotid pulse for no more than 10 second if no pulse Start chest compression  33 1. locate the correct position of sternum 2. kneeling by the right side of victim and find on (lower half of sternum) 3. Place the heel of your first hand on the top of other hand and keep your fingers well clear of the chest 4. “Push hard push fast”. Push at a rate of 100| min.  CHARACTERISTICS OF GOOD COMPRESSION  Compression depth- at least 2 inches(5cm) After each compression release the pressure on the chest without removing your hand or changing hand position this allow hearts champers to fill blood between compression 24  Never use the palm of your hand, use the heel of your hand Adult Chest Compression  4- (A)Open Airway Assess the victim fully in the position in which you find him; Then turn the victim on his back A- Head tilt , chin lift :(that allow the tongue is drawn away from the back of throat) by place one hand on his forehead and gently tilt his head back B- Jaw Thrust Manoveur if suspected spinal injury Remove any visible obstruction from the victim mouth if you can Open Airway  5- (B)BREATHING:- Check for breathing: Looking for chest movement Listening at mouth for breath sound Feeling for breath on your check IF NO breathing:-- Give mouth to mouth breath Mouth to mouth breathing  Ensure head tilt and chin lift  Pinch the soft part of nose closed with index finger and thumb of your hand  Take deep breath and place your lips around his mouth  Making sure that you have a good seal  Give 2 slow ,effective rescue breaths make chest rise and fall A compression-ventilation ratio of 30:2  When you must stop CPR A- IF the victim has any signs of circulation and breathing (ROSC) B- IF emergency services arrive C- Too exhausted to continue D- Cardiac arrest longer than 30 minute Difference between adult and childern Adult Children Infant Carotid Carotid or Brachial femoral Difference between adult and childern Adult Children Infant Two hands in center of Two hands in center of Two or three fingers in Technique chest(on lower half of chest(on lower half of center of chest(on sternum) sternum) lower half of sternum,just below nipple line At least 2 inches At least 2 inches At least 1,5 inches Depth Cycle Rescue 30 : 2 30 : 2 30:2 Rate 100|m Rate 100|m Rate 100|m breaths Tilt head ,pinch nose Tilt head ,pinch nose Tilt head, and seal ,seal over mouth ,seal over mouth over mouth and nose Chest Compression For Neonate  ‫الضغغغغغغغغغغغغ‬ ‫المتت لي غ عل غ‬ ‫صدر فل مغ‬ ‫شهر لسن‬  ‫الضغغغغغغغغغغغغ‬ ‫المتت لي غ عل غ‬ ‫صدر فل مغ‬ ‫سغغغغغغغغغغغغغغغغن ل ‪9‬‬ ‫سنوا‬  ‫الضغغغغغغغغغغغغ‬ ‫المتت لي غ عل غ‬ ‫صغغدر شغ‬ ‫ب لغ‬ Methods of oxygen delivery  METHODS OF RESCUE BREATHS  Mouth-to-Mouth Rescue Breathing  Mouth-to–Barrier Device Breathing  Mouth-to-Nose and Mouth-to-Stoma 32 Ventilation  Ventilation With Bag and Mask  Ventilation With an Advanced Airway 26-Jan-18  6- Recovery position If the individual is breathing and have pulse but unconscious put patient in recovery position to:  Maintain free airway  Prevent aspiration  Help to prevent blockage of airway  How; Recovery position Kneel beside the person Put their arm that is farthest from you out at right angle to their body Place their nearer arm across their chest Bend their nearer leg up at the knee the other leg should be straight While supporting their head and neck , roll the person away from you When they are on their side , knee their top leg bent at the knee, with the knee touching the ground How; Recovery position  Medication of resuscitation Medication Indication Oxygen Hypoxia IV fluid Expansion of circulation blood flow Morphine sulphate Pain of myocardial infraction Atropine Bradycardia Dopamine sever hypotension with bradycardia Sodium Severe acid –base balance bicarbonate Diuretics Cerebral edema or acute pulmonary edema Adrenaline Increase myocardial and cerebral blood flow  Post resuscitation complication Complication Etiology 1- Traumatic Improper chest chest pain, asymmetric fractured ribs and compression chest wall movement sternum 2- Pneumothorax Improper chest Chest pain, dyspnea compression ,hypoxemia ,cyanosis 3- Aspiration Vomiting of blood, Hypoxemia ,tracheal pneumonia semiconscious client suctioning gastric content 4- Congestive heart Overlying vigorous Increase heart and failure use of sodium respiratory rate bicarbonate and intravenous fluids Skin burn Repeated defibrillation of Erythematic and blistering of skin delivery of high voltages at site of paddle 5-Oral Improper or repeated Broken teeth ,bloody ,tracheal endotracheal intubation mouth ,hoarseness ,strider ,laryngeal damage 6-Ruptured Improper chest Upper left quadrant pain spleen compression ,hypotension 7- Cervical Hyperextension of neck Decreased sensory or neck injury (causing cervical neck motor movement below trauma) level of cervical injury EARLY DEFIBRILLATION(ALS) 35  CPR is not indicated 1. signs of definitive biological death 2. witnessed information, that cardiac arrest had happened 15 or more minutes before the rescuer arrived (time assessment in the stressing situation is not precise) 3. an evident trauma without chance to survive (catastrophic head injury) 4. DNR - “Do not attempt resuscitation” has been written in the file (incurable disease after all available therapy failed)  Age of the patient is not restriction of CPR  58 26-Jan-18