Cardiopulmonary Resuscitation (CPR) PDF

CARDIOPULMONA RY RESUSITATION CPR DR. YOSREAH MOHAMED Introduction Definition of CPR CPR is an emergency life support technique used to artificially maintain both circulation and ventilation in persons suffering from cardiac respiratory arrest until ad...

CARDIOPULMONA RY RESUSITATION CPR DR. YOSREAH MOHAMED Introduction Definition of CPR CPR is an emergency life support technique used to artificially maintain both circulation and ventilation in persons suffering from cardiac respiratory arrest until advanced life support can be made.  Purposes of CPR: - To establish effective circulation and respiration. - To establish carbon dioxide and oxygen exchange and adequate circulation, so that oxygenated blood can be delivered. - To prevent irreversible cerebral damage. Clinical manifestation of arrest: - Sudden unconsciousness. - Pallor. - Cyanosis. - Not heard B.P. - Absent carotid or femoral pulse. - Gasping then stop respiration.  The process include: Maintaining open airway Conducting CPR Maintaining breathing Maintaining circulation Determine that the scene is safe Step 1 Conduct a rapid Assessment Perform a quick visual survey, check for responsiveness, open the airway, and simultaneously check for breathing and a carotid pulse for at least 5 seconds but no more than 10. ASSESSMENT If the patient is unresponsive, isn’t breathing normally and doesn’t have a pulse, Shout for help/send someone to call EMS and get AED begin CPR. NOTE; Assess the person and activate emergency response system within a maximum of 30 seconds(this must precede starting compression)  1. CPR 1 - Give 2 Perform 30 high -quality compression CYCLEs OF Give 2 effective breaths with a barrier device CPR(30:2) 2. Then Use Automated External Defibrillator (AED) if available 2 - Then use AED Step 2 IN HEALTHCARE SETTING Place the patient on a firm, flat surface. Adjust the bed to an appropriate working height. Lower the bed side rail closest to you. IN OTHER SETTINGS, move the patient to the floor or ground and kneel beside them. Step 3 Position your hands correctly Expose the patient’s chest to ensure proper hand placement and visualize chest recoil. Place the heel of one hand in the center of the patient’s chest on the lower half of the sternum. Place your other hand on top of the first and interlace your fingers or hold them up so that they are not resting on the patient’s chest. Step 4: Position your body effectively Position yourself so your shoulders are directly over your hands. This position lets you compress the chest using a straight up-and-down motion. To help keep your arms straight, lock your elbows. Step 5: Perform 30 chest compressions For an adult, compress the chest to a depth of at least 2 inches (5- 6 cm). Provide smooth compressions at a rate of 100 to 120 per minute. Allow the chest to fully recoil after each compression. Criteria for high-quality CPR: Start chest compressions (hard and fast) within 10 seconds Allow for complete chest recoil between compressions Minimize interruptions between chest compressions Assure that the breaths make chest rise Do not over-ventilate Assess for shockable rhythm as soon as AED available when cardiac arrest occur as it is most likely a shockable rhythm  Step 6: Seal the mask and open the airway Use an adult pocket mask for single-provider CPR or a bag valve mask (BVM) for multiple- provider CPR. Seal the mask and simultaneously open the airway using the head- tilt/chin-lift technique.  Types of masks: pocket mask BVM mask  Or, use the modified jaw-thrust Step 6: maneuver, if you suspect a head, Seal the mask and neck or spinal injury. open the airway Step 7: While maintaining the mask seal and open airway, provide smooth, effortless ventilations. Each ventilation should last about 1 second Provide 2 and make the chest begin to rise. Avoid excessive ventilation. ventilations If you do not have a pocket mask or BVM, provide mouth-to-mouth or mouth-to-nose ventilations  Step 7: Provide 2 ventilations  If there is disinterest (because of an air-borne illness suspicion) in Note providing ventilation, hands-only CPR would be an equivalent option. 2 rescuers: 1. One rescuer is responsible for calling EMS and getting AED, connect and operate it. Then giving breath. 2. The other rescuer is responsible for compressions and giving breath until the first rescuer come 3. then they switch every 2 minutes(5 cycles). Step 8: Switch positions every 2 minutes When providing CPR with multiple providers, smoothly switch positions about every five cycles of compressions and breaths. One cycle consists of 30 compressions and two breaths for Adults. This should take less than 10 seconds. The compressor calls for a position change by saying “switch” in place of the number 1 in the compression cycle.  Use Automated External Defibrillator (AED) if available Follows instructions of AED Powers on AED Correctly attaches pads places proper- sized pads for person’s age in correct location Clears for analysis: clear rescuers from person for AED to analyze rhythm Clears for safely deliver a shock Press button to deliver shock Immediately resume compressions after shock delivery don’t turn of AED during CPR- REPEAT every 2 minutes Connecting AED  Continue providing CPR until: You see signs of ROSC, such as patient movement or normal breathing. Other trained providers take over and relieve you from compression or ventilation responsibilities. Step 9: You are presented with a valid do not resuscitate Continue CPR (DNR) order. You are alone and too exhausted to continue. The situation becomes unsafe Child CPR The depth of chest compression not more than 5 cm Use pediatrics AED pads until age of 8 then use adult size pads. Infants CPR: Use middle two or three fingers to apply compressions Use pediatrics AED pads and position it in front and back of the chest Cover infant’s nose and mouth by mouth in mouth to mouth breathing