CPR Lecture 2024 PDF

Emerging Situation Cardiopulmonary Resuscitation(CPR) Noha El baghdady, Ph.D Intended learning Outcomes Illustrate the 4 important actions should be taken during life- threatening emergencies Explain CPR For an adult Explain CPR for a child Explain CRP for an infant When to...

Emerging Situation Cardiopulmonary Resuscitation(CPR) Noha El baghdady, Ph.D Intended learning Outcomes Illustrate the 4 important actions should be taken during life- threatening emergencies Explain CPR For an adult Explain CPR for a child Explain CRP for an infant When to Perform CPR? When someone is unresponsive and not breathing or gasping for air. Chain of Survival illustrates 4 important actions to take during life-threatening emergencies 1. Early access and recognition, then for help. 2. Early CPR. 3. Early defibrillation. 4. Early advanced care (Post resuscitation care). Chain of Survival illustrates 4 important actions to take during life-threatening emergencies 1. Early access and recognition, then for help This first link refers to the importance of early recognition or access to those at risk of cardiac arrest Calling for help immediately for early treatment. 2. Early CPR Early cardiopulmonary resuscitation (CPR) performed by a First Aider can buy life- saving time for a casualty in cardiac arrest.  Chain of Survival illustrates 4 important actions to take during life-threatening emergencies 3. Early defibrillation Early defibrillation is the third and perhaps most significant link. Automated external defibrillation is an emergency procedure. First Aiders apply an electronic device to the chest of a cardiac arrest casualty. It delivers a controlled electric shock to the casualty’s heart. Chain of Survival illustrates 4 important actions to take during life-threatening emergencies 4. Early advanced care (Post resuscitation care) Focuses on preserving function, particularly of the brain and heart. By ambulance paramedics and other highly trained medical personnel. Basic Life Support (DRSABCD) This 7-step emergency action plan, also known as the ‘primary survey’ and ‘basic life support flowchart’, is known as D.R.S.A.B.C.D. (Drs ABCD).  Danger (hazards, risks, safety) In an emergency situation, you need to check for potential hazards and ensure the safety of all those at the scene. Quickly and thoroughly survey the scene to look for any threats to safety. Check for any risk to yourself, bystanders and the casualty.  Danger (hazards, risks, safety) – Hazards Examples  Moving a casualty 1- Check a casualty in the position in which you find them, provided they are not at further risk. 2- May need to roll them onto their back “gently, while supporting the head and neck”. 3- Moving a casualty — especially an unconscious casualty — ambulance personnel If you need to move the casualty before an ambulance arrives → get assistance from bystanders, take extreme care, and use good manual handling practices. Using good body mechanics - maintaining a straight back and bending your legs, not your back.  Moving a casualty Ambulance personnel- who have the necessary training and equipment. 1. Do not lift and twist at the same time 2. Don't move a casualty on your own. 3. Keep the load close to your body when lifting — do not reach and lift. Causes of unconsciousness The causes of unconsciousness can be classified into 4 broad groups 1. Low brain oxygen levels 2. Heart and circulation problems (e.g. Fainting, abnormal heart rhythms) 3. Metabolic problems (e.g. Overdose, intoxication, low blood sugar) 4. Brain problems (e.g. head injury, stroke, tumour, epilepsy) Different causes may be combined in the unconscious person  Response “Causes of FISH SHAPED unconsciousness” Stroke Fainting Heart Attack Infantile Asphyxia Shock Poisons Head Injury Epilepsy Diabetes Assessment of responsiveness “C.O.W.S. method” Can you hear me? Ask “Can you hear me?” “Are you hurt or sick?” Also, ask if you can help the casualty. Along with the possibility of eliciting a response, this has the added advantage of gaining consent, or not. Open your eyes. Instructing the casualty to open their eyes is the most instinctive action the casualty will take, if they are able to. If their eyes are open, are they able to ‘look left’, look right’? What is your name? Asking their name is also instinctive. The name is irrelevant, so long as they respond to your question. Squeeze my hands. Squeeze the casualty’s hand to see if they squeeze back in response. A casualty that cannot hear you, may feel your squeeze and respond accordingly. The casualty DOES respond If the casualty responds by speaking or moving and appears conscious, leave them in the position in which you found them (provided there’s no further danger or risk). Do a ‘secondary survey’ 1- Verbal 2- Visual assessment “a head-to-toe examination” Get help if required Observe and reassess the casualty regularly The casualty DOES NOT respond Send for help Send for help Sending for help as early as possible is vitally important Shout for help to alert nearby people Where possible, direct a bystander to call for an ambulance Ask someone find and bring an AED if available If you are on your own, use your mobile phone to call the ambulance  Airway An open and clear airway is essential. This takes priority over any injuries. If possible, check the airway without moving the casualty. However, you may need turn the casualty onto their side or back. Airway Adults (8 years &over) A gradual full head tilt is recommended: Place your hand on the forehead Place your fingertips under the point of the casualty’s chin Gently tilt the head back and lift the chin to open the airway ‫ أذق الجبهة وارفع الذقن‬/ ‫ايد على الجبهة – ايد على الذقن‬ Airway Children (1 – 8 years) A gradual full head tilt is recommended for children from 1 year up to 8 years of age. Children should be managed as for adults Infants (under 1yr) For infants, maintain a neutral head position/jaw support. DO NOT tilt their head back, as this can compromise their airway. Clearing the airway Look into the back of the throat to see if anything is blocking the pathway.  Breathing Is the casualty breathing ‘normally’? While keeping the airway open, assess their breathing using “‘Look, listen and feel’ method” 1- Look to see if the chest rises and falls 2- Listen at the mouth for sounds of normal breathing 3- Feel for air against your cheek  Breathing If casualty is breathing ‘normally’: Promptly roll them into the ‘recovery position’ Check the casualty’s condition and be sure to call for an ambulance Observe and reassess the casualty for continued breathing Assess for injuries and treat accordingly while waiting for medical help to arrive The ‘Recovery Position’- Infants An infant should not be left laying on their side, rather they should be held in this position, as they are likely to roll back on to their back. In general, it does not matter which side you lay the casualty on. https://firstaidforlife.org.uk/recovery-position/ Recovery position - Pregnant Women  Cardiopulmonary Resuscitation (CPR) Kneel by the side of the casualty and place the heel of one hand (or two fingers on an infant), in the centre of the casualty’s chest, on the lower half of their sternum Place your other hand over the top of the first one  Cardiopulmonary Resuscitation (CPR) Press straight down on the sternum, one C Call 123 third the depth of the chest Allow complete recoil of the sternum back to its starting position Repeat 30 times, at a speed of 100 – 120 times per minute (approx. 2 compressions per second) *Note: Rib fractures and other injuries are common but acceptable consequences of CPR.  Cardiopulmonary Resuscitation (CPR) – Infant/child Infants ---- use the two-finger technique Children----- use either one hand or two hands. Continuing Cardiopulmonary Resuscitation (CPR) Without delay, return your hands or fingers quickly to the centre of the casualty’s chest, then give the next 30 compressions and 2 breaths Continue giving 30 compressions and [2 rescue breaths!] at 100-120 per minute Apply Automated External Defibrillator (AED) as soon as possible, if available Ask for help from bystanders where possible * Do not apply any pressure over the casualty’s ribs, upper abdomen, or the bottom end of the bony sternum (breastbone) CPR Defibrillation Automated external defibrillators (AEDs) are safe and effective to use. Use of an AED makes it possible to defibrillate many minutes before professional help arrives. Ensure safety. Send someone to retrieve AED if not already done so. CPR should continue while another individual opens and sets up AED. Defibrillation Follow the spoken/visual prompts of the AED. Remove clothing from chest and ensure chest is dry before attaching electrode pads, as shown on pads. Make sure no one touches the casualty while the AED is analysing rhythm and/or when a shock is being delivered. If a shock is indicated Ensure nobody touches the casualty Push the shock button as directed. o Note: fully-automatic AEDs will deliver the shock automatically When directed, resume CPR (30 compressions: 2 breaths) Continue to follow the voice/visual prompts of the AED If no shock is indicated Immediately resume CPR (30 compressions: 2 breaths) Continue to follow the voice/visual prompts of the AED  Multiple rescuers Ensure an ambulance has been called Ensure someone has been sent to get equipment, e.g. AED If there more than one rescuer is present, swap the role of performing CPR approximately every 2 minutes to reduce fatigue Change over with minimal delay between compressions  When to stop CPR 1. The casualty starts breathing normally 2. The scene becomes too dangerous to continue 3. Healthcare professional takes over 4. An authorised healthcare professional tells you to stop 5. You become physically unable to continue THANK YOU!