CARDIOPULMONARY

RESUSCITATIONCPR

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Cardiopulmonary Resuscitation (CPR) CPR is a proven technique to administer basic

life support to a patient whose heart has stopped beating.

CPR consists of artificial respiration which supplies oxygen to the blood and heart compressions which supply blood to the body.

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Automated External Defibrillator (AED) Device that generates an electric shock AED analyses the patient’s heart rhythm and

indicates if an electric shock would be beneficial While in an abnormal rhythm, the heart does not

effectively pump blood throughout the body CPR and early defibrillation give the best chance

of survival

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Pulse Check in CPR Carotid Artery - Adult/Child Brachial Artery- Infant Pulse check is only taught to trained responders

If the patient is unresponsive and not breathing, and you don’t find a pulse after 10 sec, you must conclude the patient is in cardiac arrest. You should immediately begin CPR and AED without further delay.

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Landmarking-Adult With the hand closest to the head, place the heel of that

hand on the sternum in the centre of the chest. Make sure it is not on the xiphoid process.

Place the heel of the other hand on top of the first hand. Interlace the fingers to keep them off the chest. Landmark every time you remove your

hands from an adult patient’s chest.

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Landmarking-Child Place the heel of one hand on the sternum in the centre

of the chest. Make sure it is not on the xiphoid process. Only the heel of the hand should be in contact with the

chest. For the child, you administer cardiac compressions with

one or two hands - as needed Subsequent landmarking is

done visually.

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Landmarking-Infant Place two fingers in the middle of the infant's

chest between the nipples Slide your fingers to just below the nipple line Administer chest compressions with the two

fingers

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Depth of CompressionsAdult, Child and Infant:

Compress the chest down one third to one half it’s depth

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Cardiac Compression and Ventilation RatiosGroups (yr.) Single

Rescuer CPR

Two Rescuer CPR

Compression Rates

Adult (>8

yrs)

30 comp.

2 ventilations

30 comp.

2 ventilations

100 per minute

Child

(1-8 yrs)

30 comp.

2 ventilations

30 comp.

2 ventilations

100 per minute

Infant

(<1 yrs)

30 comp.

2 ventilations

30 comp.

2 ventilations

100 per minute

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One Rescuer CPR, Adult•Scene survey

•Establish unresponsiveness

•Activate EMS

•Open airway

•Check for breathing

• If absent, check pulse

• If absent, landmark

•30 compressions + 2 breaths

•100 compressions per minute

• repeat 5 sets of 30:2, reassess

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Two Rescuer CPR - Adult or Child•Survey the scene

•Rescuer 1 is performing CPR

•Rescuer 2 will identify him/her self & checks that EMS has been activated

•Rescuer 1 complete 30:2 cycle then reassess vitals - no more than 10 sec.

•Rescuer 2 co-operates with Rescuer 1 with reassessment

• if no visible signs:

•One rescuer now performs chest compressions

•The other now administer rescue breaths

•Rescuer 1 and 2 will change positions with little interruption every few minutes

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One Rescuer CPR - Child•Scene survey

•Establish unresponsiveness

•Activate EMS (if alone, do 2 min of

CPR before EMS)

•Open airway

•Check for breathing,

• if absent, check for pulse

• if absent, landmark

•30 compressions + 2 breaths

•100 compressions per minute

• repeat 5 sets of 30:2 reassess

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One Rescuer CPR - Infant•Scene survey

•Establish unresponsiveness

•Activate EMS (if alone - 2 min of

CPR before EMS)

•Open airway

•Check for breathing,

• if absent, check for pulse

• if absent, landmark

•30 compressions + 2 breaths

•100+ compressions per minute

•Repeat 5 sets of 30:2, reassess

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Do Not Resuscitate (DNR) Decapitated In Rigor Mortis Incinerated Eviscerated Decayed Prolonged submersion (days of decomposition) Ordered not to by a physician or police officer

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Key Points Use an even squeezing motion when doing the

compressions CPR should never be interrupted for more than 10

seconds Always release pressure between compressions Maintain contact with the skin at all times For adults/child

interlace fingers of both hands or extend them straight out to give a straight, downward pressure on the sternum

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Key Points Expect some damage to the patient’s chest

while doing CPR. Injuries to the chest area can be life-threatening

if they result in damage to either the heart or lungs, or cause severe internal bleeding.

Responders may require CISM support after performing CPR

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Chain of Survival Healthy Choices Recognition of Warning Signs Early Access to the Emergency Medical Services (EMS)

System Early CPR Early Defibrillation Early Advanced Care Early Rehabilitation

Health Care Provider Level (HCP) EMS activation: if the patient is suffering

respiratory arrest, if alone the HCP should do 5 cycles of CPR before calling EMS

HCP would do two breaths before compressions are started

Two rescuer CPR on children or infants will be done at rate of 15:2 when using a BVM

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Health Care Provider Level (HCP) Aged guidelines are:

Infant: up to one year of age Child: 1 yr to puberty Adult: after puberty

Infant compressions may be delivered using the two thumbs with hands encircling the chest

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