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CPR for AdultsMa.Teresa J. Mayuga
Emergency Department
Head Nurse
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A. Chest Compressions
Importance:
One important part of CPR is chestcompressions, which keep bloodflowing to the heart, brain, and othervital organs.
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CHEST COMPRESSION
TECHNIQUE 1. Position yourself at the victims side
2. Make sure the victim is lying on his back
on a firm, flat surface. If the victim is lyingface down, carefully roll him onto his back.
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4. Put the heel of one hand on the centerof the victims bare chest between the
nipples. 5. Put the heel of your other hand on top
of the first hand.
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6. Straighten your arm and position yourshoulders directly over your hand.
7. Push hard and fast. Press down 1 to
2 inches with each compression. For eachcompression, make sure you push straightdown to the victims breastbone
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8. At the end of each compression, makesure you allow the chest to recoil or re-
expand completely. Full chest recoil allowsmore blood to refill the heart betweenchest compression. Incomplete chest
recoil will reduce the blood flow created bychest compression.
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9. Deliver compression in a smoothfashion at a rate of 100 compression per
minute.
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10. Place patient in a recovery positiononce breathing and pulse are present.
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Chest Compression Technique
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Chest Compression TechniqueStep Action
1 Position yourself at the victims side.2 Make sure the victim is lying on his back on a firm, flat surface. If the victim is lying
facedown, carefully roll him onto his back.
3 Move or remove all clothing covering the victims chest. You need to be able to see the skin.
4Put the heel of one hand on the center of the victims bare chest between the nipples.
5 Put the heel of your other hand on top of the first hand.
6 Straighten your arms and position your shoulders directly over your hands.
7 Push hard and fast. Press down 1 to 2 inches with each compression. For each chest
compression, make sure you push straight down on the victims breastbone.
8 At the end of each compression, make sure you allow the chest to recoil or re-expandcompletely. Full chest re-coil allows more blood to refill the heart between chestcompressions. Incomplete chest recoil will reduce the blood flow created by chestcompressions.
9 Deliver compressions in a smooth fashion at a rate of 100 compressions per minute.
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Foundation Facts
If you have difficulty pushing the breastbonedeep enough during compressions, put one
hand on the breastbone to push on thechest. Grasp the wrist of that hand with yourother hand to support the hand as it pushes
the chest. This technique may be helpful forrescuers whose hands and wrists arearthritic.
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Compression Rate
Scientific evidence has not identified a
single ideal compression rate. Most
studies support a compression rate ofabout 100 compressions per minute ifcompressions are deep enough andinterruptions to compressions are
minimized.
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B. Opening Airway
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Head Tilt-Chin-Lift
StepAction
1 Place one hand on the victims forehead
and push with your palm to tilt the headback.
2 Place the fingers of the other hand underthe bony part of the lower jaw near the
chin.
3 Lift the jaw to bring the chin forward.
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The head tilt-chin-lift relieves airway obstructionin the unresponsive victim. A, Obstruction by thetongue. When a victim is unresponsive, thetongue can block the upper airway. B, The headtilt-chin-lift maneuver lifts the tongue, relievingairway obstruction.
Head Tilt-Chin-Lift
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CAUTION: Things to avoid With
Head Tilt-Chin Lift Do not press deeply into the soft tissue
under the chin because this might obstruct
the airway. Do not use the thumb to lift the chin.
Do not close the victims mouth completely
(unless mouth-to-nose breathing is thetechnique of choice for the victim).
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Jaw Thrust Maneuver
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Jaw Thrust Maneuver
Step Action
1 Place one hand on each side of the victims head,
resting your elbows on the surface on which thevictim is lying.
2 Place your fingers under the angles of the victimslower jaw and lift with both hands, displacing the
jaw forward.
3 If the lips close, retract the lower lip with yourthumb.
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CPR Rescue Protocol
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The following steps are for lay rescuers responding to a call for helpduring situations other than witnessed arrest (i.e you did not see the
victim collapse.
1. Establish scene safety. Make sure that you wont end
up a victim as well.
2. Establish yourself to the bystander as capable ofperforming CPR and seek permission to help.
3. Check for unresponsiveness.
4. If unresponsive, get someone to activate local EMS orcall for medical assistance
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5. Open Victims Airway. Perform the head tilt- chin lift
maneuver or jaw trust maneuver. If you think a neckinjury is involved.
6. Check for signs of breathing, deliver 2 initial rescuebreaths
7. Check for signs of circulation. If none, start CPR.
8. Deliver 30 chest compression and 2 ventilations percycle. Check for signs of circulation after every 5cycles
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9. If victim recovers with normal breathing, place inrecovery position
10. If signs of circulation return but the victims breathing is
inadequate, perform rescue breathing
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For witnessed arrest
1. Check unresponsiveness.
2. Never leave the victim alone unless you have to gethelp and no one is around
3. If there are two rescuers, one can take care of theABCs and ventilating the victim on one side while the
other does the chest compression from the oppositeside.
4. Switching should be done every 5 cycles
5. Control the crowd.
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GOLDEN RULES IN GIVING
EMERGENCY CARE
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1. What to DO:
Do obtain consent when possible.
Do think the worst. Its best to administer first aid forthe gravest possibility.
Do remember to identify yourself to the victim.
Do provide comfort and emotional support.
Do respect the victims modesty and physical privacy. Do be as calm and as direct as possible.
Do care for the most serious injuries first.
Do assist the victim with his or her prescriptionmedication.
Do keep onlookers away from the injured person.
Do handle the victim to a minimum.
Do loosen tight clothing.
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2.What Not to DO:
Do not let the victim see his/ her own injury.
Do not leave the victim alone except to gethelp.
Do not assume that the victims obviousinjuries are the only ones.
Do not make any unrealistic promises.
Do not trust the judgment of a confused victimand require them to make decision.
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