save your breath…€¦ · chris miller, at age 15 – saved by erika yee, a band mate who learned...
TRANSCRIPT
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Save your Breath…
Save a Life
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Sudden Cardiac Arrest — Any Age, Anybody
Chris Miller, at age 15 – Saved by Erika Yee, a
band mate who learned compression-only CPR in
Girl Scout Camp.
Russell Vossbrink, at age 36 - A crime lab
investigator saved by a co-worker.
Rafael “Ralphie” Rendon, at age 14 - Collapsed
during high school football practice. A volunteer
coach responded.
Brian Duffield, at age 41 - Collapsed after a
swimming workout. A paramedic was nearby.
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Causes of Death (U.S.)
Lloyd-Jones D, et al. American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke
statistics--2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee.
Circulation. 2009 Jan 27;119(3):e21-181.
Sudden Cardiac
Arrest
• Heart disease kills more
people each year than cancer
− 1 in every 4 deaths
• Every year 230,000 - 325,000
people have a cardiac arrest
outside of a hospital.
− Only 7.6% will survive
Heart
Disease
26%
Cancer
23%
All other
causes
19%
Stroke
6%
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Cardiac Arrest: Fact vs. Fiction
Stereotype Reality
Male
Old
Overweight Smoker
High cholesterol
Chest Pain
Dizziness
Heart Attack
Male and Female
Any Age
No Known
Risk Factors
Often No
Cardiac History
Often No
Symptoms
Gender
Age
Risk
Factors
Medical
History
Presenting
Symptoms
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• Blockage in coronary artery
• Person usually conscious
• Upper body discomfort
or pain
• Heart stops
• Person is unconscious
• Often no previous symptoms
• Person may be gasping or not
be breathing at all
Heart Attack vs Cardiac Arrest
Heart Attack: Cardiac Arrest:
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Primary vs Secondary Cardiac Arrest
• Heart stops pumping
• Blood in arteries full
of oxygen
• Often unexpected
witnessed collapse
Secondary CA
• Heart stops pumping
due to lack of oxygen
• Drowning, Drug
Overdose or Choking
Primary CA
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Out-of-Hospital Cardiac Arrest
• Approximately 70-80% of all adult cardiac
arrest are a primary cardiac arrest.
Chest Compression
Only CPR
Ann Emerg Med. 1997 Jul;30(1):69-75.
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What is Chest Compression Only CPR?
• A method of resuscitation developed through
extensive research at The University of Arizona
Sarver Heart Center for primary cardiac arrest
• In Arizona, we have been doing this for
approximately 10 years
• Continuous forceful chest compressions to
circulate the person’s blood to their brain and
heart
• Rescue breathing isn’t necessary.
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Why isn’t Rescue Breathing Necessary?
–Lungs are full of air
–Blood is full of oxygen
–Circulating the oxygenated blood is the key
During Primary Cardiac Arrest:
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Why Might “Rescue Breathing” be Harmful?
• Any interruption of chest compressions
stops blood flow to the brain
• Increased pressure in the chest decreases
blood return to the heart
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Ewy GA, et al. Circulation.
2007;116(22):2525-30.
Blood Flowing To The Brain
Blood Flowing To The Brain
Chest Compressions Only
Compressions + Breaths (30:2)
Pausing for breaths means No Blood Flow
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What Stops People from Doing CPR?
Coons SJ, et al. Resuscitation 80;334-340:2009 This study was designed and funded by the Sarver Heart Center
The University of Arizona College of Medicine and SHARE
Mouth-to-Mouth
Harming the Person
Legal Consequences
Won’t Perform Properly
Physically Unable
Chest Compressions Only
Better than dead
Good Samaritan Law
Easier to Do
Do Your Best / Call For Help
Fear / Concern Solution
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When to use Chest Compression Only CPR?
• Obvious Breathing Problems:
– Drowning
– Choking
– Drug overdoses
• Children less than 8
• Someone who unexpectedly collapses, and is unresponsive.
Traditional
CPR (30:2)
Chest Compression
Only CPR
• Vast Majority
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40%
30%
25%
20%
15%
10%
5%
0%
18% 18%
34%
Surv
ival to
Hospital D
ischarg
e
No
CPR
Traditional
CPR
CCO
CPR
Bystander CPR in Arizona (2005 to 2010)
Witnessed Primary Cardiac Arrest
Rates are for ventricular fibrillation; from Bobrow, et al. JAMA October 2010
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What to do: 3 Cs–
Compress Chest at
100 Per Minute
Call 911
Send Someone for an A.E.D.
(if available)
Are You
Alright?
Check
Shake & Shout
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How to Do Chest Compression Only CPR With the victim on the floor:
1. Kneel beside them
2. Place the heel of one hand on top of the other
3. Lock your elbows
4. Aim for the middle of the chest (on the sternum at the armpit line)
5. Push hard and fast (try for 100/min.)
6. Take turns with another person when tired.
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Chest Compressions: Rate and Depth
• Allows the heart to refill
• Staying Alive (Beegees)
or
I Gotta Feeling
(Black Eyed Peas)
• After each compression,
take all weight off the
chest
At least
100 Compressions per Minute
At least
2 inches in depth
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Are They Breathing?
• Gasping is a sign of cardiac arrest
• Majority of people with cardiac arrest gasp
• Can be a sign of minimal, but adequate
blood flow to the brain.
• DO NOT stop chest compressions if they
gasp
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AEDs They may look different, but they all function the Same!
Open and Follow Instructions
• Turn AED ON
• Apply Pads to Bare Chest
• Plug in Pads (if necessary)
• Analyze Patient (CLEAR!)
• Push Shock to defibrillate,
if directed (CLEAR!)
• Immediately resume CPR
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The Universal Symbol
•Safe
•Easy
•Voice Prompted
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For more info on purchasing or maintaining AEDs,
talk to your event leader!
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http://tinyletter.com/UAmedREACT
Never forget! REACT CCO newsletter
1 email every 3 months, unsubscribe any time.
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What to do: 3 Cs–
Compress Chest at
100 Per Minute
Call 911 &
Send Someone for an A.E.D.
Are You
Alright?
Check
Shake & Shout
Use an A.E.D. When it Arrives
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Save your Breath…
Save a Life
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How to Do Chest Compression Only CPR With the victim on the floor:
1. Kneel beside them
2. Place one hand on top of the other
3. Lock your elbows
4. Aim for the middle of the chest (on the sternum between the nipples)
5. Push hard and fast (try for 100/min.)
6. Take turns with another person when tired.
![Page 27: Save your Breath…€¦ · Chris Miller, at age 15 – Saved by Erika Yee, a band mate who learned compression-only CPR in Girl Scout Camp. Russell Vossbrink, at age 36 - A crime](https://reader035.vdocument.in/reader035/viewer/2022062919/5f01d3197e708231d4013874/html5/thumbnails/27.jpg)
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Bystander CCO CPR Improves Chance of Survival from Cardiac Arrest
100%
80%
60%
40%
20%
0%
Time between collapse and defibrillation (min) 0 1 2 3 4 5 6 7 8 9
Surv
ival (%
)
Nagao, K Current Opinions in Critical Care 2009
EMS Arrival Time based on TFD 90% Code 3 Response in FY2008. Standards of Response Coverage 2008.
EMS Arrival No CPR
Traditional
CPR
CCO CPR
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Three-Phase Model of Resuscitation
Weisfeldt ML, Becker LB. JAMA 2002: 288:3035-8
0 2 4 6 8 10 12 14 16 18 20
Arrest Time (min)
Circulatory
Phase
Electrical Phase
Metabolic Phase
0
100
Myocardial ATP
Perc
en
t
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SOS-Kanto study group. Cardiopulmonary resuscitation by bystanders with chest
compression only (SOS-KANTO): an observational study. Lancet. 2007;369:920-6.
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25%
20%
15%
10%
5%
0%
5.2% 7.8%
13.3%
Surv
ival to
Hosp
ita
l D
isch
arg
e
No
CPR
Traditional
CPR
CCO
CPR
150/2,900
52/666
113/849
Bystander CPR in Arizona (2005 to 2010)
All out-of-hospital cardiac arrests
Rates are for all cardiac arrests; from Bobrow, et al. JAMA October 2010
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• FAST for Stroke if people ask about stroke
• Face –Does one side droop? Smile?
• Arms – Raise arms? Is one weak or
numb?
• Speech – Slurred? Repeat a simple
sentence?
• Time – Have symptoms? Call 911! Get to
hospital immediately!