Transcript CPR for life

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CPR for life
Welcome
« Everything about CPR »
New 2005 standards
Notice
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This slide-show cannot replace in any way, an apropriate
CPR trained course in First-Aid and CPR given by certified
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Demo
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« CPR for life »
83 slides on a total of 285 in it’s original version.
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click in the screen to continue…
Or
•Or choose a subjet in the next following menu
Main Menu
• Law and rules about first-aid
• The goals of First-Aid
• Protect yourself
• The intervention protocol(Démo)
• Unconsciousness and loss of consciousness
• Heart disease (Démo)
• Cerebral stroke (Démo)
• The CPR technic
•Adult (Démo)
•Infant
•Baby
• Respiratory unchoking
• Drowning accident
•Conscious Adult
•Conscious Infant
•Unconscious Infant
•Conscious Baby
•Unconscious Baby
The intervention protocol
At any time when we intervine, it is very important to respect this protocol to
ensure that our actions are adequate and safe
 Check the area around:
• See for possibility of any dangers…
 For me
…if so, make it secured
 And the victim
•Check the number of victim(s).
More victims than rescuers 911
•Check for witness.
•They may know what happens
•For help
•Try to determine the causal mechanism.
Trauma * yes  •Do not move the victim
•Cervical protection
* or no
•911
 If « no » = Medical problem
The trauma to the head and spinal column
 Our spinal column
 Cervical
C1 to C7
 Thorax
T1 to T12
 Lumbar
L1 to L5
 Sacral
•As shown on this picture, nearest the
trauma is located near the column
neck and head, the more likely the
damages are important.
•The coloured parts, shows the parts at risk
of paralysis, according to the affected area.
•It is therefore very important to
maintain the victim spine immobile,
to take the least possible risk to
aggravate the injury.
Note that damage to the cervical spine (c1 to c7)
can lead to cardio-respiratory arrest.
The intervention protocol
 The primary exam:
T’
A
B
C
The intervention protocol
 The primary exam:
T he state of consciousness
A irway
B reathing
C irculation
The intervention protocol
 The primary exam:
The state of consciousness
Talk to the victim to see if it is « Alert ».
•Request the permission to help
 if « no answer » * Make noise
*Clap your hands
* Whistle
 if « still no reaction » *Create a pain
*Press firmly the trapezoids
*Rub the sternum
No reaction =  Inconscious = Ambulance
Ask to a witness to call the « 911 » or
call them yourself if your alone …………
but
The recovery position
Never leave an unconscious victim alone lying on his back.
If you are alone and you must leave to call the ambulance,
take care not to let the victim on his back.
Why ??
Why ?
The major risk is the tongue of the victim that could collapse in
the bottom of its throat and obstructs the airways.
Risk of regurgitation or vomit that could be sucked into
the lungs of the victim.
At the unconsciousness
the stomach sphincter
is relax and may open.
The vomit
may be sucked
into the lungs.
The tongue in the bottom of the throat
The blood circulation
•When you place the victim
in the recovery position
it is always preferable to turn
on its left side.
•The inferior vena cava, is located
at the bottom of the abdomen on the
right side of the spine. This one risk
to be compressed by the organs
that lie ahead and thus reduce
bloodstream.
•This has a very little impact
with most people.
•Be careful especially with pregnant women and obese people, cause the weight
of the fetus or weight of the viscera could hinder a more significant blood
circulation if the victim is lying on its right side.
The intervention protocol
 The primary exam
The state of consciousness
AIRWAY
Take a look in the victim’s mouth and
remove any foreign objet that could be in .
By placing a hand on his forehead and
2 fingers on the chin…
…switch the head back to full extension to
remove the tongue from the back of the throat.
Keep the victim’s head in that position.
The tongue collapsed in the throat
The intervention protocol
 The primary exam
The state of consciousness
Airway
Breathing
Continue to keep the victim’s head in extention .
Approaching your ear above the mouth and
nose of the victim. (5 to 10 seconds)
•Listen to the sound of his breathing
•See if the thorax is moving
•Try to feel his breath on your cheek
•Immediately give 2
effectives breaths
…if there is no breathing
 How
The intervention protocol
 The effectives breaths
the head must be kept in back full extention.
If you have no mask: Pinch the victim’s nose, open your mouth
wide, make a seal on the victim’s mouth and blow the air very slowly.
Just enough air so that the victim’s chest raise somewhat.
Too fast and too strong breats will cause that the air will fill
the lungs and the overflow will go into the stomach.
This will cause the victim to regurgitate.
If the air does not penetrate, and you made a tight seal on his mouth,
put the victim's head in a neutral position, switch again the head
back in a full extention to remove the tongue from the bottom of the
throat and try an effective breath again…
The intervention protocol
If the air does not penetrate for 2 consecutives times, and you sure
have made a tight seal on his mouth….
 That’s mean that the victim’s airways are blocked
:
 Immediately begin the the unchoking manœuvre…
If the air penetrate this time, keep the
victim’s head in this position and give
another effective breath and then…
 …go to step « C »
The intervention protocol
 The primary exam
The state of consciousness
Airway
Breathing
Circulation
Check promtly the victim’s reaction:
chest moves, coughs, or any reaction…
or serious bleeding *
« * «Immediately control any serious bleeding or haemorrhage!
And if…
…if the victim is not beginning to breath, immediately
begin the C.P.R. manœuvre.
(Cardio-Pulmonary Resuscitation)
We will see this technique during practice on mannequins
The Heart Diseases
And the
C erebral
V ascular
A ccident
The causes
Although it is very important to know the CPR
techniques, it is equally important to understand the
causes that lead to a cardio-respiratory arrest.
The main causes with adults:
•Choking
•Drowning
•Electrocution
•The asphyxiation
•Hypothermia
•Traumas
•Cardiac diseases
The most common cause with adults is naturally:
•The cardiac deseases
« Some statistics»
•Heart disease are responsible for over 39% of all deaths in
Canada. (about 80.000 peoples per year)
•The pain felt, was the first, the only and last one for 17% of them !
•About 14000 peoples a year die of a stroke (C.V. A.)
•When the first signs and symptoms appears, 80% of the victims
wait more than 4 hours before they decide to go to the hospital.
•Half of the deaths occurs before the arrival at the hospital.
•90% of the victim who arrive at the hospital with a pulse will
emerge without damages.
•More than 27% of Canadians are overweight.
•More than 4 minutes without breathing and brain cells begin to
deteriorate.
•Since CPR is taught to the public, the number of victims who
survived to cardiac arrest has doubled.
What should we conclude from these statistics?
At the heart attack
The sooner we recognize the signs and symptoms more quickly we react.
The sooner we go to the hospital and more chance of survival there is .
At cardiac arrest
The sooner I recognize the problem sooner I call the ambulance.
The sooner I call the ambulance sooner they arrive.
The sooner I start the CPR more chance of survival there is .
The sooner the ambulance arrive sooner we can "defibrille."
The sooner the ambulance arrive sooner it returns to the hospital.
And more there will be peoples trained to recognize the problems and
administer CPR and more lives will be saved!!!
The survival chain
The Heart and Stroke Foundation of Quebec (HSFQ)
 A chain is as strong as the weakest of its links!
Link
Care of
Each person
Healthy choice
Rescuer and the victim
Fast recognize
Rescuer and the victim
Fast access
Rescuer
Early CPR
Ambulance and « rescuer »
Early defibrillation
Advanced cares
Hospital
Fast readjustment
Hospital and the victim
The rescuer is the vital link in the chain of survival!!!!!!!
The Heart Diseases
The principal risk factors
1 st link
•
•
•
•
•
•
•
•
•
•
•
Junk food
High blood cholesterol
Overweigth
Physical inactivity
Smoking
High blood pressure (The silent killer)
Stress
Age
Family history
Diabetes
Sex (women are as much at risk than men now)
The Heart Diseases
1 st link
 The principal risk factors
Which one can I control ?
• Junk food
Yes
• High blood cholesterol
 Yes
• Overweigth
 Yes
• Physical inactivity
 Yes
• Smoking
 Yes
• High blood pressure (The silent killer)
 Yes
• Stress
 Yes
• Age
 No
• Family history
 No
• Diabetes
 Yes/No
• Sex (women are as much at risk than men now)
 No
 As you can see we can control most risk factors !
The silent killer (hypertension)
•High blood pressure is so called because the signs and symptoms
often go unnoticed. You can’t feel it and you can’t see it !
•The only way to know about your blood pressure is to consult
your doctor and have him to measure your blood pressure.
• He must check your tension at different times and situations before
he diagnose hypertension.
Its adverse effects
•Causes hardening of the arteries.
•Causes the increasing of the volume of the heart muscle.
•Facilitates the accumulation of cholesterol in the artery walls due
to the loss of elasticity of them.
•Greatly increases the risk of cerebral stroke.
The hypertension
It is very easy to diagnose hypertension, at the condition
you consult your doctor.
However, your doctor can’t tell you for how long ago
hypertension was installed.
High blood pressure can occur at any age.
High blood pressure can be controlled quite easily by following
your doctor’s recommendations like:
 Changes in dietary habit.
 Exercise and weight loss.
 Stress Management.
 Medication (in some cases).
 Medical checks and follow up.
Controlling blood pressure can help greatly to reduce risk of
developing heart disease or stroke.
The age and physical inactivity
The current trend seems to confirm that heart disease manifest
themselves at an age increasingly unlike the popular belief.
More and more cases are already manifest in the early twenties.
We must stop believing that it can happen only after fourty years
of age.
See by yourself 
It appears that our kids under
14 years old spend an average of
27 hours per week in front of a screen
computer, television or video game
The same poll revealed that they
spend an average of 22 minutes
per week to discuss with their
parents or family.
In the states 33% of the kids less than
8 years old are already overweight.
Our kids!!
In our time, our parents ran to
catch us and bring us inside the
home at meal time.
Today we must fight to send them
outside !
It leaves us speechless ! ! ! ! ? ? ? ?
Coté, Le Soleil, decembrer, 5 2002.
What about alcohol?
It is recognized that alcohol was not a risk factor
leading inevitably to heart disease.
Specialists agree that drinking very moderately alcohol may be
beneficial to your cardio-vascular system.
European poeples who usually drink red wine regularly have a
mortality rate much lower concerning cardiovascular disease.
•Europe +- 17%
Canada +-39%
Against this, their mortality rate caused by cancers of the
digestive system, or liver cirrhosis is much higher than in Canada.
Our heart
 Has the size of our closed fists.
 Beats about 72 times per minute.
 Which means 100,000 beats per day.
The strongest and most resistant muscle of our body
 No other one works harder !
He therefore greatly need oxygen and nutrients.
The coronary arteries that run all around him, feeds
freshly oxygenated blood to him.
Adult cardiac rhythm.
between 50 and 100 per minute.
Infant cardiac rhythm.
between 80 and 150 per minute.
Baby cardiac rhythm.
between 130 and 180 per minute.
The first signs and symptoms of angina
•When cholesterol begins to accumulate
on the walls of coronary arteries
this causes narrowing of these, thus
the heart is not receiving enough nutrients
and O2 and he will complain about this
unusual lack of O2.
• The victim will feel strange sensations when
he is doing an exercise asking an unusual effort.
As:
Pain or tightness in chest.
Difficulty breathing.
Indigestion feelings.
Nausea or vomitting.
Cool and pale skin.
Blue-tinted lips and nostrils.
Anxiety and denial
This is an angina crisis

The chest angina
Angina does not cause permanent damage to the heart.
Angina is a warning that it is urgent to do something..
Angina can be treated and unwind when promtly treated.
We must naturally do a clean-up in our risk factors.
We must therefore consult our doctor immediately before it
gets worst.
but
The reality is quite different and people are waiting too long before
they consult and cholesterol continues to accumulate on the arteries
walls and they will eventually clog up completely.
slam!!!
the heart attack suddenly arrive
The heart attack
Upon the occurrence of heart attack, anything can happen.
About 17% of people collapse and die within minutes.
The heart attack cause irreversible damage to the heart muscle
when it is not treated in the next 180 minutes. (3 hours)
It is therefore extremely important to recognize the warning signs
of a heart attack and act immediately
Subsequently of a heart attack, cardiac arrest can occur at any time.
So, what are the signs and symptoms of the heart attack
 The signs and symptoms of the heart attack
The signs and symptoms of heart attack and angina
are almost the same.
With the difference that during the angina crisis, the pain and
discomfort will disappear quickly with rest and taking nitro..
Therefore the nitro has mostly no effect on a heart attack, since
the nitro has an effect on dilation of the arteries. Dilate a totaly
obstructed artery will change nothing. It is completely blocked!!!
The signs and symptoms
 Anxiety and denial.
 Pain or tightness in chest.
 Difficulty breathing.
 Indigestion feelings.
 Nausea or vomitting.
 Cool and pale sweating skin.
 Blue-tinted lips and nostrils.
 Fear.
 Vomitting.
During the angina crisis or heart attack
*The pain may appear at various places and various intensity.
**The pain is sometimes less noticeable on a women.
Why the feeling of indigestion?
The feeling of indigestion is very often present during
the angina crisis and heart attacks
This is the misleading element that makes peoples and the family
around the victim to get alarmed too late.
The victim prefer to believe in a bad digestion rather than in a
heart attack.
What cause that feeling ?
•The heart cannot pump adequately oxygenated blood
in the body, the brain will restrict some vital organs
of the normal oxygenated blood they usually receive.
•It is the brain that the first will feel in danger and it will
immediately stop the normal supply of oxygenated blood to the
digestive system. This will cause this sensation and sometimes
even vomiting.
•The skin will also be rationed of oxygenated blood, which causes
pale skin, cyanosis and cold sweats.
What should the rescuer do
immediately?
Immediately sit down the victim in a semi-sitting rest position.
Never lay down the victim in order not to overload the heart.
Keep the victim calm and rest.
Loosen tie, shirt collar, waist belt, brassiere, and so on to
allow the victim to breathe easily.
Immediately call emergency relief.
Within the first 2 minutes after the start of the onset of
the signs and symptoms.
Continue to monitor the victim and don’t leave the victim alone
unless required.
Do not give anything to the victim (water, or any liquid) except
in the case we will see further.
*******************
While waiting for the ambulance, begin the ANAMNESIS of the victim.
L’ANAMNESIS
(The medical history of the victim)
Ask and note the following information:
•Ask to describe his symptoms.
•Ask if this is the first time that unease happen.
•Ask if he has already consulted a doctor about this malaise.
•Ask if he takes medication and whether he has it with him.
•If the victim take the nitro, ask if he already took it and when?
•If necessary, attend him in taking nitro, according to the
dosage indicated. (Often: 1 dose per five minutes)
(Maximum 3 doses, sometimes 4)
•Ask the time of his last meal.
•Ask if he suffers of allergy. (Medication, food, aspirinemd …)
•Ask if he suffers of any disease or clinical problem.
•Ask what activity he was doing when the malaise began.
•Note the time of the incident and any signs that you saw.
Upon the arrival of the ambulance, give them all the
informations collected and any other relevant informations.
The aspirin
md
•The aspirin ,(AAS ACETYLSALICYLIC ACID)
•The effects of aspirinmd is known to most people.
•Analgesics properties.
•Through its effect, « works as a blood thinners ».
md
•It goes without saying that this is not the role of rescuer,
to prescribe any medications whatsoever.
•However it would be acceptable to ask the victim if he is
allergic to aspirinmd or if his doctor ever advised him not to
take it.
•Remember him the effects of aspirinmd and attend him if
he wants to take one. (1-325mg. or 2-80mg. (Baby))
•Aspirinmd reduced by about 20% the effects of the heart
attack and increases the effect of thrombolysis he will
receive at the hospital.
If the victim has taken the "Aspirin md", indicate it to the
paramedics upon arrival (the time and dose)
The vascular cerebral accident
VCA
Poeples who are suffering of high blood
pressure are very exposed to this kind of
problem. "Cerebral hemorrhage"
The same risk factors listed before for
heart disease also apply to stroke.
These accidents can be easily fatal to
the victim.
The thrombosis often sends warning signs and
happens over a long period.
The embolism occurs very suddenly because the blockage is
caused by a clot or plaque of cholesterol that comes from another
part of the circulatory system.
Vascular cerebral accident
Cerebral hemorrhage
(aneurysm)
Cerebral thrombosis
Cerebral embolism
Compression:
A vessel of the brain is
compressed by a tumor,
or the swelling caused
by a shock,
a clot or by a
bleeding tissues
surround it..
The signs and symptoms of stroke
•Paralysis of the facial muscles.
•Sudden difficulty speaking or loss of usage of speaking.
•Sudden vision problems.
•Numbness and tingling in the extremities.
•Partial or total paralysis that can be only temporary.
•Confusion.
•Sudden, violent and strong headaches.
•Unequal pupils.
•Sometimes, loss of control of the sphincters
•Loss of consciousness.
All these signs and symptoms do not arrive all at the same
time. One or two of these signs and symptoms are enough
to be alarmed.
What to do now?
If the victim is still conscious:
•Place the victim in semi-sitting position and reassure.
•Ask someone to call 911 or do it yourself.
•Do not give the victim anything to drink, or medication.
•Monitor the victim from close in case he lose consciousness.
•Take note of the time and all signs and symptoms.
•Continue to monitor the victim until the ambulance arrives.
If the victim is unconscious or becomes unconscious
•Place the victim on its back and begin the ABC
•Airways
A
•Breathing
B
•Circulation sign
C
•If the breathing is present, place the victim in a recovery
position, lying on its paralysed side.(Change the victim’s position side every 5 minutes)
And if the victim suddenly collapsed
unconscious
 Lie the victim flat on the floor on his back (if not already done)
Begin the ABC and if the victim is not breathing…
Begin the intervention protocol
and the CPR
Main menu
C P R technique
Cardio
P ulmonary
Resuscitation
Adult technique, applies at the age of 8 +
The goal of the C.P.R
Cardio-Pulmonary-Resuscitation
•Most people believe that the goal of CPR is to restart the
heart of the victim.
•This is somewhat true, but the chances of restarting a heart
that has stopped due to a heart disease are very low.
•In fact, the main goal of CPR is to pump the blood of the victim in
order to keep his brain alive and doing so extend the fibrillation period.
•Following the cardiac arrest, heart will fibrille for a maximum period
of 12 minutes, because after 12 minutes without oxygen to the brain,
brain cells are irreversibly damage and died.
•The CPR will help to extend fibrillation until the arrival of
the defibrillator.
•If it goes over 12 minutes between cardiac arrest and the arrival of
the defibrillator, this one becomes useless if nobody provide CPR.
The A E D
Automatic External Defibrillator
The 5th link of the chain
•And even if a miracle occurs and the victim’s heart restart after
more than 12 minutes without breathing, the victim would be in a
"vegetable" condition at the best.
•So with the arrival of the ambulance, if fibrillation stopped, after
analysis, the defibrillator will send the message
"no shock recommended "
and even if the rescuer wants to give a shock anyway, it is
impossible because the A E D is the one that decides.
No fibrillation, No defibrillation
Then the rescuers will provide CPR to the victim until arriving at
the hospital and the doctor will decide if it is useful to continue
resuscitation manoeuvres.
« Not much chances »
THE NORMAL ELECTRICAL
ACTIVITY OF THE HEART
The electric systhem of the heart
Normal ECG
Abnormal ECG …. bradycardia
Abnormal ECG …Tachycardia uncoordinated movement
Ventricular fibrillation
The defibrillator's function is to stop the ventricular fibrillation and
restore a normal electrical activity…
…the condition is, fibrillation must be present! !
THE NORMAL ELECTRICAL
ACTIVITY OF THE HEART
Early defibrillation
When cardiac arrest occurs, it is extremely vital that the
defibrillation is carried out as soon as possible.
A period of less than 4 minutes would be the most beneficial
for the victims.
The defibrillation technique (A.E.D.) is
now accessible to all…
…and it is strongly recommended that
the AED becomes quickly available in all
public institutions and enterprises,
where there is a large number of people…
…and that a larger number of rescuers can provide the AED.
The CPR by coughing = nonsense…
Subject: IMPORTANT read this! Cough CPR
A cardiologist says If everyone who gets this mail sends it to 10 people, you can bet that we'll save at least one life.
Read this... It could save your life!! Let's say it's 6.15 pm and you're driving home (alone of course), after an unusually hard day on the job. You're really tired,
upset and frustrated. Suddenly you start experiencing severe pain in your chest that starts to radiate out into your arm and up into your jaw. You are only about
five miles from the hospital nearest your home. Unfortunately you don't know if you'll be able to make it that far. You have been trained in CPR, but the guy that
taught the course did not tell you how to perform it on yourself.
HOW TO SURVIVE A HEART ATTACK WHEN ALONE
Since many people are alone when they suffer a heart attack, without help, the person whose heart is beating improperly and who begins to feel faint, has only
about 10 seconds left before losing consciousness.
these victims
can help themselves
by coughing
repeatedly and very vigorously. A deep breath
False - In no However,
way condoned
or recommended
by medical
authorities.
should be taken before each cough, and the cough must be deep and prolonged, as when producing sputum from deep inside the chest. A breath and a cough
must be repeated about every two seconds without let-up until help arrives, or until the heart is felt to be beating normally again. Deep breaths get oxygen into
August
2007)
the lungs and coughing movements Example:(Submitted,
squeeze the heart and keep
the blood
circulating. The squeezing pressure on the heart also helps it regain normal rhythm.
In this way, heart attack victims can get to a hospital. Tell as many other people as possible about this. It could save their lives!!
BE A FRIEND AND PLEASE SEND THIS ARTICLE TO AS MANY FRIENDS AS POSSIBLE
Commentary:
An email forward that offers spurious advice about how to survive a heart attack has been continually circulating around the
Internet since at least 1999.
The message outlines a technique for surviving a heart attack while alone that involves vigorous coughing. According to the email,
a cardiologist has advised forwarding the message to others in order to save lives. However, the alleged cardiologist is not
named, nor is there any reference to a reputable medical institution. In my opinion, any life-critical "medical advise" that is not
supported by credible reference material should be used with extreme caution.
It should be noted that the cough procedure outlined in the email is not, in itself, a hoax and has been researched and tested by
medical experts. In fact, so called "Cough CPR" might be beneficial under certain controlled circumstances. However, this does
not mean that the advice in the email message is valid and useful. The most important factor to consider is that, according to
medical experts, cough CPR should only be performed under strict professional supervision.
According to the American Heart Association, "the usefulness of 'cough CPR' is generally limited to monitored patients with a
witnessed arrest in the hospital setting". The American Heart Association article also notes: The American Heart Association does
not endorse "cough CPR," a coughing procedure widely publicized on the Internet. As noted in the American Heart Association's
textbook Basic Life Support for Healthcare Providers, the American Heart Association DOES NOT TEACH THIS AS PART OF
THE CORE CURRICULUM IN ANY COURSE.
Adult CPR technique
8+
•The victim lying on his back on a hard and flat surface.
4th link
•The rescuer kneeling at his sides at shoulder level.
•The rescuer exposes the victim’s chest to the bottom of the sternum
•Find the compression site that is the width of the index above the
xiphoïde appendix.
•Place the heel of his other hand over his index
finger and then his first-hand over the other hand
and starts the chest compressions.
30 chest compressions
(3,8 to 5 cm deep)(11/2 to 2 in. deep).
At a speed of 100 compressions per minute.
(30 chest compressions in about 20 seconds)
Followed of 2 effective breaths.
Consequently
30 chest compressions + 2 breaths = 1 cycle x 5 = 2 minutes
CPR hands position
Note: Only the heel
of the hand is in
contact with the
sternum of the
victim.
CPR rescuer position
•The shoulders over the victim
•The elbows blocked.
•The arms perpendicular to the
victim's chest.
•The knees slightly apart.
•The rescuer let down the weight
of its trunk on the victim.
•The movement is initiated at the
rescuer hips.
•The rescuer keeps a visual contact
with the face of the victim.
•30 consecutives compressions followed of 2 effectives breaths
30 in about +- 20 seconds
Adult CPR demo
On the mannequins
CPR technique demo
1
•After checking for the safety of the area
the rescuer check the state of consciousness
of the victim by making noise with his hands.
The step T of « The ABC »

•Having found no
reaction she creates a
pain by tightening the
trapezoids and rubbing
the victim’s sternum
with its knuckles.
CPR technique demo
2
•The victim had no reaction when she
speaks, neither to noise or pain…
•The rescuer request a witness to call
Emergency Medical Service (EMS) (911).
•… and immediatly the rescuer begins « The ABC »
of the victim.
•She starts by takink a look in the mouth of the
victim in case there would be a foreign object or
food.
CPR technique demo
3
A
•Having suspected no possibility of spinal
trauma, she turns the victim's head in full
rear extension to open the airways.
B
•She brings her ear very close over the mouth and
nose of the victim and she listens to the breathing,
looks to his chest to see if the thorax moves
and tries to feel the victim’s breath on her cheek.
CPR technique demo
4
•The rescuer takes five to ten (5 to 10)
seconds to assess the breathing of the victim.
 And as the victim is not breathing:
•The rescuer opens wide her mouth, covers the
whole mouth of the victim, make a tight seal, pinch
the nose of the victim and gives a slow breath.
Just enough air to raise the chest of the
victim somewhat.
The use of a pocket mask or a
face shield is strongly recommended.
CPR technique demo
5
•The rescuer turns its face toward the chest of the
victim to take a deep breath and allow time for the
victim to expire…
•…she then continues with a second (2nd) slow breath.
CPR technique demo
6
•The rescuer look at the victim from head to toe,
to try to find signs of circulation.
(Move, coughing, chest movement etc…)
C
CPR technique demo
 And as the victim does not have any reaction…
•The rescuer find the compression site that is just
the width of the index finger above the xiphoïde
appendix…
•…release the victim's head and place the heel of
her hand beside her index, then the other hand
over the other one, cross the fingers and…
7
CPR technique demo
8
•…the knees slightly apart for better stability,
shoulders over the victim, elbows blocked,
the rescuer begins the chest compressions.
•The rescuer perform 30 chest compressions to a depth
from 3.8 to 5 cm (112 to 2 in.) at a speed of
100 per minute ( 30 = + - 20 seconds) and…
CPR technique demo
9
•…then she stops the chest compressions, place the victim’s
head in a rear extension to open the airways and give a slow
breath to the victim…
•…the rescuer turns its face toward the chest of the
victim to take a deep breath and allow time for the
victim to expire.
•…she then continues with a second (2nd) slow breath.
CPR technique demo
•…the rescuer then returns immediatly at the same
location on the chest of the victim…
•…and continues with 30 more chest compressions.
•And so on…
10
CPR technique demo
11
•…the rescuer return continuously to the same location on the
chest of the victim…
•…and continues with 30 more chest compressions
•…followed withs 2 slow and effectives breaths…
•…and so on until the arrival of the ambulance which will take
over, or until the evidence of resumed breathing and circulation
or until exhausted its capacity to continue…
Note: Taking the pulse is no longer required at the CPR, the pulse is very
unreliable and difficult to determine and has the effect of delaying the beginning of
resuscitation manoeuvres!
CPR technique demo
12
And if at any given time, breathing gets back:
•Stop immediately the CPR manoeuvre and…
•…resume to « The ABC ».
•The rescuer takes five to ten (5 to 10)
seconds to assess the breathing of the victim…
…and if the victim is not breathing…
•The rescuer immediately continue with the CPR technique
•30 compressions followed by 2 slow breaths…
until the arrival of the ambulance…
CPR technique demo
13
•…continue with 30 compressions followed by 2 slow breaths…
… and continue the manoeuvres until clearly breathing and circulation signs
appears, or as long as your ability to continue or until the arrival of paramedics.
CPR technique demo
14
And if at any given time, breathing gets back:
•Stop immediately the CPR manoeuvre and…
•…resume to « The ABC ».
•The rescuer takes five to ten (5 to 10)
seconds to assess the breathing of the victim…
…and if the victim is really breathing…
•The rescuer turns the victim immediately in the
recovery position and continues to monitor the
victim with great vigilance…
… until the arrival of the ambulance
CPR technique demo
15
When you will hear the ambulance arriving…
do not stop the manoeuvres…
…wait until the paramedics tell you to stop.
To give the victim the greatest possible chance
of survival, the manoeuvres should not be stopped…
Report to ambulance
•When the ambulance arrives, it is essential to report to the
paramedics all the details of the event.
• Your name and skills.
• What’s happen.
• The time of the event.
• The event witness name.
• Everything that has been noted in the medical history of the victim.
•The signs and symptoms seen on the victim.
•The allergy.
•The medication
•The medical history
•The hour of the last meal
•The events or activity preceding the incident
•The developments since your arrival on the scene.
•Any other details: the name of the victim, hospital card, etc…
Let them take charge of the situation, offer your help and stay available as
needed.
After a resuscitation attempt
successful or not!
• After a resuscitation attempt, whether successful or not,
the rescuer feels often troubled, in mourning and even sometimes
he feels not being up to the situation and culpabilise.
•It is very important to talk to someone about it !!!
•The Quebec heart and stroke foundation can greatly help you!
Moreover, any resuscitation attempt should be reported to the HSFQ.
The information thus obtained will be very useful and they can also
provide their support if needed.
• Please contact:
Quebec heart and stroke foundation (HSFQ)
1434, rue Sainte-Catherine Ouest
Bureau 500
Montreal (Quebec) H3G 1R4
Tel. : (514) 871-1551
1-800-567-8563
Telec : (514) 871-9385
The acts of good citizenship
•We must never hesitate to encourage gestures of good citizenship
and not hesitate to emphasize to your friends, your family and
the general population.
• If you witnessed, a remarkable act of good citizenship, please do
not hesitate to recommend that person with concerned agencies.
•This person deserves that his gesture be emphasized, which could
encourage citizenship… which our planet so badly needs!
•Every years, in November, the Quebec government submits a
certificate of good citizenship to these citizens.
There is a form to recommend a person who has raised a gesture of good
citizenship.
•To get it please contact:
Quebec heart and stroke foundation (HSFQ)
Tél. : (514) 871-1551
1434, rue Sainte-Catherine Ouest
1-800-567-8563
Bureau 500
Téléc : (514) 871-9385
Montreal (Quebec) H3G 1R4
Test your knowledge in CPR
If you want to check your knowledge in First-Aid and CPR
You can answer an online quiz,
by clicking on this link below.
But, press « ESC » first to remove that frame.
CPR and First-Aid quiz
End of the slide-show
Thank’s for your attention !
Raymond Morneau
www.quebecfirstaid.com
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