Transcript CPR and First Aid Basics!

Unit 21 Cardiac Arrest and
Cardiopulmonary Resuscitation
韩明华
山东省泰安卫生学校
Review
 What are the most common causes of upper gastrointestinal
hemorrhage?
Peptic ulcer disease; erosive gastritis; esophageal varices
 Upper GI hemorrhage is characteristically manifested by:
Hematemesis and melena
 If the blood loss is more than 40% of the total blood volume,
it may cause:
Hypovolemic shock, with pallor, cool clammy skin,
hypotension and tachycardia
Learning Objectives
 Tell all the steps of the chain of survival and
present the importance of each step
 Know how to perform one rescuer CPR and two
rescuer CPR in adults
 Use AED correctly and proficiently
BACKGROUND
 Approximately 540,000 people die of cardiac arrest per year
in China
 Survival to hospital discharge presently approximately 5-10%
 Typically <20% of bystanders can perform CPR before
arrival of emergency services
 Early resuscitation and prompt defibrillation (within 1-2
minutes) can result in >60% survival
What is Cardiac Arrest?
Causes of Cardiac Arrest
 Trauma
 Drowning
 Electrical shock
 Hypersensitivity reactions
 Drug overdose
 Cardiac dysrhythmias: ventricular fibrillation
 CAD/AMI
Patient Symptoms of Cardiac Arrest
 Unconsciousness
 No breathing
 No heart sounds
 No major pulse (carotid or
femoral)
 Dilation of pupils
Resulting in…
No Oxygen to the Brain or Body
Organs
Start CPR Immediately
 Better chance of survival
 Brain damage starts in 4-6 minutes
 Brain damage is certain after 10 minutes
without CPR
CPR-Cardiopulmonary Resuscitation
 CPR is the care given to a
victim who is not breathing and
does not have a pulse.
 Revives heart (cardio) and
lung (pulmonary)
functioning
 Keeps blood that contains
oxygen flowing to the brain and
vital organs until ACLS arrives.
How CPR Works
 Effective CPR provides 1/4 to 1/3 normal
blood flow
 Rescue breaths contain 16% oxygen
Chain of Survival
Early
Access
Early
CPR
Early
Early
Defibrillation
Defibrillation
Early
Advanced
Care
FAST SPEED IS THE KEY TO SUCCESS
Cardiac Chain of Survival
 Early recognition and quick call to 1-2-0
 Begin CPR right away
 Use AED quickly
 EMS get victim to hospital ASAP
 Best chance of survival if these things are done
QUICKLY!!!
Check the scene for safety:
Make sure there is nothing around that will
cause you harm before approaching the victim,
such as spilled chemicals, traffic, fire, and other
hazardous items.
Survey The Scene, then: RAP
 R - Responsiveness
Are you
okay?
Tap shoulder and shout loudly
RAP
 A - Activate EMS
( if unresponsive)
 Call 120 or the local
emergency number (If there
are other people at the scene,
ask them to call for help!)
 Make sure you give the 120
operator the correct
information!
RAP
 P - Position on back
 On a hard, flat surface
 Always be aware of head and spinal cord injuries
 Support neck and spinal column
Steps of CPR
Call
ABC
 Airway
 Breathing
 Circulation
SAVING A LIFE IS EASY
Checking Vital Signs
 A – Airway
 Open the airway and maintain the
airway open
 Head tilt chin lift
B – Check For Breathing
 Look, listen and feel
for normal breathing
 No longer than 10
seconds
Breathing
 If the victim is not
breathing, give two breaths
 Pinch the nose
 Seal the mouth with yours
 Watch the chest rise
 Check for choking
 Clear the airway
 Mouth to mouth devices
 Masks /Shields
Compressions
 If no signs of life, start chest compression…
 Using both hands, give 30 chest compressions at a
rate of 100 per minute
 Count 1, 2, 3 …
push hard and push fast
Land mark
press down on the
sternum 1 ½ to 2 inches
Place the heel of one hand in
the centre of the victim’s chest.
Place the heel of your other
hand on top of the first hand.
30 : 2
After 30 compressions open the airway again using head tilt and chin lift give
2 breaths while watching the chest rise.
CPR
 After 30 chest compressions give:
 2 slow breaths
 Continue compressions and breaths at a ratio
of 30:2 until help arrives or victim recovers
 If the victim starts moving: check
breathing
Two Partner CPR
 Rescuer 1:
 RAPAB
 Rescuer 2:
 place hands for
compressions
 Compression rate: 30:2
 Switch off when tired
Checking for CPR Effectiveness
 Does chest rise and fall with rescue breaths?
 Have a second rescuer check pulse while
you give compressions
When Can I Stop CPR?
 Victim revives
 Trained help arrives
 Too exhausted to continue
 Unsafe scene
 Physician directed (do not resuscitate orders)
 Cardiac arrest of longer than 30 minutes
 (controversial)
Why CPR May Fail
 Delay in starting
 Improper procedures (ex. Forget to pinch nose)
 No ACLS follow-up and delay in defibrillation
 Only 15% who receive CPR live to go home
 Terminal disease or unmanageable disease
(massive heart attack)
Complications of CPR
 Rib fractures
 Laceration of liver, spleen or lungs
 Vomiting
 Stomach distension
Here are some Key points you NEED to remember!
 Check the person for consciousness
 Call for help!
 Open the airway and look, listen, and feel for signs of life
 Give 30 chest compressions with both hands then open the
airway and give 2 rescue breaths.
 Continue the 30 to 2 ratio until EMS arrives.
This Video is from the American Heart Association. It will
take you through the important steps of CPR for an adult!
Click to watch the video!
Even With Successful CPR, Most Won’t
Survive Without ACLS
 ACLS (Advanced Cardiac
Life Support)
 ACLS includes defibrillation
(AED), oxygen, drug
therapy
AED
Automated External Defibrillator
AED
Public access AED
Home AED
What does an AED do?
 The AED is programmed to analyze the heart’s electrical
activity, and decide whether the electrical shock would help.
It then builds up an electric charge and deliver to the patient
when you push the button. If a victim truly has no pulse, the
AED is the only thing that will bring the victim back to life.
CPR only keeps blood and oxygen flowing through the body.
CPR alone does NOT restart the heart!
•
CPR (only) ……………………… 0-2%
• EMS/ER …………………… 5-15%
• CPR+AED…….. 30-75%
Electrode placement
 Remove electrodes from package
 Apply to victims :upper right chest
left lower side of chest
 Wet victims should be toweled dry.
 Hairy chest may need shaving.
SWITCH ON AED
 Some AEDs will automatically
switch themselves on when the
lid is opened
ATTACH PADS TO CASUALTY’S BARE
CHEST
ANALYSING RHYTHM
DO NOT TOUCH VICTIM
SHOCK INDICATED
 Stand clear
 Deliver shock
• Don’t Touch Patient During Analysis
• Keep Clear of the Victim
While Delivering Shock
Trainning Section
SHOCK DELIVERED
FOLLOW AED INSTRUCTIONS
30
2
IF VICTIM STARTS TO BREATHE NORMALLY
PLACE IN RECOVERY POSITION
Key Points of Using AED
•
•
•
•
•
Turn on AED
Wipe chest dry; Shave chest hair
Attach pads
Analyze rhythm
Deliver shock
• WHAT TO DO NEXT• After shock, give about 2 minutes of CPR.
AED-Video
This Video is from the European Resuscitation Council.
American Heart Association (AHA)
Resuscitation Training Center of Caritas Medical Center
Basic Life Support for Healthcare Providers
CPR & AED Program (Adult)
Two rescuer CPR Practice
CPR-Infant
Cardiac Arrest
How to perform CRP
Chain of survival
How to use AED!
Classroom Exercises
100 per minute
 Chest compression rate is about _______
 The new ratio of compressions to breaths in adult, child
30 : 2
and infant is _______
1.5-2 inches in adults
 Press down on the sternum __________
 Tell the chain of survival:
Access-CPR-AED-EMS------Fast Speed
 Steps of CPR:
Airway, Breathing, Circulation
Assignments
 One rescuer CPR practice in adults
 Two rescuer CPR practice
 Recite the steps of using AED
 CPR+AED practice in pairs
？