Transcript CPR - Teacher Pages

CPR
CPR Saves Lives
– Cardiopulmonary Resuscitation or CPR and
defibrillation within 3-5 minutes can save over
50% of cardiac arrest victims
– CPR followed by AED saves thousands of lives
each year
– In most cases CPR helps keep victim alive until
EMS or AED arrives
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Circulatory System
Basics
Circulatory System
• Circulatory system consists of heart, blood, and
blood vessels.
• Transports blood to lungs
• Delivers carbon dioxide and picks up oxygen
• Transports oxygen and nutrients to all parts of
body
• Helps regulate body temperature
• Helps maintain body’s fluid balance
Anatomy of the Heart
Coronary Arteries
Major Arteries
Circulatory System
Emergencies
Circulatory System Emergencies
• Any condition that affects respiration reduces
ability to deliver oxygen
• Heart conditions
• Severe bleeding
• Shock
• Stroke
Cardiac Arrest
• Cardiac Arrest (sudden stopping of the heart)
may occur as a result of heart attack
• Brain damage begins 4 - 6 minutes after
cardiac arrest
• Brain damage becomes irreversible in 8 - 10
minutes
• Dysrhythmia, an abnormal heartbeat, may
also reduce heart’s pumping effectiveness
Causes of Cardiac Arrest
– Heart attack
– Drowning
– Suffocation
– Stroke
– Allergic reaction
– Diabetic emergency
– Prolonged seizures
– Drug overdose
– Electric shock
– Certain injuries
Chain of Survival
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Early Access
Early CPR
Early Defibrillation
Early Advanced Care
Cardiopulmonary Resuscitation (CPR)
– CPR helps keep patient alive by circulating some
oxygenated blood to vital organs
– Ventilations move oxygen into lungs where it is
picked up by blood
– Compressions on sternum increase pressure
inside chest, moving some blood to brain/other
tissues
– CPR effective only for a short time
– CPR should be started as soon as possible
– In some instances, the heart may start again
spontaneously with CPR
Basic Skills
Rescue Breathing
Chest Compressions
Rescue Breathing
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The risk of infection from CPR is extremely low but
the US Occupational Safety and Health
Administration requires that healthcare workers
use standard precautions in the workplace,
including CPR
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Standard Precautions include using barrier devices
such as a face mask or bag-mask device when
giving breaths.
Head Tilt-Chin Lift
• Place one hand on the victim’s forehead and
push with your palm to tilt the head back.
• Place the fingers of the other hand under the
bony part of the lower jaw near the chin.
• Lift the jaw to bring the chin forward.
Jaw Thrust Maneuver
• If a victim has a head or neck injury use the jaw
thrust maneuver to open the airway.
• Place one hand on each side of the victim’s head
• Place your fingers
under the angles of
the victim’s lower
jaw and lift with
both hands
Mouth to Mouth Breathing
• Position yourself at the victim’s side
• Perform the head tilt / chin lift
• Pinch the victim’s nose and cover his mouth
with yours
• Deliver air over 1 second to
make the chest rise
Mouth to Mask Breathing
• Position yourself at the victim’s side.
• Place the mask on the victim’s face, using the
bridge of the nose as a guide.
• Perform the head tilt / chin lift
• Deliver air over 1 second to make the chest rise
Bag-Mask Breathing
• Position yourself at the victim’s side.
• Place the mask on the victim’s face, using the
bridge of the nose as a guide.
• Using the EC technique, hold the
mask in place while you hold the
airway open.
• Perform the head tilt / chin lift
• Squeeze the bag to give breaths
(1 second each) watching for the
chest rise
Rescue Breathing
• Respiratory Arrest- an adult, child, or infant has a
pulse but is not breathing effectively
• Rescuers should give breaths without compressions.
Adults
Infants and Children
Give 1 breath every 5-6 seconds Give 1 breath every 3-5 seconds
(about 10-12 breaths per
(about 12-20 breaths per
minute)
minute)
Give each breath in 1 second
Each breath should make the chest rise
Check the pulse about every 2 minutes
Tracheostomies
• Opening created in the airway
through which the individual
breathes
• Rescue breaths must be
given through the stoma
Advanced Airways
• Secured airways inserted by physicians or
paramedics
Chest
Compressions
Chest Compressions Basics
• Position yourself at the victim’s side
• Make sure the victim is lying face up on a firm
surface
• If you suspect a head or neck injury, try to
keep the head, neck, and torso in one line
when turning
Hand Placement
• Put the heel of one hand on the center of the
victim’s chest on the lower half of the sternum
• Put the heel of your other hand on top of the
first hand
• Straighten your arms and
position your shoulders
directly over your hands
Rate and Depth
• Push hard and fast.
• Press straight down at least 2 inches
• Deliver compressions in a smooth fashion at a
rate of at least 100/min.
One-Rescuer
CPR
1. Assess the victim for response and look for
normal or abnormal breathing. If there is no
response and no breathing, or no normal
breathing (i.e. only gasping), shout for help.
Tap and shout,
“Are you OK?”
2. If you are alone, activate the emergency
response system and get an AED (or
defibrillator) if available and return to the
victim.
3. Check the victim’s pulse (take at least 5
seconds but no more than 10 seconds).
4. If you do not definitely feel a pulse within 10
seconds, perform 5 cycles of compressions
and breaths (30:2 ratio), starting with
compressions (C-A-B sequence)
CPR Sequence
• ASSESSES: Checks for response, no breathing or no
normal breathing (5-10 seconds)
• ACTIVATES emergency response system
• Check for PULSE (carotid) 5-10 seconds
• GIVES HIGH QUALITY CPR:
– Correct HAND PLACEMENT
– ADEQUATE RATE: At least 100/min (30 compressions in 18
seconds or less)
– ADEQUATE DEPTH: 2 inches
– MINIMIZES INTERRUPTIONS: Gives 2 breaths in less that 10
seconds
Chest Compressions Alert
– Be careful with your hand position
– For adults/children, keep your fingers off patient’s
chest
– Do not give compressions over bottom tip of
breastbone
– When compressing, keep elbows straight and hands in
contact with patient’s chest at all times
– Compress chest hard and fast, but let chest recoil
completely between compressions.
– Minimize amount of time used giving ventilations
between sets of compressions.
AED
Automated External
Defibrillator
AED
• Automated External Defibrillator – computerized
devices that can identify cardiac rhythms that need a
shock, and then can deliver the shock
• Used to treat victims of sudden cardiac arrest with
ventricular fibrillation - the heart muscle may
“quiver” and/or not contract together to pump blood
• An electric shock can stop the quivering heart fibers
• This allows the muscle fibers of the heart to “reset”
so they can begin to contract at the same time
Using the AED
Power on the AED
• Open the carrying case or the top of the AED
• Turn the power on (some devices will “power
on” automatically when you open the lid.
Power on the AED
• Open the carrying case or top of the AED
• Turn the power on (some devices will “power
on” automatically when you open the lid or
case
• The AED will guide you through the steps
Attach AED pads to victim’s bare chest.
• Use adult pads for victims 8 years and older
• Peel away the backing from the AED pads
• Attach the AED pad to the victim’s bare chest
– One in the upper right chest below the collarbone
– The other to the side of the left nipple
– Attach the pads to the machine
• Attach the AED cable to the
device
“Clear” the victim and Analyze the
rhythm
• Be sure no one is touching the victim
• Some AED’s will tell you to push a button to
analyze, others will begin automatically
• Some AED’s may take about 5-15 seconds to
analyze
If the AED advises a shock, it will tell
you to clear the victim
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Loudly state a “clear the victim” message
Look to be sure no one is touching the victim
Press the shock button
The shock will produce a sudden contraction
of the victim’s muscles
Resume CPR
• If no shock is needed, and after delivering a
shock, immediately resume CPR starting with
compressions
• After 5 cycles or about 2 minutes, the AED will
prompt you to repeat previous steps
• If “no shock advised” immediately restart CPR
beginning with chest compressions
Special Situations
• Hairy chest – use a razor (in some cases) or
quickly remove the AED pad to remove hair
• Water – remove the victim and dry quickly
• Implanted defibrillator / pacemaker – do not
place the pad on the device
• Transdermal medication – remove the patch
and wipe with a cloth
Operation of an AED
• Power on the AED
• Attach the pads to the victim’s bare chest and
cable to the device
• “Clear” the victim and analyze the rhythm
• If the AED advises a shock, it will tell you to
clear the victim
• If no shock is advised
2 Rescuer Sequence with an AED
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Check for response and check breathing
Check for pulse
Attempt defibrillation with AED
Power on the AED
Attach the pads to the victim’s bare chest
“Clear” the victim and analyze the rhythm
If the AED advises a shock, it will tell you to clear the victim
If no shock is needed, immediately resume CPR, starting with
compressions
• After 5 cycles or about 2 minutes of CPR, the AED will ask you
to clear and analyze the victim
CPR
Review
• What is the rate for performing chest
compressions for a victim of any age?
100 per minute
Describe a way you can allow the chest to recoil
completely after each chest compression.
Allow the chest to expand
completely between each
compression.
After you open the airway and pinch the nose of
an unresponsive adult or child, what is the
best way to give mouth-to-mouth breaths?
Seal your mouth over the victims
mouth and give 2 breaths, watching
for the chest to rise
What is the best way for a rescuer to know that
a rescue breath is effective?
The chest will rise with each breath.
You must check adequate breathing before
giving breaths to an unresponsive adult
victim. You do this by looking for chest rise
and feeling for airflow through the victim's
nose or mouth. What other sign should you
assess?
Listen for airflow from the victim’s
nose or mouth
When you do not suspect a cervical spine injury,
what is the best way to open an unresponsive
victim's airway?
The head tilt / chin lift technique
What should be the next step when you find an
unresponsive adult victim who has agonal
gasps and you have sent someone to activate
the emergency response system?
Check the carotid pulse
How do you know when to start cycles of chest
compressions with breaths for an adult?
The victims is unresponsive, is not
breathing, and does not have a
pulse.
What are the steps common to the operation of
all AED's in the correct order?
Power on, attach pads, clear &
analyze, clear & deliver shock if
advised
After you power on an AED and attach the pads
to the victim, what is the next step you should
do?
Clear the victim so the AED can
analyze the heart rhythm
What might happen if you touch the victim
while the AED is delivering a shock?
The AED could shock you while it is
shocking the victim.
You are using an AED on an adult victim, and the
AED gives a "no shock indicated" (or "no shock
advised") message. Until advanced care
personnel arrive, what should you do next?
Leave the pads in place and
continue CPR
What is the best way to relieve severe choking in
a responsive adult?
Perform abdominal thrusts
A choking adult becomes unresponsive while
you are doing abdominal thrusts for severe
choking. You ease the victim to the floor and
send someone to activate your emergency
response system. What should you do next?
Begin CPR, when you open the
airway, look for and remove the
object if seen, before giving breaths
• Which of the following statements best
describes why you should minimize
interruptions when giving chest compressions
to any victim of cardiac arrest?
If you minimize interruptions, you
increase the victims chance of
survival.
Breathing stops but the heart still continues for
2-3 minutes. What is this called?
Respiratory arrest.
You find a victim lying on his right side. He is not
breathing but has a pulse. What should you
do?
Give a rescue breath every 5
seconds.
What happens during a cardiac arrest?
The heart and breathing stop
without warning.
Before starting chest compressions, you need to
check for a pulse. What pulse site should you
use?
Carotid
A person shows signs of circulation after CPR
was started. What should you do?
Place the victim in the recovery
position, lying on their side.
The purpose of the recovery position is to:
Prevent aspiration.