Transcript CPR - cloudfront.net

Cardiopulmonary Resuscitation
and AED
Remember the BASICS!
Outline
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Introduction to CPR
History
Review of the Circulatory System
Causes of Cardiac Arrest
CPR
AED
Introduction to CPR
Time is Critical!
• > 300,000 people experience sudden
cardiac death in prehospital settings each
year.
• If resuscitation begins within a few
minutes, many of these individuals have a
chance for survival.
Time is Critical!
Begin resuscitation within minutes:
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Patient’s collapse witnessed
EMS immediately activated
CPR started immediately
Defibrillation within minutes
Trained bystanders are not always available
or willing to do CPR.
The role of the rescuer is critical in reaching
the patient quickly and beginning
resuscitation.
Historical Perspective
• Early 1900s: Shafer Method
Historical Perspective
• 1960s – Peter Safar
– Prone position inadequate
– Expired air did provide sufficient O2.
– Head tilt, chin lift kept patent airway
Historical Perspective
• 1955: Paul Zoll: 1st successful closed
chest defibrillation, external pacing
Historical Perspective
• 1930s: In hospital resuscitation team
• 1960s: MICU with physicians
• 1970: Education in Seattle
– 100,000 laypersons CPR
– 911 dispatch education
– Paramedic training
• 1979: 1st AED developed
– Sensing electrode in pharynx
– Shocking electrode on tongue and abdomen
• 1974: Training of laypersons formally
sanctioned
Review of the Circulatory System
What is the function of the
circulatory system?
The Circulatory System
• Delivers O2 and nutrients
• Removes CO2 and wastes
Why is the function of the circulatory
system critical to our survival?
If the heart stops pumping
• Lack of O2 and accumulation of wastes
quickly lead to death
Major
Arteries
Where are capillaries found
and what is their purpose?
Capillaries
• Found throughout the body
• Connect smallest arteries to smallest veins
• O2, nutrients, and
wastes move
through thin
walls
• Microscopic
How does a vein differ from
an artery?
Veins
• Carry blood back to heart
• Lower pressure
What is the function of blood?
Blood
• The fluid of the circulatory system
• Carries O2, nutrients, and wastes
Heart Physiology
• Left Ventricle contracts – sends wave
of blood
• Pressure wave felt as pulse
• No contraction = No blood flow =
cardiac arrest
Time is Critical!
• Brain damage
begins in 4–6 min
• Brain damage
irreversible in 8–10
min
Circulation must be
restored within 4–
6 minutes.
CPR
• Provides minimal amount of
circulation/oxygenation until cause of
cardiac arrest corrected
• External chest compressions circulate
blood
• Artificial ventilations provide O2 to lungs
Causes of Cardiac Arrest
Causes of Cardiac Arrest
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Heart disease
Respiratory arrest
Medical emergencies
Drowning and suffocation
Congenital heart defects
Trauma
The cause of
cardiac arrest is
important
BUT
do not delay CPR to
obtain history
CPR
• Combines external chest compressions
with artificial ventilation
• Provides 30% (or less) of normal
circulation
• Only effective for short period of time
CPR – 1 Rescuer
• Assess
responsiveness
• Summon EMS
• Position the
patient
CPR – 1 Rescuer
• Check for a pulse
(≤ 10 seconds)
No pulse..activate EMS…
Get AED
CPR – 1 Rescuer
• If there is no
pulse, find your
landmarks, lower
half of the
sternum, between
the nipples
CPR – 1 Rescuer
• Begin chest
compressions
CPR – 1 Rescuer
• Perform 30 chest
compressions
• Push hard
• Push fast
• Allow the chest to
recoil after each
compression
CPR – 1 Rescuer
• Administer two
ventilations then
return to
compressions
CPR – 2 Rescuer
1
2
3
4
CPR - Children
• Use heel of one
hand
• Keep airway open
with other hand
• 30 compressions:2
ventilations if alone
(2 rescuers use
15:2)
CPR - Infant
• Give chest thrusts
and puffs of air
• 30 compressions:2
ventilations if alone
• 15 compressions: 2
ventilations with 2
rescuers
Sequence of Survival
The chances of survival from cardiac
arrest depend upon the sequence (chain)
of survival being intact.
All links are equally important and one
weak link can break the chain.
Sequence of Survival
Also known as Chain of Survival
• Recognition and Early
Access
• Early CPR
• Defibrillation
• Early Advanced Care
Recognition and Early Access
• Depends on public
education
• EMS must be
immediately
notified
• 9-1-1 dispatchers
can provide CPR
instructions
Early CPR
• Must begin within
4-6 minutes of
collapse
• Public training is
necessary
• Rescuers have a
critical role
Defibrillation
•Ventricular fibrillation
a common cause of
Cardiac arrest
•Can only be corrected
with defibrillation
Copyright © 2004 Elsevier (USA). All Rights Reserved
Defibrillation
• Chance of
success
decreases with
time
• AEDs save lives!
Copyright © 2004 Elsevier (USA). All Rights Reserved
Ventricular Fibrillation
V-Fib
• The most common cause of sudden
cardiac death
– Chaotic, disorganized heart activity
– Heart muscle cannot pump blood
Ventricular Fibrillation
V-Fib
• Requires immediate defibrillation
• CPR lengthens window of survival
Early Advanced Care
• Medication
• Advanced airway
management
• Post-resuscitation
care
AED
AEDs
• Safe, accurate &
lightweight
• Easy to operate
What is public
access defibrillation?
PAD
• AEDs in public
places
• Training the public
in CPR/AED
Special Considerations
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Children
Clothing
Body hair
Water
Transdermal
medication patches
• Implanted
defibrillators or
pacemakers
• Metal surfaces
• Jewelry and glasses
AED
Assess
• Check your
patient
Universal Steps
Power
↓
Patient
↓
Analyze
↓
Shock
Power
• Turn the power
on
Patient
• Apply pads to
patient
Analyze
• Stay clear whi
patient’s heart
rhythm is analy
Clear
• Head to toe and
toe to head:
everyone is
clear!
Shock
• Defibrillate
Patient
• Standard is set of 1
shock
• Immediately restart
CPR for 2 minutes
then check pulse
Summary
• Continual beating, or contracting, of the
heart is necessary to keep blood
circulating throughout the body.
• Brain damage begins in 4 to 6 minutes of
cardiac arrest.
• There are many causes of sudden cardiac
death, but the most common is ventricular
fibrillation.
Summary
• Survival from cardiac arrest depends on
the sequence (chain) of survival.
• Rescuers are critically important in
maintaining the sequence (chain) of
survival.
CPR Video
Remember Hard and
Fast !!
Keep the Beat of
Staying Alive !!!