Pavan kr cpr 2013

CPR - Adult
Alternate Names : Cardiopulmonary Resuscitation -
Adult, Rescue Breathing and Chest Compressions -
Adult, Resuscitation - Cardiopulmonary – Adult
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Prepared By - Pavan Kumar Jain,
Assistant Prof. Sumandeep Nursing College,
Sumandeep Vidyapeeth, Vadodara

CPR IS A PIVOTAL AND COMMON PROCEDURE
WHILE DEALING WITH UNRESPONSIVE
UNCONSIOUS VICTIM.
• CPR has for 50 years consisted of the combination of
artificial blood circulation with artificial respiration (also
known as mouth-to-mouth (MTM)) i.e., chest
compressions and lung ventilation. However, in March
2008 the American Heart Association, in an historic
reversal, endorsed the effectiveness of chest
compressions alone--without artificial respiration--for
adult victims who collapse suddenly in cardiac arrest
(see Cardio cerebral Resuscitation below).
• CPR is generally continued, usually in the presence of
advanced life support, until the patient regains a heart
beat (called "return of spontaneous circulation" or
"ROSC") or is declared dead.
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Pavan Kumar Jain,Assistant Prof.
Sumandeep Nursing College Vadodara

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PURPOSES:-
CPR is unlikely to restart the heart, but rather its purpose is to
maintain a flow of oxygenated blood to the brain and the
heart, thereby delaying tissue death and extending the brief
window of opportunity for a successful resuscitation without
permanent brain damage.
Defibrillation and advanced life support are usually needed to
restart the heart.
CPR is a combination of:
Rescue breathing, which provides oxygen to a person's
lungs.
Chest compressions, which keep the person's blood
circulating. 5

INDICATIONS:
Unconsciousness
No respirations or brief irregular, 'gasping' breaths
No Pulse
These problems may be seen in conditions such as:
Cardiac arrest
Suffocation
Chocking
Drowning
Electrocution
Drug overdose
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• Patients dying an expected death
from a chronic life-limiting medical
illness.
• Predictors of near 0% survival and
never leaving the hospital include:
metastatic cancer, pneumonia, renal
failure, sepsis, multiple organ
failure, acute stroke, and a CPR event
> 30 minutes.
• Consider ‘do not attempt
resuscitation’ (DNAR)when the
patient: does not wish to have CPR
Contra-
indications
for CPR
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Scientific principles:
• In essence, Cardio (heart) Pulmonary (lung) Resuscitation (revive, revitalize)
serves as an artificial heartbeat and an artificial respirator.
• If a pulse is not present, a precordial thump to the mid-sternum may be tried.
• Subsequently, check “ABC’s” of BLS.
• The mouth and phar-ynx should be examined for no obstruction/foreign body.
• The tongue should be removed from the posterior pharynx by tilting the head
backward and hyperextending the neck.
• If no breathing is noted, mouth-to-mouth or mouth-to-nose breathing should
be initiated in four quick breaths. One should check chest rises with each
ventilation.
• If a carotid pulse is not present after the initial ventilations, external cardiac
compression over the lower half of the sternum ( N/o xiphoid process) should
be initiated. The ster-num should be depressed 3 to 5 cm, with the patient
lying on a flat hard surface.
• Compressions should be approximately 60 per minute, with a ratio of 5
compressions to 1 ventilation if two res-cuers are present. A single rescuer
must give 15 chest compressions alternating with two venti-lations every 15
seconds. 8

•It is an
emergency
procedure, and
not requires any
preparation.
Preparation:
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STEPS
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• It is critical to remember that
dialing 108.
Let's begin by very
first step of Basic
Life Support
• 1. Your location 2. Your phone number
3. Type of emergency
4. Victim's condition
Provide operator
with
• If you’re alone with the victim, try to
call for help
prior to starting
CPR on an adult
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•Always check
for any potential
hazards before
attempting to
perform CPR.
Always
remember
to exercise
solid
common
sense!
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• DO NOT leave the victim alone.
• DO NOT try make the victim
drink water.
• DO NOT throw water on the
victim's face.
• DO NOT prompt the victim into
a sitting position.
• DO NOT try to revive the victim
by slapping his face
what to do in
an
emergency, we
must first
emphasize
what not to
do: ..
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American Heart
Association's guidelines
dictate that Adult CPR is
performed on any
person over the age of 8.
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• Before you start any rescue
efforts, you must remember to
check the victim for responsiveness.
Responsiveness.
• Otherwise, shake the victim gently and shout
"Are you okay?" to see if there is any
response. If the victim is someone you
know, call out his name as you shake him.
If suspect - spinal
or neck injury, do
not move or
shake him.
• check the A-B-C
Airway Breathing Circulation
If there is no
response
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"A" is for
AIRWAY
• Look, listen and feel for
any signs of breathing.
If you determine that the
victim is not
breathing, then the tongue
is the most common
airway obstruction in an
unconscious person.
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• If the person is still not
breathing on his own after the
airway has been cleared, you
will have to assist him breathing
"B" is for
BREATHING
• Gently support his chin so as to
keep it lifted up and the head
tilted back. (Hyper extended
neck)
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"C" is for
CIRCULATION
• In order to determine if the victim's heart is
beating, place two fingertips on his carotid
artery, located in the depression between the
windpipe and the neck muscles (Figure 5), and
apply slight pressure for several seconds.
• If there is no pulse then the victim's heart is
not beating, and you will have to perform
chest compressions
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The depth of compressions
should be approximately
1½ to 2 inches - remember:
2 hands, 2 inches (Figure
3).
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Count aloud as you compress 30 times
at the rate of about 3 compressions
for every 2 seconds. Finish the cycle
by giving the victim 2 breaths. This
process should be performed four
times - 30 compressions and 2 breaths
- after which remember to check the
victim's carotid artery for pulse and
any signs of consciousness.
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If there is no pulse, continue performing 30
compressions/2 breaths, checking for pulse after
every 4 cycles until help arrives.
If you feel a pulse (i.e. the victim's heart is beating)
but the victim is still not breathing, rescue breaths
should be administered, one rescue breath every
five seconds (remember to pinch the nose to
prevent air from escaping). After the first rescue
breath, count five seconds and if the victim does
not take a breath on his own, give another rescue
breath.
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New CPR Guidelines from the AHA 2010
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Latest CPR changes are:
Skill New Old
Rescue Breaths Normal breath for 1 second
until chest rises
Deep breath for 2 seconds
Chest Compression to
Ventilation Ratio Adult, Child, Infant - 30:2
Adult - 15:2
Child - 5:1
Infant - 5:1
Chest Compression Ratio
Adult, Child, Infant - At
least 100/minute
Adult or Child - About
100/minute
Infant - About 120/minute
Chest Landmarking
Adult or Child - Center of
Chest
Infant - Just below nipple
line at center of chest
Adult or Child - Trace up the
ribs
Infant - One finger width
below nipple line at center
of chest
AED 1 shock,
then 5 cycles of CPR (about
2 minutes)
Up to 3 shocks,
then 1 minute of CPR
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