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Cardiopulmonary resuscitation (CPR) - an emergency procedure

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Cardiopulmonary resuscitation (CPR) is an emergency procedure that combines chest compressions often with artificial ventilation in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person who is in cardiac arrest. It is recommended in those who are unresponsive with no breathing or abnormal breathing, for example, agonal respirations.[1]

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Cardiopulmonary resuscitation (CPR) - an emergency procedure

  1. 1. CARDIOPULMONARY RESUSCITATION (CPR) Check out ppt download link in description Or Download link : https://userupload.net/38urdql2w91i
  2. 2. OUTLINE OF PRESENTATION  Introduction  History of CPR  Causes of cardiac arrest  Diagnosis of cardiac arrest  Definition of CPR  Aim of CPR  Sequence of operations in CPR
  3. 3.  Stages of CPR  CPR in adult victim  CPR in child  CPR in infants  Conclusions  Public health significance  References OUTLINE OF PRESENTATION
  4. 4. HISTORY  Friedrich Maass : Father of CPR.  He first started using chest compressions in the year 1892.  Later he defines CPR (1960) as integrated cardiac compressions and rescue breaths.  American Heart Association – ‘CPR can double or triple the survival chances after a sudden cardiac arrest’
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  6. 6. CAUSES OF CARDIAC ARREST Ischemic heart disease Valvular disorders Cardiac tamponade Ruptured aorta Airway obstruction Acute respiratory failure Shock Embolisms of different origin Poisoning C A R D I A C E X T R A C A R D I A C
  7. 7. DIAGNOSIS OF CARDIAC ARREST In the beginning Blood pressure measurement Take the pulse on peripheral arteries Auscultation of cardiac tones LOSS OF TIME
  8. 8. SYMPTOMS OF CARDIAC ARREST  Absence of pulse on carotid arteries – a pathognomic symptom  Respiration arrest – may be in 30 seconds after cardiac arrest  Enlargement of pupils – may be in 90 seconds after cardiac arrest
  9. 9. INTRODUCTION  CPR is one of the technique aimed at maintaining blood flow following cardiac arrest.  The goal of CPR is to continue to provide a small amount of blood and oxygen to the tissues to prevent permanent damage till standard care arrives.
  10. 10. 1. Check responsiveness 2. Call for help 3. Correctly place the victim and ensure the open airway 4. Check the presence of spontaneous respiration 5. Check pulse 6. Start external cardiac massage and artificial ventilation SEQUENCE OF OPERATIONS (six c’s)
  11. 11. MAIN STAGES OF CPR ABCD format A = airway B = Breathing C = Circulation D = Defibrillator
  12. 12. PRIOR TO CPR…. Basic life support (BLS) Position of the patient Ensure airway Breathing Circulation
  13. 13. BASIC LIFE SUPPORT CONSISTS OF: Airway management Artificial ventilation External chest compression Advantages: 1. Helps to provide continuous supply of oxygenated blood to the brain and heart. 2. Avoids irreversible damage to the victim.
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  15. 15. CPR- IN ADULT VICTI M Recognition of unconsciousness Summon assistance and position the patient Assessment of airway Breathing Circulation 1 2 3 4 5
  16. 16. RECOGNITION OF UNCONSCIOUSNESS  Stimulate the victim by shaking the shoulders or by shouting the victim's name.  Lack of response _ diagnosed as unconscious.  Follow the ABCD format.
  17. 17. SUMMON ASSISTANCE AND POSITIONING THE VICTIM  Summon should call EMS (emergency medical service)  Place the victim in supine position.  The head and chin of the victim are placed parallel to the floor and feet elevated slightly 100. ---- To facilitate return of blood from the periphery
  18. 18. ASSESSMENT AND MAINTAINCE OF AIRWAY 1. Head tilt and chin lift can be employed to obtain the patient airway. 2. The rescuer places one hand on the victim’s forehead and the other bony prominence of the chin.
  19. 19. BREATHING Look, listen and feel the breathing not more than 10 seconds .
  20. 20. BREATHING  If the victim is not breathing, give two breaths (1 second or longer) – Pinch the nose – Seal the mouth with yours  If the first two don’t go in, re-tilt and give two more breaths
  21. 21. ARTIFICIAL BREATHING Mouth to mouth or mouth to nose respiration Ventilation by a face mask and a self- inflating bag with oxygen 2 initial subsequent breaths wait for the end of expiration 10-12 breaths per minute with a volume of app. 800 ml, each breath should take 1,5-2 seconds Control over the ventilation check chest movements during ventilation check the air return
  22. 22. COMPRESSIONS After giving breaths… Locate proper hand position for chest compressions – Place heel of one hand on center of chest at the nipple line
  23. 23. COMPRESSIONS – Using both hands, give 30 chest compressions • Count 1, 2, 3 … – Depth of compressions: 1 .5 to 2 inches – For children: ½ to 1/3 of chest depth and use 1 or 2 hands (keep one hand on forehead if possible)
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  25. 25. CPR After 30 chest compressions: • 2 slow breaths • Continue until help arrives or victim recovers • If the victim starts moving: check breathing
  26. 26. ADVANTAGES OF COMPRESSIONS It creates blood flow by increasing the intrathoracic pressure and direct compression on heart. When sternum is compressed, intrathoracic pressure increases. It produces cardiac output by compressing the vessels with in the chest cavity Forces blood back to and through, the heart.
  27. 27. COMPRESSION – VENTILATION RATIO For single rescuer: A compression-ventilation ratio of 30:2 is recommended.
  28. 28. Currently, Compression-ventilation ratio is15:2 Advantages: 1. Minimizes the interruptions in chest compression. 2. Reduce the likelihood of hyperventilation COMPRESSION – VENTILATION RATIO
  29. 29. AUMATED EXTERNAL DEFIBRILLATOR
  30. 30. AUTOMATED EXTERNAL DEFIBRILLATOR (AED) Defibrillation is the application of electrical shock to help and restore the heart’s regular rhythm
  31. 31. AUTOMATED EXTERNAL DEFIBRILLATOR Early defibrillation is the single most important factor in determining survival from cardiac arrest.
  32. 32. WHEN TO ACHIEVE AED? Defibrillation should be performed with in the first eight minutes after cardiac arrest. Ideally, the sooner, the better.
  33. 33. TYPES OF AED Automatic Semi-automatic
  34. 34. TYPES OF AED Automatic: where machine does all of the work. Semi Automatic: where machine tells you when to push button to deliver shock.
  35. 35. MUST TO REMEMBER Always making sure that CPR is still in progress while you are setting up the AED.
  36. 36. Now attach the adhesive pads to the cables remembering- White is negative, anterior chest wall. Red is positive , left anterior axillary line. “Red on Ribs! White on right!”
  37. 37. INDICATIONS FOR AED Unresponsive Apneic Pulseless patients > 8 years old
  38. 38. HOW TO PERFORM CPR ON CHILD? Use the same compression-breath rate as is used for adults: 30 compressions followed by two breaths. This is one cycle. Following the two breaths, immediately begin the next cycle of compressions and breaths.
  39. 39. Child age: 1-8 years Use only one hand to perform heart compressions. Breathe more gently. If you’re alone, perform five cycles of compressions and breaths on the child — this should take about two minutes — before calling 911 or your local emergencies. HOW TO PERFORM CPR ON CHILD?
  40. 40. CPR FOR INFANTS Give CPR – Press sternum 1/2 to 1/3 depth of the chest – Use middle and ring finger 30 compressions to 2 If alone, resuscitate for 2 minutes then call 911
  41. 41. CHOKING: CONSCIOUS INFANTS • Position with head downward. • 5 back blows (check for expelled object) • 5 chest thrusts (check for expelled object) • Repeat
  42. 42. CPR FOR INFANTS
  43. 43. CONCLUSIONS  CPR is one of the technique aimed at maintaining blood flow following cardiac arrest.  The goal of CPR is to prevent permanent damage by constant supply of small amount of oxygen and blood to the tissues.  Two causes for cardiac arrest  Cardiac  Extra cardiac
  44. 44.  Main stages of CPR includes airway, breathing, circulation and defibrillator.  Compression- ventilation ratio is 30:2 for two rescuers 15:2 for one rescuers CONCLUSIONS
  45. 45. PUBLIC HEALTH SIGNIFICANCE • Members in the health care team should be trained thoroughly in performing the CPR Which includes medical and dental doctors, nurses, anganwadi workers, local dais and auxiliaries. • Regular continuing medical education programs should be conducted. • All the health institutions should be well equipped in providing CPR by trained professionals.
  46. 46. • Incorporation of medical emergencies, which includes technique of CPR in out reach programs. • Health professionals should educate and train the population regarding medical emergencies. PUBLIC HEALTH SIGNIFICANCE
  47. 47. REFERENCES 1. Stanley F. Malamed - Medical emergencies in the dental office-5th & 6th edition. 2. KD Tripathi, Essentials of medical pharmacology;5th edition, jaypee publishers. 3. Medical emergencies in the dental office, The dental clinics of North America, Jan 1982:W.B Sounders company.
  48. 48. 4. Sujit K. Chaudhri. Concise medical physiology, 2nd edition, New central book agency, calcutta,1995 . 5. WWW. Google. Com as accessed on 22-12-11and 26- 12-11 REFERENCES
  49. 49. CLICK HERE TO DOWNLOAD THIS PPT https://userupload.net/38urdql2w91i

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