Cardio pulmonary Resuscitation for Nursing students

1. CARDIO PULMONARY
RESUSCITATION

2. C P R

3. C.P.C.R
It is a life saving measure for
the purpose of Oxygenating the
brain and heart until appropriate
definite medical treatment can
restore normal cardiac and
pulmonary function.

4. FOR WHAT C.P.R?
To restore effective circulation and
ventilation.
To prevent irreversible cerebral
damage due to anoxia.When the heart
fails to maintain the cerebral circulation
approximately five-six minutes the brain
may suffer irreversible damage.

5. PHASES OF C.P.R
Phase I –BASIC LIFE SUPPORT(BLS)
C A B D
Phase II-ADVANCED CARDIAC LIFE
. SUPPORT(ACLS)
Phase III-PROLONGED LIFE
. SUPPORT (PLS)

6. BASIC LIFE SUPPORT
BLS is the external support of
circulation and ventilation for a
patient with cardiac or respiratory
arrest by rescue breaths & cardiac
compression.
C A B D

7. INDICATION
CARDIO PULMONORY ARREST
It has been defined as the abrupt
cessation of spontaneous and
effective Ventilation and systemic
perfusion .

8. CAUSES OF CARDIO
. PULMONARY ARREST
Mechanical -Obstruction of airway.
-Drowning.
-Accidents.
-Burns.
-Smoke inhalations.
Cardiac –C A D
-CHF
-Cardiac tamponade.

9. Respiratory –Respiratory failure.
-Neuromuscular disease.
-Pulmonary embolism.
Drugs -Poisoning.
-Antidepressant.
-Cardiac drugs.
-Muscle relaxants.
Metabolic and electrolyte imbalance

10. SIGNS AND SYMPTOMS
Immediate
-complete
. unconsciousness
-Apnoea and gasping.
-Absence of heart
. beat.
Later.
- Dilatation of
. Pupils.
-Cold and clammy
. peripheries

11. CABD OF BASIC LIFE
SUPPORT
C
RESTORE
CIRCULATION

12. CABD OF BASIC LIFE
SUPPORT
A
Clear Airway

13. “A”-CLEAR AIRWAY
Hyperextend neck to open the airway
a) Neck lift &Head tilt maneuver.
b) Chin lift &Head tilt maneuver.
c) Jaw thrust maneuver.

14. Remove obstructing substance from the
mouth with finger.
Use the first finger as a hook to dislodge
any material causing obstruction (finger
sweep).

15. CABD OF BASIC LIFE
SUPPORT
B
REVIEW
BREATHING

16. B-BREATHING
Put your face close to the
casualty’s mouth and look,listen
and feel for five seconds.

17. METHODS OF BREATHING
a)Mouth to Mouth & Mouth to Nose

18. METHODS OF BREATHING
b)By using Mask

19. METHODS OF BREATHING
C)By using ambu bag

20. C-CIRCULATION
Restore circulation by,
-Precordial thump
andor
-External cardiac Compression

21. D OF BASIC LIFE SUPPORT
D
Defibrillation (AED)

22. CPR-PROCEDURE
Preparation of the
. Patient& environment
 No time is lost in explaining the procedure to
the patient or his relatives.
 Ask crowd to leave the room or make space
around the victim.
 The patient may be shifted to a hard surface
or a hardboard is placed under his thorax.
 Remove or push aside the clothing,which
covered the patient’s chest to observe for
cardiac beats & respirations.

23.  Place the patient on his back without any
pillows.
 Tight clothing around the neck and chest
should be removed.
 External cardiac massage must be started
within four to six minutes following cardiac
arrest

24. STEPS OF C P R
1.Establish that the victim is unconscious by
“SHAKING” & “SHOUTING” method.
2.”CALL FOR HELP” ( activate emergency
response system and arrange crash cart)
3.Position the victim on his back on a hard flat
surface.
4.Check for BREATHING.

25. 4.Check for “BREATHING”.
Place your ear above the victim’s mouth & look along
the chest and abdomen.
Hear &feel any breath.
See movements along the chest and abdomen.

26. I-If no RESPIRATION
5.Open the airway by an appropriate
method & remove obstructions if any.
6.Restore breathing by any appropriate
method.
-Give the first two inflation as
quickly as possible.
-do not allow the victim’s lungs to
deflate fully between each breath and
make sure that breath are full.

27. 7.check carotid pulse
If the carotid pulse is present,continue to
give inflations at normal rate(16-18/mts)until
natural breathing is restored.

28. II-if no CAROTID PULSE
Immediately start external chest
compression(external cardiac massage)
with artificial respiration.

29. STEPS OF .
. CARDIAC COMPRESSION
Place victim on a hard surface.
Kneel the victim’s side.
Locate xiphoid process.
Measure 1-2” above the xiphoid process
(or between the nipples)
Place heel of one hand at this point on
the sternum.
Place other hand on top of it.
Interlock the fingers to keep them off
the victim’s ribs.

31. Keep elbows straight and lean forward.
Make full use of your body weight when
delivering downward compression.
Apply steady smooth pressure to depress
victim’s sternum 1.5-2”
Relax pressure completely but don’t let
your hand leave from victim’s chest.

33. Cpr ,with mouth to mouth
ventilation

35. Reassess the victim after 5 cycles
(30 compression & 2 ventilation in
each cycle)
Repeat the cycle.

36. IMP.NOTES
Perform compression at rate of 100/mnt.
According to AHA – 30:2 method.
Depth of compression in adult is 1.5-2 inches.
Mouth to mouth ventilation should not
be done in victim with poisoning,serious
facial injuries,recurrent vomiting.

37. ASSESSMENT

38. ONE RESCUER

39. TWO RESCUER

40. 2 RESCUER WITH A.E.D DEMO

41. ADVANCED AIRWAY

42. IN CHILDREN AND INFANT
CHILDREN
The methods for resuscitation youth and
older are the same as for adult.But they
must be done slightly faster and with light
pressure.
Breath Rate – 20/mts .
compression rate- 100/mts.
Compression depth-2.5cm-3.5 cm.

43. IMP. NOTES
One rescuer method – 30:2
Two rescuer method – 15:2
One hand method(alternative)

44. INFANT
For infants gentle puffs and very light
pressure with two finger only should be done
 By using two finger (one rescuer)
 By using thump of both hand(alternative in
two rescuer)
 It is difficult to feel the Carotid pulse in an
infant so,instead,use brachial pulse.

45. IMP.NOTES
To locate the correct massage
position imagine a line joining the
baby’s nipples.Place tips of two
fingers just below the mid point of
this line.
Breath rate – 20/mts.
Compression rate – 100/mts.
Compression depth – 1.5-2.5 cm.
One rescuer method – 30:2.
Two rescuer method – 15:2

46. INFANT ONE RESCUER

47. TWO RESCUER

48. SUM UP THE MAIN STEPS
Clear airway & CHECK FOR RESPIRATION
If no respiration
Give 2 quick lung inflations
Assess the carotid pulse
If no carotid pulse
Compress chest 30times
Repeat 2 lung inflation with 30 compression
cycle
Re assess after every 5 cycle

49. Signs of effective Resuscitation
Constriction of pupils (key sign that brain
is sufficiently oxygenated)
Distinct carotid pulsation with each
cardiac compression
Blinking upon stimulation of the eyelids
Breathing that begins spontaneously
Movement and struggling
Decreased cyanosis

50. When to stop CPR ?
Effective , spontaneous
ventilation and circulation
established
Physician say “to stop”
Victim is transferred to
emergency medical center

51. POST RESUSCITATION
. COMPLICATIONS
Trauma
Fractured ribs &
sternum
Pneumothorax
Ruptured spleen
Inspiration pneumonia
Burns
Rhythm disturbances
Cervical neck injury
Renal failure

52. AFTER CARE
Rubbing the limbs upwards ,with firm
grasping pressure and energy . This must
be continued under the blanket or over
the dry clothing
Promote the warmth of the body by the
applications of hot water bottles
Prevent unnecessary gathering of
persons around the victim

53. On the restoration of life, a teaspoon
full of warm water can be given.
Place the victim in recovery position.
Patient should be kept in bed and
encouraged to sleep.
Under no circumstances hold the victim
up by the feet.

54. Ms.Jinchu Paul