Cardio-Pulmonary Resuscitation

Cardio-Pulmonary Resuscitation (CPR) is the first aid procedure intended to revive a heart and lung arrest within 3-4 minutes from the time the heartbeat and breathing stops to prevent death or irreversible brain damage.


ABC's of Life Support

1. Opening and maintaining the airways
   
2. Providing ventilation through rescue breathing
   
3. Providing artificial circulation through the use of external chest compression
   

STEPS OF CPR

1. Assessment of responsiveness
   

• Can be detected in 3-5 seconds from the accident.
  
• Gently shake the shoulders and ask loudly, “Hey! Hey! Are you okay? Must be twice.
  
• If the victim is unresponsive, call for help.
  
• “Help! Call 911: Activate E.M.S. System! And get the A.E.D.”
  
• If you or someone else has called the emergency response number, kneel at the victim's side near the head, and start CPR.
  

2. Airway: Maintain and open the airway
   

• There are two techniques to open the airway:
  
  • Jaw Thrust Technique – If you suspect the victim has a neck injury, place your hands alongside the cheeks, curl the tips of your fingers under the angle of the jaw, then pull the face toward you.
    
  • Head Tilt-Chin Lift Technique – While pushing back on the forehead, used your other hand to lift the chin forward.
    

3. Breathing
   

• Hold the open airway of the victim
  
• Look, listen and feel to determine if the victim is breathing adequately.
  
• If not, give two slow rescue breaths via:
  
  • Mouth to mouth or mouth to nose
    
  • Mouth to barrier device
    
  • Bag Mask Technique
    
• Deliver breaths slowly by placing your mouth over the victim's mouth, while pinching the victim's nose closed and exhale. If you deliver breaths too quickly or forcefully, you will force air into the stomach instead of the lungs.
  

4. Circulation
   

• After you give 2 rescue breaths, look for signs of circulation
  
  • Look for adequate breathing, coughing or movement in the response to the two rescue breaths and try to feel the carotid pulse.
    
  • Do not take more than 10 seconds to check the pulse.
    
• Chest compression are performed on the lower half of the sternum. Locate for the correct position for the chest compression.
  
• Provide 30 compression, compress the breastbone 1 ½ to 2 inches with each compression
  
• Push hard, push fast, allow chest recoil
  
• Give 30 compressions and 2 ventilations
  
• Continue to provide 4 cycles of 30 chest compressions and 2 slow breaths. After cycles of CPR, check the pulse. If signs of circulation return, stop chest compression and continue providing rescue breathing if needed. One breath every five seconds. If you do not detect signs of circulation, continue to provide 5 cycles of 30 chest compression and 2 slow rescue breaths.
  

Note: Put you other hand on top of your first hand with fingers interlock . Keep your arms straight and your elbows locked. Two handed compressions may be used only if a child is greater than 8 years old. Use one hand compression for ages 1 – 8.


When to Terminate CPR

Spontaneous ventilation and circulation are detected
Trained personnel has already arrived
Operator is too exhausted
Physician has announced that the patient is dead.


Complications of CPR

1. Fractured ribs
   
2. Lacerated liver
   
3. Punctured lungs
   
4. Gastric distention
   

Recovery Position

1. Place the nearest arm on the victim's chest
   
2. The nearest leg over the other
   
3. Raise the farther arm on the head of the victim
   
4. Hold the victim on the shoulder blade and waist
   
5. Turn the patient away from you as a single unit