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CARDIOPULMONARY RESUSCITATION (CPR)
CARDIOPULMONARY RESUSCITATION (CPR) (Definition, Purpose, Equipment, General Instructions, Procedure, Method, Do’s and don’ts in CPR and Complications.
UPDATED 2024
Cardiopulmonary resuscitation is a lifesaving technique useful in many emergencies, including heart attack or near drowning, in which someone’s breathing or heartbeat has stopped. The American Heart Association recommends that everyone – untrained bystanders and medical personnel alike – begin CPR with chest compressions.
Resuscitation includes all measures that are applied to revive patients who have stopped breathing suddenly and unexpectedly due to either respiratory or cardiac failure.
Cardiac arrest is one of the common causes for cardio-respiratory failure. When a person stops breathing spontaneously, his heart also stops beating. Clinical death occurs within 4-6 minutes, the cells of the brain which is sensitivity to the paucity of oxygen begin to deteriorate. If the oxygen supply is not restored, the patient suffers irreversible brain damage and biological death occurs.
Artificial ventilation accompanied by cardiac massage to facilitate normal breathing and heart action in the event of cardiac arrest.
To re-establish effective ventilation and circulation
EQUIPMENT
- Cardiac board
- Suction apparatus
- Oxygen supply
- Box containing Ambu bag
- Sterile endotracheal tube (2.5 – 5.5 mm)
- Extra-batteries
- Laryngoscope with 0, 1, 2 size tongue blades and stillet, Magill forceps, adhesive scissors, airway syringes 1, 2, 5, 10 cc
- Intracardiac needle 20 G, 22 G, 6-8 cm length
- Needles 23 G and 20 G
- Elastoplasts bandage
- Ventilation given with ambu-bag
GENERAL INSTRUCTIONS
- Identify “RED FLAG” signs of critically ill child-changes in level of consciousness, flaccid posturing, cyanosis severe chest retractions, grunting respiration, increased respiratory rate, shallow respiration, see saw respiration, i.e. abdominal protrusion with inhalation, irregular respirations with periodic deep sighs, apneas, absent pulse, absent heart rate, absent carotid pulse, dilated pupils, unrecordable blood pressure, cold clammy skin
- ACT quickly! As child can go into cerebral hypoxia within 3 to 4 minutes which will lead to permanent brain damage
- Assess child (look, listen, feel) and if not breathing call for help
- Immediately start cardiopulmonary resuscitation (CPR)
- Equipment for CPR to be always accessible and is functioning condition
- All CPR equipment to be checked at beginning of each shift
- All staff to be skillful at CPR
- Airway : establish patient airway by suctioning oropharynx with catheter, and deflate stomach by aspirating stomach contents
Ventilation by mouth to mouth:
- Breathing: establish breathing by artificial ventilation
Ambu bag on mouth and nose, and connect to 100% oxygen. Select ET tube using the formula:
Age in years + 4 /4
Calculate size of ET tube approximately as diameter of child’s little finger. The ET tube is inserted
- Circulation: initiate cardiac compression to a distance calculated using the formula (ET size multiply 3 cm)
Serial rhythmic compressions of chest that help circulate oxygen containing blood to vital organs
- Site: sternum compression – below level of infant’s nipples
- Width one finger breadth
- Depth 0.5 – 1 inch
- Rate 100 times per minute
- Site: lower margin of child’s rib cage to notch where ribs and sternum meet
- Avoid compression over notch
- Place heel of nurse’s hand over lower half of sternum (between nipple line and notch)
- Depth: 1-1.5 inches
- Rate: 100 times per minute
Ratio of Cardiac Compression to Ventilation (CPR)
- 2 persons – 5:1
- 1 person – 15:2
One Rescuer CPR
Shake shoulders and ask “are you okay”, shout for help. Open the airway: the most important action for successful resuscitation is immediate opening of the airway. Tilt the head by applying firm backward pressure on the victim’s forehead with palm of one hand. Place two or three fingers of the other hand under the bony part of the lower jaw near the chin and lift the chin
Check for breathing: please check close to victim’s mouth and nose. Look at chest to see if it rises and falls. Listen and feel for exhaled air (for at least 5 seconds)
External Cardiac Massage
Breathe : maintain an open airway. Pinch nose. Seal lips around victims mouth and deliver two full breathes watching chest to rise and fall with each breath
Check for circulation : feel for a carotid pulse. Again shout for help/activate EMS system. If pulse is present, continue to give artificial ventilation at the rate of 1 breath or 12 mm
Circulate : if pulse is absent, run fingers along the lower rib to notch in centre of the heart where ribs meet sternum. With middle finger in notch, place index finger on lower end of sternum. Place heel of other hand on lower ½ of sternum next to index finger. Put the heel of 1 st hand on top. With shoulders directly over sternum and elbows locked, compress straight up and down 15 minutes, at the rate of 80 – 100 times a minute, using the count “one and two and three and”, etc. return quickly to victims head to deliver two breaths. Compression depth should be 1.5 – 2 inches
Two-rescuer CPR : two medical professional arriving at same time – no
CPR in Progress
- First rescuer
Determine unresponsiveness
Opens the airway
Checks for breathing
Ventilates twice, watching chest movement
Checks for carotid pulse: give command to begin compressions if pulse is absent
- Second rescuer
Locates landmark and proper hand position on sternum
Begins chest compressions on command – at rate of 80-100 per minute, counting “one and two and three and four and five and”
Pauses after each fifth compression to allow for ventilation
Calls for a switch when fatigued. Give clear signal “change and two and three and four and five”
- Both rescuers change simultaneously
Compression moves to victim’s head. After checking for pulse, give breath and command to continue compressions
Ventilator moves to chest : finds landmark and properly positions hands, begins compressions on command pausing after each 5 th compression for breath
If CPR is in progress by lay person, rescue team enters after completion of cycle of 15 compressions and 2 ventilations and start with a reassessment
If CPR is in progress by a professional rescuer, the 2 nd professional rescuer takes over compressions at the end of a cycle and after 1 st rescuer reassesses pulse and gives another breath
DO’S AND DONOT’S IN CPR
- Reassure victim that help is on the way
- For major injuries call 9-1-1 immediately
- Check victim’s status regularly
- Use direct pressure to stop bleeding
- Check to see if victim’s airways are clear
- If no pulse or respiration, start CPR
- To prevent transmission of disease, use latex gloves
- Keep victims in shock warm (use blanket, etc)
- Assume spinal injury when blunt force trauma is present
- Raise head if bleeding in upper torso area
- Raise feet if bleeding in lower torso areas
- Flush all burns and chemical injuries with clean water
- Have MSDS sheets on the jobsite for 9-1-1 responders
- Call the Poison Control Center for chemical ingestion
- Do not move the victim unless absolutely necessary
- Always suspect “spinal injury” (and don’t move the victim)
- Do not set fractures and breaks (simply immobilize the victim)
- Do not apply a tourniquet (use “direct” pressure to stop bleeding)
- Do not remove items imbedded in the eye (cover with a Dixie cup)
- Do not use burn ointments
- Do not hesitate to call 9-1-1
COMPLICATIONS
Cardiopulmonary resuscitation, or CPR, is a technique used to support the circulation of blood and oxygen in the body of a victim who is not breathing and does not have a pulse. CPR is physically invasive for the victim and techniques used during CPR carry risks and the chance of complications. Ultimately, the risk of complications is small and should not deter the use of CPR for a victim in need
Broken bones
Rib fractures are the most common complication of CPR. Chest compressions administered during CPR are given quickly and with enough force to compress the chest about 1 inch in depth. This provides pressure to the ribs, which can be strong enough to cause ribs to fracture. Victims who are elderly, small in stature or children have the highest risk of developing rib fracture during chest compressions. Additionally, the chest bone, or sternum, also endures pressure and stress during chest compressions and can fracture as well
Internal Injuries
Internal organs lie within the area pressured by chest compressions. As the chest is compressed during CPR, ribs and chest bones can break, puncturing the lungs and liver. Additionally, internal bruising of the heart and liver can occur
Vomiting and Aspiration
As chest compressions are administered, pressure builds inside the body, which can force stomach contents up the esophagus and result in vomiting. This causes the risk of aspiration, or absorbing the vomit into the respiratory system. Aspiration is a serious complication which makes it difficult to provide the victim with adequate air and can ultimately damage lung tissue or result in infection, like pneumonia.
Body Fluid Exposure
CPR presents the risk of exposure to body fluids. It provides mouth-to-mouth rescue breathing to a victim without use of a mask results in saliva exposure between victim and rescuer. Blood and vomit may also be present during CPR, which carries the risk of communicable disease such as hepatitis and AIDS. The American Heart Association encourages the use of a barrier mask when administering rescue breathing during CPR for protection against contamination
Gastric Distention
Rescue breathing during CPR provides air directly into the lungs of the victim. If air is delivered too forcefully or for too long a time, the victim can accumulate air build-up in the stomach, called gastric distension. Gastric distension causes the stomach to swell and places pressure on the lungs. CPR efforts can become complicated if gastric distension occurs due to reduced ability to deliver adequate oxygen to the lungs, and can also result in vomiting and aspiration. Gastric distension can often be avoided by proper, careful administration of rescue breathing during CPR
ADMISSION PROCEDURE
CARE OF PATIENT UNIT
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- cardiopulmonary resuscitation
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z Make sure the scene is safe Check for breathing. 3. When you do Hands-Only CPR, how many chest compressions should you perform each minute? About 50. z 100 to 120 130 to 150 150 to 200. 4. How deep should you push on the chest of a teen or an adult when you do Hands-Only CPR? At least 1 inch.
mpressions-Airway-Breathing (CAB)Adults The new protocol for CPR. equires a change from ABC to CAB. The single trained rescuer is now advised to give 30 compressions at the rate of at least 100 per minute (as above) before giving two rescue breaths and th. n continuing at the rate of 30:2. The same rate of 30:2 is.
CARDIOPULMONARY RESUSCITATION (CPR) (Definition, Purpose, Equipment, General Instructions, Procedure, Method, Do's and don'ts in CPR and Complications. UPDATED 2024 Cardiopulmonary resuscitation is a lifesaving technique useful in many emergencies, including heart attack or near drowning, in which someone's breathing or heartbeat has stopped.
For an adult, compress the chest to a depth of at least 2 inches (5 cm). If you are using a feedback device, make sure the compressions are no more than 2.4 inches (6 cm) deep. Provide smooth compressions at a rate of 100 to 120 per minute. Allow the chest to fully recoil after each compression. Avoid leaning on the patient's chest at the top ...
LESSON ASSIGNMENT LESSON 1 Review of the Circulatory and Respiratory Systems. TEXT ASSIGNMENT Paragraphs 1-1 through 1-6. LESSON OBJECTIVES After completing this lesson, you should be able to: 1-1. Identify the general functions of the circulatory system. 1-2. Identify the components of the circulatory system and their functions. 1-3.
cpr assignment - Free download as Word Doc (.doc / .docx), PDF File (.pdf), Text File (.txt) or read online for free. CPR is a lifesaving technique used when someone's breathing or heartbeat has stopped. It keeps oxygenated blood flowing until more definitive treatment can restore a normal heart rhythm. When performing CPR, there are several important steps to follow: 1) Call for emergency ...
CPR, AED, and Basic First Aid Student Book, Version 8.0 Purpose of this Student Book This ASHI CPR, AED, and Basic First Aid Version 8.0 Student Book is solely intended to facilitate certification in an ASHI CPR, AED, and Basic First Aid training class. The information in this handbook is furnished for that purpose and is subject to change without
Step 5. form 30 chest compressionsFor an adult, compress the chest to a depth o. at least 2 inches (5 cm). If you are using a feedback device, make sure the compressions are no more t. n 2.4 inches (6 cm) deep.Provide smooth compressions at a rat. of 100 to 120 per minute.Allow the chest to fully rec.
4. If you haven't been trained in CPR, continue chest compressions until there are signs of movement or until emergency medical help arrives. If you have been trained in CPR, go on to next step, opening the airway and rescue breathing. Airway If you're trained in CPR and you've performed 30 chest compressions, open the child's airway.
Continue CPR •If no AED is available, OR whilst waiting for one to arrive, continue CPR •Do not interrupt resuscitation until: •A health professional tells you to stop OR •The victim is definitely waking up, moving, opening eyes, and breathing normally •OR •You become exhausted •It is rare for CPR alone to restart the heart. Unless
www.thecarenet.ca. hr. stopher Fran. Question and Answer1. What is CPR?Cardio-pulmonary Resuscitation (CPR) is the term often used to describe the treatment to try to restart a person'. heart after it has stopped beating. The heart may stop for many reasons, such as due to an unexpected event, such as an accident, or as a result.
New in 2020: Algorithms for healthcare providers and lay rescuers for treating overdoses are provided. Cardiac arrest in pregnancy requires individualized management of resuscitation. EMS should notify healthcare facilities in advance to ensure all resources are available for both infant and mother. perimortem cesarean delivery if necessary.
The child can speak and play The child can't speak but can cough The child can cough and laugh The child can't cough, speak, or breathe. 12. When you perform CPR with breaths on an adult, how many breaths do you give after every 30 compressions? 2 breaths. 4 breaths. 6 breaths. 8 breaths.
3. Give 30 chest compressions.Q Place the heel of one hand in the center of the child's che. t, with your other hand on top. Position your body so that your shoulde. s are directly over your hands. (Alternatively, in a small child, you can use a one-handed CPR technique: place the heel of one hand in the.
Perform within 5-10 seconds. Normal breathing with Definite Carotid Pulse. Reassess every 2 minutes. Assess the cause and Manage. Abnormal or No breathing with Definite Carotid pulse. Provide 1 breath every 5. econds using BMVReass. Abnormal or No breathing without. • Cycles of 30 Chest Compressions and 2 Breaths.
Cpr Assignment - Free download as PDF File (.pdf), Text File (.txt) or read online for free.
A CPR assignment consists of the following seven stages: Source Materials. During this first stage you will explore source materials, which can include Web sites, articles, text books, pictures, movies, animations, or references to your course materials. The source materials (which are always available during an assignment) will also provide ...
Immediately begin cardiopulmonary resuscitation (CPR) with chest compressions (30 compressions at 100 per 1 minute) followed by 2 blowing air into the injured ́s airways. The ratio of compressions to breath does not change - 30:2, connects a defibrillator.
hospital-based CPR cases reported in the medical literature demonstrated an overall initial success rate of 39 percent, however only 17 percent of CPR patients survived to hospital discharge. This was one of the first large studies to make a strong distinction between initial restoration of heartbeat by CPR and survival to leave the hospital. 3.
FIRST AID/CPR/AED INSTRUCTOR COURSE PRACTICE-TEACHING ASSIGNMENTS 1. Identify your assignments using the number you have been assigned. 2. You will teach one topic from each of the three tables below (Assignment I, II, III). 3. Use the Instructor Candidate's Practice-Teaching Workbook (Appendix C) to help you prepare for, conduct and
Opens the airway. Provides bag-mask ventilation. Inserts airway adjuncts as appropriate†. The team owns the code. No team member leaves the triangle except to rotate compressors or to protect his or her safety. TIMER/. RECORDER.