Professional Documents
Culture Documents
DEFINITIONS
Casualty - is the person with the medical problem, such as a person who is not breathing.
When being treated by medical personnel, the casualty may be referred to as a patient.
Rescuer - is the person who is assisting the casualty; for example, the person giving mouth-to-
mouth resuscitation to a casualty who is not breathing.
Airway - consists of the body structures through which air from the atmosphere passes while
going to the lungs.
CARDIOPULMONARY RESUSCITATION
Improper hand position during cardiac compressions can cause rib fracture
Failure to adequately ventilate the client due to improper head position can lead to
hypoxia and gastric distention.
Poor oxygen profusion to vital organs may result in brain and tissue damage.
The body attempts to maintain homeostasis by shunting circulation to vital organs,
resulting in less perfusion to the periphery, which can result in distal tissue damage.
Critical Aspects
Establish whether the patient is unresponsive. (Shake the patient and shout, Are you
OK?)
Activate the emergency response system immediately if the patient is an adult. If you are
alone and the patient is an infant or child, perform CPR for 1 minute, and then activate the
emergency response system.
Critical Aspects
A Airway. Open the patients airway. Use either the head tilt chin lift maneuver or
the jaw thrust maneuver.
B Breathing. Check for breathing. (Place your ear over the patients mouth and nose.
Look, listen, and feel for breathing for no longer than 10 seconds.) If the patient is
breathing, continue to hold the airway open. If the patient is not breathing, administer two
(2) slow breaths.
C Circulation. Check for signs of circulation. Use the carotid pulse in adults and
children, and the brachial or femoral pulse in infants. Assess for pulse for 5 to 10 seconds.
Also check for other signs of circulation, such as movement.
Critical Aspects
EQUIPMENT:
Resuscitation bag with mask, mouth shield, or face mask with one way valve.
Oxygen source, if available
Chest compression board or hard surface
PERFORMING CARDIOPULMONARY RESUSCITATION
ONE AND TWO PERSON
ASSESSMENT:
ASSESSMENT:
Assess the patients cardiac and respiratory status after cardiac rhythm and respirations
are restored.
The patients condition is typically unstable after an arrest; therefore, careful, frequent
assessment of the cardiac and respiratory systems is necessary to quickly detect
deterioration in patients status.
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PROCEDURE:
1. Establish whether the patient is unresponsive by shaking him and shouting Are you OK?
2. Activate the emergency response system immediately if the patient is an adult. If you are
alone and the patient is an infant or child, perform CPR for 1 minute, and then activate the
emergency response system.
R: Activating the emergency response system immediately ensures that advanced life
support equipment such as a defibrillator, airway management equipment, and IV
medication are on the way for use.
PROCEDURE:
3. Carefully place the patient on a hard surface. Logroll the patient if you suspect a cervical
spine injury. If the patient is in a hospital bed, place a CPR board under the patients back.
PROCEDURE:
Position yourself on the floor, with your knees parallel to the patients sternum.
R: This position requires the least amount of body movement when you switch from
compressions to ventilation.
Position yourself on the floor, with your knees parallel to the patients sternum. The
second person should position himself on the opposite side of the patient, with his knees
parallel to the patients sternum. If the patient is in a hospital bed, stand with your body
parallel to the patients sternum.
R: Positioning one person on each side of the patient allows one person to deliver chest
compressions while the other person ventilates the patient.
Place one hand on the patients forehead, and apply firm pressure, tilting the patients
head back.
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R: This maneuver pulls the base of the tongue away from the back of the throat
maintaining an open airway.
HEAD-TILT-CHIN-LIFT MANUEVER
Kneel at the patients head, with your elbows on the floor. Place your thumbs on his
lower jaw near the corners of the mouth.
R: Placing thumbs on the lower jaw near the corners of the mouth prepares you to lift the
lower jaw to pull the open the airway.
Place your fingers around the lower jaw, and lift the lower jaw with your fingertips.
R: This maneuver pulls the base of the tongue away from the back of the throat,
maintaining an open airway while protecting the cervical spine.
6. While keeping the airway open, check for breathing by placing your ear over the patients
mouth and nose. Look, listen, and feel for breathing for no longer than 10 seconds.
R: Assesses the patients ability to move air into and out of the lungs. Cardiac arrest can
occur independently of respiratory arrest, at least initially.
7. If the patient is breathing or resumes effective breathing, continue to hold the airway open.
Alternatively, if the patient is not breathing, administer two (2) slow breaths.
R: You should initiate two slow breaths immediately if the patient isnt breathing to
provide the patient with much needed oxygen.
a. Pinch the patients nose with your thumb and fingers. Place your mouth, the mouth
shield, or the face mask over the patients mouth.
R: Prevents air from escaping through the nares when you deliver a breath.
R: allowing 1 second per breath allows the adults lungs to expand appropriately and
ensures adequate oxygen delivery.
a. Pinch the childs nose with your thumb and fingers. Place your mouth, mouth shield, or
the face mask over the childs mouth.
R: Prevents air from escaping through the nares when you deliver a breath.
b. Delivering two breaths over 1 second per breath allows the childs lungs to expand
appropriately and ensures adequate oxygen delivery.
a. Place your mouth over the infants mouth and nose, forming a seal.
R: A seal keeps air from escaping through the nares when you deliver a breath.
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R: delivering two breaths over 1 second per breath allows the infants lungs to expand
appropriately and ensures adequate oxygen delivery.
8. Check for signs of circulation, using the carotid pulse in adults and children and the brachial
or femoral pulse in infants. Assess for a pulse for 5 to 10 seconds. Also check for other signs of
circulation, such as movement.
R: lets you know whether chest compressions are indicated. Chest compressions are
indicated when the pulse is absent in the adult or is less than 60 beats per minute in the
infant. Check the pulse for 5 to 10 seconds, because the pulse may be present but difficult
to detect if it is slow, irregular, weak, or rapid.
9. If signs of circulation are absent, correctly position your hands, and begin chest
compressions. If a second person is present, the second person should assess the pulse while the
first person performs compressions.
R: Correct hand placement prevents patient injury. Allowing the second person to check
for pulse helps assesses the effectiveness of CPR.
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Adult:
1. Place the heel of one hand over the lower half of the sternum, and place your other
hand on top of the first hand, locking them in position.
Child:
1. Place the heel of one hand over the lower half of the sternum.
2. Compress 1/3 to the depth of the chest at a rate of 100 compressions per minute.
R: The chest must be adequately compressed to ensure adequate circulation and to
prevent injury.
Infant:
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2. Compress 1/3 to the depth of the chest at a rate of at least 100 compressions per
minute, 120 compressions per minute in the newborn.
Variation: Adult
The second rescuer should administer the ventilations, making sure to deliver the breath
as the rescuer administering compressions pauses between compressions.
Note: The ratio for compressions to ventilations is 15:2 for two persons and 30: 2 for one
person CPR in adult. The person performing chest compressions must pause momentarily
to allow the second person to deliver ventilations.
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Administer two breaths for every 30 compressions with a single rescuer and 2 breaths per
15 compressions with two rescuers.
R: This technique delivers about 20 breaths per minute and 100 compressions per minute.
PERFORMING CARDIOPULMONARY RESUSCITATION
ONE AND TWO PERSON
11. Continue CPR for four cycles, and then reassess pulse.
12. Stop CPR if the patient responds, regains an adequate pulse, and begins to breath; if you are
too exhausted to continue; or if signs of death are obvious.
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EVALUATION
After the airway is opened, monitor for the return of spontaneous respirations.
Evaluate the effectiveness of ventilations and chest compressions.
PATIENT TEACHING
Instruct the family and caregivers where they can receive CPR training and certification
if the patient is at risk for experiencing cardiopulmonary arrest.
Explain the importance of keeping emergency phone numbers readily available in the
event of an emergency.
HOME CARE
Activate the emergency response team by dialing 911 in the community setting or by
dialing an other designated emergency number if the 911 service is not available.
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