Saint Louis School Inc.

HS Emergency Medical Services

Department
DRRRM
Emergency Medical Services
Mrs. Ignacio + EMS Speakers
Basic Life Support: First Aid Training
CPR
- Cardiac Arrest
- Cardiac arrest is the abrupt loss of heart
function in a person
- In cardiac arrest death results when the
heart suddenly stops working properly
- CPR is as ease as
- CAB
- Compressions – push hard and
fast on the center of the
victim’s chest
- Airway – tilt the victim’s head
back and lift the chin to open
the airway
- Breathing – give mouth to
mouth rescue-breaths
- Ratio: 30 compressions / 2 breaths
- Rate: 100 – 120 compressions per minute
- Depth: 2 – 2.4 inches or 5cms – 6cms
- Cycles: 1 cycle = 30 compressions and 2 breaths
- Avoid leaning on the chest between
compressions to allow full chest wall recoil
- Its main purpose is to restore partial flow of
oxygenated blood to the brain and heart
- Minimize interruption of Chest Compression –
less than 10 seconds to deliver 2 breaths or
exchange in compressor
- Deliver breaths during pauses in compressions
and delivers each breath over approximately 1
second
- Five cycle should take no more than 2 minutes
(exchange in compressor after 5 cycles)
Cardio Pulmonary Resuscitation (CPR)
When NOT to START CPR
4. Confirmed gestation of < 23 weeks or birth
weight < 400 grams, anencephaly
5. Attempts to perform CPR would place the
rescuer at risk of physical injury
6. When to STOP CPR
7. All rescuers who have started resuscitation
procedures should continue to do so unless
8. S – SPONTANEOUS signs of circulation are
restored
9. T – TURNED over to medical services or properly
trained and authorized personnel
10. O – OPERATOR is already exhausted and cannot
continue CPR
11. S – SCENE becomes unsafe (such as traffic,
impending or ongoing violence – gun fires, etc.)
12. S – SIGNED waiver to stop CPR
Pediatric CPR
Infant CPR
- 1 finger below the nipple line, center of the
chest
- Middle and ring finger, flexing at the wrist
- 2 – thumbs hand encircling technique
- Puff only for artificial ventilation(observe for
visible chest rise)
Child CPR
- Lower half of the sternum, between the nipples
- One hand only or Two hand for large children
- 30:2 for single rescuer, 15:2 for 2 man rescuer
- To maximize simplicity in CPR training, it is
reasonable to use the adult chest compression
rate of 100/min to 120/min for infants and
children
- High priority of obtaining an AED quickly in a
sudden, witness collapse, because such an
event is likely to have a cardiac/heart etiology.

All victims of cardiac arrest should receive CPR unless:

1. Patient has a valid DNAR ( Do Not Attempt

Resuscitation) order
2. Patient has signs of irreversible death (Rigor
Mortis, Decapitation, Dependent Lividity) Hands Only CPR
3. No Physiological benefit can be expected
- “Just in Time CPR”
because the vital functions have deteriorated as
in septic or cardiogenic shock
 Saint Louis School Inc. HS Emergency Medical Services
Department
- Untrained DRRRM
lay rescuers should provide
compression-only CPR, with or without 1. Basic Life Support (BLS)
dispatcher assistance - BLS is the foundation for saving lives
- The rescuer should continue compression-only following cardiac arrest
COR until the arrival of an AED or rescuers with - Fundamental aspects of adult BLS include
additional training immediate recognition of sudden cardiac
arrest and activation of the emergency
Compression – Airway – Breathing response system (ERS), early performance
C – Chest COMPRESSION of high quality CPR, and rapid
defibrillation when appropriate.
- Place the victim on a hard flat surface in supine
position Adult BLS
- Interlock fingers 1. Ensure scene safety
- Position your hand a. Quick scan of the patient’s location and
- Center of the chest surrounding make sure there are no
- Lower half of the sternum imminent physical threats such as toxic or
A – Open AIRWAY electrical hazards
b. Introduce yourself
- This must be done to ensure an open passage 1. Check for response
for spontaneous breathing OR mouth to mouth 2. Shot for nearby help and activate the emergency
during CPR response system
- Head-tilt/ Chin-lift - If someone responds, ensure that the
- Tilt the head back with your hand and lift up the phone is at the side of the victim if at all
chin possible
4. Check for no breathing or only gasping; if none,
B – Give BREATHS
begin CPR with compressions
- Deliver TWO quick breaths/blows that make the - Provide CPR if the victim is unresponsive
chest rise with no normal breathing, even when the
- Allow the chest to fall completely between victim demonstrates occasional gasps
breaths - C – Perform 30 Compressions on the
- Turn your head towards the patient’s chest as chest
you inhale for the 2nd breath - A – Airway – Open it! Head- tilt / chin-lift
- B – Give Two Breaths
Pediatric Chain of Survival
- Do this until AED/ Defibrillator arrives,
1. Safety of Rescuer and Victim ALS provider takes over or victims starts
2. Early CPR to move
3. Activate Emergency Response System - Place victim on recovery position if victim
4. Advance Life Support starts to move
5. Post-Cardiac Arrest Care
Don’ts in Chest Compression
Adult Chain of Survival
1. Jerker
1. Immediate Recognition and Activation of ERS 2. Massager
2. Immediate High-Quality CPR 3. Bender
3. Rapid defibrillation 4. Rocker
4. Basic and Advance Emergency Service 5. Bounce
5. Advanced life support and Post Arrest Care 6. Double crosser
7. Star Gazer
Three Kinds of Life Support
 Saint Louis School Inc. HS Emergency Medical Services
Department
Ways DRRRM
to - Chest discomfort
Ventilate the Lungs - Sweating
- Mouth to Mouth - Nausea
- Mouth to Mouth and Nose - Shortness of breath
- Mouth to Nose - Sudden fainting
- Mouth to Stoma - Pain radiating to the lower jaw, arms,
- Mouth to Face Shield epigastric area, or back
- Bag Valve Mask - Feeling of impending doom
- Mouth to Mask - Risk Factors:
1. Non-modifiable (cannot be changed)
The 5 Components of High-quality CPR a. Hereditary
b. Age
1. Ensuring chest compressions of adequate rise
c. Gender
2. Ensuring chest compressions of adequate depth
2. Modifiable (can be changed)
3. Allowing full chest recoil between compressions
a. Cigarette smoking
4. Minimizing interruptions in chest compressions
b. Elevated Cholesterol
5. Avoiding excessive ventilation
c. Lack of Exercise
- The rescuer breaths during pauses in
d. Hypertension
compression and delivers each breath over
e. Obesity
approximately 1 second
f. Stress
Activate Medical Assistance g. Diabetes mellitus

- Both trained and untrained bystanders should Recovery Position

be instructed to Activate Medical Assistance as
soon as they have determined that an adult
victim requires emergency care “Call First”
- While for infants and children “ Care First”
approach is recommended
- Information to be remembered in Activating
Medical Assistance
C – Case of the Patient
- Mechanism of injury
- Nature of illness
H – Help Needed
Stroke
A – Address (Include landmark)
N – Name of caller - A stroke occurs when the blood supply to your
T – Telephone Number of the Caller brain is interrupted or reduced. This deprives
your brain of oxygen and nutrients, which can
Heart Attack
cause your brain cells to die. A stroke may be
- It occurs when the oxygen supply to the heart caused by a blocker artery (Ischemic Stroke) or
muscle (myocardium) is cut-off for a prolonged the leaking or bursting of a blood vessel
period of time. This cut-off results from a (hemorrhagic stroke)
reduced blood supply due to sever narrowing or - Signs and Symptoms:
complete blockage of the disease artery. The - Sudden numbness or weakness of the
result is death (infarction) of the affected part face, arm, or leg
of the heart. - Sudden confusion, trouble speaking or
- Signs and Symptoms: understanding
 Saint Louis School Inc. HS Emergency Medical Services
Department
DRRRM
- Sudden trouble walking, dizziness, loss
of balance or coordination
- Sudden sever headache with no known
cause

Golden Rules in Giving Emergency Care:

- DO:
- DO Obtain consent when possible
- DO Think of the worst
- DO Remember to identify yourself
- DO Provide comfort and emotional
support
- DO Respect the victim (modesty and
privacy)
- DO Be calm and direct as possible
- DO Care for the most serious injuries first
- DO Assist the victim on medication
- DO Keep onlookers away from the injured
person
- DO Handle the victim to a minimum

Golden Time

- Time is critical
- 0 – 1 minute cardiac irritability
- 0 – 4 minutes brain damage not likely
- 4 – 6 minutes brain damage possible
- 6 – 10 minutes brain damage very likely
- More than 10 minutes irreversible brain
damage