SIMPLIFIED CPR

DOES ANYONE HAVE PREVIOUS

RESCUE BREATHING TRAINING?

DO YOU STILL REMEMBER THE CYCLE?

Chest Compression Only
CPR
Save your Breath…
Save a Life
What is
Chest Compression Only CPR?
• A new method of resuscitation developed
through extensive research at The University
of Arizona Sarver Heart Center for primary
cardiac arrest
• Continuous forceful chest compressions to
circulate the person’s blood to their brain and
heart
• Rescue breathing isn’t necessary.
 Why isn’t
Rescue Breathing Necessary?

During Primary Cardiac Arrest:

• Lungs are full of air
• Blood is full of oxygen
• Circulating the oxygenated blood is the
key
Why Might “Rescue Breathing” be Harmful?
• Any interruption of chest
compressions stops blood flow to the
brain

• Increased pressure in the chest

decreases blood return to the heart
Chest Compressions Only

Blood Flowing
To The Brain

Compressions + Breaths (30:2)

Pausing for
breaths means
No Blood Flow

Blood Flowing
To The Brain

Ewy GA, et al. Circulation.

2007;116(22):2525-30.
Why
Chest Compression Only CPR?
• It saves more lives
• Dramatically better than doing
nothing.
• Because of interruption of chest
compressions, also does better than
traditional CPR.

Bobrow, et al. JAMA October 2010

What Stops People from Doing CPR?
Fear / Concern Solution
Mouth-to-Mouth Chest Compressions Only

Harming the Person Better than dead

Legal Consequences Good Samaritan Law

Won’t Perform Properly Easier to Do

Physically Unable Do Your Best / Call For Help

Coons SJ, et al. Resuscitation 80;334-340:2009 This study was designed and funded by the Sarver Heart Center
The University of Arizona College of Medicine and SHARE
Causes of Death (U.S.)
Heart
Sudden Cardiac
Disease Arrest
All other 26%
causes • Heart disease kills more
19% people each year than cancer
Cancer
− 1 in every 2.9 of all deaths
23%
• Every year 230,000 - 325,000
people have a cardiac arrest
Stroke
6%
outside of a hospital.
− Only 7.6% will survive

Lloyd-Jones D, et al. American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke
statistics--2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee.
Circulation. 2009 Jan 27;119(3):e21-181.
 Cardiac Arrest:
Fact vs. Fiction

Stereotype Reality
Gender Male Male and Female
Age Old Any Age
Overweight
Risk No Known
Smoker
Factors High cholesterol Risk Factors

Medical Heart Attack Often No

History Cardiac History

Presenting Chest Pain Often No

Symptoms Dizziness Symptoms
Heart Attack vs Cardiac Arrest
Heart Attack: Cardiac Arrest:
• Blockage in coronary artery • Heart stops

• Person usually conscious • Person is unconscious

• Upper body discomfort • Often no previous symptoms

or pain
• Person may be gasping or not
be breathing at all

OFTEN A CARDIAC ARREST OCCURS DUE

TO A HEART ATTACK. CALL 911
SIGNS OF STROKE (blood supply to brain
is interrupted or there’s bleeding in the brain)
• FAST for Stroke (things to remember/check)
• Face –Does one side droop? Numb? Smile?
• Arms – Raise arms? Is one weak or numb?
• Speech – Slurred? Indistinct? Garbled? Repeat a simple
sentence?
• Time – Have symptoms (ie any of Above)? Call 911! Get to
hospital immediately!
• It only takes minutes for brain cells to start dying.
Primary vs Secondary Cardiac Arrest
Primary CA Secondary CA

• Heart stops pumping

• Heart stops pumping
due to lack of oxygen
• Blood in arteries full of oxygen
• Drowning, Drug
• Often unexpected witnessed Overdose or Choking
collapse
 When to use
Chest Compression Only CPR?
Chest Compression Traditional
Only CPR CPR (30:2)
• Someone who unexpectedly • Obvious Breathing Problems:
collapses, and is • Drowning
unresponsive. • Choking
• Drug overdoses

• Vast Majority •Children less than 8

WHEN IN DOUBT, DO
COMPRESSIONS!!
 Out-of-Hospital Cardiac Arrest

• Approximately 70-80% of all adult cardiac arrest

are a primary cardiac arrest.

Chest Compression
Only CPR

Ann Emerg Med. 1997 Jul;30(1):69-75.

Bystander CCO CPR Improves Chance of
Survival from Cardiac Arrest
100%
CCO CPR
80%
Survival (%)

60%
Traditional
40% CPR

20% No CPR
EMS Arrival
0%
0 1 2 3 4 5 6 7 8 9
Time between collapse and defibrillation (min)
Nagao, K Current Opinions in Critical Care 2009
EMS Arrival Time based on TFD 90% Code 3 Response in FY2008. Standards of Response Coverage 2008.
 What to do: 3 Cs–
Are You Alright? Check Shake & Shout (DON’T waste
time looking for pulse/airway)

Call (911, 9111), 0998 593 7446

Send Someone for an A.E.D.

Compress Chest 2” at
100 Per Minute (Staying Alive)

Use an A.E.D. When it Arrives

How to Do Chest Compression Only CPR
With the victim on the floor:
1. Kneel beside them
2. Place the heel of one hand on top of the other
3. Lock your elbows
4. Aim for the middle of the chest (on the sternum between the nipples)
5. Push hard and fast (try for 100/min.)
6. Take turns with another person when tired.
 Chest Compressions:
Rate and Depth

At least At least
100 2 inches
Compressions per Minute in depth
• Allows the heart to refill
• Staying Alive • After each compression,
take all weight off the chest
• I Gotta Feeling
• by Black Eyed Peas
 Are They Breathing?
• Gasping is a sign of cardiac arrest
• Catching breath, short/shallow intake, struggling effort,
naghahabol ng paghinga, hingal
• Majority of people with cardiac arrest gasp
• Can be a sign of minimal, but adequate blood flow to the brain.
• DO NOT stop chest compressions if they gasp (its actually a
sign that you are doing a good job)
• Your hands become their heart and each chest compression
becomes their heartbeat
 What to do: 3 Cs–
Are You Alright? Check Shake & Shout (DON’T waste
time looking for pulse/airway)

Call (911, 9111), 0998 593 7446

Send Someone for an A.E.D.

Compress Chest 2” at
100 Per Minute (Staying Alive)

Use an A.E.D. When it Arrives

 AEDs Auto External
Defibrillators
They may look different, but they all function the Same!

Open and Follow Instructions

• Turn AED ON
• Apply Pads to Bare Chest
• Plug in Pads (if necessary)
• Analyze Patient (CLEAR!)
• Push Shock to defibrillate,
if directed (CLEAR!)
• Immediately resume CPR
How to Do Chest Compression Only CPR
With the victim on the floor:
1. Kneel beside them
2. Place one hand on top of the other
3. Lock your elbows
4. Aim for the middle of the chest (on the sternum between the nipples)
5. Push hard and fast (try 2” for 100/min. “Staying Alive” “I Gotta Feeling”)
6. Take turns with another person when tired.
WHEN TO STOP CPR

• WHEN MEDIC ARRIVES

• WHEN TOO TIRED TO CONTINUE, GENERALY 20-30
MINUTES ALONE & PHYSICAL FATIGUE SETS IN
• OBVIOUS SIGN OF LIFE ( DELIBERATE MOVEMENT,
SPEAKING, HEAD/EYE MOVES LOOKING AROUND)
• OBVIOUS DEATH (MALAMIG NA BANGKAY, EXCESSIVE
BLEEDING BECAUSE THERE’S NO BLOOD TO CIRCULATE)
 Thank You
Save your Breath…
Save a Life

EDWIN J. PIANO