The ABCs: Techniques of Adult CPR

ABCs of CPR
(Cardio Pulmonary Resuscitation)

MS. AGATHA L. GARCIA, R.N.

November 29, 2008

Objectives:
At the end of the discussion, the participants are expected to:
Discuss the basic principles and mechanics of basic life support in cardio-pulmonary arrest. Demonstrate the techniques in performing cardio-pulmonary resuscitation in a given situation.

Requirements

Why the Need for CPR Training?

Cardiovascular diseases are now the leading causes of death in the country. Most people die of a heart attack before they even reach the hospital. There are other situations aside from heart attack that can lead to cardio-respiratory arrest and therefore needs CPR Since these events can occur anytime and anywhere, it is the person nearest the victim who may witness this arrest This person must be able to recognize this emergency and must be able to institute CPR immediately.

This person could be..

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YOU!!!

Chain of Survival Early Call for Help Early CPR Early defibrillation Early medical care

Action in an Emergency
Is anyone in danger? Move to the quietest victim first Open the airway

If not breathing

Check for breathing

If breathing

Look for signs of circulation

Continue Rescue Breathing

START CPR!!!

CPR
Provides temporary O2 to blood and brain by external breathing and external chest compression to the body. Victims chance of survival drops 7-10% per minute without CPR from start of cardiac arrest. When effective, CPR can provide up to 30% of the normal heart output. Delays cerebral (brain) death while waiting for other treatments described in the Chain of Survival.

Survey the Scene

Survey for safety of the victim and the rescuer Look up, down, right, and left

Check for Responsiveness

Tap or gently shake the victim Are you OK?

Call for Help!!!

Details of what happened Number of people injured Type of illness or injuries Whether or not person is breathing The exact address with landmarks if possible A contact phone number

Airway: Head Tilt Chin Lift Place one hand on victims forehead Place fingers of the other hand under the bony part of the lower jaw near chin Tilt head and lift jaw avoid closing victims mouth

Jaw Thrust: Head or Neck Injury

Check for Breathlessness

Maintain open airway Place you ear over victims mouth and nose

L Look for chest rise L Listen for air movement in your ear F Feel for breathing on your cheek for
5 to 10 seconds

Breathing: 2 Rescue Breaths Maintain open airway Pinch nose Open your mouth, make a tight seal around outside of victims mouth Give 2 slow breaths (1 breath in every second) LLF Allow for exhalation between breaths

Check for Pulse

Maintain head tilt with one hand on forehead. Locate Adams Apple with middle and index finger. Slide finger down into the groove of neck on side closest to you. Feel carotid pulse for 5-10 seconds, but not more than 10 seconds

Circulation
Locate compression area. Kneel facing the victims chest. With middle and index fingers of hand nearest victims legs, locate lower edge of victims rib cage on side closest to you Follow rib cage to notch at lower end of beast bone Position shoulders over hands with elbows locked and arms straight Give 30 compression: compress breast bone 1 - 2 in. Compress down and release pressure smoothly, keeping hand contact with chest at all times

Adult One-Rescuer CPR

Continue cycles of 30 compressions followed by 2 slow breaths After 5 cycles of 30:2 (about 2 minutes), check pulse If still with no pulse, continue 30:2 beginning with chest compression Recheck pulse every two minutes

Adult Two-Rescuer CPR

Rescuer 1 - open airway (head tilt, chin lift) - check breathing (LLF) - 2 slow breaths - check carotid pulse Rescuer 2 - If no pulse, give cycles of 30 chest compressions followed by 2 slow breaths by Rescuer 1 - After 1 minute, check pulse. - If no pulse, continue 30:2 cycle (Rescuer 2 giving 30 compressions, followed by Rescuer 1 giving 2 slow breaths

Recovery Position

All victims of cardiac arrest should receive CPR unless:

1. Patient has a valid DNAR order. (Do Not Attempt Resuscitation) 2. Patient has signs of irreversible death. (Rigor mortis, Decapitation, Dependent Lividity) 3. No physiological benefit can be expected because the vital functions have deteriorated as in septic or cardiogenic shock. 4. Confirmed gestation of <23 weeks or birth weight <400 grams, anencephaly, and confirmed trisomy 13 or 18.

When to Stop CPR?

1. Effective and spontaneous (normal) breathing and circulation has been restored. 2. Responsibility is assumed by a more senior emergency medical professional who may determine unresponsiveness to resuscitation efforts such as a paramedic arriving on the scene or a physician in the E.R. 3. Recognition of reliable criteria indicating irreversible death. 4. Rescuer is unable to continue resuscitation due to exhaustion, the scene is no longer safe, or when continued resuscitation may place other lives at risk. 5. Presentation of a valid DNAR order to the rescuer.

CPR: All Together Now

Establish scene safety. Determine unresponsiveness. Go get HELP! A Airway Open It! Head Tilt / Chin Lift B Breathing Check for breathing, look, listen, feel for chest rise with your hand, IF NOT BREATHING, give two breaths. 6. C Circulation Is the patient moving? Is he/she motionless and not breathing? And what is the skin color? 7. If not moving and no signs of circulation, perform 30 compressions on the chest, then give 2 breaths (30:2) 8. Do this for 4 cycles and then recheck for signs of circulation. 1. 2. 3. 4. 5.