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    Adult CPR

    Uploaded by

    Noor A. Zaki
    Cardiopulmonary resuscitation (CPR) is performed when someone's heart stops beating. The key steps of CPR are: 1. Call for emergency

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Adult CPR

    Uploaded by

    Noor A. Zaki
    8 views55 pages
    Cardiopulmonary resuscitation (CPR) is performed when someone's heart stops beating. The key steps of CPR are: 1. Call for emergency

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    © © All Rights Reserved

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    PDF, TXT or read online from Scribd

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    Cardiopulmonary resuscitation (CPR) is performed when someone's heart stops beating. The key steps of CPR are: 1. Call for emergency

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    8 views55 pages

    Adult CPR

    Uploaded by

    Noor A. Zaki
    Cardiopulmonary resuscitation (CPR) is performed when someone's heart stops beating. The key steps of CPR are: 1. Call for emergency

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 55

    Cardiopulmonary

    Resuscitation (CPR)

    Prof. Nagwa Elkobbia


    Prof. of Anesthesia & Surgical Intensive
    Care
    Faculty of Medicine, Alexandria University
    Cardiac arrest:

    Is a sudden unexpected cessation of


    circulation and respiration. This means
    inability of the heart to maintain
    cerebral perfusion and keep the brain
    alive.
    Brain

    ◼ Hypoxia > 3- 4
    min ➔ damage
    Causes of Cardiac Arrest (CA)
    ◼ Hypoxia
    ◼ Hypercapnia
    ◼ Marked shifts in electrolyte
    ◼ Marked shifts in acid base balance
    ◼ Electric shock
    ◼ Sudden massive hemorrhage
    ◼ Drowning
    ◼ Massive pulmonary embolism
    Types of CA

    ◼ Ventricular Fibrillation (VF)or


    ventricular tachycardia
    ◼ Asystole
    ◼ Pulseless electrical activity
    I. Ventricular Fibrillation (VF)
    ◼ Most common, adult, Best outcome
    ◼ ECG: rapid, wavy, totally irregular
    ◼ No QRS complexes
    ◼ Heart: small in size, fibrillating
    irregularly.
    II. Asystole
    ◼ECG: no electrical activity, straight line
    Heart:big motionless
    More in children, poor outcome
    Pulseless electrical activity
    No palpable pulse and ECG rhythm is present
    More in children
    Poor outcome
    The most common condition is
    electromechanical dissociation EMD
    Forms Of CA
    Cardiac
    Arrest

    Shockable Unshockable

    Ventricular Asystole
    Fibrillation Pulsless
    Electrical
    Tachycaria
    Activities
    Signs

    ◼ No pulse in carotid or femoral artery


    ◼ Unconsciousness
    ◼ Respiratory arrest (apnea)
    ◼ ECG (VF,EMD,asystole)
    Adult cardiopulmonary
    resuscitation (CPR)

    ◼ The aim of CPR is to provide oxygen to vital


    organs especially heart and brain until normal
    circulation is restored.
    ◼ The brain has a very limited capacity for
    anaerobic metabolism, therefore, cannot
    stand hypoxia more than 3-4 min, after which
    brain damage will occur
    I- Basic Life Support (BLS)
    ❑ No need for any equipment to maintain
    a) Airway
    b) Breathing
    c) Circulation
    ❑ Provide 0xygen to the vital organs

    ❑ Until normal circulation is restored.


    2. Advanced cardiac life support (ACLS) :use of all
    technical skills and resources
    BLS+ intubation
    Defibrillations (D)
    IV access
    Drug therapy
    Management of arrhythmias

    3. Prolonged life support (PLS)


    Intensive care and brain protection
    Chain of survival
    Adult Chain Of Survival
    1. Immediate recognition of cardiac arrest
    and activation of emergency response
    system
    2. Early CPR with an emphasis on chest
    compressions
    3. Rapid defibrillation
    4. Effective advanced life support
    5. Integrated post–cardiac arrest care
    Ensure Personal Safety
    Assess Victim (Tap and Shout)
    Assess Breathing
    Call 123

    Circulation: Begin Chest Compressions


    Airway: Open the Victims Airway
    Breathing: Provide Rescue Breaths
    Check
    Response

    Yes No
    Changing The Sequence To C-
    A-B
    ◼ Chest compressions will be initiated
    sooner
    ◼ Ventilation only minimally delayed until
    completion of the first cycle of chest
    compressions
    ◼ 30 compressions ➔ approximately 18
    seconds
    Why did CPR change from A-
    B-C to C-A-B?

    ◼ Just like you can hold your breath for a


    minute or two without having brain
    damage
    ◼ What cardiac arrest victims really need
    is for that blood to get flowing again.
    Does Not Respond

    ◼ Shout for help

    ◼ Turn the patient


    onto his back.
    Check Circulation
    principle of CPR is that
    we want blood and oxygen
    circulating throughout the body
    at all times.
    The primary intervention to be
    performed for circulation is
    Chest Compressions.
    Chest Compressions circulate blood
    and oxygen.
    -
    -When performing CPR with rescue
    breathing give 30 compressions
    followed by 2 breaths (30:2
    Compressions to Breaths Ratio).
    -Transition from compressions to breaths
    as quickly as possible.
    -Your goal should be
    ➢ to begin chest compressions within 10
    seconds of discovery of the victim
    ➢ not interrupt compressions for more
    than 10 seconds for any reason unless
    absolutely necessary.
    ◼ Make sure the victim is laying flat on his
    back, on a HARD FIRM FLAT SURFACE.

    ◼ quickly remove any clothing covering the


    chest. This allows us to find the correct
    location to perform compressions
    (C) Chest Compression

     Kneel by the side of


    victim
     Hand in the middle of
    the lower half of
    sternum
    ◼ Locate the center of the
    chest, between the
    breasts and place the
    palm of one hand on top
    of the lower half of the
    sternum.
    ◼ Place the second hand
    on top of the first hand.
    You may overlay or
    interlock your fingers.
    ◼ Position yourself over the
    victim and use your entire
    body to push up and down
    on the persons chest.
    ◼ If you use your arms and

    not your body - your arms


    will become fatigued
    quickly
    ◼ Compress the chest at the rate of at least
    100 compressions per minute.
    ◼ Remember to pace yourself so not to get
    fatigued.
    ◼ After each compression, allow the chest to
    return to its normal position before
    compressing again.
    ◼ This chest recoil allows the heart to refill
    with blood and provide the most effective
    CPR possible.
    Compress Sternum

    • Depth 5-6 cm (2-2½


    inches)
    • Rate 100/min.
    • Compression /
    Relaxation 1:1
    Push A Little Faster.

    ◼ Push at least 100 compressions per


    minute.
    ◼ 30 compressions should take you 18
    seconds.
    ◼ push at least 2 inches deep on the
    chest.
    Chest Compression

    ◼ Allow the chest to recoil completely after


    each compression
    ◼ Without losing contact between hands
    and the sternum
    Mechanism of blood flow during
    chest Compression
    intra thoracic pressure (thoracic
    pump).

    Directly compress the heart (cardiac


    pump)

    Forces blood
    Remember to
    that when flow
    CPR is not being performed,
    blood and oxygen are not circulating, and cellular
    injury and death may occur.
    (A) Open The Airway

    1. Head tilt, chin lift


    2. Jaw thrust
    ❑ Look in the mouth, if a foreign body is
    visible, remove it.
    Head tilt- Chin lift
    Jaw-Thrust
    Check Breathing
    (B) Rescue Breathes

    ◼ After 30 compressions,
    ◼ Open the airway,
    ◼ 2 Rescue breathes
    Rescue Breathes

    ◼ Inspiratory time 1 second


    ◼ Enough volume ➔ visible chest rise
    ◼ O2 as soon as possible
    ◼ Avoid rapid or forceful breaths
    ◼ Attempt tracheal intubation only if
    trained
    ◼ opening the victims airway ,
    covering the victims mouth
    completely with your mouth
    ◼ pinching the victims nose

    ◼ giving a regular breath for about


    1 second.

    ◼ Let the victim exhale and give


    the second breath just as you did
    with the first breath.
    ◼ giving artificial breathing to
    someone who isn't breathing on
    their own.
    ◼ When giving rescue breathing,
    give just enough Air to see the
    chest rise.
    ◼ If not see the chest rise and
    fall, readjust head, attempt the
    breaths again.
    ◼ If the breaths do not make the
    chest rise and fall for a second
    time - move on to circulation
    and compressions.
    Ambu bag Barrier devices
    ◼ limit exposure to the rescuer
    to exhaled air, body fluids,
    and disease process.
    ◼ place it on the victims face
    with the pointy end over the
    bridge of the nose.
    ◼ Deliver breaths as in mouth
    to mouth breathing
    Face Mask Ambu Bag
    2 Rescue Resuscitation
    Chest Compression, Rescue Breaths

    ◼ Continue with chest


    compression and
    rescue breaths
    ◼ Rate 30:2
    Non-Asphyxial CA
    ◼ First few minutes (4-5 ), blood O2 content
    remains high
    ◼ Ventilation less important than chest
    compression
    ◼ Adult, CPR should start with chest
    compression
    Asphyxial Arrest

    ◼ 5 initial breaths before compression


    ◼ If alone ➔ 1 minute CPR before call for
    help

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