CPR & First Aid

CPR & FIRST AID
Life support systems

Lungs – breathing
Absorbs oxygen
Heart – circulation
Pumps & circulates oxygenated blood
Brain – system controller

Brain damage after 4-6 minutes
Damage is irreversible
Sudden Death
Cardiac / Respiratory arrest
Unconsciousness
No breathing
No pulse
CAUSES OF SUDDEN DEATH
Heart Attack
Stroke
Electrocution
Poisoning
Drowning
Suffocation
Severe Allergic Reaction
Trauma
Definition of CPR
C ardio
P ulmonary
R esuscitation
Purpose of CPR
Critical emergency intervention
BLS – Basic Life Support
Performed for cardiac or

respiratory arrest
Artificially pumps heart to keep
circulation to brain
Provides a vital link in CHAIN

OF SURVIVAL
Chain of Survival
Series of actions to maximize survival
Each action is time-critical and linked
Missing link will result in poor outcome/survival

AHA Adult Chain of Survival -
New
Adult CPR
Algorithm
D anger
R esponse
C ompression
A irway
B reathing
D anger
Check scene
Ensure safety for –

Self
Victim
R esponse
Check for response –
Tap
Call
Activation
Get help
Emergency number –
 Fixed line
 H/phone
 Hospital
Activation – call for help
New CPR Sequence
Compressions
A compression is the act of pushing on the
chest
People often don’t push hard enough because
they’re afraid of hurting the victim
An injury is unlikely, but it is better than death
It is better to push too hard than not hard
enough
Compressions
Lock fingers
Correct
posture
Chest Compression
Technique –
Position – center of chest / nipple line
Depth – 1.5 – 2 ” deep
Rate – ‘push hard & push fast’
→ approx. 100-120 times/min
Ratio – 30 compressions : 2 breaths
*Check pulse after every 5 cycles or

2 minutes
A irway
Open airway –
Head tilt, chin lift
Jaw thrust
Check mouth for foreign body –

Dentures
Jaw thrust
Head tilt, chin lift – to open airway
Opening Airway to lift up tongue
BEFORE AFTER
Open the Airway
Give Breaths
Compressions are the most important part
of CPR
If you are also able to give breaths, you will
help even more
Your breaths need to make the chest rise
When the chest rises, you know the person
has taken in enough air
Give Breaths
B reathing
Look
Check
Breathing Listen
Feel
Check for 5-10 seconds

LOOK for chest movement LISTEN for breathing sound
FEEL for air breathe out
B reathing
If no breathing –
Give 2 rescue breaths
Check for chest rise
Routes –
mouth-to-mouth
mouth-to-nose
mouth-to-tracheostomy
mouth-to-mask
Mouth-to-mouth
Face shield Face mask
Pocket Mask
C irculation
Check carotid pulse
Feel for 5-10 seconds

Check carotid pulse
C irculation
If pulse present but NO breathing –
Commence RESCUE BREATHING

Rate – 10-12 breaths / minutes
Recheck pulse after every 2 minutes

Recovery position
If pulse & breathing present –
place in Recovery position

Recovery position
Recovery position – step 1
When to stop CPR?
Victim revives
Another trained rescuer takes over
Medical assistance arrives
You are exhausted

Hazards of CPR
Incorrect chest compressions –
Fractures – ribs & xiphoid
Lacerations – liver, spleen & lungs
Incorrect rescue breath volumes –

Gastric distension
Vomiting
Other concerns
Victim who vomits
Wearing dentures
Chest compressions only
If I am alone?
Paediatric CPR
Age groups –
Child – age 1 – puberty
Infant – newborn to 1 year old

Prevention Early Access
Basic CPR Early

Advanced Life
Support
Paediatric CPR - algorithm
Danger
Response
Airway
Breathing
Circulation
Defibrillation
Child CPR
D anger
Assess situation
Ensure safety
R esponse
Check response –
Tap
Call
Call for help

A irway
Open airway –
Head tilt, chin lift
Jaw thrust
Observe for foreign body –

Remove only if seen
B reathing
Look
Check
breathing Listen
Feel
Assess for 5-10 seconds

B reathing
If no breathing –
C irculation
Check carotid pulse
Check for 5-10 seconds

C irculation
If no pulse or pulse < 60 bpm
Start chest compressions –
1 hand
2 hands
Chest Compression
Technique –
Depth – 1 – 1.5 ” deep
Rate – approx. 100 times/min
Ratio – 30 compressions : 2 breaths
*Check pulse after every 5 cycles or

2 minutes
C irculation
If pulse present (> 60 bpm) but no breathing –
Rescue breathing @ 12 – 20 breaths/min
Recheck pulse after 2 minutes

Recovery position
Recovery position
D efibrillation
AED – Automated external defibrillator
For 1-8 years old –

Use Paediatric pads
D efibrillation
Check rhythm
> 1 year old –

First shock – after 5 cycles of CPR
if rhythm is shockable
Resume CPR after 1 shock (4 J/kg bw)
Check rhythm after every 5 cycles of

Compression : Breaths
Infant CPR
D anger
Assess situation
Ensure safety
R esponse
Check response –
Tap
Call
Call for help

A irway
Open airway –
Head tilt, chin list
Jaw thrust
Observe for foreign body –

Remove only if seen
B reathing
Look
Check breathing Listen
Feel
Assess for 5-10 seconds

B reathing
If not breathing –
C irculation
Check brachial pulse
Check for 5-10 seconds

Checking brachial pulse
C irculation
If no pulse or < 60 bpm
Start chest compression –
2 fingers technique
2 fingers technique
Compression : breathing – 30:2
C irculation
Technique for infant CPR –
Rate – 100 / min
Depth – ½ to 1” deep
Ratio – 30 compression : 2 breaths
* Check pulse after 5 cycles / 2 minutes

Rescue breathing
If pulse present (> 60 bpm) but no breathing
–
Rescue breathing @ 12 – 20 breaths/min
Recheck pulse after 2 minutes

Recovery position
Recovery position
Cardiopulmonary Resuscitation
Primary survey – BLS
Focus on basic CPR & defibrillation
Secondary survey – ACLS

Focus on intubation, IV access, rhythm,
drugs & cause of arrest
BLS – Basic Life Support
Airway –
 examine mouth for foreign body, vomitus or blood
 handling patient with cervical spine injury
Breathing –
 airway or using mask & ambubag
Circulation –
 Correct sequence of compression / breathing
Defibrillation –
 Shockable rhythm deliver 360 J (Monophasic)
Resuscitation
 Confirm no pulse / respiration
 Activate Code Blue
 Commence CPR
 Arrival of resuscitation equipment
 Arrival of resuscitation team
 Identify team leader
 Rhythm diagnosis
 Prompt defibrillation
 Intubation & IV access & Drugs
Resuscitation
Identify underlying cause
Ongoing assessment for response to Tx
Documentation
Family notification
Transfer to CCU (if successful)
Clearing up & checking equipment
Emergency Trolley
Top shelf
Emergency  Equipment
1st Drawer
Trolley  Drugs
2nd Drawer
 Medical supplies
3rd Drawer
 Laryngoscope & Airway (Intubation)
Bottom Drawer
 IV Fluid / Ambubag / O2 equipment
Bag-Valve-Mask
(Ambubag)
Using an ambubag
Holding
an
ambubag

CPR & First Aid

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CPR & FIRST AID

Life support systems

Brain – system controller

Performed for cardiac or

Provides a vital link in CHAIN

Each action is time-critical and linked

Missing link will result in poor outcome/survival

Ensure safety for –

*Check pulse after every 5 cycles or

Check mouth for foreign body –

Check for 5-10 seconds

Feel for 5-10 seconds

Commence RESCUE BREATHING

Recheck pulse after every 2 minutes

place in Recovery position

Another trained rescuer takes over

Medical assistance arrives

You are exhausted

Incorrect rescue breath volumes –

Chest compressions only

Child – age 1 – puberty

Infant – newborn to 1 year old

Basic CPR Early

Call for help

Observe for foreign body –

Assess for 5-10 seconds

Check for 5-10 seconds

Start chest compressions –

*Check pulse after every 5 cycles or

Rescue breathing @ 12 – 20 breaths/min

Recheck pulse after 2 minutes

For 1-8 years old –

> 1 year old –

Resume CPR after 1 shock (4 J/kg bw)

Check rhythm after every 5 cycles of

Call for help

Observe for foreign body –

Check breathing Listen

Assess for 5-10 seconds

Check for 5-10 seconds

Start chest compression –

* Check pulse after 5 cycles / 2 minutes

Rescue breathing @ 12 – 20 breaths/min

Recheck pulse after 2 minutes

If pulse & breathing present –

Secondary survey – ACLS

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