PRACTICE TEACHING ON

CPR

GUIDED BY:MR.PAVANKUMAR JAIN

PRESENTED BY:MS.SONALPATEL

CPR CENTURIES & DECADES AGO

CPR NOW A DAYS…

INTRODUCTION: CPR (or cardiopulmonary resuscitation) is a combination of rescue breathing (mouth-to-mouth resuscitation) and chest compressions. If someone isn't breathing or circulating blood adequately, CPR can restore circulation of oxygen-rich blood to the brain. Without oxygen, permanent brain damage or death can occur in less than 8 minutes.

CPR alone is unlikely to restart the heart; its main purpose is to restore partial flow of oxygenated blood to the brain and heart. It may delay tissue death and extend the brief window of opportunity for a successful resuscitation without permanent brain damage. CPR may however induce a shockable rhythm. CPR is generally continued until the person regains return of spontaneous circulation (ROSC) or is declared dead .

DEFINITION: “Cardiopulmonary resuscitation (CPR) is a combination of mouth-to-mouth resuscitation and chest compressions that delivers oxygen and artificial blood circulation to a person who is in cardiac arrest. It can be life-saving first aid.”

OR

“Cardiopulmonary resuscitation (CPR) is a procedure used when a patient's heart stops beating and breathing stops. It can involve compressions of the chest or electrical shocks along with rescue breathing”

- (Acc. To AHA)

OR

“An emergency procedure in which the heart and lungs are made to work by manually compressing the chest overlying the heart and forcing air into the lungs. CPR is used to maintain circulation when the heart stops pumping, usually because of disease, drugs, or trauma.”

1. To maintain an open and clear airway (A).2. To maintain breathing by external ventilation

(B).3. To maintain Blood circulation by external

cardiac massages (C).4. To save life of the Patient.5. To provide basic life support till medical and

advanced life support arrives

PURPOSE:

PRINCIPLES OF CPR:

1.To restore effective circulation and ventilation.

2.To prevent irreversible cerebral damage due to anoxia. When the heart fails to maintain the cerebral circulation for approximately four minutes the brain may suffer irreversible damage.

PROCEDURE:

PREPRATION:

1. To recognize the signs of cardiac arrest2. Protect the patient’s brain from anoxia by immediately

starting artificial ventilation of the lungs and external cardiac massage.

3. Call for help.4. The Cardio Pulmonary Resuscitation must be initiated

within three to four minutes in order to prevent permanent brain damage.

5. Strike the centre of the chest sharply with the side of the clenched fist twice.

6. Call for assistance.

7. Clear the airway of false teeth vomits food material etc.

8. Initiate ventilation and external cardiac massage without wasting time.

9. The CPR techniques should not be discontinued for more than five seconds before normal circulation and ventilation of lungs are established except

10.When the patient is moved to a hard surface.11.When endotracheal intubation is being carried out (maximum

time allowed for these two procedures is 15 seconds).12.Before CPR is attempted in a patient, make sure that the airway

is clear. It may be obstructed due to many reasons; so keep the patient’s neck hyper extended after confirming that he is having any cervical injury.

Cont….

ARTICLES USED IN CPR:

1.ENDOTRACHEAL TUBE 2. AMBU BAG WITH MASK

3.SUCTION TUBE OR CATHETER

4.NASAL AIRWAY/ORAL AIRWAY

5.LUBRICATING JELLY:

CPR KIT:

1. OXYGEN ADMINISTRATION SET2. LARYNGOSCOPE WITH DIFFERENT

SIZE3. I.V. INFUSION SET, CUT DOWN SETS

AND IV FLUIDS4. CARDIAC MONITOR WITH

DEFIBRILLATOR5. MECHANICAL VENTILATOR6. TRACHEOSTOMY SET7. GAUZE COTTON ETC.8. STERILE SYRINGES AND NEEDLES.

OTHER…..

AIRWAY

BREATHING

CIRCULAT-ION

DEFIBR-ILATIO

N

STEPS

• It is critical to remember to dial 108.

Lets begin by very first step to

basic life support.

• Your location and phone number.

• Types of emergency and victims condition

Provide operation

with

• If you alone with victim try to call for help.

Provide to starting CPR on

an adult

What to do in an

emergency, we must

first emphasize what not to

do:

-Do not leave the victim alone.-Do not try to victim drink water.-Do not throw water on victims face.-Do not prompt the victim in sitting position.-Do not try to revive the victim by slapping his face.

CHECK FOR RESPONSIVENESS

SHOUT FOR HELP

AIRWAY Look, Listen And Feel For Any Sign Of Breathing. If You Determine That The Victim Is Not Breathing, than The Tongue Is Most Common Airway Obstruction In An Unconscious patient

With The Victim Lying Flat On His Back, Place Your Hand His Forehead And Your Another Hand Under The Tip Of The Chin

Gently Tilt The Victim’s Head Backward. In This The Position Te Weight Of The Tongue Will Force It To Shift Away From Back Of The Throat, Opening The Airway.

If The Person Is Still Not Breathing On His Own After The Airway His Cleared, You Will Have Assist Him BREATHING.

BREATHING: Gently Support His Chin So As To Keep It Lift Up And Head Tilled Back Pinch His Nose With Your Finger To Prevent Air From Escaping Once You Being To Ventilate And Your Mouth Over The Victim’s , Creating A Tight Seal

If the first two don’t go in, re-tilt and give two more breaths.Give TWO Full Breath Allow Victim’s Lungs To Relax- Place Your Ear Near His Mouth And Listen For Air To Escape The Chest Fall As The Victims InhalesIt Should Be Done More Than 10 Second.

CIRCULATION In Order To Determine If The Victim’s Heart Is Beating, Place Two Fingertips On His Carotid Artery, Locate In His Depression Between The Windpipe And Neck Muscles And Apply Slight Pressure Several Second. If There Is No Pulse Than Victim’s Heart Is Not Beating, And You Will Have Perform Chest Compression.

COMPRESSIONS• Place the heel of one hand

in the centre of the chest

• Place other hand on top

• Interlock fingers

• Compress the chest– Rate 80-100 min-1

– Depth 4-5 cm

– Equal compression : relaxation

• When possible change CPR operator every 2 min

THE RECOVERY POSITIONIf the victim starts to breath normally

1 2

3

4

CAUSES OF FAILURE OF CPR:

1. Massive myocardial infraction2. Cardiac temponade3. Enlarged heart with incompetent valves4. Obstructed airway5. Severely diseased or damaged lung6. Pulmonary embolism7. Chest deformity8. Fractured rib cage9. Faulty techniques of CPR- Inadequate airway opening- Placement of patient on soft yielding surface- Inadequate chest compression- Improper seal around the patient mouth- Improper defibrillation- Inadequate / improper drug therapy- Prolonged interruptions.

CONTRAINDICATIONS :

1.Patient Dying With An Expected Death From Chronic Life Limiting Medical Illness

2.Predictors of near 0% survival and never leaving the hospital include: metastatic cancer, Pneumonia, renal failure, sepsis, multiple organ failure, acute stroke, and CPR event>30 min

3.Consider ‘do not attempt resuscitation” (DNAR) when the patient do not wish to have CPR.

COMPLICATIONS OF CPR:1.Rib fracture/ sturnal fractures2.Anterior Mediastinum3.Hemopericardium4.Upper airway complications5.Abdominal viscus6.Iatrogenic injuries7. Pulmonary complications