Occupational Health
Centre, NFASL
Health Education ---CPR
By
Dr.Ashok
CPR
C---Cardio----------------------------Heart
P---Pulmonary-----------------------Lung
R---Resuscitation--------------------
Revival
Definition
An emergency procedure
used to restart a person's
heartbeat and breathing
after one or both have
stopped.
Who Invented CPR
1960.
Resuscitation pioneers Drs. Kouwenhoven, Safar, and
Jude combine mouth-to-mouth breathing with chest
compressions to create cardiopulmonary
resuscitation, the lifesaving actions we now call CPR.
New name of CPR is BLS
Peter Safar: father of modern cardiopulmonary
resuscitation.
Objective of CPR
keep oxygen flowing in and
out of the lungs and
to keep oxygenated blood
flowing through the body.
3 Priorities of Life support
Preserve life.
Prevent deterioration.
Promote recovery.
CPR FACTS
• CPR is one way of buying time until normal
heart& lung function is restored or a defibrillator
becomes available.
• CPR provides artificial breathing and circulation,
keeping oxygenated blood flowing to the heart
and brain.
• The earlier you give CPR, the greater the chance
of success.
Basic components of CPR
CAB---Easy to Remember
C---Chest Compression
A---Airway
B---Breathing
Critical components of CPR
Five main components of high-performance CPR
have been identified:
chest compression fraction (CCF),
chest compression rate,
chest compression depth,
chest recoil (residual leaning),
and ventilation. These CPR components were
identified due to their contribution to blood flow and
outcome.
Seven steps of CPR
STEP 1: CALL OHC/Trained First aider.
STEP 2: ASSESS THE SCENE OF THE EMERGENCY.
STEP 3: OPEN THE VICTIM'S AIRWAY.
STEP 4: CHECK FOR BREATHING & Circulation.
STEP 5: 30 CHEST COMPRESSIONS.
STEP 6: 2 RESCUE BREATHS.
STEP 7: REPEAT THE CYCLE.
New standards of CPR
Push hard and Fast
Pushing chest 2-2/12 inch with each compression
Maintain Chest compression Rate 120/min
Continue CPR till you handover casualty to medical
person or till medical person arrives
Chest compression is more important than artificial
respiration
Qualities of First aider
Prompt and Quick. A great first aider must be able to recognise when
someone needs emergency help. ...
Calm and Controlled. First aiders face a variety of emergency
situations from time to time. ...
Effective Communicator. ...
The Ability to Lead. ...
Knowledge of Your Limit.
Crowd Manager
CPR---Trained Vs General Public
For
healthcare providers and those trained:
conventional CPR using chest compressions
and mouth-to-mouth breathing at a ratio of
30:2 compressions-to-breaths. ...
Forthe general public or bystanders who
witness an adult suddenly collapse:
compression-only CPR, or Hands-Only CPR.
Cardiac Arrest
Itis unexpected and
unexplained cessation of heart
beat is called cardiac arrest
At any age, can be anybody
Causes of Cardiac and Respiratory
Arrest
Heart Attack
Poisoning
Head Injury
Electric Shock
Electrolyte Imbalance
Snake Bite
Drowning
Allergic Reaction
Scorpion Bite etc---------
Sudden Cardiac Arrest statistic's in
India
More than 80% cardiac arrest occurs outside the hospital
More than 350,000 cardiac arrests occur outside of the hospital
each year
roughly estimated at 7 lakh cases of SCD annually) with 21% of the
deaths in people who were below 50 years of age.
Cardiac Arrest Vs Heart Attack
Cardiac Arrest--------Stoppage of Heart Beat
HeartAttack----------Reduced Blood supply
due to spasm or complete stoppage of blood
supply to heart muscle due to blockage in
one or multiple arteries supplying blood to
heart muscles.
Signs and Symptoms of CPA
No Pulse
No Blood Pressure
No Respiration Or Gasping
Un conscious
Pupils sluggishly or not reacting to light
Unresponsiveness
Normal Values Of Vital Parameter's
Blood Pressure----------100-130/70---90 mm of Hg
Pulse -------------------60----90/min
Respiration----------12-----14/min
Major Arteries in Human Body
Anatomy Of Heart
Pathway of Blood circulation
Coronary artery Spasm
Blockage of Coronary artery
Coronary Arteries
Fig-1 Fig-2
Airway Management
Hand positioning in CPR
Hand Positioning For Chest
Compression
Fig-1 Fig-2
Step wise Hand positioning in CPR
Kneel beside the person who needs help.
Place the heel of one hand on the centre of the chest.
Place the heel of the other hand on top of the first hand, then
INTERMINGLE your fingers together.
Position your body so that your shoulders are directly over your
hands; keep your arms straight.
Push hard, push fast BY USINH HEEL OF HANDS KEEPING FINGERS
POINTING UPWARDS. Use your body weight to help you administer
compressions that are at least 2 inches deep and delivered at a rate
of at least 100 compressions per minute. (Be sure to let the chest rise
between compressions.)
Mouth to Mouth Breathing
Artificial Respiration-AMBU bag
automated artificial manual breathing
units
Parts of Ambu bag
self-inflating bag,
one-way valve,
mask, and an oxygen reservoir.
Ambu bag ventilation and
oxygenation
For each breath, steadily and smoothly squeeze the bag to deliver a
tidal volume of 6 to 7 mL/kg (or about 500 mL for an average size
adult) over 1 second, and then release the bag to allow it to reinflate.
If using a 1000-mL volume bag, squeeze only halfway to obtain the
correct tidal volume.
In cardiac arrest cases, do not exceed 8 to 10 breaths per minute (ie,
one complete breath every 6 to 7.5 seconds).
Observe for proper chest rise during ventilations
Monitor the patient, checking breath sounds and, if possible, end-tidal
carbon dioxide and pulse oximeter.
Effective CPR Ratio
30:2 (30 Chest compression and 2 Artificial Breathing)
15:1
Compression Rate/Min---------120/min
Artificial Respiration Rate--------10/min
High Quality CPR
High-quality CPR should be performed by
anyone - including bystanders. There are
five critical components:
Minimize interruptions in chest compressions
Provide compressions of adequate rate and
depth
Avoid
leaning on the victim between
compressions
Ensure proper hand placement
Avoid excessive ventilation
Complications of CPR
Aspiration Pneumonia
Fracture Ribs
Fracture Sternum
Injury to Heart
Injuryto abdominal internal organ like
Liver/Spleen etc.
Recovery Position-Left side
Steps of Recovery Position
Kneel beside the person.
Straighten their arms and legs.
Fold the arm closest to you over their chest.
Place the other arm at a right angle to their body.
Get the leg closest to you and bend the knee.
While supporting the person’s head and neck, gently take the
bent knee closest to you and very gently roll the person away
from you.
Adjust the upper leg, so both the hip and knee are bent at
right angles. Ensure the person is steady and cannot roll.
Tilt the head back and make sure the airways are clear and
open.
Purpose of Recovery Position
If a person is unconscious but is breathing and has
no other life-threatening conditions, they should be
placed in the recovery position. Putting someone in
the recovery position will keep their airway clear
and open. It also ensures that any vomit or fluid
won't cause them to choke.
BLS
Step 1: Scene Safety. ...
Step 2: Assess Breathing.& Circulation ...
Step 3: Activate EMS. ...
Step4: Get the Automated External
Defibrillator (AED) ...
Step 5: CPR (Chest Compressions)
AED
An automated external defibrillator (AED)
is a medical device designed to analyse the
heart rhythm and deliver an electric shock to
victims of ventricular fibrillation to restore the
heart rhythm to normal.
Ventricular fibrillation is the uncoordinated
heart rhythm most often responsible for
sudden cardiac arrest.
Indication: Sudden cardiac Arrest
Positioning of AED PADS
The positioning of AED pads on victims chest wall is
important, as the electrical shock needs to travel
through the heart muscle.
The first pad is placed underneath the collar bone
(Clavicle)Right Chest, the second is placed on left
side of chest wall, underneath the armpit.(As shown
in figure)
AED Pad placement----Diagrammatic
view
Contraindication
The AED Is Faulty or Has Expired Parts. ...
The Victim Has a DNR. ...
The Victim Is Wet or Lying in Water. ...
The Victim Has a Medication Patch or Pacemaker. ...
The Victim Has a Hairy Chest.
Do Not use an AED on a victim lying on a conductive surface
Types of AED
public access
and professional use.
Public access AEDs can be found in
airports
community centres
schools
government buildings
hospitals and
other public locations. They are intended to be used by
laypeople who have received minimal training.
Samaritan Law
The Good Samaritan Law allows a person, without
expectation of payment or reward and without any
duty of care or special relationship, voluntarily come
forward to administer immediate assistance or
emergency care to a person injured in an accident,
or crash, or emergency medical condition.
30th March 2016
Purpose of Samaritan laws
Good Samaritan laws are written to
encourage bystanders to get involved
in these and other emergency
situations without fear that they will be
sued if their actions inadvertently
contribute to a person's injury or death.
CO Poisoning
Toluene Poisoning
Effect Of HF acid
Complications of Phenol Poisoning
