Basic Life

Support
 CPR Basics
During cardiac arrest, there is no blood flow. Chest compressions create a small amount of blood flow to the vital organs such
as the brain and heart - the more effective the chest compressions, the more blood flow is produced. Chest compressions that
are too shallow or too slow or chest compressions that are interrupted frequently do not deliver as much blood flow to the
brain and heart as effective chest compressions. Every time chest compressions are restarted following an interruption, the
first few compressions are not as effective as later compressions. Frequent or prolonged interruptions in chest compressions
decrease blood flow and the victim's chance of survival.

CPR may not save the victim even when performed properly, but if started within 4 minutes of cardiac arrest and defibrillation
is provided within 10 minutes, a person has a 40% chance of survival.

CPR provides a trickle of oxygenated blood to the brain and heart and keeps these organs alive. In other words,
Cardiopulmonary Resuscitation (CPR) serves as an artificial heartbeat and an artificial respirator until defibrillation can shock
the heart into a normal rhythm or emergency equipment arrives.

Remember the CAB's of CPR: Circulation, Airway and Breathing

 CPR CAN MEAN - LIFE

 Do you know that over a million-and-a-half heart attacks happens every year, and more
than 20% of people die before even reaching a hospital. Latest data shows that cardiac
arrest is becoming the number one cause of death.
 When the heart stops, the absence of oxygenated blood can cause permanent brain
damage in only a few minutes. Death will occur within approximately 8-10 minutes.
 Statistics show that the earlier CPR is initiated, the greater the chances of survival. In fact,
chances of survival are doubled if help is provided within four minutes. This few minutes
can be the difference between life and death.
 CPR CAN MEAN - LIFE

Without oxygen in:

0 - 4 mins. brain damage unlikely
4 - 6 mins. brain damage possible
6 - 10 mins. brain damage probable
over 10 mins. probable brain death
 Adult Chain of Survival

Activate
Emergency
Early recognition High quality CPR
Medical Services
(EMS)

Post cardiac arrest

Early defibrillation Recovery
care
 Assess the scene for safety – scan the scene for safety-you do
not want to become the victim

Check for responsiveness- tap and shout, “are you ok” If the
person answers, CPR is not needed.

Delegate or Activate the emergency response system (911) and get

and AED
Check for breathing and pulse-watch the chest for rise and fall,
1-Rescuer check pulse on the carotid artery –either side of the trachea, no
longer than 5-10 seconds
Adult BLS If no responsiveness, no pulse and not breathing: Begin
chest compressions initiate the CABs of CPR which include:
C-Circulation, A-Airway, B-Breaths
The depth of chest compressions to 2 inches for adults &
children and 1.5 inches for infants. Or you may think of 1/3
depth of any chest.
Deliver ventilation if pocket mask or barrier device is
available

Use AED immediately when it arrives

 Compression to Ventilation Ratio

Victim One person Rescue Two or more Rescuers

Adult…………………………………………. 30:2 30:2
Puberty >
2 Inches or 5 cm or 1/3 depth of chest
Child……………………………………………. 30:2 15:2
1>puberty
2 inches or 5cm or 1/3 depth of chest
Infant………………………………………….
30:2 15:2
0-12 months
1.5 inches or 4 cm or 1/3 depth of chest
 The Lone Rescuer

 The lone rescuer should begin CPR with 30 compressions rather than ventilation to reduce
delay to first compression.
 The depth of chest compressions is 2 inches for adults & children and 1.5 inches for
infants. Or you may think of 1/3 depth of any chest.
 In case of emergency DO NOT...
• ...leave the victim unattended.
• ...make the victim drink.
• ...throw water on the victim's face.
• ...put the victim into a sitting position.
• ...slap his/her face.
Compressions

When performing chest compressions, proper hand placement is very

important. To locate the correct hand position place two fingers at the
sternum (the spot where the lower ribs meet) then put the heel of
your other hand next to your fingers.

Place one hand on top of the other and interlace the fingers . Lock
your elbows and using your body's weight, compress the victim's
chest. The depth of compressions should be at least 2 inches -
remember: 2 hands, 2 inches. Count aloud as you compress 30 times
at the rate of about 3 compressions for every 2 seconds or
approximately 100 -120 compressions per minute.
 Compressions

 At the end of each compression, make sure you allow the chest to
recoil (re-expand) completely. Chest recoil allows blood to flow
into the heart and is necessary for chest compressions to create
blood flow.
 Remember to push hard and fast 100-120 compressions/minute
always.
 Airway: Clear the airway.

 Put the person on his or her back on a firm surface. Kneel next to the person's neck and
shoulders. Open the person's airway using the head tilt-chin lift. Put your palm on the
person's forehead and gently push down.
 Then with the other hand, gently lift the chin forward to open the airway. Check for
normal breathing, taking no more than 10 seconds: Look for chest motion, listen for
breath sounds, and feel for the person's breath on your cheek and ear. Do not consider
gasping to be normal breathing.
Breathing: Breathe for the
person

 With the airway open (using the head tilt-chin

lift), apply pocket mask if not available, continue
with chest compressions.
 Prepare to give two rescue breaths. Give the first
rescue breath — lasting one second — and watch
to see if the chest rises. If it does rise, give the
second breath. If the chest doesn't rise, repeat the
head tilt-chin lift and then give the second breath.
 Breaths

 Breaths should be delivered over 1 second with 1 second

in between, this is to avoid gastric inflation (which could
cause aspiration to the victim).
 Review

 Remember - you may be the victim's only chance of survival. You can increase that chance by 40% simply by administering
Cardiopulmonary Resuscitation (CPR).
 Check the victim for unresponsiveness by shouting and shaking him/her. If there is no response, Call 911 and return to the
victim. In most locations the emergency dispatcher can assist you with CPR instructions. Pulse Location - Carotid artery
(neck)
 Circulation
If the victim is still not breathing normally, coughing or moving, begin chest compressions. Push down with 2 hands 2
inches 30 times right between the nipples. Pump at the rate of 100-120 minute, faster than once per second.
 Airway
Tilt the head back and listen for breathing.
 Breathing
If not breathing normally, give breaths, but use a barrier device. If you know the victim and feel comfortable then; pinch
nose and cover the mouth with yours and blow until you see the chest rise. Give 2 breaths. Each breath should take 1 second.
Rescue Breathing-Open
the airway

 To effectively give rescue breaths, it’s

essential that the person’s airway is open and
clear. To open a person’s airway, do the
following:
1. Place your hand on their forehead.
2. Gently tilt their head back.
3. Use the fingers of your other hand to carefully
lift their chin upward
4. Use a barrier device, pocket mask or bag-
mask-device.
5. Do not do mouth to mouth if you do not know
the victim, if you do here are the steps

This Photo by Unknown Author is licensed under CC BY-SA

 Give rescue breaths

 Now that the airway is open, you can proceed to give rescue breaths. To do this:
1. Use the fingers of one hand to pinch the person’s nostrils shut. This helps to prevent air from escaping through their
nose.
2. Cover their mouth with yours, forming a seal so that air doesn’t escape.
3. Give rescue breaths by gently breathing into their mouth. A rescue breath should last about 1 second. Aim to give a
rescue breath every 5 to 6 seconds for adults; Check to see if the person’s chest rises as you give the first rescue
breath. If it doesn’t, repeat step 2 (open the airway) before giving additional rescue breaths. Children or infants give 1
breath every 2 to 3 seconds.
4. Continue giving rescue breaths until emergency medical services (EMS) arrives or the person begins breathing
normally on their own.
 Important note: It’s also possible to give rescue breaths mouth-to-nose. This is an option when a person’s mouth is
too injured to effectively give rescue breaths using a mouth-to-mouth technique.
 Important notes: In a situation where someone has a
pulse but isn’t breathing, it’s important to be aware of
the following:

Someone who isn’t breathing or isn’t breathing well

Rescue may make occasional gasping sounds. This isn’t the
same thing as normal breathing. This is called agonal
Breathing breathing.

Respiratory arrest can sometimes happen before cardiac

arrest. If at any point you notice that the person’s pulse
has stopped, begin CPR immediately.
 Questions

 Do you think CPR is more effective with more than one rescuer?
 What role is critical when performing CPR?
 What role should be alternated to give the best CPR performance?
 Do you need to know your roles and responsibilities as a rescuer?
 Do you have limitations, and should you let your lead know?
 An AED will eliminate an irregular heat beat and restore the heart back to a normal
cardiac rhythm. True or False?
 AED USE

 When an AED arrives the first step is to is turn it on.

 Not all AED’s will tell you to attach the pads.
 The next step is to follow the prompts.
 Do not touch the victim when giving a shock.
 An AED will reanalyze about every 2 minutes this should allow you to give at least 5-6 cycles of
CPR.
 When the AED reanalyzes switch the compressor role-be fast when making this change.
 After the AED delivers a shock, immediately begin chest compressions.
Placement for AED Pads
 AED USE

 If the AED pads do not stick due to hair or moisture, you must
remove the hair or, if wet, wipe the chest off and reattach the pads.
 Make sure the pads do not touch each other, if the chest is to small
place one on the center of chest and one directly on the back.
 You may use adult pads on a child or infant, but you may not use
the child/infant pads on an adult.
 Choking-Responsive/Unresponsive Victim

 If someone appears to be choking, they will not be able to talk or breath. This is an obstructed airway.
 First step is to ask if you can help them, if yes then tell someone to call 911.
 Second stand behind the victim and wrap your arms around them and give abdominal thrust until the object
dislodges.
 If the object does not dislodge, the victim will be come unresponsive, and CPR will need to be started beginning
with chest compressions.
 Before giving breaths, look inside the mouth for object, if you can see it remove it. If nothing, then attempt
breaths.
 If it is an infant, then give 5 back slaps and 5 chest thrusts until removed, or if unable to remove object the CPR
needs to begin with chest compressions. Look inside the mouth before giving breaths. Remember they are now
unresponsive.
Placement for Abdominal Thrust (responsive victim)
 Placement for Infant
GIVE 5 BACK SLAPS AND 5 CHEST THRUSTS UNTIL OBJECT EJECTS.
 Reference

American Heart Association. (2020). Basic life support

provider manual (International English).