Cardiopulmonary resuscitation
• Cardiopulmonary resuscitation (CPR) is a lifesaving technique useful in many emergencies,
including heart attack or near drowning, in which someones breathing or heartbeat has stopped.
Cardio Pulmonary Resuscitation is a technique of basic life support for oxygenating the brain
and heart until appropriate, definitive medical treatment can restore normal heart and ventilatory
action.
• To maintain an open and clear airway
(A).• To maintain breathing by external ventilation
(B).• To maintain Blood circulation by external cardiac massages
(C).• To save life of the Patient.
• To provide basic life support till medical and advanced life support arrives.
INDICATION:
Cardiac Arrest
• Ventricular fibrillation (VF)
• Ventricular tachycardia (VT)
• Asystole• Pulse less electrical activityRespiratory Arresst
• This may be result of following:
• Drowning
• Stroke
• Foreign body in throat
• Smoke inhalation
• Drug overdose
• Suffocation
• Accident, injury
• Coma
• Epiglottis paralysis.
To restore effective circulation and ventilation
.• 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.
SEQUENCES OF PROCEDURES PERFORMED TO RESTORE THECIRCULATION
OF OXYGENATED BLOOD AFTER A SUDDEN PULMONARY AND/ORCARDIAC
ARRESTCHEST COMPRESSIONS AND PULMONARY VENTILATION
PERFORMED BY ANYONE WHO KNOWS HOW TO DO IT, ANYWHERE,
IMMEDIATELY, WITHOUTANY OTHER EQUIPMENT
Approach safely
Check response
Shout for help
Open airway Check breathing
Call 108
30 chest compressions 2 rescue breaths
1
APPROACH SAFELY! Approach safely WATCH OBSERVE Check response Shout for help
Open airway Check breathing Call 108 .
30 chest compressions 2 rescue breaths
CHECK RESPONSE Approach safely Check response Shout for help Open airway Check
breathing Call 112 .30 chest compressions 2 rescue breaths
CHECK RESPONSE Shake shoulders gently Ask “Are you all right?” If he responds •
Leave as you find him. • Find out what is wrong. • Reassess regularly.
SHOUT FOR HELP Approach safely Check response Shout for help Open airway
Check breathing Call 112 30 chest compressions 2 rescue breaths
OPEN AIRWAY Approach safely Check response Shout for help Open airway Check
breathing Call 112 30 chest compressions 2 rescue breaths
OPEN AIRWAY Head tilt and chin lift - lay rescuers - non-healthcare rescuers No need
for finger sweep unless solid material can be seen in the airway
OPEN AIRWAY Head tilt, chin lift and jaw thrust
CHECK BREATHING Approach safely Check response Shout for help Open airway
Check breathing Call 108 .30 chest compressions 2 rescue breath
CHECK BREATHING
• Look, listen and feel for NORMAL breathing
• Do not confuse agonal breathing with NORMAL breathing
Occurs shortly after the heart stops in up to 40% of cardiac arrests
• Described as barely, heavy, noisy or gasping breathing
• Recognise as a sign of cardiac arrest
Approach safely Check response Shout for help
Open airway Check breathing Call 108
30 chest compressions 2 rescue breaths
30 CHEST COMPRESSIONS Approach safely Check response Shout for help Open
airway Check breathing Call 108
30 chest compressions 2 rescue breaths
CHEST COMPRESSIONS
• Place the heel of one hand in the centre of the chest
• Place other hand on top
• Interlock fingers
• Compress the chest – Rate 100 min-1 – Depth 4-5 cm (1.5 to 2 inch) – Equal
compression : relaxation
• When possible change CPR operator every 2 min
RESCUE BREATHS Approach safely Check response Shout for help Open airway
Check breathing Call 112 30 chest compressions 2 rescue breaths
• Pinch the nose
• Take a normal breath
• Place lips over mouth
• Blow until the chest rises
2
• Take about 1 second
• Allow chest to fal
l• Repeat
RECOMMENDATIONS:-
Tidal volume 500 – 600 ml-
Respiratory rate give each breaths over about 1s with enough volume to make the
victim’s chest rise- Chest-compression-only continuously at a rate of 100 min
CONTINUE CPR 30: 2
COMPLICATIONS:
Coronary vessel injury
• Diaphragm injury
• Hemopericardium
• Hemothorax
• Interference with ventilation
Liver injury
• Myocardial injury
• Pneumothorax
• Rib fractures
• Spleen injury
• Sternal fracture
• Adrenaline (epinephrine) is the main drug used during resuscitation from cardiac
arrest.
Atropine• Atropine as a single dose of 3mg is sufficient to block vagal tone completely
and should be used once in cases of asystole.
It is also indicated for symptomatic bradycardia in a dose of 0.5mg-1mg.Amiodarone• It
is an antiarrhythmic drug.
Maintains airway patency with use of airway adjuncts as required (suction, high flow
oxygen with O2 or bag valve mask ventilation)
.• Assist with intubation and securing of ETT
• Inserts gastric tube and/or facilitates gastric decompression post intubation as required.
• Assists with ongoing management of airway patency and adequate ventilation
Supports less experienced staff by coaching/guidance e.g. drug preparation
• If a shockable rhythm is present (VF/VT) ensure manual defibrillator pads are applied
and connected
.• If CPR is in progress, prepare and independently double check and label 3 doses of
adrenaline
• Prepare and administer IV fluids
• Document medications administered (including time)
