CPR/AED/ Training

by

Dr. Mehwish
Waseem
Chain of Survival
• The chain of survival are four steps to
help increase the chances of an injured
person of surviving a cardiac arrest.
Chain of Survival – step one

• After determining that there is an injury needing

advanced care; if unconscious
• Call EMS
▫ Questions you will need to answer:
▫ Nature of the emergency?
▫ Where are you?
▫ How many are hurt?
Chain of Survival – step two
• Begin CPR
▫ Most adult cardiac arrests (CA) victims heart
is in ventricular fibrillation (VF).
▫ CPR will not usually stop VF but plays an
important part in pushing oxygenated blood
to the brain and heart andan prolonging VF so
that an AED will be useful.
▫ CPR can double or triple the victims survival
rate
▫ For every passing minute without CPR; rate
of surviving drops 7-10%.
▫ With CPR there is only a 3-4% drop each
minute.
 Rescuer CPR

• 1 - Check for scene safety.

• 2 – Check for responsiveness.
• 3 – If no response ACTIVATE (call)EMS and get
an AED.

• A – Open the Airway (head-tilt-chin-lift or Jaw

thrust) Look, Listen, Feel for breath (5 – 10
secs).
• B – Give 2 breaths (give enough breath to make
the chest rise).***remember to pinch the nose.
• Start CPR 30 compressions and 2 breaths at a
rate of 100 compressions per min.
Vomiting/other breathing
• If someone does throw up – do not panic.
▫ Roll victim towards you. Use your body to hold
them.
▫ Clean out the mouth – roll back and continue.
• Mouth to nose
▫ Use when it is impossible to use the mouth due
to injury.
• Face shields and masks – may be used -
▫ Very little chance of transfer of bodily fluids if
perform mouth to mouth without mask.
▫ Using shield or mask can slow down the CPR
process
▫ “Chest compression only” CPR is more beneficial
than no CPR at all.
Recovery position
• If victim begins breathing and having a
pulse then turn victim to their side.

• No position is perfect- just make sure they

are stable, near a true lateral position,
and there is no pressure on the chest to
impair breathing
Chain of Survival – step three
• Use an AED
▫ The use of the AED will stun the
fibrillating heart, if the heart is still
viable the normal pacemakers in the
heart will begin firing and start a normal
rhythm.
▫ If used within 5 min; chances of survival
is 49-75%.
What is an AED?
• Automated external defibrillator – is an
computerized defibrillator
▫ it can analyze heart rhythm
▫ recognize shockable rhythm
▫ advise the operator whether the rhythm should be
shocked
▫ very easy to use

• AED’s computer chips analyze the rate, size

and wave shape of human cardiac rhythm.
▫ will not shock a properly functioning heart
▫ will not shock a heart that has stopped – VF is not
present
Universal steps of AED use
• Place AED parallel to patients left ear
• Power on the AED first
 Some automatically turn on when opened
• Attach the AED to the patients chest with
electrode pads
 Remove clothing – to bear chest
 Place one pad above right nipple and one to the side
and below the left nipple.
• Analyze rhythm
 Make sure everyone is clear (must say “stand clear of
the victim”). No contact
 Push analyze
 Charge AED if shock is required (some machine charge
automatically)
• Shock if indicated – (after checking everyone
is clear again)
• Begin CPR for five cycles then analyze again
• If shock is advisable again you clear everyone
and shock
• If shock is not advisable – continue with CPR
• If victim has pulse and is breathing put into
recovery position.
 DO NOT take off pads or turn off AED until prompted
by EMS
Special Considerations
• Water
 Must remove victim from water or wet
surface
 Dry before attaching pads
• Metal surfaces
 Is victim lying on metal surface? – if so
move victim
 The metal surface may cause the shock
form the AED to hit
• Transdermal medications
 Remove patch and wipe clean before
attaching AED pads
• Implanted pacemakers and defibrillators
 Do not place an AED electrode directly
over implanted device.
 Move at least one inch to the side of
device
Chain of Survival – step four
• Advanced Care – EMS
▫ Response time is 7-8 minutes – CPR is
extremely important.
How to recognize major
emergencies
Heart Attack
Myocardial infarction

• Coronary heart disease is the leading cause of death

in all over the world.
• During MI - part of heart muscle is starting to die.
• Caused by a blockage of an artery (coronary) due
to buildup of cholesterol deposits or a blood clot.
• Victims are usually awake and can talk but feels
severe pain
• Most critical time is within the first 30
minutes after Symptoms begin.
Heart Attack
• Most common symptoms

▫ Pain or pressure in the center of the

chest – which last more than 3-5
minutes.

▫ Pain might feel pressure, fullness,

squeezing, or heaviness

▫ Pain might spread to shoulder, neck,

lower jaw and down arm (usually the
left).
▫ Pain lasts 3-5 minutes. Sometimes will
stop momentarily but then begin again.
 Other Sx – lightheadedness, fainting,
sweating without fever, nausea,
shortness of breath

▫ Most victims will downplay symptoms, you

must take action!!!

▫ Call EMS, get the nearest AED, and have

the person rest in a position that is
comfortable where they can breathe easily.
 Put them in an area that you can get them to
the floor easily and paramedics can get in .
Stroke
• It is a rapid onset of neurological
problems like weakness, paralysis in one
or more limbs, difficulty speaking, visual
problems, intense dizziness, facial
weakness, altered consciousness, and
severe headache.
• Two causes
▫ blood vessel to brain is blocked by a blood
clot
▫ blood vessel to brain breaks
• #3 cause of death and #1 cause of
serious disability in the world.
Stroke
• Most signs
overlooked; three
major signs to
observe
▫ facial droop
▫ arm weakness –
most obvious
when victim
attempts to
extend arms with
eyes closed – one
or both may not
move very well
▫ speech difficulties – slurring of
words and sentences

▫ Call EMS immediately if see signs

of stroke
Provide CPR if needed
Foreign body obstruction
• Usually caused by food, but can be caused by
many objects
• Major signs
▫ choking signal
▫ poor ineffective coughs
▫ inability to speak
▫ high pitched sounds while inhaling
▫ increased difficulty breathing
▫ Blue lips or skin (cyanosis)
▫ Loss of consciousness and responsiveness
• Heimlich maneuver in conscious victim
• CPR in unconscious victim
Choking
• Universal sign of choking – hand
around throat
• Ask questions
▫ Are you choking? Can you speak? May I
help you? – Very important.
 If they say no leave them alone until they
pass out – then it is assumed they want
help.
• If a person can speak or can cough - do
not help
New CPR Sequence
 35

hank you