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Cpr ppt

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  • 1. BY ASHOK BISHNOI Lcturer,JINR
  • 2. INTRODUCTION:-  Sudden death occur when heartbeat & breathing stop suddenly or unexpectedly. the major role of CPR is to provide oxygen to heart ,brain,& the other vital organ until medical treatment (advance cardiac life support-ACLS) can restore normal heart action.
  • 3. DEFINITION:-  Angela Morrow RN 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.  Mosby medical dictionary CPR is a basic emergency procedure for life support consisting of artificial and manual external cardiac massage .
  • 4. CHAIN OF SURVIVAL:-
  • 5. INDICATIONS:-  Cardio vascular disorders CAD, congenital heart diseases , coronary embolism, cardiac rupture & dissection  Pulmonary causes pulmonary embolism, pulmonary edema, asphyxia  Metabolic causes hypoglycemia, electrolyte imbalances
  • 6.  Fluid imbalance extensive hemorrhage, hypotension, shock  Neurological causes brain injuries, massive cva  Poisons substance and drug overdose co poisoning, propanolol over dose  Other causes electrical shock, hypothermia, narcotic overdose
  • 7. WARNING SIGNS OF CARDIO PULMONARY ARREST:-  Early signs: . loss of consciousness & convulsions  Late signs: . Apnoea .Dilated pupils .Absence of heart sounds
  • 8.  Other signs  Changes in respiratory rate  A weak or irregular pulse  Bradycardia  Cyanosis  Hypothermia
  • 9. CPR PROCEDURE
  • 10. EQUIPMENTS i. Ambu bag and masks with different size. ii. Oropharyngeal airways. iii. Endotracheal tubes of appropriate sizes and stillet. E T T U B E
  • 11. iv. Paediatric laryngoscope with straight (Miller) and curved (McIntosh) blade – Appropriate sizes. v. Suction apparatus. vi. NG tube.
  • 12. i. IV equipments & fluids ii. Pulse-oxymetry iii. Oxygen sources iv. Automated external defibrillator v. Emergency drugs vi. Cardiac monitor
  • 13. STEPS FOR CPR:- Airway:-Maintaining an open airway. Breathing:-Providing artificial ventilation by rescue breathing. Circulation:-Promoting artificial circulation by external cardiac compression. Defibrillation:-Restoring the heart beat.
  • 14. Shake shoulders gently Ask “Are you all right?” If he responds • Leave as you find him. • Find out what is wrong. • Reassess regularly. CHECK RESPONSE
  • 15. (A) AIRWAY :-  Head tilt chin lift manoeuvre  Jaw thrust manoeuvre
  • 16.  HEAD TILT CHIN LIFT MANOEUVRE
  • 17.  JAW THRUST MANOEUVRE
  • 18. (B) Breathing:- Look Listen Feel
  • 19. Method:  Mouth to mouth ventilation  Mouth to mask ventilation  Bag mask ventilation
  • 20.  MOUTH TO MOUTH VENTILATION
  • 21. MOUTH TO MASK VENTILATION
  • 22. BAG MASK VENTILATION
  • 23. NEONATAL PEDIATRIC ADULT
  • 24. (C) Circulation:- Assess pulse {Adult}
  • 25. Assess pulse (infant)
  • 26. CHEST COMPRESSIONS
  • 27. • 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 3-5 cm(1.5 to 2 inches) – Equal compression : relaxation • When possible change CPR operator every 2 min CHEST COMPRESSIONS
  • 28. IN ADULT
  • 29.  IN CHILD
  • 30.  IN INFANT
  • 31. (D) DEFIBRILLATION:-  Device that delivers direct electrical current across the myocardium. The aim is to produce synchronous depolarization of cardiac muscle STRATEGIES: Test defibrillate for  full battery charge  switch on power button  change paddle mode
  • 32.  Key issues: Paddle site: Rt intraclavicular region lt lower axillary region Paddle size: 8cm -12 cm wave form patterns : monophasic biphasic truncated exponential biphastic rectilinear
  • 33. Energy level: Pediatric : 2-4 J/kg Adult: Monophasic=> 360J Biphasic truncated=> 150-200J Biphasic rectilinear=> 120 J
  • 34.  STEPS:-  switch on  select paddle mode  assess rhythm  press paddles firmly over the chest  deliver the shock  resume cpr
  • 35. Intensive care:-(shifting in ICU)  transfer to ICU  monitor closely and continuously  monitor vital signs every hour  watch for convulsions  intubate if necessary  catheterize the patient and monitor output  record the procedure
  • 36. POST CARDIAC ARREST MANAGEMENT:- Continued care  To ensure hemodynamic monitoring  To minimize the effect of loss of spontaneous circulation of various organs  To recognize and treat recurrent cardiac arrests Objectives:  Optimize cardio pulmonary function& systemic perfusion  Transport victim out of hospital  Identify and treat thre precipating factor  Intitute measure to prevent recurrence and improve neurological function
  • 37.  Respiratory system;  Intubate & mechanically ventilate until they are stable  Administer supplemental oxygen  Obtain chest x ray  Administer drugs  Avoid hyperventilation  Cardio vascular system:  Obtain expert consultation  Monitor ecg , x-ray, lab analysis,  Monitor intra arterial blood pressure  Administer drugs
  • 38. COMPLICATIONS OF CPR:-:-  Rib fractures  Laceration related to the tip of the sternum  Liver, lung, spleen  Aspiration  Vmiting