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Cpr
 

Cpr

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    Cpr Cpr Document Transcript

    • Cardiopulmonary resuscitation (CPR) is a combination of rescue breathing and chest compressions delivered to victims thought to be in cardiac arrest. When cardiac arrest occurs, the heart stops pumping blood. CPR can support a small amount of blood flow to the heart and brain to “buy time” until normal heart function is restored. Causes of cardiac arrest - Heart disease – this is the most common cause of cardiac arrest - Drowning -Head injury - Drug overdose -Suffocation -Poisonous gases -Electric shock. CPR can be life-saving first aid and increases the person’s chances of survival if started soon after the heart has stopped beating. If no CPR is performed, it only takes 3–4 minutes for the person to become brain dead, due to lack of oxygen. By performing CPR, you provide the needed oxygen and circulate the blood, so that the brain and other organs can stay alive while you wait for the ambulance. CPR does not guarantee that the person will survive but it does give that person
    • a chance when otherwise there would have been none. CPR must be performed for minimum 20 minutes. CPR is most successful when administered as quickly as possible. It should only be performed when a person shows no signs of life; that is, when they are: - Unconscious, Unresponsive -Not breathing normally -Pulseless -Not moving. Positioning - CPR is most easily and effectively performed by laying the patient supine on a relatively hard surface, which allows for effective compression of the sternum. Delivery of CPR on a mattress or other soft material is generally less effective. - The health care provider giving compressions should be positioned high enough above the patient so he or she is able to gain leverage and use his or her body weight to adequately compress the chest. Remember the ABCs- airway, breathing and circulation — to remember the steps explained below. Move quickly through airway and breathing to begin chest compressions.
    • 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, chinlift maneuver. Put your palm on the person's forehead and gently tilt the head back. Then with the other hand, gently lift the chin forward to open the airway. - Check for normal breathing, taking no more than five or 10 seconds. Look for chest motion, listen for normal breath sounds, and feel for the person's breath on your cheek and ear. Gasping is not considered to be normal breathing. If the person isn't breathing normally and you are trained in CPR, begin mouth-to-mouth breathing. If you believe the person is unconscious from a heart attack and you haven't been trained in emergency procedures, skip mouth-to-mouth rescue breathing and proceed directly to chest compressions. Breathing: Breathe for the person
    • - Rescue breathing can be mouth-to-mouth breathing or mouth-to-nose breathing if the mouth is seriously injured or can't be opened. - With the airway open (using the head-tilt, chin-lift maneuver), pinch the nostrils shut for mouth-tomouth breathing and cover the person's mouth with yours, making a seal. - 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 maneuver and then give the second breath. - Begin chest compressions to restore circulation. Circulation: Restore blood circulation with chest compressions - Place the heel of one hand over the center of the person's chest, between the nipples. Place your other hand on top of the first hand. Keep your elbows straight and position your shoulders directly above your hands.
    • - Use your upper body weight (not just your arms) as you push straight down on (compress) the chest 2 inches (approximately 5 centimeters). Push hard at a rate of 100 compressions a minute. - After 30 compressions, tilt the head back and lift the chin up to open the airway. Prepare to give two rescue breaths. Pinch the nose shut and breathe into the mouth for one second. If the chest rises, give a second rescue breath. If the chest doesn't rise, repeat the head-tilt, chin-lift maneuver and then give the second rescue breath. That's one cycle. If someone else is available, ask that person to give two breaths after you do 30 compressions. If you're not trained in CPR and feel comfortable performing only chest compressions, skip rescue breathing and continue chest compressions at a rate of 100 compressions a minute until medical personnel arrive. - If the person has not begun moving after five cycles (about two minutes) and an automatic external defibrillator (AED) is available, apply it and follow the prompts. Administer one shock, then resume CPR — starting with chest compressions — for two more minutes before
    • administering a second shock. If you're not trained to use an AED, a 911 operator may be able to guide you in its use. Use pediatric pads, if available, for children ages 1 to 8. Do not use an AED for babies younger than age 1. If an AED isn't available, then continue CPR until there are signs of movement or until emergency medical personnel take over. Key points - The key thing to keep in mind when doing chest compressions during CPR is to push fast and hard. - Chest compressions can become quickly tiring. Another bystander should be prepared to take over if the initial rescuer becomes fatigued. - Care should be taken to not lean on the patient between compressions, as this prevents chest recoil and worsens blood flow. - A key determinant of survival is the rapid delivery of high-quality CPR (within minutes of cardiac arrest). - Attempting to perform CPR is better than doing nothing at all, even if the provider is unsure if he
    • or she is doing it correctly. This especially applies to many people’s aversion to providing mouth-tomouth ventilations. If one does not feel comfortable giving ventilations, chest compressions alone are still better than doing nothing. Complications - Performing chest compressions may result in the fracturing of ribs or the sternum, though the incidence of such fractures is widely considered to be low. - Artificial respiration using noninvasive ventilation methods (eg, mouth-to-mouth, BVM) can often result in gastric insufflation. This can lead to vomiting, which can further lead to airway compromise or aspiration. This problem is eliminated by inserting an invasive airway, which prevents air from entering the esophagus. - When done properly, CPR can be quite fatiguing for the provider. If possible, in order to give consistent, high-quality CPR and prevent provider fatigue or injury, new providers should intervene every 2-3 minutes (ie, providers should swap out,
    • giving the chest compressor a rest while another rescuer continues CPR). - Infection What to do if the person recovers during CPR - CPR may revive the person before the ambulance arrives. - Review the person’s condition if signs of life return (coughing, movement or normal breathing). If the person is breathing on their own, stop CPR and place them on their side with their head tilted back. - If the person is not breathing, continue full CPR until the ambulance arrives. - Be ready to recommence CPR if the person stops breathing or becomes unresponsive or unconscious again. Stay by their side until medical help arrives. Talk reassuringly to them if they are conscious. - It is important not to interrupt chest compressions or stop CPR prematurely to check for signs of life – if in doubt, continue full CPR until help arrives. It is unlikely you will do harm if you give chest
    • compressions to someone with a beating heart. Regular recovery (pulse) checks are not recommended as they may interrupt chest compressions and delay resuscitation. Stopping CPR Generally, CPR is stopped for one of the following reasons: - The person revives and starts breathing again on their own. - Medical help, such as ambulance paramedics, arrive to take over. - The person performing the CPR is forced to stop from physical exhaustion.
    • compressions to someone with a beating heart. Regular recovery (pulse) checks are not recommended as they may interrupt chest compressions and delay resuscitation. Stopping CPR Generally, CPR is stopped for one of the following reasons: - The person revives and starts breathing again on their own. - Medical help, such as ambulance paramedics, arrive to take over. - The person performing the CPR is forced to stop from physical exhaustion.