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Pavan kr cpr 2013 Pavan kr cpr 2013 Presentation Transcript

  • CPR - AdultAlternate Names : Cardiopulmonary Resuscitation -Adult, Rescue Breathing and Chest Compressions -Adult, Resuscitation - Cardiopulmonary – Adult1Prepared By - Pavan Kumar Jain,Assistant Prof. Sumandeep Nursing College,Sumandeep Vidyapeeth, Vadodara
  • CPR IS A PIVOTAL AND COMMON PROCEDUREWHILE DEALING WITH UNRESPONSIVEUNCONSIOUS VICTIM.• CPR has for 50 years consisted of the combination ofartificial blood circulation with artificial respiration (alsoknown as mouth-to-mouth (MTM)) i.e., chestcompressions and lung ventilation. However, in March2008 the American Heart Association, in an historicreversal, endorsed the effectiveness of chestcompressions alone--without artificial respiration--foradult victims who collapse suddenly in cardiac arrest(see Cardio cerebral Resuscitation below).• CPR is generally continued, usually in the presence ofadvanced life support, until the patient regains a heartbeat (called "return of spontaneous circulation" or"ROSC") or is declared dead.2Pavan Kumar Jain,Assistant Prof.Sumandeep Nursing College Vadodara
  • 3Pavan Kumar Jain,Assistant Prof.Sumandeep Nursing College Vadodara
  • Pavan Kumar Jain,Assistant Prof.Sumandeep Nursing College Vadodara4
  • PURPOSES:-CPR is unlikely to restart the heart, but rather its purpose is tomaintain a flow of oxygenated blood to the brain and theheart, thereby delaying tissue death and extending the briefwindow of opportunity for a successful resuscitation withoutpermanent brain damage.Defibrillation and advanced life support are usually needed torestart the heart.CPR is a combination of:Rescue breathing, which provides oxygen to a personslungs.Chest compressions, which keep the persons bloodcirculating. 5Pavan Kumar Jain,Assistant Prof.Sumandeep Nursing College Vadodara
  • INDICATIONS:UnconsciousnessNo respirations or brief irregular, gasping breathsNo PulseThese problems may be seen in conditions such as:Cardiac arrestSuffocationChockingDrowningElectrocutionDrug overdose6Pavan Kumar Jain,Assistant Prof.Sumandeep Nursing College Vadodara
  • • Patients dying an expected deathfrom a chronic life-limiting medicalillness.• Predictors of near 0% survival andnever leaving the hospital include:metastatic cancer, pneumonia, renalfailure, sepsis, multiple organfailure, acute stroke, and a CPR event> 30 minutes.• Consider ‘do not attemptresuscitation’ (DNAR)when thepatient: does not wish to have CPRContra-indicationsfor CPR7Pavan Kumar Jain,Assistant Prof.Sumandeep Nursing College Vadodara
  • Scientific principles:• In essence, Cardio (heart) Pulmonary (lung) Resuscitation (revive, revitalize)serves as an artificial heartbeat and an artificial respirator.• If a pulse is not present, a precordial thump to the mid-sternum may be tried.• Subsequently, check “ABC’s” of BLS.• The mouth and phar-ynx should be examined for no obstruction/foreign body.• The tongue should be removed from the posterior pharynx by tilting the headbackward and hyperextending the neck.• If no breathing is noted, mouth-to-mouth or mouth-to-nose breathing shouldbe initiated in four quick breaths. One should check chest rises with eachventilation.• If a carotid pulse is not present after the initial ventilations, external cardiaccompression over the lower half of the sternum ( N/o xiphoid process) shouldbe initiated. The ster-num should be depressed 3 to 5 cm, with the patientlying on a flat hard surface.• Compressions should be approximately 60 per minute, with a ratio of 5compressions to 1 ventilation if two res-cuers are present. A single rescuermust give 15 chest compressions alternating with two venti-lations every 15seconds. 8Pavan Kumar Jain,Assistant Prof.Sumandeep Nursing College Vadodara
  • BodyCirculation
  • •It is anemergencyprocedure, andnot requires anypreparation.Preparation:10Pavan Kumar Jain,Assistant Prof.Sumandeep Nursing College Vadodara
  • STEPS11Pavan Kumar Jain,Assistant Prof.Sumandeep Nursing College Vadodara
  • • It is critical to remember thatdialing 108.Lets begin by veryfirst step of BasicLife Support• 1. Your location 2. Your phone number3. Type of emergency4. Victims conditionProvide operatorwith• If you’re alone with the victim, try tocall for helpprior to startingCPR on an adult12Pavan Kumar Jain,Assistant Prof.Sumandeep Nursing College Vadodara
  • •Always checkfor any potentialhazards beforeattempting toperform CPR.Alwaysrememberto exercisesolidcommonsense!13Pavan Kumar Jain,Assistant Prof.Sumandeep Nursing College Vadodara
  • • DO NOT leave the victim alone.• DO NOT try make the victimdrink water.• DO NOT throw water on thevictims face.• DO NOT prompt the victim intoa sitting position.• DO NOT try to revive the victimby slapping his facewhat to do inanemergency, wemust firstemphasizewhat not todo: ..14Pavan Kumar Jain,Assistant Prof.Sumandeep Nursing College Vadodara
  • American HeartAssociations guidelinesdictate that Adult CPR isperformed on anyperson over the age of 8.15Pavan Kumar Jain,Assistant Prof.Sumandeep Nursing College Vadodara
  • • Before you start any rescueefforts, you must remember tocheck the victim for responsiveness.Responsiveness.• Otherwise, shake the victim gently and shout"Are you okay?" to see if there is anyresponse. If the victim is someone youknow, call out his name as you shake him.If suspect - spinalor neck injury, donot move orshake him.• check the A-B-CAirway Breathing CirculationIf there is noresponse16Pavan Kumar Jain,Assistant Prof.Sumandeep Nursing College Vadodara
  • "A" is forAIRWAY• Look, listen and feel forany signs of breathing.If you determine that thevictim is notbreathing, then the tongueis the most commonairway obstruction in anunconscious person.17Pavan Kumar Jain,Assistant Prof.Sumandeep Nursing College Vadodara
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  • 19Pavan Kumar Jain,Assistant Prof.Sumandeep Nursing College Vadodara
  • • If the person is still notbreathing on his own after theairway has been cleared, youwill have to assist him breathing"B" is forBREATHING• Gently support his chin so as tokeep it lifted up and the headtilted back. (Hyper extendedneck)20Pavan Kumar Jain,Assistant Prof.Sumandeep Nursing College Vadodara
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  • 22Pavan Kumar Jain,Assistant Prof.Sumandeep Nursing College Vadodara
  • 23Pavan Kumar Jain,Assistant Prof.Sumandeep Nursing College Vadodara
  • "C" is forCIRCULATION• In order to determine if the victims heart isbeating, place two fingertips on his carotidartery, located in the depression between thewindpipe and the neck muscles (Figure 5), andapply slight pressure for several seconds.• If there is no pulse then the victims heart isnot beating, and you will have to performchest compressions24Pavan Kumar Jain,Assistant Prof.Sumandeep Nursing College Vadodara
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  • 26Pavan Kumar Jain,Assistant Prof.Sumandeep Nursing College Vadodara
  • 27Pavan Kumar Jain,Assistant Prof.Sumandeep Nursing College Vadodara
  • The depth of compressionsshould be approximately1½ to 2 inches - remember:2 hands, 2 inches (Figure3).28Pavan Kumar Jain,Assistant Prof.Sumandeep Nursing College Vadodara
  • Count aloud as you compress 30 timesat the rate of about 3 compressionsfor every 2 seconds. Finish the cycleby giving the victim 2 breaths. Thisprocess should be performed fourtimes - 30 compressions and 2 breaths- after which remember to check thevictims carotid artery for pulse andany signs of consciousness.Pavan Kumar Jain,Assistant Prof.Sumandeep Nursing College Vadodara29
  • If there is no pulse, continue performing 30compressions/2 breaths, checking for pulse afterevery 4 cycles until help arrives.If you feel a pulse (i.e. the victims heart is beating)but the victim is still not breathing, rescue breathsshould be administered, one rescue breath everyfive seconds (remember to pinch the nose toprevent air from escaping). After the first rescuebreath, count five seconds and if the victim doesnot take a breath on his own, give another rescuebreath.Pavan Kumar Jain,Assistant Prof.Sumandeep Nursing College Vadodara30
  • New CPR Guidelines from the AHA 2010Pavan Kumar Jain,Assistant Prof.Sumandeep Nursing College Vadodara31
  • Latest CPR changes are:Skill New OldRescue Breaths Normal breath for 1 seconduntil chest risesDeep breath for 2 secondsChest Compression toVentilation Ratio Adult, Child, Infant - 30:2Adult - 15:2Child - 5:1Infant - 5:1Chest Compression RatioAdult, Child, Infant - Atleast 100/minuteAdult or Child - About100/minuteInfant - About 120/minuteChest LandmarkingAdult or Child - Center ofChestInfant - Just below nippleline at center of chestAdult or Child - Trace up theribsInfant - One finger widthbelow nipple line at centerof chestAED 1 shock,then 5 cycles of CPR (about2 minutes)Up to 3 shocks,then 1 minute of CPRPavan Kumar Jain,Assistant Prof.Sumandeep Nursing College Vadodara32
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