Cardiopulmonary Resuscitation  (CPR) Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D. Consultant in Cardiac & Diabetic ...
Waiting to see the consultant as an outpatient Minutes move by, hours pass by - making you impatient One comes out as the ...
“ Call Mary”, orders the medic, “Feel his pulse” Feels sorry the patient, failing to check his impulse Acute as he is, wit...
Origin PA said “No more pleasure to gain, than to relieve somebody in pain” Of all professions, none is nobler than the on...
In the Hospital As he sees me, the medic with a sea of troubles Expects me to give a magical cure to see off all his troub...
Cardiopulmonary resuscitation (CPR): First aid Cardiopulmonary resuscitation (CPR) is a lifesaving technique useful in man...
History Of CPR  Modern CPR developed in the late  1950s and early 1960s . The discoverers of mouth-to-mouth ventilation we...
Facts about CPR  <ul><li>Sudden cardiac arrest is the leading cause of death in adults. Most arrests occur in persons with...
First Aid for a Choking Conscious Adult  Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D.   If the adult or child becom...
Remember the ABCs Airway, Breathing and Circulation  AIRWAY: Clear the airway Put the person on his or her back on a firm ...
Remember the ABCs Airway, Breathing and Circulation BREATHING: Breathe for the person Rescue breathing can be mouth-to-mou...
Remember the ABCs Airway, Breathing and Circulation CIRCULATION: Restore blood circulation Place the heel of one hand over...
 
To perform CPR on a child The procedure for giving CPR to a child age 1 through 8 is essentially the same as that for an a...
First Aid for a Choking Conscious Child  (1-8 years old) The procedure for clearing an obstructed airway is the same for c...
 
To perform CPR on a baby Most cardiac arrests in infants occur from lack of oxygen, such as from drowning or choking. If y...
To perform CPR on a baby AIRWAY: Clear the airway Place the baby on his or her back on firm, flat surface, such as a table...
To perform CPR on a baby CIRCULATION: Restore blood circulation Imagine a horizontal line drawn between the baby's nipples...
First Aid for a Choking Conscious Infant (<1 years old)  Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D. Step 4   Repe...
ASK THE DOCTOR  The following are questions about CPR sent in from visitors just like yourself. What is the correct action...
ASK THE DOCTOR  The following are questions about CPR sent in from visitors just like yourself. What is the ratio of 2-per...
ASK THE DOCTOR  The following are questions about CPR sent in from visitors just like yourself. If a person has had bypass...
ASK THE DOCTOR  The following are questions about CPR sent in from visitors just like yourself. Will CPR always save a lif...
ASK THE DOCTOR  The following are questions about CPR sent in from visitors just like yourself. What if the victim vomits?...
ASK THE DOCTOR  The following are questions about CPR sent in from visitors just like yourself. What if the victim is wear...
ASK THE DOCTOR  The following are questions about CPR sent in from visitors just like yourself. In cardiopulmonary arrest ...
ASK THE DOCTOR  The following are questions about CPR sent in from visitors just like yourself. When should I stop CPR?   ...
ASK THE DOCTOR  The following are questions about CPR sent in from visitors just like yourself. If successful CPR is depen...
HumanBody – Some Interesting Facts & Figures - I 1. The largest cell in the body is the ovum or egg cell with a diameter o...
HumanBody – Some Interesting Facts & Figures - II 8. Human feet contain a quarter of all the bones in the body i.e. about ...
HumanBody – Some Interesting Facts & Figures - III 15. Surface area of the air sacs of our lungs (from where O 2  & CO 2  ...
HumanBody – Some Interesting Facts & Figures - IV 22. An average brain has about 1500 Crore neurons (nerve cells). 23. Bra...
HumanBody – Some Interesting Facts & Figures - V 28. Till the age of two, the release of urine from the bladder is a refle...
HumanBody – Some Interesting Facts & Figures - VI 36. Liver is the largest gland in the body having size approx. 21.5cms x...
HumanBody – Some Interesting Facts & Figures - VII 43. It takes 16 seconds for the blood to be pumped from your heart to y...
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Cpr & Human Body

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Cpr & Human Body

  1. 1. Cardiopulmonary Resuscitation (CPR) Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D. Consultant in Cardiac & Diabetic Care H2, Turnbulls Road , 1st Cross street, On Chamiers road (Next to Canara Bank) Nandanam, Chennai – 600 035 Phone: Clinic 24355368 , Residence 42112244 , Mobile 9381047102
  2. 2. Waiting to see the consultant as an outpatient Minutes move by, hours pass by - making you impatient One comes out as the other goes in, still how many patients? Even as your heart harps, mind admires the physician's patience. As your turn comes you see the intern “ How long have you had this?”, Asks he with concern And proceeds to probe all your deeds and 'miss' deed From what you eat to where you slept, only to help you indeed! He hears the lung's lullaby and heart's hustlings with stethoscope Sees you eye to eye, deep into the eye with ophthalmoscope Even as he takes off his white robe Says He 'You are infested with a terrible microbe'. A on being a Patient From impatient to in-patient
  3. 3. “ Call Mary”, orders the medic, “Feel his pulse” Feels sorry the patient, failing to check his impulse Acute as he is, with all his body heat Cute as she is, measures him in Fahrenheit. “ Gulp this” says the girlie, handing over a tab of paracetamol “ Help yourself as I rub the swab of alcohol!” As the millies from the vial being syringed Your sinews feel your milieu being infringed. “ Will I be all right?”, you ask your illness’s course Wondering whimsically what has brought this curse “ Don't worry, be happy”, consoles the nice nurse Swells your heart with hope, even as your fingers feel a thinner purse. - Dr.R.Ravindranath M.D. Write your Will When one gets ill He goes to the doctor to have some pill If he gets well, he pays the bill Or out of sight, having left his will!
  4. 4. Origin PA said “No more pleasure to gain, than to relieve somebody in pain” Of all professions, none is nobler than the one who makes the disabled able again Even Ma nods, “Next to god no one else serves the sad one” So also thought I, and acted to become one. Education Eleven to twelve years, many finish their education Seven to eleven years, again to complete medication Greek and Latin to decipher, papers to present and volumes to study Takes another decade to become steady. First Posting Peanuts, they pay for many a sleepless night away 'Noble Profession', powerful politicians shrug off the talk of pay Drugless Dispensaries, day and night, what to dispense? Only spiritless workers, with 'spirits' at exchequer's expense. Night Call “ Doctor! Doctor!”, a restless patient knocks at the dead of night Little he cares about the resting physician's plight “ I didn't have time, had to see off friends at the weekend” The beach and the movies have left him weakened.
  5. 5. In the Hospital As he sees me, the medic with a sea of troubles Expects me to give a magical cure to see off all his troubles Only the doctor knows the diseases he has so many Even half of them can't be cured with all his money. Chamber As I analyze umpteen symptoms and systemic signs He asks me to detail the treatment designs Even before I say we are in the sight of diagnosis Eagerly he asks, “What is the prognosis?” In the ICU With fingers crossed, I wonder, “What is the GOD's will ?” One of the relatives asks, “Should we prepare his will ?” When I say for all his ills, there is no panacea Another one asks, “What do you think of euthanasia?” Billing “ You are the GOD in Human form, saving me from all the bother, From the deathbed thee brought back in good stead, my father. What can I do for you? “asks he, says I, “Pay only my fees”. “ What can I do? “(changed tone), again pleads he, as if I fleece. The Ultimate With trauma you see the experienced surgeon, who sewed the tissues intact Traumatic experiences, he gets, being sued for non issues, in fact. Let not the people shower praises, in abundance, as their gratitude Enough if 'sense' prevails over 'nonsense' to change their attitude. - Dr.R.Ravindranath M.D.
  6. 6. Cardiopulmonary resuscitation (CPR): First aid Cardiopulmonary resuscitation (CPR) is a lifesaving technique useful in many emergencies, including heart attack or near drowning, in which someone's breathing or heartbeat has stopped. CPR involves a combination of mouth-to-mouth rescue breathing and chest compression that keeps oxygenated blood flowing to the brain and other vital organs until more definitive medical treatment can restore a normal heart rhythm. When the heart stops, the absence of oxygenated blood can cause irreparable brain damage in only a few minutes. Death will occur within eight to 10 minutes. Time is critical when you're helping an unconscious person who isn't breathing. To learn CPR properly, take an accredited first-aid training course, including CPR and how to use an automated external defibrillator (AED). Before you begin Assess the situation before starting CPR: Is the person conscious or unconscious? If the person appears unconscious, tap or shake his or her shoulder and ask loudly, &quot;Are you OK?&quot; If the person doesn't respond, call 911 (or your local emergency number), or have someone else do it. But if you're alone and the victim is an infant or a child age 1 to 8 who needs CPR, perform two minutes of CPR before calling for help. Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D.
  7. 7. History Of CPR Modern CPR developed in the late 1950s and early 1960s . The discoverers of mouth-to-mouth ventilation were Drs. James Elam and Peter Safar . Though mouth-to-mouth resuscitation was described in the Bible (mostly performed by midwives to resuscitate newborns) it fell out of practice until it was rediscovered in the 1950s. In early 1960 Drs. Kouwenhoven, Knickerbocker, and Jude discovered the benefit of chest compression to achieve a small amount of artifical circulation. Later in 1960, mouth-to-mouth and chest compression were combined to form CPR similar to the way it is practiced today. Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D.
  8. 8. Facts about CPR <ul><li>Sudden cardiac arrest is the leading cause of death in adults. Most arrests occur in persons with underlying heart disease. </li></ul><ul><li>CPR doubles a person's chance of survival from sudden cardiac arrest. </li></ul><ul><li>75% of all cardiac arrests happen in people's homes. </li></ul><ul><li>The typical victim of cardiac arrest is a man in his early 60's and a woman in her late 60's. </li></ul><ul><li>Cardiac arrest occurs twice as frequently in men compared to women. </li></ul><ul><li>CPR was invented in 1960 </li></ul><ul><li>There has never been a case of HIV transmitted by mouth-to-mouth CPR. </li></ul><ul><li>In sudden cardiac arrest the heart goes from a normal heartbeat to a quivering rhythm called ventricular fibrillation (VF). This happens in approximately 2/3rds of all cardiac arrests. VF is fatal unless an electric shock, called defibrillation, can be given. CPR does not stop VF but CPR extends the window of time in which defibrillation can be effective. </li></ul><ul><li>CPR provides a trickle of oxygenated blood to the brain and heart and keeps these organs alive until defibrillation can shock the heart into a normal rhythm. </li></ul><ul><li>If CPR is started within 4 minutes of collapse and defibrillation provided within 10 minutes a person has a 40% chance of survival. </li></ul>Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D.
  9. 9. First Aid for a Choking Conscious Adult Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D.   If the adult or child becomes unresponsive perform CPR . if you see an object in the throat or mouth, remove it.                       Step 3. A chest thrust may be used for markedly obese persons or in late stages of pregnancy.                       Step 2. Perform an abdominal thrust (Heimlich Maneuver) repeatedly until the foreign body is expelled.                       Step 1. Determine if the person can speak or cough. If not, proceed to the next step.
  10. 10. Remember the ABCs Airway, Breathing and Circulation 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-chin lift. Put your palm on the person's forehead and gently push down. Then with the other hand, gently lift the chin forward to open the airway. Check for normal breathing, taking no more than 10 seconds: Look for chest motion, listen for breath sounds, and feel for the person's breath on your cheek and ear. Do not consider gasping to be normal breathing. If the person isn't breathing normally or you aren't sure, begin mouth-to-mouth breathing. Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D.
  11. 11. Remember the ABCs Airway, Breathing and Circulation 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), pinch the nostrils shut for mouth-to-mouth 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 and then give the second breath. Begin chest compressions go to &quot;CIRCULATION&quot; below. Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D.
  12. 12. Remember the ABCs Airway, Breathing and Circulation CIRCULATION: Restore blood circulation 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 1 1/2 to 2 inches. Push hard and push fast give two compressions per second, or about 100 compressions per 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 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 the person has not begun moving after five cycles (about two minutes) and an automated external defibrillator (AED) is available, open the kit and follow the prompts. If you're not trained to use an AED, a 911 operator may be able to guide you in its use. Trained staff at many public places are also able to provide and use an AED. Use pediatric pads, if available, for children ages 1 to 8. If pediatric pads aren't available, use adult pads. Do not use an AED for infants younger than age 1. If an AED isn't available, go to Number 5 below. Continue CPR until there are signs of movement or until emergency medical personnel take over.
  13. 14. To perform CPR on a child The procedure for giving CPR to a child age 1 through 8 is essentially the same as that for an adult. The differences are as follows: Perform five cycles of compressions and breaths on the child this should take about two minutes before calling 911 or the local emergency number, unless someone else can call while you attend to the child. Use only one hand to perform heart compressions. Breathe more gently. Use the same compression/breath rate as is used for adults: 30 compressions followed by two breaths. This is one cycle. Following the two breaths, immediately begin the next cycle of compressions and breaths. Continue until the victim moves or help arrives. Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D.
  14. 15. First Aid for a Choking Conscious Child (1-8 years old) The procedure for clearing an obstructed airway is the same for children and adults. Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D.   If the adult or child becomes unresponsive perform CPR . if you see an object in the throat or mouth, remove it.                       Step 3. A chest thrust may be used for markedly obese children.                       Step 2. Perform an abdominal thrust (Heimlich Maneuver) repeatedly until the foreign body is expelled.                       Step 1. Determine if the person can speak or cough. If not, proceed to the next step.
  15. 17. To perform CPR on a baby Most cardiac arrests in infants occur from lack of oxygen, such as from drowning or choking. If you know the infant has an airway obstruction, perform first aid for choking. If you don't know why the infant isn't breathing, perform CPR. To begin, assess the situation. Stroke the baby and watch for a response, such as movement, but don't shake the child. If there's no response, follow the ABC procedures below and time the call for help as follows: If you're the only rescuer and CPR is needed, do CPR for two minutes about five cycles before calling 911 or your local emergency number. If another person is available, have that person call for help immediately while you attend to the baby. Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D.
  16. 18. To perform CPR on a baby AIRWAY: Clear the airway Place the baby on his or her back on firm, flat surface, such as a table. The floor or ground also will do. Gently tip the head back by lifting the chin with one hand and pushing down on the forehead with the other hand. In no more than 10 seconds, put your ear near the baby's mouth and check for breathing: Look for chest motion, listen for breath sounds, and feel for breath on your cheek and ear. If the infant isn't breathing, begin mouth-to-mouth breathing immediately. BREATHING: Breathe for the infant Cover the baby's mouth and nose with your mouth. Prepare to give two rescue breaths. Use the strength of your cheeks to deliver gentle puffs of air (instead of deep breaths from your lungs) to slowly breathe into the baby's mouth one time, taking one second for the breath. Watch to see if the baby's chest rises. If it does, give a second rescue breath. If the chest does not rise, repeat the head tilt-chin lift and then give the second breath. If the chest still doesn't rise, examine the mouth to make sure no foreign material is inside. If the object is seen, sweep it out with your finger. If the airway seems blocked, perform first aid for a choking infant. Begin chest compressions go to &quot;CIRCULATION&quot;. Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D.
  17. 19. To perform CPR on a baby CIRCULATION: Restore blood circulation Imagine a horizontal line drawn between the baby's nipples. Place two fingers of one hand just below this line, in the center of the chest. Gently compress the chest to about one-third to one-half the depth of the chest. Count aloud as you pump in a fairly rapid rhythm. You should pump at a rate of about 100 times a minute. Give two breaths after every 30 chest compressions. Perform CPR for about two minutes before calling for help unless someone else can make the call while you attend to the baby. Continue CPR until you see signs of life or until a professional relieves you. Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D.
  18. 20. First Aid for a Choking Conscious Infant (<1 years old) Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D. Step 4 Repeat steps 2 & 3 above until effective or the infant becomes unconscious. If the infant becomes unresponsive, perform CPR- if you see an object in the throat or mouth, remove it.                                            Step 3 Give 5 chest thrusts.                                            Step 2 Give 5 back blows. Step 1 Determine if the infant can cry or cough. If not, proceed to next step.
  19. 21. ASK THE DOCTOR The following are questions about CPR sent in from visitors just like yourself. What is the correct action where someone needs to be moved to perform CPR, such as a car accident? Does the risk of additional harm (such as spinal injury or bleeding) outweigh the benefits of CPR if nobody qualified is on scene? If the person is in need of CPR and must be moved, move the person and begin CPR.  Remember if you don't do CPR the person will die.  The neck injury is only theoretical if you move the person.  Death, if you don't do CPR, is 100% certain.  Whenever you move a person with a possible neck injury try to support the head during movement and keep it as straight as possible. During the CPR, what is the percentage of heart efficiency as a pump? The best estimate of the heart efficiency during CPR is 20-30% of normal. I heard that no matter if a person is unconscious that you should perform CPR. Is this true? When should you not perform CPR? It is true that sometimes a person may be unconscious and their heart is still beating and they may still be breathing. Such a situation, for example, may occur in someone who has just had a grand mal seizure. If you tried to do CPR on such a person he or she would probably groan and even try to push you away. This would be your clue that CPR was not needed. CPR is intended only for someone whose heart and breathing has stopped. If the victim moves or pushes you away, you should stop CPR. Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D.
  20. 22. ASK THE DOCTOR The following are questions about CPR sent in from visitors just like yourself. What is the ratio of 2-person CPR? The ratio of chest compressions to mouth-to-mouth is the same for 2 person CPR as for 1 person CPR, namely 30:2. How do I perform CPR on a person who has a tracheal stoma? Do I have to cover their mouth or just breath directly into the stoma? There are two types of stomas, one which communicates to the nose and mouth and one which doesn't. Since you won't know which type you are dealing with, it is best to pinch the victim's nose closed, keep the victim's mouth closed and breathe directly into the stoma opening. When you are giving mouth to mouth are you actually breathing oxygen into the victim's lungs or are you trying to stimulate breathing by breathing carbon dioxide into their lungs? You are breathing oxygen into the lungs. Your exhaled breath contains 16% oxygen which is close to the 20% contained in the air you breathe in. When performing CPR, how do I know if it's working? You can tell if the chest rises with ventilation. It is hard to determine if the chest compression results in a pulse. Do the best you can and don't stop. It's better to perform CPR imperfectly than not at all. Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D.
  21. 23. ASK THE DOCTOR The following are questions about CPR sent in from visitors just like yourself. If a person has had bypass surgery, and a situation occurs that they require CPR, are there any special considerations that need to be made? No, CPR should be done in the regular fashion. Is it easier to break an overweight person's ribs or a skinnier persons ribs when performing cpr? The weight of the victim has little to do with the chances of breaking a rib, instead the age of the victim seems to determine the fragility of the bones. Can I kill someone if I do CPR incorrectly? No. Remember the person in cardiac arrest is already clinically dead. CPR can only help. Even if it's not done &quot;letter perfect&quot; it will probably provide some benefit to the victim. What if I crack a rib when I do CPR? Frequently ribs are broken with the pressure CPR places on the sternum. Some studies quote up to 30% of cardiac arrest victims have broken ribs as a result of CPR. This happens more frequently the older the victim since the cartilage is less compliant and the bones more easily crackable. But remember, it's better to have a cracked rib than be dead. Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D.
  22. 24. ASK THE DOCTOR The following are questions about CPR sent in from visitors just like yourself. Will CPR always save a life? No, in fact, most instances of CPR for cardiac arrest are unsuccessful. What is the recovery position? Assuming the person has a pulse and is breathing, the recovery position means placing the person on his or her side. This allows for the person not to choke on saliva and helps keep the airway open. The downside arm may be raised to support the head. What should you do for a person who has been accidentally shocked by electricity? A person with electric shock (assuming the shock doesn't severely damage the body) often dies from the heart going into ventricular fibrillation. Such a person needs CPR and it should be performed in the regular fashion. If CPR begins quickly and if a defibrillator arrives quickly this person has an excellent chance of survival. I want to know what the current teachings are on helping a choking victim. I have heard conflicting information on back blows for an adult. Is it still recommended, or discouraged? The first action to take in adults and children is the Heimlich maneuver. Back blows are the first thing to do only in infants who are conscious. In doing the back blows the infant should be in a face down position with the head lower than the body. Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D.
  23. 25. ASK THE DOCTOR The following are questions about CPR sent in from visitors just like yourself. What if the victim vomits? Vomit is obviously unpleasant. If it happens (and it may in one out of 20 cardiac arrests) merely turn the head to the side and wipe out the vomit as best you can with your finger. If someone has an asthma attack and collapses, what should a person do? Will CPR help? If someone collapses from an asthma attack, it is because he or she is not getting enough oxygen. This is because all the lung's small airways have narrowed and are not allowing enough air to reach the air sacs. Mouth to mouth respiration may help a little. The real need is to get this person to an emergency department so that the patient can receive medications and emergency endotracheal intubation (a tube in the main airway). What are some of the causes of CPR being used for in infants and children? Usually CPR in infants and children is performed for respiratory arrest such as severe asthma. Ventricular fibrillation is rare in children but very common in older adults. In regards to administering the Heimlich Maneuver to a victim while they are lying down, should the head be facing up, as when administering CPR (in order to clear the airway), or to the side? The victim's head should be facing up with the victim on his/her back. Since the airway is blocked you shouldn't spend much time positioning the head. The Heimlich maneuver is the most important thing to do and should unblock the airway
  24. 26. ASK THE DOCTOR The following are questions about CPR sent in from visitors just like yourself. What if the victim is wearing dentures? Keep them in place if possible as they will allow for a better seal of your mouth on his/hers. Can I get AIDS from doing CPR? No. There has never been a documented case of AIDS transmitted by CPR. Can I get sued if I perform CPR? You theoretically could but there has never been a successful suit brought against someone performing CPR. Does the Good Samaritan law protect me? Yes, if you give assistance, including CPR, for a medical emergency Good Samaritan laws cover you. What are agonal respirations? When the heart stops beating in cardiac arrest the breathing center in the brain is still alive for a couple of minutes and will cause the victim to take a few abnormal breaths. These abnormal breaths associated in dying are called agonal respirations. They may appear like snoring, gasping, or snorting and will disappear in a couple of minutes. Don't let abnormal breathing stop you from starting CPR. Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D.
  25. 27. ASK THE DOCTOR The following are questions about CPR sent in from visitors just like yourself. In cardiopulmonary arrest occurring outside of a hospital what are statistics regarding successful uncomplicated recovery? Also in this situation how many patients are successfully resuscitated but are then in a vegetative state? The statistics vary from locale to locale. In New York City or Chicago the survival rate (discharge alive from the hospital) is 2 or 3%. In Seattle the survival rate is 20% overall and 35% for ventricular fibrillation. Less than 5% of those discharged have severe neurologic damage. Over 60% return to their prior level of mental status. Persistent vegetative states (PVS)s are very unusual. Can CPR be performed on dogs? CPR can be performed on dogs. To give respiration you will need to keep the dogs mouth and lips closed and breathe through the nose. Cover the dogs nose completely with your mouth to prevent air from leaking out. You should see the chest rise if you are doing it properly. To give chest compressions you might need to press side to side instead of straight down on the chest. This is especially true for funnel chested dogs. The rates of respiration to chest compression are the same as for humans. In general, most instances of CPR for dogs will involve accidents of smoke inhalation or drowning. Respirations may indeed prove life saving especially if the dog has a heart beat. Once the dog's heart stops beating it is unlikely that CPR will be of benefit. By the way, the name gingy in my address is for my 13 year-old golden retriever. If a person moves when I do CPR should I stop? Yes, if a person moves his arms or legs they don't need CPR.
  26. 28. ASK THE DOCTOR The following are questions about CPR sent in from visitors just like yourself. When should I stop CPR? When help arrives to take over, or the victim starts to move. What chance does the person (on whom I perform CPR) have of surviving? If you do CPR on a person whose heart has stopped beating there is a 30% chance the person will live if a defibrillator can arrive within several minutes to shock the heart. What should I do if I'm alone and I do not know CPR? If you are alone and don't know how to do CPR call 911 and ask the emergency dispatcher to give you instructions over the phone. If a pregnant women chokes should I do the Heimlich Maneuver or can it harm the baby? You should do the chest thrust in a very pregnant woman. This is like the Heimlich except you grab around the middle chest instead of the upper abdomen. What is the reason calling 911 occurs after 2 minutes of CPR for infants and children whereas for adults, the call is made immediately? It is because airway problems are the main cause of cardiac arrest in infants and trying to correct that problem takes precedent over calling 911. Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D.
  27. 29. ASK THE DOCTOR The following are questions about CPR sent in from visitors just like yourself. If successful CPR is dependent on a defibrillator arriving, are there any portable defibrillators available? Portable defibrillators which operate automatically (they are called automated external defibrillators - AEDs) are available and may be purchased without a prescription. They cost around $1500. The training is very simple and takes only minutes. You should talk to your doctor as to whether one of these might be indicated in your situation. In a trekking guidebook I own it states that if there has been a trauma fall and the victim has no pulse, then CPR is futile, is this true? Doing CPR in the wilderness is futile. I would, however, make an attempt to open the airway and perhaps give several ventilations. You may be dealing with respiratory arrest and a little mouth to mouth could be lifesaving. Is it true that if a victim &quot;regains&quot; a pulse after doing CPR he/she has probably had a pulse all along? You are partially correct. The most common cause of cardiac arrest is VF and this cannot be converted with CPR alone. Electricity is required. However there are some instances when the heart is going very slowly and CPR can oxygenate the system enough to get the heart going again. Also there are instances when the person is really in respiratory arrest and the heartbeat is too faint to feel. In this situation CPR may be enough to get the heart beating stronger. Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D.
  28. 30. HumanBody – Some Interesting Facts & Figures - I 1. The largest cell in the body is the ovum or egg cell with a diameter of 0.2 mm. The smallest cells are of the brain and measure only 0.005mm across the cell body. 2. Life span of the Bone's cells is maximum (15 or 20 years). 3. Nerve cells don't divide or reproduce. Once they destroy, they destroy for ever. 4. An adult human being has about 206 bones in the body but a newborn baby has 330 bones. As bones grow during childhood, some of them join together and the number finally gets reduced to 206 by the time of adulthood. 5. The largest bone in the body is the thigh bone, the 'femur‘. It is about 48 cm. long in a man (of average ht. 1.75m.) 6. The smallest bone in the body is the stirrup bone in the ear which is only 3mm. long. Human skull has 29 bones. This include all the bones in the face and the three small bones inside the ear. The only movable bone in the skull is the lower jaw. Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D.
  29. 31. HumanBody – Some Interesting Facts & Figures - II 8. Human feet contain a quarter of all the bones in the body i.e. about 52 bones. 9. There are about 650 muscles in the human body. They grow and increase in strength by the age of 25 and then start gradually weakening. 10. Largest muscle in the body is the buttock muscle, the 'Gluteus maximus'. 11. Smallest muscle in the body is 'Stapedius‘ (less than 13mm. long) which moves a tiny bone in the ear. 12. Muscles account for 40% of our total weight. 13. When we walk, we use over 200 different muscles. When we smile, we use 17 muscles. When we frown, we use over 40 muscles. Even when we are just standing or sitting, some of the muscle fibres have to contract to keep us standing or sitting. 14. A man's lungs hold about 4 litres of air. Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D.
  30. 32. HumanBody – Some Interesting Facts & Figures - III 15. Surface area of the air sacs of our lungs (from where O 2 & CO 2 exchange takes Place in the blood) is 40 times greater than the area covered by skin. 16. The sense of taste and smell work together. If you can't smell properly, like when you have a blocked nose because of a cold, you will also find that you can't taste food Properly either. 17. There are approximately 3000 taste buds in the tongue. As a person grows older, he has fewer taste buds and thus becomes less sensitive to taste. 18. In bright light, the pupil gets smaller to let in less light. In dim light, the pupil becomes larger to let in more light. 19. Noise over 80 decibels is harmful to the ears and the body. 20. Weight of an adult brain is 1,408 gm. Female brain is smaller than the male brain. 21. Brain uses one fifth of all the energy produced in the body. Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D.
  31. 33. HumanBody – Some Interesting Facts & Figures - IV 22. An average brain has about 1500 Crore neurons (nerve cells). 23. Brain needs a constant supply of blood. If blood supply is stopped in brain for five minutes, brain cells will die resulting in stroke and as we know, dead brain cells can never be replaced. The patient will become a vegetable . 24. Right brain is associated with imagery pictures, colours, creativity (music, arts, paintings etc.), intuition etc, while left brain is associated with logical thinking, language, speech, mathematical ability. 25. About 2/3 rd of our body weight is water. 26. We lose 1-2 litres of water per day just through breathing. 27. An average person produces about 1.5 litres of urine per day. 28. Kidneys filter 120ml of blood per minute. The entire blood supply is filtered about 30 times a day. Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D.
  32. 34. HumanBody – Some Interesting Facts & Figures - V 28. Till the age of two, the release of urine from the bladder is a reflex action. After this, the action can be controlled voluntarily. 30. When we feel cold, our hairs stand up so as to trap warm air producing a little heat. 31. Number of hair on the head is about 1,00,000 to 2,00,000. 32. A hair on head grows 12mm per month. 33. About 50-100 hair fall from a person’s head everyday. 34. There are only three areas in the body without any hair growth - lips, soles, palms. 35. The tallest human on the earth has been of height 8'10&quot; and the shortest human being has been of 27 1/2“ height. This happens due to abnormal increase or decrease of growth hormone. Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D.
  33. 35. HumanBody – Some Interesting Facts & Figures - VI 36. Liver is the largest gland in the body having size approx. 21.5cms x 19cms x 14cms. 37. Human heart is of the size of a clenched fist and weighs about 300 gms. 38. The only vein that carries the pure blood is pulmonary vein (it carries pure blood from lungs to heart to be later delivered to the whole body). The only artery that carries impure blood is pulmonary artery. (It carries impure blood from heart to lungs to get it purified). 39. Largest artery in the body is Aorta from which blood is distributed in smaller arteries. 40. The largest veins in the body are Vena cava (upper &lower). 41. In the first two years, a baby's weight increases by about 271% and height by 73%. 42. By the time, a girl and boy are 18 years old, the boy will be twice the height he was at two and the girl should be about twice the height she was at 18 months of age. Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D.
  34. 36. HumanBody – Some Interesting Facts & Figures - VII 43. It takes 16 seconds for the blood to be pumped from your heart to your feet and back again and only 6 seconds from brain to heart (to and fro). 44. During a span of one month from conception, the foetus inside the womb increases by 50 times in the length and 8000 times in weight. 45. There are about 1,00,000 kms lengthy blood vessels inside our body which is 21 times the periphery of the earth. 46. There are about 30 trillion red blood cells in an adult human body. Diabetes & Heart Care Clinic Dr.R.Ravindranath M.D.

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