PRACTICE TEACHING ON
CPR (or cardiopulmonary resuscitation) is a combination
of rescue breathing (mouth-to-mouth resuscitation) and chest
compressions. If someone isn't breathing or circulating blood
adequately, CPR can restore circulation of oxygen-rich blood
to the brain. Without oxygen, permanent brain damage or
death can occur in less than 8 minutes.
CPR alone is unlikely to restart the heart; its main purpose is
to restore partial flow of oxygenated blood to the brain and heart.
It may delay tissue death and extend the brief window of
opportunity for a successful resuscitation without permanent
brain damage. CPR may however induce a shockable rhythm.
CPR is generally continued until the person regains return of
spontaneous circulation (ROSC) or is declared dead .
“Cardiopulmonary resuscitation (CPR) is a
combination of mouth-to-mouth resuscitation and chest
compressions that delivers oxygen and artificial blood
circulation to a person who is in cardiac arrest. It can
be life-saving first aid.”
“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”
- (Acc. To AHA)
“An emergency procedure in which the
heart and lungs are made to work by
manually compressing the chest overlying
the heart and forcing air into the lungs.
CPR is used to maintain circulation when
the heart stops pumping, usually because
of disease, drugs, or trauma.”
1. To maintain an open and clear airway (A).
2. To maintain breathing by external ventilation
3. To maintain Blood circulation by external
cardiac massages (C).
4. To save life of the Patient.
5. To provide basic life support till medical and
advanced life support arrives
PRINCIPLES OF CPR:
1.To restore effective circulation and
2.To prevent irreversible cerebral damage due
to anoxia. When the heart fails to maintain
the cerebral circulation for approximately
four minutes the brain may suffer irreversible damage.
1. To recognize the signs of cardiac arrest
2. Protect the patient’s brain from anoxia by immediately
starting artificial ventilation of the lungs and external
3. Call for help.
4. The Cardio Pulmonary Resuscitation must be initiated
within three to four minutes in order to prevent
permanent brain damage.
5. Strike the centre of the chest sharply with the side of
the clenched fist twice.
6. Call for assistance.
7. Clear the airway of false teeth vomits food material etc.
8. Initiate ventilation and external cardiac massage without
9. The CPR techniques should not be discontinued for more than
five seconds before normal circulation and ventilation of lungs
are established except
10.When the patient is moved to a hard surface.
11.When endotracheal intubation is being carried out (maximum
time allowed for these two procedures is 15 seconds).
12.Before CPR is attempted in a patient, make sure that the airway
is clear. It may be obstructed due to many reasons; so keep the
patient’s neck hyper extended after confirming that he is having
any cervical injury.
ARTICLES USED IN CPR:
1.ENDOTRACHEAL TUBE 2. AMBU BAG WITH MASK
3.SUCTION TUBE OR
1. OXYGEN ADMINISTRATION SET
2. LARYNGOSCOPE WITH DIFFERENT
3. I.V. INFUSION SET, CUT DOWN SETS
AND IV FLUIDS
4. CARDIAC MONITOR WITH
5. MECHANICAL VENTILATOR
6. TRACHEOSTOMY SET
7. GAUZE COTTON ETC.
8. STERILE SYRINGES AND NEEDLES.
• It is critical to
remember to dial 108.
Lets begin by
very first step to
• Your location and phone
• Types of emergency and
• If you alone with victim
try to call for help.
starting CPR on
What to do in
we must first
what not to
-Do not leave the
-Do not try to victim
-Do not throw water
on victims face.
-Do not prompt the
victim in sitting
-Do not try to revive
the victim by
slapping his face.
Look, Listen And Feel For
Any Sign Of Breathing. If You
Determine That The Victim Is
Not Breathing, than The
Tongue Is Most Common
Airway Obstruction In An
With The Victim Lying Flat
On His Back, Place Your Hand
His Forehead And Your
Another Hand Under The Tip
Of The Chin
Gently Tilt The Victim’s Head Backward. In This
The Position Te Weight Of The Tongue Will Force It
To Shift Away From Back Of The Throat, Opening
If The Person Is Still Not Breathing On His Own
After The Airway His Cleared, You Will Have Assist
BREATHING: Gently Support His
Chin So As To Keep It
Lift Up And Head
Pinch His Nose With
Your Finger To Prevent
Air From Escaping
Once You Being To
Ventilate And Your
Mouth Over The
Victim’s , Creating A
If the first two don’t go in, re-tilt and give
two more breaths.
Give TWO Full Breath Allow Victim’s
Lungs To Relax- Place Your Ear Near His
Mouth And Listen For Air To Escape The
Chest Fall As The Victims Inhales
It Should Be Done More Than 10 Second.
In Order To Determine If
The Victim’s Heart Is Beating,
Place Two Fingertips On His
Carotid Artery, Locate In His
Depression Between The
Windpipe And Neck Muscles
And Apply Slight Pressure
Several Second. If There Is No
Pulse Than Victim’s Heart Is
Not Beating, And You Will
Have Perform Chest
• Place the heel of one hand
in the centre of the chest
• Place other hand on top
• Interlock fingers
• Compress the chest
– Rate 80-100 min-1
– Depth 4-5 cm
– Equal compression :
• When possible change CPR
operator every 2 min
THE RECOVERY POSITION
If the victim starts to breath normally
CAUSES OF FAILURE OF CPR:
1. Massive myocardial infraction
2. Cardiac temponade
3. Enlarged heart with incompetent valves
4. Obstructed airway
5. Severely diseased or damaged lung
6. Pulmonary embolism
7. Chest deformity
8. Fractured rib cage
9. Faulty techniques of CPR
- Inadequate airway opening
- Placement of patient on soft yielding surface
- Inadequate chest compression
- Improper seal around the patient mouth
- Improper defibrillation
- Inadequate / improper drug therapy
- Prolonged interruptions.
1.Patient Dying With An Expected Death
From Chronic Life Limiting Medical
2.Predictors of near 0% survival and never
leaving the hospital include: metastatic
cancer, Pneumonia, renal failure, sepsis,
multiple organ failure, acute stroke, and
CPR event>30 min
3.Consider ‘do not attempt resuscitation”
(DNAR) when the patient do not wish to