om verma msc lecturer

1. CARDIO- PULMONARY RESUSCITATION
MR OM VERMA
MSc LECTURER
RELIANCE INSTITUTE OF
NURSING DHAMTARI

2. INTRODUCTIONINTRODUCTION

CARDIO-PULMONARY RESUSCITATION (CPR) IS A TECHNIQUE OF BASIC LIFE SUPPORT
FOR OXYGENATING THE BRAIN AND HEART UNTIL APPROPRIATE DEFINITIVE MEDICAL
TREATMENT CAN RESTORE NORMAL HEART AND VENTILATORY ACTION. CARDIO-
PULMONARY RESUSCITATION TECHNIQUES ARE USED TO ARTIFICIALLY MAINTAIN BOTH
CIRCULATION AND VENTILATION IN PERSONS SUFFERING FROM CARDIAC ARREST.


3.  IT INVOLVESIT INVOLVES

EXTERNAL CARDIAC MASSAGE (MANUAL HEART COMPRESSIONS).

ARTIFICIAL VENTILATION BY EITHER MOUTH TO MOUTH, MOUTH TO NOSE OR
MOUTH TO AIRWAY TECHNIQUES.

MANAGEMENT OF FOREIGN BODY OR AIRWAY OBSTRUCTION,
CRICOTHYROIDOTOMY MAY BE NECESSARY TO OPEN THE AIRWAY BEFORE CPR
CAN BE PERFORMED.


4. DEFINITIONDEFINITION
 ACCORDING TO POTTER AND PERRYACCORDING TO POTTER AND PERRY
CPR IS BASIC EMERGENCY PROCEDURECPR IS BASIC EMERGENCY PROCEDURE
OF ARTIFICIAL RESPIRATION AND MANUALOF ARTIFICIAL RESPIRATION AND MANUAL
EXTERNAL CARDIAC MASSAGE.EXTERNAL CARDIAC MASSAGE.
 ACCORDING TO SR. NANCY VOL 2ACCORDING TO SR. NANCY VOL 2

CARDIO PULMONARY RESUSCITATION: IS A TECHNIQUE OF BASIC LIFE SUPPORT FOR OXYGENATING
THE BRAIN AND HEART UNTIL APPROPRIATE ( PERFECT) DEFINITIVE (NISHCHIT RUP SE) MEDICAL
TREATMENT CAN RESTORE NORMAL HEART AND VENTILATORY ACTION.

5.  ““According to bailliers nursesAccording to bailliers nurses
dictionary”dictionary”
 Cardiopulmonary resuscitation {C.P.R}Cardiopulmonary resuscitation {C.P.R}
provides blood blow to vital organ untilprovides blood blow to vital organ until
effective circulation can beeffective circulation can be
unresponsiveness, lack of pulse andunresponsiveness, lack of pulse and
respiration , the protocol for basic liferespiration , the protocol for basic life
support is initiated.support is initiated.

6. PRINCIPLES OF CPRPRINCIPLES OF CPR
 TO RESTORE EFFECTIVETO RESTORE EFFECTIVE
CIRCULATION AND VENTILATION.CIRCULATION AND VENTILATION.
 TO PREVENT IRREVERSIBLETO PREVENT IRREVERSIBLE
CEREBRAL DAMAGE DUE TO ANOXIA,CEREBRAL DAMAGE DUE TO ANOXIA,
WHEN THE HEART FAILS TO MANTAINWHEN THE HEART FAILS TO MANTAIN
THE CEREBRAL CIRCULATION FORTHE CEREBRAL CIRCULATION FOR
APPROXIMATELY FOUR MINUTES THEAPPROXIMATELY FOUR MINUTES THE
BRAIN MAY SUFFER IRREVERSIVLEBRAIN MAY SUFFER IRREVERSIVLE
DAMAGE.DAMAGE.

7. PURPOSE OF CPRPURPOSE OF CPR
 A –To maintain an open and clean airwayA –To maintain an open and clean airway
 B - To maintain breathing by artificialB - To maintain breathing by artificial
ventilationventilation
 C - To maintain blood circulation byC - To maintain blood circulation by
external cardiac massageexternal cardiac massage
 To save life of the patient.To save life of the patient.
 To provide basic life support till medicalTo provide basic life support till medical
and advanced life support arrives (praptand advanced life support arrives (prapt
krna).krna).

8. INDICATIONINDICATION

1) CARDIACARREST:a sudden, sometimes temporary,a sudden, sometimes temporary,
cessation (stoping of some action)of the heart'scessation (stoping of some action)of the heart's
functioning.functioning.
2) RESPIRATORY ARREST (LUNGS
ACTION STOPING)
A : VENTTRICULAR FIBRILLATION (VF) is an abnormally irregular heart rhythm is an abnormally irregular heart rhythm
caused by rapid, uncoordinated fluttering ( dhadkana)caused by rapid, uncoordinated fluttering ( dhadkana)
contractions of the ventricles - the lower ...contractions of the ventricles - the lower ...
B : VENTRICULAR TACHYCARDIA (VT)
is a pulse of more than 100 beats per minute with atis a pulse of more than 100 beats per minute with at
least three irregular heartbeats in a row ( arrhythmia). Itleast three irregular heartbeats in a row ( arrhythmia). It
is caused by a malfunction in the heart's electricalis caused by a malfunction in the heart's electrical

9. CC ::ASYTOLE:-ASYTOLE:-

D : PULSELESS ELECTRICAL ACTIVITY
 is a clinical condition characterized byis a clinical condition characterized by
unresponsiveness and lack of palpableunresponsiveness and lack of palpable
pulse in the presence of organizedpulse in the presence of organized
cardiac cardiac electrical activityelectrical activity ..PulselessPulseless
electrical activityelectrical activity has previously been has previously been
referred to as electromechanicalreferred to as electromechanical
dissociation (EMD). dissociation (EMD).
a condition in which the heart ceases
to beat.

10. 
2) RESPIRATORY ARREST

A : DROWNING- to die under water or other liquid of suffocation.to die under water or other liquid of suffocation.

B : STROKE -The sudden death of brain cells due to lack of oxygen,The sudden death of brain cells due to lack of oxygen,
caused by blockage of blood flow or rupture of an artery to the brain.caused by blockage of blood flow or rupture of an artery to the brain.
Sudden loss of speech, weakness, or paralysis of one side of the body canSudden loss of speech, weakness, or paralysis of one side of the body can
be be symptomssymptoms ..

C : FOREIGN BODY IN THROAT

D : SMOKE INHALATION

E : DRUG OVERDOSE

F : ELECTROCUTION OR INJURY BY LIGHTING

11. ARTICALSARTICALS

EQUIPMENT :

A TRAY CONTAINING THE FOLLOWING ARTICLES :

1. ENDOTRAECHEAD TUBES OF VARIOUS SIZES (7, 7.5,8).

2. AN AMBU BAG WITH MASK

B) MEGAL’S FORCEPS (IN A PLASTIC COVER)

4. A SECTION TUBE OR CATHETER.

5. A) LARYNGOSCOPE WITH DIFFERENT SIZES OF BLADES.

12. 
6. ADHESIVE TYPE WITH SCISSORS.

7. LOCAL ANAESTETIC (DRUG) SPRAY.

8. GLOVES IN COVER.

9. A KIDNEY FRAY.

10. A PAPER BAG.

11. MASKS FOR VARIOUS SIZES.

12. DISPOSABLE SYRINGES WITH NEEDLES.

13. 
OTHERS

A) OXYGEN INHALATION (CENTRAL SUPPLY)

B) SUCTION POINT (CENTRAL SUPPLY)

C) DEFIBRILLATOR.


A TRAY CONTAINING EMERGENCY DRUGS

14. 
4. INJECTION SODIUM BICARBONATE.

5. INJECTION DOPAMINE

6. INJECTION GYCOLIN.

7. INJECTION DECADRON.

8. INJECTION AVIV

9. INJECTION CALCIUM GLUCONATE.

10. INJECTION LASIX.

11. INJECTION AMINOPHYLINE

12. INJECTION ISOPTIN.

15.  ACCORDING TO METHOD OFACCORDING TO METHOD OF
ADMINISTRATIONADMINISTRATION

19. DRUG OVERDOSE SUFFOCATION COMADRUG OVERDOSE SUFFOCATION COMA

20. MOUTH TO MASKMOUTH TO MASK

21. CLINICAL INDICATION FORCLINICAL INDICATION FOR
CPRCPR
 DILATED PUPILS.DILATED PUPILS.
 ABSENCE OF CAROTID AND FEMORALABSENCE OF CAROTID AND FEMORAL
PULSE.PULSE.
 ABSENCE OF HEART RATE.ABSENCE OF HEART RATE.
 IMMEDIATE LOSS OF CONCIOUSNESS.IMMEDIATE LOSS OF CONCIOUSNESS.
 APNOEA. Temporary cessation ofAPNOEA. Temporary cessation of
breathing especially during sleepbreathing especially during sleep

22. STEPS IN CPRSTEPS IN CPR
 Approach safelyApproach safely
 Check responseCheck response
 Shout for helpShout for help
 Open airwayOpen airway
 Check breathingCheck breathing
 30 chest compressions30 chest compressions
 2 rescue breaths2 rescue breaths
 Recovery PositionRecovery Position

23. Shake shoulders gently
Ask “Are you all
right?”
If he responds
• Leave as you find him.
• Find out what is wrong.
• Reassess regularly.
CHECK RESPONSECHECK RESPONSE

24. CHECK BREATHINGCHECK BREATHING
Look, listen and feel for
NORMAL breathing
not more than 10
seconds.
• Look for chest
movement.
• Listen at the victim's
mouth for breath
sounds.
• Feel for air on your
cheek.

26. CHEST COMPRESSIONSCHEST COMPRESSIONS
Lock elbows, maintain arms straight
and shoulders directly over hands on
the patient’s sternum.
- compress chest 3-5 cms.
(1½-2 inches)

27. RESCUE BREATHSRESCUE BREATHS

28. CONTINUE CPRCONTINUE CPR
30 2

29. Check the victim
for a response.
Recovery
position
Shout for
help
2 rescue
breaths
Open the airway, look,
listen & feel
Recovery
position
Assess
circulation
Chest
compressions
30:2
Continue
breathing
Responsive
Not
responding
Breathing normallyNo breathing
No pulse Pulse present
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