basic knowledge about cardiorespiratory resuscitation for Nursing students.

1. Presented by
Anuradha Bera
1st year M. Sc. Nursing Student

2. Introduction
• Cardiac arrest is a sudden, unexpected failure of heart function
occurring due to fast fluttering action of the ventricles, which
does not allow enough blood to be pumped out to the organs
which include the brain and the heart itself.
• After a cardiac arrest there are four to six minutes before brain
death occur. Chances of survival reduce by 7-10 percent with
every passing minute.
• Cardiac arrest is reversible if the victim is administered
prompt and appropriate emergency care. This generally
involves administration of cardiopulmonary resuscitation
(CPR), shock treatment and advanced life support.
• The dictionary meaning of resuscitation is “to bring back to
consciousness”.
• Sudden cardiac death is a leading cause of death. So, it is
very much important to appropriate skills of CPR.

4. Definition
• CPR, the cardiopulmonary resuscitation is an
life saving procedure used in emergencies,
which consists of chest compression and
artificial respiration.
• Cardiopulmonary resuscitation (CPR) is a
procedure to support and maintain breathing
and circulation for a person who has stopped
breathing (respiratory arrest) and/or whose
heart has stopped (cardiac arrest).

5. The condition requiring CPR:
1. Cardiac arrest: when heart stops its circulation.
Sudden cardiac arrest symptoms are immediate and drastic.
It include:
• Sudden collapse
• No pulse
• No breathing
• Loss of consciousness
• Sometimes other signs and symptoms precede sudden cardiac
arrest. These may include fatigue, fainting, blackouts.
2. Respiratory arrest: when heart continues but lungs stops its
function. It is also called pulmonary arrest.
3. Cardiopulmonary arrest: sudden cessation of heart function and
ventilator action.

6. Purpose :
• To restart the heart.
• To restore partial flow of oxygenated blood to
the brain and heart.
• To delay tissue death.
• To extend the brief window of opportunity for
a successful resuscitation without permanent
brain damage

7. Types of CPR:
• Compressions with rescue
breaths:
A universal compression to
ventilation ratio of 30:2 is
recommended for adults. With
children, if at least 2 trained
rescuers are present a ratio of
15:2 is preferred. In newborns
a ratio is 30:2 if One rescuer
and 15:2 if 2
rescuers.(According to AHA
2015 Guidelines )

8. Compression only
• For adults with cardiac arrest,
compression-only (hands-only )
resuscitation. CPR which
involves chest compressions
without artificial ventilation is
recommended as the method of
choice for the untrained rescuer
or those who are not proficient
as it is easier to perform and
instructions are easier to give
over a phone.

9. Characteristics of high quality CPR
• Start compressions within 10 seconds
of recognition of cardiac arrest.
• Push hard, push fast: Compress at a
rate of at least 100/min with a depth of
at - Least 5 cm (2 inches) for adults,
approximately 5 cm (2 inches) for
children, and
- Approximately 4 cm (1½ inches)
for infants.
• Allow complete chest recoil after each
compression.
• Minimize interruptions in
compressions (try to limit
interruptions to <10 seconds).
• Give effective breaths that make the
chest rise.
• Avoid excessive ventilation

10. Chain of survival of adult

12. Basic life support
• BLS consist of a series of sequential assessments
and actions, which are illustrated in a simplified
BLS algorithm that unchanged from 2010.
Aims of BLS
• To ensure open airway and adequate ventilation
• To maintain circulation until help comes and
definite treatment with advanced life support can
be administered.

13. Sequence of BLS

17. Technique of chest compression
• Position of rescure at the victim's side
• Make sure the victim is lying face up on a
firm, flat surface.
• If the victim is lying face down, carefully roll
him face up. If suspect the victim has a head
or neck injury, try to keep the head, neck, and
torso in a line when rolling the victim to a
face up position.
• Position of rescuer’s hands and body to
perform chest compression:
-Put the heel of one hand in the centre
the victim's chest, on the lower half of the
breastbone (sternum).
- Put the heel of other hand on top of
the first hand.
- Straighten arms and position of
shoulders directly over rescuer’s hands.

19. Breathing technique

22. Summarization of step of BLS

23. Complication
• Broken Bones
Rib fractures are the most common complication of CPR.
The chest bone, or sternum, also endures pressure and
stress during chest compressions and can fracture as well.
• Internal Injuries
Internal organs lie within the area pressured by chest
compressions. Due stress of chest compression internal
bruising of the heart and liver can occur.
• Gastric Distention
Rescue breathing during CPR provides air directly into the
lungs of the victim. If air is delivered too forcefully or for
too long a time, the victim can accumulate air build-up in
the stomach, gastric distention occours.

24. cont
• Vomiting and Aspiration
As chest compressions are administered,
pressure builds inside the body, which can
force stomach contents up the esophagus and
result in vomiting and aspiration.
• Body Fluid Exposure
CPR presents the risk of exposure to body
fluids. Providing mouth-to-mouth rescue
breathing to a victim without use of a mask
results in saliva (with/without blood) exposure
between victim and rescuer

25. Conclusion
• The individual who collapses suddenly is
managed by the initial reponse and basic life
support, public access defibrillator ( if
available), advanced life support, post
resuscitation care, and long term management.
The initial response can be carried out by
physicians, nurse, paramedical personnel, and
trained lay persons. There is requirement for
increasingly specialised skills.