2. INTRODUCTION
Basic Life Support needed for patient whose
breathing or heart has stopped
Ventilations are given to oxygenate blood when
breathing is inadequate or has stopped
If heart has stopped, chest compressions are
given to circulate blood to vital organs
Ventilation combined with chest compressions
is called cardiopulmonary resuscitation
(CPR)
CPR is commonly given to patients in cardiac
arrest as a result of heart attack
4. CARDIOVASCULAR SYSTEM:
PRIMARY FUNCTIONS
Transports blood to lungs
Delivers carbon dioxide and picks up oxygen
Transports oxygen and nutrients to
all parts of body
Helps regulate body temperature
Helps maintain body’s fluid balance
5. ANATOMY AND PHYSIOLOGY OF
THE HEARTVentricles pump blood through two loops or cycles in body
Right ventricle pumps blood to lungs to pick up oxygen and release carbon
dioxide
Blood returns to left atrium and then flows into left ventricle
Left ventricle pumps oxygenated blood through arteries to all areas of body
Blood returns through veins to right atrium, to be pumped again to lungs
Within heart, valves prevent back flow of blood so that it moves only in one
direction through these cycles
6. Heart is composed of a unique type of
muscle (myocardium) that contracts to
make pumping action.
HEART MUSCLE
8. ARTERIES
Arterial blood is oxygenated, bright red, and
under pressure
Carotid arteries—major arteries passing
through neck to head
Femoral arteries—major arteries to legs
passing through thigh
Brachial arteries—in upper arm
Radial arteries—major artery of lower arm
Arteries are generally deeper in body than
veins and more protected
9. PULSE
When left ventricle contracts, wave of
blood is sent through arteries causing
pulsing blood pressure changes in
arteries that can be palpated in certain
body locations
A pulse can be felt anywhere an artery
passes near skin surface and over a
bone
Palpate carotid pulse on either side of
neck
10. PULSE CONTINUED
Palpate femoral pulse in crease
between abdomen and thigh
Palpate radial pulse on the palm side
of wrist proximal to base of thumb
Palpate brachial pulse on the inside
of arm between elbow and shoulder
11. CAPILLARIES
Arteries progressively branch into smaller
vessels that eventually reach capillaries
Capillaries are very small blood vessels
connecting arteries with veins
throughout body
Capillaries have thin walls through which
oxygen and carbon dioxide are
exchanged with body cells
12. VEINS
From capillaries, blood drains back to
heart through extensive system of veins
Venous blood is dark red, deoxygenated,
and under less pressure than arterial
blood
Blood flows more evenly through veins,
which don’t have a pulse
Veins have valves that prevent blood
backflow
13. HEART RATE
Heart rate, measured as pulse, is affected
by many factors
With exercise, fever, or emotional
excitement, heart rate increases to meet
body’s greater need for oxygen
Various injuries and illnesses may either
increase or decrease heart rate
14. CIRCULATORY SYSTEM:
EMERGENCIES
Any condition that affects respiration
Reduces ability to deliver oxygen
Severe bleeding
Shock
Stroke
Reduces blood flow to brain
Heart conditions
Reduce tissue oxygenation
16. CARDIAC ARREST
Heart may stop (cardiac arrest) as a result
of heart attack
Brain damage begins 4 - 6 minutes after
cardiac arrest
Brain damage becomes irreversible in 8 -
10 minutes
Dysrhythmia, an abnormal heartbeat, may
also reduce heart’s pumping
effectiveness
19. CALL FIRST VS. CALL FAST
Call First
If alone with adult victim
Any victim of any age seen to collapse
suddenly
Call Fast
If alone with child victim
Unresponsive victim in cardiac arrest
because of respiratory arrest
20. CARDIOPULMONARY
RESUSCITATION (CPR)
CPR helps keep patient alive by circulating
some oxygenated blood to vital organs
Ventilations move oxygen into lungs where
it is picked up by blood
Compressions on sternum increase
pressure inside chest, moving some
blood to brain/other tissues
22. CARDIOPULMONARY
RESUSCITATION (CPR)
CONTINUED
Often electric shock from AED is needed to
restore a heartbeat—and CPR can keep
patient viable until then
CPR effective only for a short time
CPR should be started as soon as possible
In some instances, the heart may start
again spontaneously with CPR
23. CPR SAVES LIVES
CPR and defibrillation within 3-5
minutes can save over 50% of
cardiac arrest victims
CPR followed by AED saves
thousands of lives each year
In most cases CPR helps keep victim
alive until EMS or AED arrives
24. GENERAL TECHNIQUE OF CPR
If unresponsive, not breathing, and no
pulse, start chest compressions
Find the correct hand position
Two hands for adults
One or 2 hands for child
Two fingers for infant
25. GENERAL TECHNIQUE OF CPR
CONTINUED
Compress chest hard and fast at a rate of
100 compressions/minute
Adult = 1 1/2 to 2 inches deep
Infant/child = 1/3 to 1/2 chest depth
Release completely between
compressions
26. GENERAL TECHNIQUE OF CPR
CONTINUED
If alone, alternate 30 chest
compressions and 2 ventilations for
any age patient
In two-rescuer CPR for infant/child,
alternate 15 compressions and 2
ventilations
Chest-encircling method in infant
Give each ventilation over 1 second
Follow local protocol regarding
oxygen
27. SINGLE-RESCUER CPR
1.Check patient’s responsiveness,
open airway, and determine that
patient is not breathing adequately
2.Give 2 ventilations, each lasting 1
second
3.Determine victim has no pulse
30. Give 30 chest compressions at rate of 100
per minute
Then give 2 ventilations
31. CHEST COMPRESSIONS ALERT
Be careful with your
hand position
For adults/children,
keep your fingers
off patient’s chest
Do not give
compressions
over bottom tip of
breastbone
32. CHEST COMPRESSIONS ALERT
When compressing,
keep elbows
straight and hands
in contact with
patient’s chest at
all times
33. CHEST COMPRESSIONS ALERT
Compress chest
hard and fast, but
let chest recoil
completely
between
compressions.
Minimize amount
of time used
giving ventilations
between sets of
compressions.
34. PROBLEMS WITH CPR
TECHNIQUE
CPR often ineffective because of poor
technique
Compressions not delivered steadily and
constantly during resuscitation efforts
Often compressions are too shallow,
resulting in ineffective blood flow
Compressions may be given at too fast a
rate
Only good-quality CPR improves chances
of survival
35. CHEST COMPRESSIONS:
BRADYCARDIA IN CHILD
Infant or child being given rescue
breaths or oxygen may have a pulse
but still inadequate perfusion
If pulse < 60 beats/minute and infant
or child has signs of poor
perfusion, provide CPR
36. TWO-RESCUER CPR FOR ADULTS
AND CHILDREN
Minimizes time
between rescue
breaths and
compressions
CPR becomes more
effective
Can more quickly set
up AED
Reduces rescuer
fatigue
37. TWO-RESCUER CPR
Performed in cycles of 30:2 for adult
(15:2 for infant or child)
One rescuer provides breaths,
second rescuer gives chest
compressions
Rescuers switch positions every 2
minutes
Change done after full CPR cycle
Accomplish change in < 5 seconds
38. TWO-RESCUER CPR CONTINUED
If AED present, one rescuer gives
CPR while the other sets up unit
If unit advises CPR, rescuers give
CPR together
Third rescuer can apply cricoid
pressure
39. TWO-RESCUER CPR CONTINUED
If you are assisting another trained rescuer
who places an advanced airway:
Chest compressions given continually
No pauses for ventilations
Give ventilations at rate of 8 – 10 breaths/
minute
40. TRANSITIONING FROM ONE-
RESCUER CPR TO TWO-RESCUER
CPR
Second rescuer moves into position on other
side to prepare to take over chest
compressions
First rescuer completes a cycle of
compressions and ventilations
While first rescuer pauses to check for a
pulse, second rescuer finds correct hand
position for compressions
41. TRANSITIONING FROM ONE-
RESCUER CPR TO TWO-RESCUER
CPR
When first rescuer says, “No pulse, continue
CPR,” second rescuer begins chest
compressions and first rescuer then gives
only ventilations
42. DIFFERENCES IN TWO-RESCUER
TRAINING
If First Responder started CPR, arriving
second rescuer may have a higher level
of training
Rescuer with greater training determines
how CPR should best be continued
47. Continue cycles of 30:2 for adults (15:2
for child). After 5 cycles (~ 2 minutes)
switch positions.
48. ADULT OR CHILD TWO-RESCUER
CPR CONTINUED
Continue CPR until:
Patient moves
AED brought to scene and ready to use
Advanced help arrives and takes over
If patient starts breathing and has pulse,
put in recovery position and monitor
ABCs
If AED brought to scene, start AED
sequence
49. TWO-RESCUER CPR: INFANTS
Uses different hand position
Place thumbs of both hands on sternum while fingers encircle chest
Compress breastbone with both thumbs while squeezing chest with fingers
Same rate and depth as usual
54. INFANT TWO-RESCUER CPR
CONTINUED
Continue cycles of 15:2 for ~ 2 minutes
then switch roles
Continue CPR until:
Infant moves
Advanced help arrives and takes over
If infant starts breathing, hold in recovery
position and monitor ABCs
55. WHEN NOT TO PERFORM CPR
Presence of a Do-Not-Resuscitate
(DNR) order
Patient obviously dead (decapitation;
incineration; or clear signs of
prolonged death, such as rigor
mortis and dependent lividity)
Not safe to be on the scene and the
patient cannot be moved
somewhere safe
A physician pronounces the patient
dead
