CPR ( cardio pulmonary resuctation )

1. CARDIO PULMONARY
RESUCITATION
MR .ROMAN BAJRANG
BASIC BS.C NURSING 2ND YEAR
RELIANCE INSTITUTE OF NURSING
LIMTARA DHAMTARI

2. INTRODUCTION
 There is a dose relation ship between the function of the heart ? Heart
lungs ? The brain when the patient stope breathing soon his heart will
stop beating because the blood beging pumed to the brain will not
contain enough oxygen ? The cardiac contral center will stop sending
signals to the heart causing but this heart stop beating blood willnot
be sent to the lung to pick up oxygen nar will the blood be sent to the
body tissue .

3.  “According to Brunner & suddarh”
The cardic pulmonary
resucititation (CPR) is a procedure to support & maintain is a breathing
& circulation for an infants child by ar adalescent who has stopped
brathing (respiratary arrest ) & for whose heart has stopped .
 “According to K. P. PARK”
Cartiopulmonary resuscitation (CPR) is perfarmed to restarev &
maintain breath circulation & to provide oxygen & blood floure to the
heart .
 “According to BT basavanthappa”
Resuscitation consist of mauth to respiration & chest comperession .
DEFINIATION

4. TYPES OF CPR
Types of CPR
Mouth to Mouth to Mouth to
Nose method Stoma method Barrirr
device

5. MOUTH TO NOSE
The mouth to nose technique is perfarm like mouth to exhaled
throught the victims nose while hodding his ar her mouth closed
with one hand by pusting up on the chin, then hold the victim
mouth open so any nasal obstraction does not impete exhalation
of air from the victim lungs .

6. MOUTH TO STOMA
In mouth to stoma result breating the victin 2 nse must be closed
during the delivery of breatlis because the air can flow upward in
to the upper airway throught the larynx as well as downward in to
the lung you can close the kictin mouth 2 nose with one hand
determind breathing by locking at ligtening to 2 feeling at the
stroma keep the victime head & neck level.

7. MOUTH TO BARRIER
A Mouth to barrier divice is a aparatus that is placed over a
viction race as a disease prevention for the resecure during
resure breating . There are two type of mouth to barrier device .
Mask.
Face shields .

8. MASK
 Resuscitation mask cover the victim
mouth 2 nose . Most have one way
valve
so exchaled air from the victim does
not
enter the resurers mouth.

9. FACE SHIELDS
 Thease clear plastic devices
have a
mouth piece through which the
ressrav breath have a shart airway
that is inseted in to the victim
mouth over the tongue there are
smaller 2 less around the shold .
Also they cover only the victim
mouth so the nose must be
rinched .

10. OBJECTIVE
To maintain clear airway .
To restare curdical function .
To retoure consciousness of life .

11. PURPOSE OF CPR
1) To maintain bloodcirculation by external cardiac massage .
2) To carrect the disfunction to maintain .
3) To by using glass jaw come scale .
4) To exse the clothes of the ph to detect any injury ar
complication .

12. PRINCIPAL OF CPR
 To restare effective circulation & ventilation .
To prevent irreversible cerebral damage due to anoxia .

13. PREPARATION OF
ARTICLES
 Equipment :-
Endotracheql tube of variiaus zes ( 6,6,5,7,7,5,8,8,5).
An ampul bag with mask .
Stivet Cina plastic cover.
Megals percep ( in a plastic cover) .
A sultion tube ar catheter .
Laryngo scope with defferent size of to lodes.
Oral everwary.
A bowal with guaze pices .
Lubricuting jelly .
Adhesive tape with scissors .
Local anaesthetic ( drug spreny ).
Disposable syrings with needles .
Gloves in cover.
A kidney tray.
A paper bag .
Mask of sarias sizes .
Local anaesthetic drug ( xybcarine 2% ,4% .
An intravenous set & a cut down set .

14. STEP OF PROCEDURE

15. S. NO. STEPS RATIONALE
(1)
(2)
(3)
(4)
(5)
Determine unresponsiveness observe
for spontaneous respiration palpate
carataid pulse .
Callfor help in hospital setting call a
code in a pulse .
Place the victims surine on a firm plat
surface ar use a board .
Kneel at the victime side .
Open the victims air way.
Place one hand on the patient for head
and apply form back word apressure
with the patrn to till head back .
Then place finger of the other hand
under the bony part of the lower law
near the chin & life up to bring the jaut
carward 2 the teath almost to occusism
.
Prevent injury 2 attempting
resucitation of a person has
respiratary arrest .
Activetes machanism for a
additionl personal .
Internal between sternum
seurface .
Allows perfarmans of resach
breath & cheast comperession
without moving kness.
In the absence of suffeient
muscle tone the tonge ar
epiglottis will obstract the
pharynx & larynx .

16. (6)
(7)
(8)
(9)
Grasp the angle of the patients lower
joul 2 lifting with bath hands one a each
side , displace the mandible Farward
which tilting the head back word . The
jaw thrust technique .
Observe for rise a fall of the chest wall
with each respiration , if lung do not
inflate , resposition head 2 neek check
for visible airway obstraction such as
vomitus .
Sunction any secretion from the airway ,
sunction is airway , if sunction is
unavailable trunthe victims head to one
site .
Assess from pressure of carotid pulse .
(a) Corotid pulse is the most central 2
accesive artery in children over one
year . Now ever in an infants the
short stublay neck mases carotid
difficult rememner instead .
(b) Ringeris are mared up the ribcage
to notch where stermum in the
centre of the lower part of chest .
This supports the jaw 2 helps filt
the head back .
Prevent over inflain of the child
lung.
Prevents airways of the child
lung .
Carod artry pulse will persist
when may peripheras pulse are
notonger palpable perfoming
external cardiac comperession
on a victim who has a pulse may
result in senxir .
Medical complication
Result in maximum compression of
heart between sternum 2 ventetzrae ,

17. ( c) place fect of the hand on the
loewer half of sternum 2 place the
other hand or top of the hand on
sternum so that hand are parauel .
( d) fingers may be extended ar
interlaced but should be kept off the
chest .
Result in maximum result .
Reduce the risk of a rib
fracture during comresion .

18. S.NO PROPER HAND POSITION RATIONAL
(1)
(2)
(3)
(4)
(5)
Draw an emaginacy line blt nipple
over the breast bone ( sternum ) .
Place the index finger on the hand
farther from the infants hand just
under the infarmmary line where if
interseits sternums .
Using two ar there finger compress
19- 25 cm (1/2 -1 inches ) at least
100 time /mint .
At the end of very 5 compression
allow a pulse for ventilation ( ½ ½ )
seconds .
Re – assess the victim after 10 cyale
(5 compression one ventilation each
cycle .
Result maximum copression
.
Area of compreastion is one
finger with below this
intersection of middle 2 ring
fingers .
Promotes adequels cartial
out put .
Promate adequate
ventilation CPR .
Determine returen pulse 2
respiradion 2 the need to
continue CPR .
INFANT (1-12) MONTH

19. S.NO PROPER HAND POSITION RATIONAL
(1)
(2)
(3)
(4)
(5)
Locate the loewer margin of the
victims rib cage on site next to the
resecrre with middle margin & index
fingers .
Fallow margin arib cage with the
middle finger to match where ribs
sternum meet .
Place the index finger next to the
middle finger .
Place feel of the point where the
index finger axistance of the need
parrelled to sternum .
The resecure other hand maintain
the , 6 comprees sternum with one
hand 2.5 – 3.8 cm.
Result in maximum
compression .
Determines appropriate
areas for a compression .
Determine appropriate areas
for compression .
Promotes adequate cardiac
out –put .
Promotes adequate cardiac
out –put .
CHILD ( 1-7 YEAR )

20. (6)
(7)
At the end of every 5 compression
allow a puluse forventilation .
Reassess the victim after 5
comperession ventilation each
cycle .
Promate adequet
ventilation during C.P.R.
Determines rectams of pulse
& respiration & the need to
continue .

21. SING OF EFFETIVE RESUSCITION
Constriction of pupil key sing that btain is sufficiently
oxygeneted .
Distint pulsation with each cardial compression .
Blinking upon stimulation of the eye lid of the .
Decresed cyanosis .
Incarreat resuscitative technique .heart is drained of its blood
by hemorrhage of cardia tamponate .
Heart is drained of its blood by hemorrhage of v=cardia tamponate .
Blood supply to the heart is obstructed by the presence of pulmonary
embolism .
Sever chronic lung disease has destroyed lungs capacity to
oxygenates blood .
Lungs are fluid with vomitus as a rescue of aspiration during cardial
massage .

22. The circulation of blood is initiates with the external cardiac massage because
the pressure external on the pliable sternum squeezes the heart against the
spine fareing blood out of the heart againt the spine fareing blood out the
heart in to arota .
The fallows points to be taken in to consideration :-
1. The patients should be placrd on a heart .
2. The body of pt. should be harizontal b/c the blood pressure generate is not adequete to
pump the blood up the hed .
3. Assess property & indicate CPRwith in 3 mint of arrest .
4. Do not interrurt CPR for more than sever second .
5. Give CPR by maintaining basic type ABC.
6. Give compression only over sternum not on raise .
7. When you are giving cardiac comresion finger should be in upward direction to rib
fracture .
PRECAUTION

23. PAST RESUSCITATION MESURE
 Skilled after care is essestial For the Who has sufferd an arrest .
 Continuous vigilance must ensurned by skilled person for 48- 72 hrs
.
 Monitar ECG & blood pressure .
 Check the oral cavity & jaw position as his tongue may fall &
obstract the air way .
 Termp is taken every hour . A high temp usually indicates damage or
certral
 oedema .
 A chest x- ray film is obtained using rratable equipment ribs often
are accidently fracure during cardia massage .
 Insert an endatracheal tube if nit or alreacly in place ,this maintain
an open airway for the unconscious pls . Who can not clear
secretion by coughing .
 Give oxygen continuosly for 48 hrs , following .
 Record the procedure on the nurse record with data & time .

24. ARTICLES
 Defibrillatar with paddles .
 Interface material disposible
conductive get
 Resuscitative article .
ABC of CPR is based on asic 3
step:-
A – open the airway
determine breath loss ness .
B- breathing determine
palsdessness
C- circulation begib
compression .

25. ONE RESEY CPR ADULT :-
1. Determine unresponsiveness.
2. Shout for help .
A= AIRWAY:-
1. Open the airway using head hit than life the life head back & life the
most .
B = BREATHING :-
Give two farm breath (time 15 -2) second breath
pinch the nose & cover the mouth with your mouth give two brath watch
for the chest to arise .
 Check for a pulse (5-10 second ) feel for the carotid pulse .
C= CIRCULATION :-
Locate carrect hard position ½ of sternum.
 compress the sternum of 100 time per minute .
 Do is comperession .
 Give & fall breath .
 Do 4 cycles of 15 cm . a2 breath .
 Recheck pulse ( time 5 second in to pulse continue compression breathing
cycle .

26. 1. Exlernally support the circulation or respiratary of a victim of
cardiac ar respiratory arrest .
 Provide oxygen to the vital organ until treatment can restare
normal heart active .

27. SIGN AND SYMPTOMS
To sweat excessive .
Contriction of pupils .
Chest pain .
No pulse.
Breathless ness.
Unconscious .

28. DIAGNOSTIC EVALVATION
 PHIYSICAL
EXAMINATION :-
Head to toe examininition.
 HISTORY TAKING
:-
Present &
past history of the patiend .

29.  CHEST X-RAY :-  ELECTROCARDIOG
RAM :-
This first test clone dignose a heart
attach recards the electrial activity
of
your heart via electrods attached to
your skin .

30. MANAGEMENT
MEDICAL MANAGEMENT :-
Provide the stable position of the patient provide oxygen
therapy .
Provide quaely CPR procedure at pts . Condition .
Stope somiking .

31. PHARMACOLOGY MANAGEMENT
S .NO NAME OF THE
DRUG
DOSE ROUTE ACTION INDICATION
(1) Atropin sulphate . 2mg . Im . Increase the
heard rate
Bardyarrythmiss
.
(2) Calcium chloride
.
10 % Iv . Increase the rate
of venticular
contract .
Arrytrias .
(3) Doxamethesone 5mg. Iv . Reduce cerelzrol
be oedema
prodides vital the
life support .
Hypoxia .
(4) ( Dopamine
hydrochloride
Increase b.p . Hypotension .
(5) Frusemide (laxis) Increase diseresis
.
Premature
venticular
contaction .

32. NURSING
MANAGEMENT
1) Reduce the anxiety of patient .
2) To provide clean environment .
3) To improve the knowledge of the disease .
4) To provide the psychological support of the patient .

33. COMPLICATION
 damage to myocardium due to repeated high energy electrical
shocks .
Chest burndue to repeated high energy discharge & poor contact
betwwen the paddles & the skin .
Electraction of the by standers , formation of shart amount of
copnduction jelly applied on the paddlas this cause loss of electrical .

34. HEALTH EDUCATION
Intake output:-
Drink safe water.
Drink water 50ml/dl.
Use chlorine in drinking water.
Hygiene:-
maintain person hygiene.
Wash the hand before intake water and food.
Excersize:-
Active and pasive excersize.
To protecte the injury.
To maintain health.
Rest and sleep:-
Giving the active in patient to feel better in rest, sleep.
Rest for 8-10 hour.

35. BIBLIOGRAPHY