CPR

1. BASIC LIFE SUPPORT
GUIDELINES

2. RESUSCITATION
 Means Cardiopulmonary
resuscitations
 Anywhere Anybody can do

3. CPR…
 Considered when an individual
cannot adequately breathe and
maintain circulation to vital
organs.

4. WHY& WHEN TO DO IT ?
 Without CPR , irreversible
brain damage occurs within
3-4 minutes
 Should be done immediately
by a bystander
 TIME is the crucial factor
here to decide the survival

5. Minutes counts...
 when the heart stops,
damage occurs to the
Brain within < 5
minutes
 start BLS early

6. CPR…
BLS
ACLS
ALS
ANLS
CPCR – Cardio Pulmonary
Cerebral resuscitation

7. CPR… ABCDEF
How ?
 Airway
 Breathing BLS
 Circulation
 Drugs
 ECG ACLS
 Fibrillation

8. The Sequence of BLS
 Establish Unresponsiveness
 If no response call for help
 Start BLS------- A- Airway
B- Breathing
C- Circulation

9. CPR…
RECOGNITION
Is crucial in BLS
Determine
 Unresponsiveness
 Breathlessness
 Pulselessness

10. No victim should undergo
CPR
until the need
for resuscitation
is established.

12. 2. Check the Victim and see if he
responds
Gently SHAKE his shoulder
Ask loudly “Are you all
right?”

14. 3A. Responds by answering or
moving
 Leave him in the position.
 Reassess him regularly.

15. 3B. If no response
 SHOUT for help (Call for
defibrillator)
 Turn to his back and open airway.
 HEAD TILT  Hand on forehead.
 Remove any visible obstruction.
 CHIN LIFT  finger tips under the
point of chin.
Avoid head tilt in
Trauma

16. CPR…
Activation of EMS
Call for help
Call for ambulance
services
Emergency

17. BLS ALGORHYTHM
CHECK RESPONSIVENESS
OPEN AIRWAY
CHECK BREATHING
ventilation
A
B
CIRCULATION
C

18. CPR…
Airway - First basic skill
 Head tilt
 Chin lift
 Jaw thrust
 Airways
 ET intubation
 Newer airways

19. CPR…
AIRWAY
Head tilt
Jaw thrust
Chin lift

20. CPR…
Breathing – Second basic skill
 LOOK for chest movement
 LISTEN for breath sounds
 FEEL for air on your cheek
 2 slow effective rescue breathing

21. LOOK, LISTEN
AND FEEL
LOOK
LISTEN
FEEL

22. 5A. Breathing Normally
 Turn him into recovery Position.
 Send or go for help.
 Check for continued breathing.

23. Recovery position.
To maintain a good airway
To minimize the risk of aspiration

24. Recovery Position
 To Maintain a good airway.
 To Minimize the risk of aspiration.

25. 5B. Not Breathing
Rescue breathing
 Ensure head tilt and
chin lift.
 Pinch the Nose.
 Two Slow effective
breaths.
Rise and fall of the
Chest

26. Rescue Breathing
 Required if breathing is absent
or inadequate
 Give 2 slow breaths sufficient
to make the chest rise
 Adult: Over 2 seconds
 Child & Infant: Over 1 – 1 ½
seconds

27. Rescue Breathing Techniques
 Mouth-to-Mouth
 Mouth-to-Barrier
 Mouth-to-Nose
 Mouth-to Mask
 Bag-mask
device

28. Any difficulty achieving an
effective breath.
 Recheck Victims mouth.
 Recheck head tilt and chin lift.
 Make up to 5 attempts.
 Even in unsuccessful, move on
to assessment of circulation.

29. NO - Circulation
 Absent carotid pulse.
 Lay Rescuer.
 Normal Breathing.
 coughing
 Movement.
Sign of Cardiac arrest.
No More than 10 Sec.

30. CAROTID PULSE
 Identify Adam’s apple (Thyroid
Cartilage).
 Slide down to the groove.
 Palpate pulse in the groove.
 Never Palpate on both sides
simultaneously.

32. 7A. Circulation Present
 Continue rescue breathing.
 Recheck rescue breathing.
 Normally breathing  Recovery
Position.

33. 7B. No signs of Circulation
 Chest compressions.
 Identity middle of Lower half of
Sternum.
 compressions by heel of the hands.
 After 15 Compressions tilt the head,
lift the chin and give 2 effective
breaths.

34. Chest Compressions
No pulse present
START CHESTCOMPRESSIONS
Compression Rate:
Adult, Child, & Infant – 100/min

35. TECHNIQUE OF EXTERNAL
CARDIAC COMPRESSION
 Rescuer to one side of the patient
 Patient’s chest exposed and
xiphisternum identified
 Xiphisternum –Bony prominence in
the mid line at the junction of lower
borders of the ribs
 The index and middle fingers of the
lower hand placed on the
xiphisternum and heel of the other
hand is placed adjacent to them on
the sternum

36. Heel of the second hand placed
on the back of the hand on the
sternum
Fingers may be interlocked
Sternum depressed vertically4-
5cm and then released rapidly
Repeated at a rate of 80-
100/minwith compression and
relaxation each taking the same
length of time

37. Locate rib cage

38. Position your hands over middle of lower
half of sternum and fingers away from
Chest

39. Compression of Chest
Arms Vertical
Arms Straight
Press
Depress
4-5Cm

41. CPR
15 x 2 x
Chest compressions Breathing
One Rescuer

42. Two rescuers

43. Depth of Compression
 Adult: 1 ½ - 2 inches or enough
to generate a pulse
 Child & Infant: 1/3 – ½ the depth
of the chest or enough to generate
a pulse

44. Continue Resuscitation
Until
 Qualified help arrives and takes
over.
 Victim shows signs of life.
 You become exhausted.

45. Reassessment (10 seconds)
 Should be performed after the first
minute of CPR and every few
minutes thereafter
 If no pulse- resume CPR
 If pulse and breathing present-
place in recovery position
 If pulse present but no breathing-
provide rescue breathing

46. BLS Algorithm
CHECK RESPONSIVENESS
OPEN AIRWAY
CHECK BREATHING
BREATHE
ACCESS CIRCULATION
10 seconds only
CIRCULATION PRESENT
Continue Rescue Breathing
NO CIRCULATION
Compress Chest
Shake & Shout
Head tilt / Chin lift
Look, Listen and Feel
2 Effective Breaths
Signs of a Circulation
100 Per Minute 15:2 Ratio
Check Circulation every Minute

47. CPR…
 Nutshell
Adult Paediatric
Breath rate 10 – 12
bpm
20 bpm
Pulse check Carotid Brachial
Compression
rate
100/min >100/min
Compression
method
Hands
interlaced
Two or three
fingers or heel
of one hand
CV ratio 15 : 2 5 : 1
FB
obstruction
Heimlich
maneuver
Back blows
and chest
thrusts

48. ACLS
 Special equipments and
techniques
 ECG monitoring
 Defibrillation
 iv access
 Drug therapy
 Post resuscitation care

49. NOW HE IS SAFE IN HELPING
HANDS