CPR involves chest compressions and rescue breathing to restore circulation and oxygen to the brain when someone's heart has stopped. It was invented in 1960 and involves compressing the chest 100 times per minute and giving 2 rescue breaths. The purpose is to maintain life until emergency services arrive. When performing CPR, one should first check for response, shout for help, open the airway, check for breathing, call for help, then give 30 chest compressions followed by 2 rescue breaths and continue CPR until help arrives or spontaneous circulation returns.

1. PREPARED BY,
MR. JAGDISH SAMBAD
M.SC. NURSING-M.S.N,
BALAJI COLLEGE OF NURSING,

2. INTRODUCTION
• CPR (or cardiopulmonary resuscitation) is a combination of
rescue breathing (mouth-to-mouth resuscitation) and chest
compressions. If someone isn't breathing or circulating blood
adequately, CPR can restore circulation of oxygen-rich blood
to the brain. Without oxygen, permanent brain damage or
death can occur in less than 8 minutes.
• CPR alone is unlikely to restart the heart; its main purpose is
to restore partial flow of oxygenated blood to the brain and
heart. It may delay tissue death and extend the brief window
of opportunity for a successful resuscitation without
permanent brain damage. CPR may however induce a
shockable rhythm. CPR is generally continued until the
person regains return of spontaneous circulation (ROSC) or
is declared dead.

3. HISTORY
• CPR was invented in the year 1960. The invention of
this procedure is credited to surgeon and innovator
PETER SAFAR.
• The first effort at testing the technique was performed
on a dog by Redding, Safar and JW Pearson. Soon
afterward, the technique was used to save the life of a
child.
• In the 19th century, Doctor H. R. Silvester described a
method (The Silvester Method) of artificial respiration
in which the patient is laid on their back, and their
arms are raised above their head to aid inhalation and
then pressed against their chest to aid exhalation.
• The procedure is repeated sixteen times per minute.
• As time passed on, and gradual modification in this
procedure is known as cardio-pulmonary resuscitation.

4. DEFINITION
• Cardiopulmonary resuscitation (CPR) is a
combination of mouth-to-mouth resuscitation
and chest compressions that delivers oxygen
and artificial blood circulation to a person who is
in cardiac arrest. It can be life-saving first aid.

5. IMPORTANCE OF C.P.R.
REVIVAL VALUE
BETTER CHANCE OF SURVIVAL
REDUCE MORBIDITY AND MORTALITY
PREVENT BRAIN DAMAGE
PROVIDE CONTINUITY OF CARE

6. PURPOSES OF CPR
MAINTAIN
• SAVE LIFE OF THE PATIENT.
• PROVIDE BASIC LIFE
SUPPORT TILL MEDICAL AND
ADVANCED LIFE SUPPORT
ARRIVES.

7. INDICATION OF CPR
INDICATION
FOR CPR
RESPIRATOR
Y FAILURE
NEUROLOGICAL
DISTURBANCE
OTHERS
CARDIAC
ARREST

8. CONFIRMING THE NEED OF
CPR

10. STANDARDS OF CPR

11. CHAIN OF SURVIVAL

12. SEQUENCES OF PROCEDURES
PERFORMED TO RESTORE THE
CIRCULATION OF OXYGENATED BLOOD
AFTER A SUDDEN PULMONARY AND/OR
CARDIAC ARREST
CHEST COMPRESSIONS AND PULMONARY
VENTILATION PERFORMED BY ANYONE
WHO KNOWS HOW TO DO IT, ANYWHERE,
IMMEDIATELY, WITHOUT ANY OTHER
EQUIPMENT

13. Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 108
30 chest compressions
2 rescue breaths

14. APPROACH SAFELY!
WATCH
OBSERV
E
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 108
30 chest compressions
2 rescue breaths

15. CHECK RESPONSE
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 112
30 chest compressions
2 rescue breaths

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

17. SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 112
30 chest compressions
2 rescue breaths

18. OPEN AIRWAY
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 112
30 chest compressions
2 rescue breaths

19. OPEN AIRWAY
Head tilt and chin lift
- lay rescuers
- non-healthcare rescuers
No need for finger sweep
unless solid material can be seen
in the airway

20. OPEN AIRWAY
Head tilt, chin lift + jaw thrust

21. CHECK BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 108
30 chest compressions
2 rescue breaths

22. CHECK BREATHING
• Look, listen and feel
for NORMAL breathing
• Do not confuse agonal
breathing with
NORMAL breathing

23. • Occurs shortly after the heart stops
in up to 40% of cardiac arrests.
• Described as barely, heavy, noisy or
gasping breathing.
• Recognise as a sign of cardiac arrest.

24. Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 108
30 chest compressions
2 rescue breaths

25. 30 CHEST COMPRESSIONS
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 108
30 chest compressions
2 rescue breaths

26. • Place the heel of one hand in
the centre of the chest
• Place other hand on top
• Interlock fingers
• Compress the chest
– Rate 100 min-1
– Depth 4-5 cm (1.5 to 2 inch)
– Equal compression :
relaxation
• When possible change CPR
operator every 2 min
CHEST
COMPRESSIONS

27. RESCUE BREATHS
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 112
30 chest compressions
2 rescue breaths

28. • Pinch the nose
• Take a normal breath
• Place lips over mouth
• Blow until the chest
rises
• Take about 1 second
• Allow chest to fall
• Repeat

29. RECOMMENDATIONS:
- Tidal volume
500 – 600 ml
- Respiratory rate
give each breaths over about 1s with enough
volume to make the victim’s chest rise
- Chest-compression-only
continuously at a rate of 100 min

30. CONTINUE CPR
30 2

31. •Coronary vessel injury
•Diaphragm injury
•Hemopericardium
•Hemothorax
•Interference with ventilation

32. •Liver injury
•Myocardial injury
•Pneumothorax
•Rib fractures
•Spleen injury
•Sternal fracture

34. Adrenaline
• Adrenaline (epinephrine) is the main drug used
during resuscitation from cardiac arrest.
Atropine
• Atropine as a single dose of 3mg is sufficient to
block vagal tone completely and should be used
once in cases of asystole. It is also indicated for
symptomatic bradycardia in a dose of 0.5mg -
1mg.
Amiodarone
• It is an antiarrhythmic drug.

35. • Maintains airway patency with use of airway
adjuncts as required (suction, high flow
oxygen with O2 or bag valve mask
ventilation).
• Assist with intubation and securing of ETT
• Inserts gastric tube and/or facilitates gastric
decompression post intubation as required.
• Assists with ongoing management of airway
patency and adequate ventilation

36. • Supports less experienced staff by
coaching/guidance e.g. drug preparation
• If a shockable rhythm is present (VF/VT) ensure
manual defibrillator pads are applied and
connected.
• If CPR is in progress, prepare and
independently double check and label 3 doses
of adrenaline
• Prepare and administer IV fluids
• Document medications administered (including
time)