This document outlines the key aspects of cardiopulmonary resuscitation (CPR) including its objectives, components, signs of cardiac arrest, and the cardiac arrest algorithm. CPR involves chest compressions and ventilations to manually circulate blood and oxygenate tissues when someone's heart is not pumping effectively. The cardiac arrest algorithm details the steps to take including assessing breathing and pulse, beginning CPR with 30 chest compressions and 2 breaths, using an AED if available, and continuing CPR until emergency responders arrive or the victim starts moving. High-quality CPR is critical to survival and involves pushing hard and fast at the proper rate and depth along with limiting interruptions.

1. CARDIOPULMONARY
RESUSCITATION
LECTURE DEMONSTRATION
BLAISE B. NIEVE, MAN, RN (CLINICAL INSTRUCTOR)

3. OBJECTIVES
1. Describe the importance of high-
quality CPR and its impact on survival;
2. Integrate the BLS concepts of the Chain
of Survival;
3. Recognize the signs of someone
needing CPR;

4. OBJECTIVES
4. Perform high-quality CPR for an adult;
5. Appraise the importance of team in
multi-rescuer resuscitation; and
6. Perform as an effective team member
during multi-rescuer CPR.

6. CARDIOPULMONARY
RESUSCITATION
Combination of: oral resuscitation and
external cardiac massage;
Also referred to as basic life support
(BLS);

7. CARDIOPULMONARY
RESUSCITATION
Main Components:
Chest compressions, Airway, Breathing

8. CARDIAC ARREST
Cessation of cardiac function;
Unexpected and sudden;
Within 20 to 40 seconds of a cardiac arrest:
the victim is clinically dead;
After 4 to 6 minutes, the lack of oxygen
supply to the brain causes permanent and
extensive damage.

9. CARDIAC ARREST
Cardinal signs of cardiac arrest:
1. Apnea;
2. Absence of a carotid or femoral
pulse; and
3. Dilated pupils.

10. RESPIRATORY (PULMONARY) ARREST
Cessation of breathing;
May occur abruptly or be preceded by
short, shallow breathing that becomes
increasingly labored;

11. IMPORTANT!
Nurses also can be instrumental in
increasing community awareness of the
need for CPR training and ensuring its
availability.

12. CARDIAC ARREST ALGORITHM
(2015 AMERICAN HEART ASSOCIATION UPDATE)
Critical Characteristics of High-Quality
CPR:
1. Start compressions within 10 seconds of
recognition of cardiac arrest.
2. Push hard, push fast: Compress at a rate
of 100 to 120/min with a depth of:

13. CARDIAC ARREST ALGORITHM
(2015 AMERICAN HEART ASSOCIATION UPDATE)
Push Hard, Push Fast
▪Adults: At least 2 inches (5cm)
▪Children: At least one third the depth of the
chest, about 2 inches (5 cm), for children;
▪Infants: At least one third the depth of the
chest, about 1 ½ inches (4cm)

14. CARDIAC ARREST ALGORITHM
(2015 AMERICAN HEART ASSOCIATION UPDATE)
Critical Characteristics of High-Quality CPR:
3. Allow complete chest recoil after each
compressions;
4. Minimize interruptions in compressions
(try to limit interruptions to less than 10
seconds);

15. CARDIAC ARREST ALGORITHM
(2015 AMERICAN HEART ASSOCIATION UPDATE)
Critical Characteristics of High-Quality CPR:
5. Give effective breaths that make the
chest rise;
6. Avoid excessive ventilation.

16. COMPRESSION-VENTILATION RATIO
▪ Adult: 1 or 2 rescuers: 30:2
▪ Infant – Children:
▪ 1 rescuer: 30:2
▪ 2 or more rescuers: 15:2

17. COMPRESSION-VENTILATION RATIO
▪ Continuous compressions at a
rate of 100-120/min; Give 1 breath
every 6 seconds (10 breaths/min)
▪ Compression rate: 100-120/min

18. COMPRESSION DEPTH
▪ Adult: At least 2 inches (5cm)*
▪ Children: At least 1/3 AP diameter of
chest; About 2 inches (5cm)
▪ Infant: At least 1/3 AP diameter of
chest; About 1 1/2 inches (4cm)

19. HAND PLACEMENT
▪ Adult: 2 hands on the lower half of
the breastbone (sternum)
▪ Children: 2 hands or 1 hand (optional
for very small child) on the lower
half of the breastbone (sternum)

20. HAND PLACEMENT
▪ Infant:
• 1 rescuer: 2 fingers in the center of the
chest, just below the nipple line
• 2 or more rescuers: 2 thumb – encircling
hands in the center of the chest, just below
the nipple line

21. CALLING A CODE
▪ Each health care facility has policies and
procedures for announcing
cardiac/respiratory arrest and initiating
interventions;
▪ It is critical that each member of the
client care team know the procedure for
announcing this emergency.

22. THE CODE TEAM
▪ Made up of specially trained staff who
can handle the emergency;
▪ Calling the code summons the code team
to the location of the emergency.

23. THE CODE TEAM
Members:
1. Perform rescue breathing,
2. Deliver chest compressions,
3. Administer medications,
4. Make a record of the code activities, and
5. Code leader

24. CARDIAC ARREST
ALGORITHM
(2015 AMERICAN
HEART ASSOCIATION
UPDATE)

25. CARDIAC ARREST ALGORITHM
(2015 AMERICAN HEART ASSOCIATION UPDATE)
1. Victim scene safety.
2. Victim is unresponsive.
▪ Shout for nearby help. Activate emergency
response system via mobile device (if
appropriate).
▪ Get AED and emergency equipment (or send
someone to do so).

26. CARDIAC ARREST ALGORITHM
(2015 AMERICAN HEART ASSOCIATION UPDATE)
3. Look for no breathing or only gasping and
check pulse (simultaneously). Is pulse
definitely felt within 10 seconds?
Normal breathing, has pulse
No normal breathing, has pulse
No breathing or only gasping, no pulse

27. CARDIAC ARREST ALGORITHM
(2015 AMERICAN HEART ASSOCIATION UPDATE)
3a. Monitor until emergency responders arrive.
Normal breathing, has pulse

28. CARDIAC ARREST ALGORITHM
(2015 AMERICAN HEART ASSOCIATION UPDATE)
3b. Provide rescue breathing: 1 breath every 5-6
seconds, or about 10-12 breaths/min
▪ Activate emergency response system (if not
already done) after 2 minutes
▪ Continue rescue breathing; Check pulse about
every 2 minutes. If no pulse, begin CPR.
No normal breathing, has pulse

29. CARDIAC ARREST ALGORITHM
(2015 AMERICAN HEART ASSOCIATION UPDATE)
▪ If possible opioid overdose, administer
naloxone if available per protocol.
No normal breathing, has pulse

30. CARDIAC ARREST ALGORITHM
(2015 AMERICAN HEART ASSOCIATION UPDATE)
3c. Begin CPR
No breathing or only gasping, no pulse

31. CARDIAC ARREST ALGORITHM
(2015 AMERICAN HEART ASSOCIATION UPDATE)
4. Cardiopulmonary Resuscitation (CPR)
▪ Begin cycles of 30 compressions and 2
breaths*.
▪ Use AED as soon as it is available.
5. AED arrives.
6. Check rhythm. Shockable rhythm?

32. CARDIAC ARREST ALGORITHM
(2015 AMERICAN HEART ASSOCIATION UPDATE)
7. Yes, shockable
▪ Give 1 shock.
▪ Resume CPR immediately for about 2 minutes
(until prompted by AED to allow rhythm
check).
▪ Continue until ALS providers take over of
victim starts to move.

33. CARDIAC ARREST ALGORITHM
(2015 AMERICAN HEART ASSOCIATION UPDATE)
8. No, non-shockable
▪ Resume CPR immediately for about 2 minutes
(until prompted by AED to allow rhythm
check).
▪ Continue until ALS providers take over or
victim starts to move.

38. CONTRAINDICATION(S)
1. Advanced directives

39. END OF CPR DISCUSSION
© Nieve