This document discusses cardiopulmonary resuscitation (CPR) and the steps of basic and advanced life support. It states that CPR should begin immediately as brain damage can start within 4-6 minutes. The goals of CPR are to support oxygenation, ventilation and circulation until spontaneous circulation returns. Basic life support involves opening the airway, checking for breathing, giving breaths, checking the pulse and providing chest compressions. Advanced life support uses additional airway techniques and drugs to treat cardiac rhythms and reversible causes of cardiac arrest.

1. CARDIOPULMONARY
RESUSCITATION

2. Some basic points…
What are the vital organs?
Why only C – P – C – R?

3. Start CPR Immediately
Better chance of survival
Brain damage starts in 4-6 minutes
Brain damage is certain after 10
minutes without CPR

4. Support & restore effective oxygenation,
ventilation and circulation with return of intact
neurological function.
Intermediate Goal:
Return of spontaneous circulation (ROSC)

5. Approach
 BLS ( Basic Life Support) Primary survey.
 ACLS (Advanced Cardiovascular Life Support)
Secondary survey

6. Cardiopulmonary
Resuscitation
A - Airway
B - Breathing
C - Circulation
D- Defibrillation

7. Basic life support
 BLS

8. BLS Primary Survey….components
Assess Action
Airway
Open?
Head tilt- chin lift or jaw thrust
Breathing
Yes/ adequate?..... Look, Listen and Feel
2 Breaths using a barrier device,
Each over 1 sec, visible chest rise.
Circulation
Pulse present?...Carotid 5- 10 sec.
CPR until AED arrives.
C:V -30:2 5 cycles over 2 min.
Defibrillation
AED/ Shockable rhythm
Shock as indicated.
Resume CPR with compressions.

9. CHECK FOR
MOVEMENT
OR
RESPONSE

10. PHONE
EMERGENCY
NUMBER
OR
SEND SECOND
RESCUER TO
DO THIS

11. OPEN
THE
AIRWAY

12. CHECK
FOR
BREATHING
“LOOK”
“LISTEN”
“FEEL”

13. If he is breathing normally
• Turn him into the recovery position
• Send or go for help, or call for an ambulance.
• Check for continued breathing.

14. If he is not breathing normally
 Give 2 rescue breaths
• 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

15. GIVE TWO
BREATHS
CHEST
SHOULD
RISE

16. CHECK PULSE
CHECK
CAROTIDS
TIME
ALLOWED :
10 SECONDS

17. If there is pulse
- Give 1 breath every 5-6sec
- Recheck pulse every 2 min

18. 30
CARDIAC
COMPRESSIONS
2 BREATHS

19. Chest Compressions
 Patient positioning:
Firm and hard surface (ground, table/ hard bed) deflate air/
water mattresses.
 Rescuer's position:
Level with patient, elbows vertically straight and locked,
shoulders directly above the hands, heel of one palm over the
other.
 Site : sternum in inter-mammary line.
 Depth: 11/2- 2 inches.
 Rate: (5 cycles of 30:2-C:V over 2 min.).
 Allow complete chest recoil.

20. CHEST COMPRESSIONS
30 CHEST COMPRESSIONS

21. Single Rescuer BLS demo

22. AED

24. ECG RHYTHMS

25. TALL
WIDE
QRS COMPLEXES
PATIENT HAD
NO PULSE
PULSELESS
VENTRICULAR
TACHYCARDIA

26. UTTER CHAOS!!!
VENTRICULAR
FIBRILLATION

27. FLAT LINE!!!
ASYSTOLE

28. IS
NOT
THE ECG NORMAL?
YES!
BUT THE PATIENT
HAS NO PULSE!!!
PULSELESS
ELECTRICAL
ACTIVITY

29. DEFIBRILLATORS
Principle
Types : Monophasic (360 JOULES)
Biphasic (120 – 200 Joules)

30. ADVANCED
CARDIAC
LIFE SUPPORT

31. ACLS Secondary survey
Advanced, invasive assessment and management techniques
required.
Basic airway adjuncts:
OPA, NPA
Advanced Airway interventions:
Combitube, LMA, Endotracheal intubation.
Advanced circulatory interventions:
Drugs to control heart rhythm and blood pressure.

33. Airway in ACLS
 Once an advanced airway is placed
 Continuous chest comressions without interruptions
for breaths
 Artificial breaths at the rate of 8 – 10 / minute
 Avoid hyperventilation

34. Drugs used in CPR - ACLS
 Adrenaline – for VF,VT,PEA,Asytole
- 1 mg every 3 – 5 minutes
- IV or IO
 Vasopressin – for VF,VT,PEA,Asytole
-40 U
- IV or IO
- as an alternative for I or II dose of
adrenaline

35. Drugs used in CPR - ACLS
 Atropine – Only for Aystole and slow PEA rate
- 1 mg
- I.V / I.O
- Repeat every 3 – 5 minutes

36. Drugs used in CPR – ACLS –
Anti- arrythmics
 In cases of VF / Pulseless VT
 Amiodarone : 300 mg IV / IO once,
then 150 mg IV/IO once
 Lidocaine : 1 – 1.5 mg as the I dose,
then, 0.5 – 0.75 mg/Kg IV/IO
Maximum of 3 doses or 3 mg /Kg
 Magnesium : 1 – 2 mg IV/IO

37. Common Reversible Causes
H`s T`s
Hypovolemia Toxins
Hypoxia Tamponade (cardiac)
Hydrogen ion (Acidosis) Tension pneumothorax
Hyper-/ Hypokalemia Thrombosis (coronary/ pulmonary)
Hypoglycemia Trauma
Hypothermia

38. DO REMEMBER
TO LOOK FOR AND TREAT
THE FACTOR WHICH LEAD TO
THE CARDIAC ARREST!!!

39. ADVANCED CARDIAC
LIFE SUPPORT
ALGORITHM

41. Thank u