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Rohini Pandey
1st Year M.Sc.Nursing
KGMU Institute Of Nursing
HISTORY
• 1740- The Paris Academy of sciences officially
recommended mouth to mouth resuscitation
for drowning victims.
• 1767- The Society for the Recovery of Drowned
Persons became the first organized effort to
deal with sudden & unexpected death.
• 1891- Dr. Friedrich Maass performed the first
documented chest compression in humans.
• 1960- CPR was developed.
CPR is a technique of basic life support for
oxygenating the brain and heart until
appropriate, definitive medical treatment
can restore normal heart and ventilatory
action.
HEART
The heart is
a muscular organ in
humans and other
animals, which
pumps blood through
the blood vessels of
the circulatory system.
• To maintain Blood circulation
by external cardiac massages
(C).
• To maintain an open and clear
airway (A).
• To maintain breathing by
external ventilation (B).
• To save life of the Patient.
• To provide basic life support till
medical and advanced life
support arrives.
Cardiac Arrest
Respiratory Arrest
PRINCIPLES OF CPR
• To restore effective circulation
and ventilation.
• To prevent irreversible cerebral
damage due to anoxia. When
the heart fails to maintain the
cerebral circulation for
approximately four minutes the
brain may suffer irreversible
damage.
1. Sequences of procedures performed to
restore the circulation of oxygenated
blood after a sudden pulmonary and/or
cardiac arrest.
2. Chest compressions and pulmonary
ventilation performed by anyone who
knows how to do it, anywhere,
immediately, without any other
equipment.
ARTICLES REQUIRED
• Arrest board/ back board/ flat surface.
• Oral airway.
• A piece of lint to place over victim’s
mouth or oral barrier device for mouth
to mouth respiration.
• Mask and Ambu bag.
Approach safely
Chest Compression
Open airway
Check breathing
Call 108
Check response
Shout for help
2 rescue breaths
APPROACH SAFELY!
• WATCH
• OBSERVE
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 108
30 chest compressions
2 rescue breaths
CHECK RESPONSE
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 112
30 chest compressions
2 rescue breaths
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
SHOUT FOR HELP
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 112
30 chest compressions
2 rescue breaths
Chest Compression
Approach safely
Check response
Shout for help
Chest compression
Check breathing
Call 112
30 chest compressions
2 rescue breaths
• 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
– Depth 4-5 cm (1.5 to 2 inch)
– Equal compression : relaxation
• When possible change CPR
operator every 2 min
CHESTCOMPRESSIONS
OPEN AIRWAY
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 112
30 chest compressions
2 rescue breaths
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
OPEN AIRWAY
Head tilt, chin lift + jaw thrust
CHECK BREATHING
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 108
30 chest compressions
2 rescue breaths
CHECK BREATHING
• Look, listen and feel
for NORMAL
breathing
• Do not confuse agonal
breathing with
NORMAL breathing
• 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
Approach safely
Check response
Shout for help
Open airway
Check breathing
Call 108
30 chest compressions
2 rescue breaths
RESCUEBREATHS
Check response
Shout for help
Chest compression
Open airway
Check breathing
Call 112
30 chest compressions
2 rescue breaths
Approach safely
• 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
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
CONTINUE CPR
30 2
• Coronary vessel injury
• Diaphragm injury
• Hemopericardium
• Hemothorax
• Liver injury
• Myocardial injury
• Pneumothorax
• Rib fractures
• Spleen injury
• Sternal fracture
Adrenaline
• Adrenaline (epinephrine) is the main
drug used during resuscitation from
cardiac arrest.
• 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
• 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)
ANY QUESTION?
SUMMERIZATION
CONCLUSION
THANKYOU

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Cpr

  • 1. Rohini Pandey 1st Year M.Sc.Nursing KGMU Institute Of Nursing
  • 2.
  • 3. HISTORY • 1740- The Paris Academy of sciences officially recommended mouth to mouth resuscitation for drowning victims. • 1767- The Society for the Recovery of Drowned Persons became the first organized effort to deal with sudden & unexpected death. • 1891- Dr. Friedrich Maass performed the first documented chest compression in humans. • 1960- CPR was developed.
  • 4. CPR is a technique of basic life support for oxygenating the brain and heart until appropriate, definitive medical treatment can restore normal heart and ventilatory action.
  • 5. HEART The heart is a muscular organ in humans and other animals, which pumps blood through the blood vessels of the circulatory system.
  • 6.
  • 7.
  • 8. • To maintain Blood circulation by external cardiac massages (C). • To maintain an open and clear airway (A). • To maintain breathing by external ventilation (B). • To save life of the Patient. • To provide basic life support till medical and advanced life support arrives.
  • 10. PRINCIPLES OF CPR • To restore effective circulation and ventilation. • To prevent irreversible cerebral damage due to anoxia. When the heart fails to maintain the cerebral circulation for approximately four minutes the brain may suffer irreversible damage.
  • 11. 1. Sequences of procedures performed to restore the circulation of oxygenated blood after a sudden pulmonary and/or cardiac arrest. 2. Chest compressions and pulmonary ventilation performed by anyone who knows how to do it, anywhere, immediately, without any other equipment.
  • 12. ARTICLES REQUIRED • Arrest board/ back board/ flat surface. • Oral airway. • A piece of lint to place over victim’s mouth or oral barrier device for mouth to mouth respiration. • Mask and Ambu bag.
  • 13. Approach safely Chest Compression Open airway Check breathing Call 108 Check response Shout for help 2 rescue breaths
  • 14. APPROACH SAFELY! • WATCH • OBSERVE 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. Chest Compression Approach safely Check response Shout for help Chest compression Check breathing Call 112 30 chest compressions 2 rescue breaths
  • 19. • 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 – Depth 4-5 cm (1.5 to 2 inch) – Equal compression : relaxation • When possible change CPR operator every 2 min CHESTCOMPRESSIONS
  • 20. OPEN AIRWAY Approach safely Check response Shout for help Open airway Check breathing Call 112 30 chest compressions 2 rescue breaths
  • 21. 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
  • 22. OPEN AIRWAY Head tilt, chin lift + jaw thrust
  • 23. CHECK BREATHING Approach safely Check response Shout for help Open airway Check breathing Call 108 30 chest compressions 2 rescue breaths
  • 24. CHECK BREATHING • Look, listen and feel for NORMAL breathing • Do not confuse agonal breathing with NORMAL breathing
  • 25. • 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
  • 26. Approach safely Check response Shout for help Open airway Check breathing Call 108 30 chest compressions 2 rescue breaths
  • 27. RESCUEBREATHS Check response Shout for help Chest compression Open airway Check breathing Call 112 30 chest compressions 2 rescue breaths Approach safely
  • 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
  • 31.
  • 32. • Coronary vessel injury • Diaphragm injury • Hemopericardium • Hemothorax
  • 33. • 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.
  • 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)