CPR involves procedures to manually maintain heartbeat and breathing when these functions have stopped. It provides oxygen to vital organs until medical treatment can restore normal heart function. CPR consists of opening the airway, providing rescue breaths, and external chest compressions to circulate blood. The goals are to keep oxygenated blood flowing to the brain and heart until definitive treatments like defibrillation can be applied. CPR is used to treat cardiac arrest from conditions like heart attacks, drug overdoses, and respiratory issues.

1. BY
ASHOK BISHNOI
Lcturer,JINR

2. INTRODUCTION:-
 Sudden death occur when heartbeat &
breathing stop suddenly or unexpectedly.
the major role of CPR is to provide oxygen to
heart ,brain,& the other vital organ until
medical treatment (advance cardiac life
support-ACLS) can restore normal heart
action.

3. DEFINITION:-
 Angela Morrow RN
Cardiopulmonary resuscitation
(CPR) is a procedure used when a patient's heart stops
beating and breathing stops. It can involve
compressions of the chest or electrical shocks along
with rescue breathing.
 Mosby medical dictionary
CPR is a basic emergency
procedure for life support consisting of artificial and
manual external cardiac massage
.

4. CHAIN OF SURVIVAL:-

5. INDICATIONS:-
 Cardio vascular disorders
CAD, congenital heart diseases , coronary
embolism, cardiac rupture & dissection
 Pulmonary causes
pulmonary embolism, pulmonary edema, asphyxia
 Metabolic causes
hypoglycemia, electrolyte imbalances

6.  Fluid imbalance
extensive hemorrhage, hypotension, shock
 Neurological causes
brain injuries, massive cva
 Poisons substance and drug overdose
co poisoning, propanolol over dose
 Other causes
electrical shock, hypothermia, narcotic overdose

7. WARNING SIGNS OF CARDIO
PULMONARY ARREST:-
 Early signs:
. loss of consciousness & convulsions
 Late signs:
. Apnoea
.Dilated pupils
.Absence of heart sounds

8.  Other signs
 Changes in respiratory rate
 A weak or irregular pulse
 Bradycardia
 Cyanosis
 Hypothermia

9. CPR PROCEDURE

10. EQUIPMENTS
i. Ambu bag and masks with different size.
ii. Oropharyngeal airways.
iii. Endotracheal tubes of appropriate
sizes and stillet.
E
T
T
U
B
E

11. iv. Paediatric laryngoscope
with straight (Miller) and
curved (McIntosh)
blade – Appropriate sizes.
v. Suction apparatus.
vi. NG tube.

12. i. IV equipments & fluids
ii. Pulse-oxymetry
iii. Oxygen sources
iv. Automated external defibrillator
v. Emergency drugs
vi. Cardiac monitor

13. STEPS FOR CPR:-
Airway:-Maintaining an open airway.
Breathing:-Providing artificial ventilation by rescue
breathing.
Circulation:-Promoting artificial circulation by
external cardiac compression.
Defibrillation:-Restoring the heart beat.

14. 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

15. (A) AIRWAY :-
 Head tilt chin lift manoeuvre
 Jaw thrust manoeuvre

16.  HEAD TILT CHIN LIFT MANOEUVRE

17.  JAW THRUST MANOEUVRE

18. (B) Breathing:-
Look Listen Feel

19. Method:
 Mouth to mouth ventilation
 Mouth to mask ventilation
 Bag mask ventilation

20.  MOUTH TO MOUTH VENTILATION

21. MOUTH TO MASK VENTILATION

22. BAG MASK VENTILATION

23. NEONATAL PEDIATRIC ADULT

24. (C) Circulation:-
Assess pulse
{Adult}

25. Assess pulse (infant)

26. CHEST COMPRESSIONS

27. • 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 3-5 cm(1.5 to 2 inches)
– Equal compression : relaxation
• When possible change CPR
operator every 2 min
CHEST COMPRESSIONS

28. IN ADULT

29.  IN CHILD

30.  IN INFANT

31. (D) DEFIBRILLATION:-
 Device that delivers direct electrical current
across the myocardium. The aim is to produce
synchronous depolarization of cardiac muscle
STRATEGIES:
Test defibrillate for
 full battery charge
 switch on power button
 change paddle mode

33.  Key issues:
Paddle site: Rt intraclavicular region
lt lower axillary region
Paddle size: 8cm -12 cm
wave form patterns :
monophasic
biphasic truncated exponential
biphastic rectilinear

34. Energy level:
Pediatric : 2-4 J/kg
Adult: Monophasic=> 360J
Biphasic truncated=> 150-200J
Biphasic rectilinear=> 120 J

36.  STEPS:-
 switch on
 select paddle mode
 assess rhythm
 press paddles firmly over the chest
 deliver the shock
 resume cpr

37. Intensive care:-(shifting in ICU)
 transfer to ICU
 monitor closely and continuously
 monitor vital signs every hour
 watch for convulsions
 intubate if necessary
 catheterize the patient and monitor output
 record the procedure

38. POST CARDIAC ARREST MANAGEMENT:-
Continued care
 To ensure hemodynamic monitoring
 To minimize the effect of loss of spontaneous
circulation of various organs
 To recognize and treat recurrent cardiac arrests
Objectives:
 Optimize cardio pulmonary function& systemic
perfusion
 Transport victim out of hospital
 Identify and treat thre precipating factor
 Intitute measure to prevent recurrence and improve
neurological function

39.  Respiratory system;
 Intubate & mechanically ventilate until they are stable
 Administer supplemental oxygen
 Obtain chest x ray
 Administer drugs
 Avoid hyperventilation
 Cardio vascular system:
 Obtain expert consultation
 Monitor ecg , x-ray, lab analysis,
 Monitor intra arterial blood pressure
 Administer drugs

40. COMPLICATIONS OF CPR:-:-
 Rib fractures
 Laceration related to the tip of the
sternum
 Liver, lung, spleen
 Aspiration
 Vmiting