Cpr

1. CPR
Dr.Mrs.Lakshmi.R
Lecturer, CON
JIPMER

2. DEFINITION:
It is a technique of basic life support for
the purpose of oxygenating the brain and
Heart, until definitive medical treatment
can restore the normal heart & ventilatory
function

3. Causes
MECHANICAL:
• Accident
• Burn
• Gas inhalation
• Drowning

4. Causes
PULMONARY:
• Lung injury
• Neuro muscular disease
• Pulmonary embolism
• Respiratory failure

5. DRUGS:
• Cardiac depressant drugs
• Anti arrhythmic drugs

6. METABOLIC&ELECTROLYTE
IMBALANCE:
• Hypoglycemia
• Hyperkalemia
• Hypokalemia
• Hypocalcaemia
• Hypo & Hypernatremia

7. SIGNS & SYMPYOMS:
IMMEDIATE:
• Unresponsiveness
• Unconsciousness
• No pulse

8. Late signs &symptoms:
• Cold and clammy extremity
• Cyanosis
• Dilated pupil

9. PHASE ONE:
Basic Circulation
Life Airway
Support Breathing

10. PHASE TWO:
Advanced Defibrillation&
Cardiac Drugs
Life ECG
Support

11. PHASE 3:
Prolonged Gauging
Life Human mentation
Support Intensive care

12. AMERICAN HEART ASSOCIATION:
2010 GUIDELINES
Health Care Provider
 “PUSH HARD AND PUSH FAST”
 At least 100 COMPRESSIONS / MINUTE*
 Allow the chest to recoil -- equal compression and relaxation times
 <10 seconds for pulse checks or rescue breaths
 Compression Depth*
 Adults 2”
 Child/Infant 1/3 depth of chest 1.5" infant 2" child
 Avoid excessive ventilations

13.  A-B-C changed to C-A-B*
 Critical element is chest compressions
 Delay in A-B
 Avoidance of A & B
 Early defib
 If alone--call and retrieve AED
 Exception asphyxial arrest
AMERICAN HEART ASSOCIATION:
2010 GUIDELINES

14. • Cricoid pressure not recommended
• Advanced airway = 1 every 6-8 seconds
• Adult: 1 every 5-6 Peds: 1 every 3
• With advanced airway- no pause
AMERICAN HEART ASSOCIATION:
2010 GUIDELINES

16. Simplified
Universal
BLS algorithm

17. Electrical Therapies
• Shock first vs CPR first
• No precordial thump
• AED in hospital (goal to shock =< 3 mins)
AMERICAN HEART ASSOCIATION:
2010 GUIDELINES

18. ACLS
• Simplified algorithm
• Optimized CPR quality with monitoring
• Waveform capnography (>12 mmHg)
• Atropine deleted (PEA/Asystole)
• Chronotropic drugs for brady, then pacing
• Adenosine safe for monomorphic wide tachs
• Post-cardiac arrest
AMERICAN HEART ASSOCIATION:
2010 GUIDELINES

21. Summary
Recognition Unresponsive (for all ages)/No breathing
or no normal
breathing (ie, only gasping)/No pulse
palpated within 10 seconds for all ages
(HCP only)
CPR sequence C-A-B
Compression rate At least 100/min
Compression depth At least 2 inches (5 cm)
Chest wall recoil Allow complete recoil between compressions
HCPs rotate compressors every 2 minutes
Compression interruptions Minimize interruptions in chest compressions
Attempt to limit interruptions to <10 seconds
Airway Head tilt–chin lift (HCP suspected trauma: jaw
thrust)

22. Compression-to-ventilation
ratio (until advanced
airway placed)
30:2
1 or 2 rescuers
Ventilations: when rescuer
untrained or trained and
not proficient
Compressions only
Ventilations with advanced
airway (HCP)
1 breath every 6-8 seconds (8-10
breaths/min)
Asynchronous with chest
compressions
About 1 second per breath
Visible chest rise
Defibrillation Attach and use AED as soon as
available. Minimize interruptions in
chest compressions before and after
shock;
resume CPR beginning with
compressions immediately after each
shock.