This document discusses cardiopulmonary resuscitation (CPR). It defines CPR as a technique used to establish artificial ventilation and circulation for a patient whose heart has stopped. It notes that CPR may save a victim's life if started within 4 minutes of cardiac arrest and defibrillation is provided within 10 minutes, giving a 40% chance of survival. The document then outlines the basic steps of CPR including checking for response, opening the airway, checking for breathing, and beginning chest compressions at a rate of 100-120 compressions per minute with rescue breaths every 30 compressions. It also discusses advanced CPR techniques used in a hospital setting that include advanced airway management and use of defibrillation and

1. CARDIOPULMONARY RESUSCITATION
Guided by
Dr.Shyam p warma
Assistant professor
SDM college of Ayurveda and hospital
Hassan
Presenting by
Adivishwanatha gupta
1st year PG scholar

2. •Cardiopulmonary resuscitation (CPR) is a lifesaving
technique useful in many emergencies, including
heart attack or near drowning, in which someone's
breathing or heartbeat has stopped.
•CPR may not save the victim even when performed
properly, but if started within 4 minute of cardiac
arrest and defibrillation is provided within 10
minutes, a person has a of survival of 40%
Introduction

3. Definition
• Cardio Pulmonary Resuscitation 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.
• It is series of steps used to establish artificial ventilation and
circulation in the patient who is not breathing and has no cardiac
activity

4. Purpose of cpr
• To restore cardio and pulmonary function
• Prevent the irreversible damage from anoxia

5. Indications
• Cardiac arrest and respiratory arrest
Causes of cardiac arrest
• Hypoxia hypotension hypothermia
• Hypoglycaemia
• Hypo kale is
• Acidosis
• Cardiac tamponade
• Tension pneumothorax
• Thrombo embolism
• Toxicity and etc

6. Causes for respiratory arrest
• Drowning
• Stroke
• Foreign body in throat
• Smoke inhalation
• Drug over dose
• Accident or injury
• Epiglottis paralysis
• Poisoning

7. • CPR can be done by any one ,who has knowledge of it
• It can be classified into two method
• BLS – basic life support(done by any one medico or non medico
without equipment’s)
• ACLS – advance cardiac life support
• Done by medico with full of equipment
• Done in fully equipped area like hospitals or ambulance

8. Basic life support
• Approach safely
• Check response
• Shout for help
• Open airway
• Check breathing
• Call 108
• Start chest compressions

9. Check response
• Shake the shoulders gently
• Shout or speak near ear (ask are you all right )
• Try to wake him up

10. Check breathing and pulse
• Look listen and feel for normal breathing
• If agonal breathing is it is sign of cardiac arrest
• (Agonal breathing is a barely heavy noisy or gasping breathing )
• Check pulse radial or carotid

11. Airway
• Check air way
• For any foreign body
• If absent start cpr chest compression followed with rescue breathing
• If foreign is visible do finger sweep (not in the conscious person )
• (Try to remove the foreign body using fingers )
• Head tilt +chin lift + jaw thrust position to clear the air way

14. Heimlich manoeuvre:
• if the pt is conscious or the foreign body cannot be removed by a
finger sweep.
• It is done while the pt is standing up or lying down.
• This is a subdiaphragmatic abdominal thrust that elevates the
diaphragm expelling a blast of air from the lungs that displaces the
foreign body.
• In infants his can be done by a series of blows on he back and chest
thrusts

16. Chest compression or cardiac massage
• The human brain cannot survive more than 3minutes with lack of
circulation ,so chest compression must be started immediately for any
patients with absent central pulsation (carotid pulse )

17. Technique of chest compression
• Pt should be placed on hard surface
• The palm of one hand is placed in the con cavity of the lower half the
sternum two fingers above the xiphoid process ( xiphisternal
junction)
• The other hand is placed over the hand which is on sternum
• Shoulders should be positioned directly over the hands with the
elbows locked straight and arms extended. Use your upper body
weight to compress.
• Sternum must be depressed atleast 5 cm in adults, and 2-4 cm in
children, 1-2 cm in infants .

18. • Push hard and push fast
• Must be performed at a rate of 100-120 /min
• During compression ventilation is provided simultaneously
• The ratio of chest compression and ventilation should be 30:2 when
single rescuer is present when more than one chest compression
should not be interrupted for ventilation
• Chest compressions must be continued for 2 minute before
reassessment of cardiac rhythm.
• (2 minutes = equivalent to 5 cycles 30:2).

23. Breathing
• Mouth to mouth breathing: with the airway held open, pinch the
nostrils closed, take a deep breath and seal your lips over he patients
mouth. Blow steadily into the patients mouth watching the chest rise
as if the patient was taking a deep breath
• Mouth to nose breathing seal the mouth shut and breath steadily
though the nose
• Mouth to mouth and nose is used in infants and small children

26. When to terminate the cpr
• Pulse and respiration returns
• Emergency medical help arrives
• Physician declared patient is decease (dead)
• the rescuer was exhausted and physically unable to continue to
perform BLS

27. A(C)LS– ADVANCE (CARDIAC)LIFE SUPPORT
• Includes
• Circulation by cardiac massage
• Airway management by equipment
• Breathing by advanced techniques
• Defibrillation by manual defibrillator
• Drugs

28. • There is no change in chest compression method or rate in acls
• Airway and breathing method will be done by advanced equipment
and techniques
• Use of drugs is present based on conditions

29. Airway and breathing
• Face mask
• Oropharyngeal airway
• Nasopharyngeal airway
• Laryngeal mask
• Endotracheal tube
• Combitube
• Cricothyrotomy
• Tracheostomy

31. Level of oxygen supplied by different methods
• Expired air = 16% O2
• Ambu Bag (room air) = 21%
• Ambubag+ O2 = 45% O2 O2 (10-15L)
• AmbuBag+O2+ Reservoir bag = 85% O2

32. Nasopharyngeal airway

34. Oropharyngeal airway
• Based of size of the person
different sized mouth gag is used

35. ENDOTRACHEL TUBE INTUBATION

42. TRACHEOSTOMY
Indications
• Laryngeal edema
• Where Endotrachial intubation
not possible
• When pt is going to be ventilator
for long period
• Paralysis of glottis

43. Defibrillator
• To activate the electric impulse
in cardia
• Indicated in VT ,VF,asystol etc
• Placement of leads is very imp
• Cardiac activity should be
checked after each defibrillation
shock used
• Left lead is placed on left mid
clavicular line and right lid
placed on right supra axillary
line

49. Thank you