CPR involves restarting a person's heartbeat and breathing after they have stopped. It was developed in the 1960s and combines chest compressions and mouth-to-mouth breathing. The objectives of CPR are to keep oxygen flowing to the lungs and oxygenated blood flowing through the body. It is performed through cycles of 30 chest compressions followed by 2 rescue breaths at a rate of 120 compressions per minute. High quality CPR requires minimizing interruptions, providing adequate rate and depth of compressions, avoiding excessive ventilation, and ensuring proper hand placement. CPR is used to buy time until normal heart and lung function can be restored or a defibrillator becomes available.

1. Occupational Health
Centre, NFASL
Health Education ---CPR
By
Dr.Ashok

2. CPR
C---Cardio----------------------------Heart
P---Pulmonary-----------------------Lung
R---Resuscitation--------------------Revival

3. Definition
An emergency procedure used to
restart a person's heartbeat and
breathing after one or both have
stopped.

4. Who Invented CPR
 1960.
 Resuscitation pioneers Drs. Kouwenhoven, Safar, and Jude
combine mouth-to-mouth breathing with chest
compressions to create cardiopulmonary resuscitation, the
lifesaving actions we now call CPR.
 New name of CPR is BLS
 Peter Safar: father of modern cardiopulmonary
resuscitation.

5. Objective of CPR
keep oxygen flowing in and out of
the lungs and
 to keep oxygenated blood flowing
through the body.

6. 3 Priorities of Life support
 Preserve life.
 Prevent deterioration.
 Promote recovery.

7. CPR FACTS
• CPR is one way of buying time until normal heart& lung
function is restored or a defibrillator becomes
available.
• CPR provides artificial breathing and circulation,
keeping oxygenated blood flowing to the heart and
brain.
• The earlier you give CPR, the greater the chance of
success.

8. Basic components of CPR
 CAB---Easy to Remember
 C---Chest Compression
 A---Airway
 B---Breathing

9. Critical components of CPR
 Five main components of high-performance CPR have
been identified:
 chest compression fraction (CCF),
 chest compression rate,
 chest compression depth,
 chest recoil (residual leaning),
 and ventilation. These CPR components were identified
due to their contribution to blood flow and outcome.

10. Seven steps of CPR
 STEP 1: CALL OHC/Trained First aider.
 STEP 2: ASSESS THE SCENE OF THE EMERGENCY.
 STEP 3: OPEN THE VICTIM'S AIRWAY.
 STEP 4: CHECK FOR BREATHING & Circulation.
 STEP 5: 30 CHEST COMPRESSIONS.
 STEP 6: 2 RESCUE BREATHS.
 STEP 7: REPEAT THE CYCLE.

11. New standards of CPR
 Push hard and Fast
 Pushing chest 2-2/12 inch with each compression
 Maintain Chest compression Rate 120/min
 Continue CPR till you handover casualty to medical person
or till medical person arrives
 Chest compression is more important than artificial
respiration

12. Qualities of First aider
 Prompt and Quick. A great first aider must be able to recognise when
someone needs emergency help. ...
 Calm and Controlled. First aiders face a variety of emergency situations from
time to time. ...
 Effective Communicator. ...
 The Ability to Lead. ...
 Knowledge of Your Limit.
 Crowd Manager

13. CPR---Trained Vs General Public
 For healthcare providers and those trained:
conventional CPR using chest compressions and
mouth-to-mouth breathing at a ratio of 30:2
compressions-to-breaths. ...
 For the general public or bystanders who witness
an adult suddenly collapse: compression-only
CPR, or Hands-Only CPR.

14. Cardiac Arrest
It is unexpected and unexplained
cessation of heart beat is called
cardiac arrest
At any age, can be anybody

15. Causes of Cardiac and Respiratory Arrest
 Heart Attack
 Poisoning
 Head Injury
 Electric Shock
 Electrolyte Imbalance
 Snake Bite
 Drowning
 Allergic Reaction
 Scorpion Bite etc---------

16. Sudden Cardiac Arrest statistic's in India
 More than 80% cardiac arrest occurs outside the hospital
 More than 350,000 cardiac arrests occur outside of the hospital each year
 roughly estimated at 7 lakh cases of SCD annually) with 21% of the deaths in
people who were below 50 years of age.

17. Cardiac Arrest Vs Heart Attack
 Cardiac Arrest--------Stoppage of Heart Beat
 Heart Attack----------Reduced Blood supply due to
spasm or complete stoppage of blood supply to
heart muscle due to blockage in one or multiple
arteries supplying blood to heart muscles.

18. Signs and Symptoms of CPA
 No Pulse
 No Blood Pressure
 No Respiration Or Gasping
 Un conscious
 Pupils sluggishly or not reacting to light
 Unresponsiveness

19. Normal Values Of Vital Parameter's
 Blood Pressure----------100-130/70---90 mm of Hg
 Pulse -------------------60----90/min
 Respiration----------12-----14/min

20. Major Arteries in Human Body

21. Anatomy Of Heart

22. Pathway of Blood circulation

23. Coronary artery Spasm

24. Blockage of Coronary artery

25. Coronary Arteries
Fig-1 Fig-2

26. Airway Management

27. Hand positioning in CPR

28. Hand Positioning For Chest Compression
Fig-1 Fig-2

29. Step wise Hand positioning in CPR
 Kneel beside the person who needs help.
 Place the heel of one hand on the centre of the chest.
 Place the heel of the other hand on top of the first hand, then INTERMINGLE
your fingers together.
 Position your body so that your shoulders are directly over your hands; keep
your arms straight.
 Push hard, push fast BY USINH HEEL OF HANDS KEEPING FINGERS POINTING
UPWARDS. Use your body weight to help you administer compressions that are
at least 2 inches deep and delivered at a rate of at least 100 compressions per
minute. (Be sure to let the chest rise between compressions.)

30. Mouth to Mouth Breathing

31. Artificial Respiration-AMBU bag
automated artificial manual breathing units

32. Parts of Ambu bag
 self-inflating bag,
 one-way valve,
 mask, and an oxygen reservoir.

33. Ambu bag ventilation and oxygenation
 For each breath, steadily and smoothly squeeze the bag to deliver a tidal
volume of 6 to 7 mL/kg (or about 500 mL for an average size adult) over 1
second, and then release the bag to allow it to reinflate. If using a 1000-mL
volume bag, squeeze only halfway to obtain the correct tidal volume.
 In cardiac arrest cases, do not exceed 8 to 10 breaths per minute (ie, one
complete breath every 6 to 7.5 seconds).
 Observe for proper chest rise during ventilations
 Monitor the patient, checking breath sounds and, if possible, end-tidal carbon
dioxide and pulse oximeter.

34. Effective CPR Ratio
 30:2 (30 Chest compression and 2 Artificial Breathing)
 15:1
 Compression Rate/Min---------120/min
 Artificial Respiration Rate--------10/min

35. High Quality CPR
 High-quality CPR should be performed by anyone -
including bystanders. There are five critical
components:
 Minimize interruptions in chest compressions
 Provide compressions of adequate rate and depth
 Avoid leaning on the victim between compressions
 Ensure proper hand placement
 Avoid excessive ventilation

36. Complications of CPR
 Aspiration Pneumonia
 Fracture Ribs
 Fracture Sternum
 Injury to Heart
 Injury to abdominal internal organ like
Liver/Spleen etc.

37. Recovery Position-Left side

38. Steps of Recovery Position
 Kneel beside the person.
 Straighten their arms and legs.
 Fold the arm closest to you over their chest.
 Place the other arm at a right angle to their body.
 Get the leg closest to you and bend the knee.
 While supporting the person’s head and neck, gently take the bent knee
closest to you and very gently roll the person away from you.
Adjust the upper leg, so both the hip and knee are bent at right angles.
Ensure the person is steady and cannot roll.
 Tilt the head back and make sure the airways are clear and open.

39. Purpose of Recovery Position
 If a person is unconscious but is breathing and has no
other life-threatening conditions, they should be placed in
the recovery position. Putting someone in the recovery
position will keep their airway clear and open. It also
ensures that any vomit or fluid won't cause them to
choke.

40. BLS
 Step 1: Scene Safety. ...
 Step 2: Assess Breathing.& Circulation ...
 Step 3: Activate EMS. ...
 Step 4: Get the Automated External Defibrillator
(AED) ...
 Step 5: CPR (Chest Compressions)

41. AED
 An automated external defibrillator (AED) is a
medical device designed to analyse the heart
rhythm and deliver an electric shock to victims of
ventricular fibrillation to restore the heart rhythm
to normal.
 Ventricular fibrillation is the uncoordinated heart
rhythm most often responsible for sudden cardiac
arrest.
 Indication: Sudden cardiac Arrest

42. Positioning of AED PADS
 The positioning of AED pads on victims chest wall is
important, as the electrical shock needs to travel through
the heart muscle.
 The first pad is placed underneath the collar bone
(Clavicle)Right Chest, the second is placed on left side of
chest wall, underneath the armpit.(As shown in figure)

43. AED Pad placement----Diagrammatic
view

44. Contraindication
 The AED Is Faulty or Has Expired Parts. ...
 The Victim Has a DNR. ...
 The Victim Is Wet or Lying in Water. ...
 The Victim Has a Medication Patch or Pacemaker. ...
 The Victim Has a Hairy Chest.
 Do Not use an AED on a victim lying on a conductive surface

45. Types of AED
 public access
 and professional use.
 Public access AEDs can be found in
 airports
 community centres
 schools
 government buildings
 hospitals and
 other public locations. They are intended to be used by
laypeople who have received minimal training.

46. Samaritan Law
 The Good Samaritan Law allows a person, without
expectation of payment or reward and without any duty
of care or special relationship, voluntarily come forward
to administer immediate assistance or emergency care to
a person injured in an accident, or crash, or emergency
medical condition.
 30th March 2016

47. Purpose of Samaritan laws
 Good Samaritan laws are written to encourage
bystanders to get involved in these and other
emergency situations without fear that they
will be sued if their actions inadvertently
contribute to a person's injury or death.

48. CO Poisoning

49. Toluene Poisoning

50. Effect Of HF acid

51. Complications of Phenol Poisoning