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1. FO1 Marko D Mission EMT-B
Bureau of Fire Protection

2.  Emphasis on, and recommendations to improve,
delivery of effective chest compression
A single compression-to-ventilation ratio for
all single rescuers for all victims
Recommendation that each rescue breath be
given over 1 second and should produce
visible chest rise

3.  A new recommendation that single shocks,
followed by immediate CPR, be used to attempt
defibrillation for VF cardiac arrest. Rhythm checks
should be performed every two minutes.
 Simplified Hand Placement

4.  Give effective chest compressions all rescuers
should “push hard and push fast”
Allow the chest to recoil completely after
each compression, and use approximately
equal compression and relaxation times.
Limit interruptions in chest compressions

5.  The AHA recommends a compression-to
ventilation ratio of 30:2

6. Breathing and Circulation
• Air that enters the lungs contains:
– 21% O2
– trace of CO2
• Air exhaled from the lungs contains:
– 16% O2
– 4% CO2
• Clinical death (0 - 4 min. - brain damage not
likely, 4 - 6 min. - damage probable).
• Biological death (6 - 10 min. - brain damage
probable; over 10 min. - brain damage is certain).
Body System
HUMAN BODY

7. The Heart

8. The
Circulatory System

9. The Circulatory System
Delivers oxygen and
nutrients to the tissues.
Removes waste products
from the tissues

10. Pulse
Left ventricle contracts, sending a wave
of blood through the arteries. This can
be felt anywhere an artery passes near
the skin surface over a bone.
Carotid
Radial
Femoral

11. When the patient has lost a pulse,
they are in cardiac arrest.
Brain damage begins in 4 - 6 minutes
and becomes irreversible in 8 - 10
minutes.
Pulse

12. Reasons the Heart will Stop
Sudden Death and Heart Disease
Respiratory Arrest, Especially in children
Medical Emergencies
Drowning, Suffocation, Trauma, Bleeding

13. Regardless of the
reason, the First
Responder’s emergency
medical care of cardiac
arrest is CPR.

14. Cardiopulmonary Resuscitation
“The combination of artificial
ventilation and external chest
compressions is called
cardiopulmonary resuscitation
(CPR).”

15. CPR
Cannot sustain life indefinitely
Must be started as early as possible.
CPR increases the amount of time
that defibrillation will be effective.

16. Chain of Survival

17. Check the Scene Safety
Check for Responsiveness
Response
Monitor
No Response
Activate Medical Assistance
Check for Signs of Life
Is Breathing
Monitor/
Recovery Position
No Sign of Life
Give 2 Breaths
Chest does not rise,
Retilt the head and ventilate
Still chest does not rise
Perform unconscious choking
Check for pulse
No Pulse/Not Sure
Give cycles of 30ECC and 2RB
If definite Pulse, Begin
RB: 1 breath every
5 seconds for 1 minute

18. Establish unresponsiveness.

19. Open airway.

20. Look, listen, feel.

21. Ventilate.

22. Check pulse.

23. Locate compression site.

24. Begin compressions.

25. One-Rescuer CPR for Two Minutes

26. Recheck pulse.

27. Two-rescuer CPR

28. RESCUE BREATHING ADULT CHILD INFANT
Opening of airway (Head-Tilt-
Chin Lift Maneuver)
Maximum tilt of the head Neutral plus position Neutral position
Location for checking of signs
of circulation
Carotid pulse
(Side of the neck)
Carotid pulse
Brachial pulse (inner aspect of
upper arm)
Method Mouth-to-mouth or Mouth-to-nose
Mouth-to-mouth or Mouth-to-
nose
Mouth-to-mouth & nose
Breaths
Normal breath (1 second per breath)
Normal breath (1 second per
breath)
Gentle, slow breath
(1 to 1.5 seconds per breath)
Rate
10 to 12 breaths per minute (1 breath
every 4 to 5 seconds)
12 breaths in 1 minute
20 breaths per minute (1 breath every 3 seconds)
20 breaths in 1 minute
Counting for standardization
purposes: Mnemonic ADULT-1
breathe every 5 seconds ;
CHILD / INFANT -1 breath every
3 seconds.
Breath 1, 1002, 1003, 1001, breath 1,
1002, 1003, 1002, breath 1, 1002,
1003, 1003, breath… 10010 or up
to 10012, breath
Breath 1, 1001, breath 1, 1002, breath 1, 1003, breath…1, 1020,
breath
TABLE OF COMPARISON ON RESCUE BREATHING
FOR ADULT, CHILD, and INFANT

29. TABLE OF COMPARISON ON CARDIOPULMONARY RESUSCITATION
FOR ADULT, CHILD, AND INFANT
CPR ADULT CHILD INFANT
Compression Area Center of Chest, between nipples
Just below the nipple
line
Depth
Approximately 1 ½ to
2 inches.
1/3 to ½ the depth of the chest
How to Compress
2 hands. Heel of 1
hand, other hand on
top
2 hands
1 hand
2 fingers
(middle & ring
fingertips).

30. ADULT CHILD INFANT
Rate
Approximately 100/min
Compression-ventilation
ratio.
30:2
(1 or 2 rescuers)
30:2 (1 rescuer)
15:2 (2 rescuer)
Counting for standardization
purposes.
1, 2, 3, 4, 5, 6, 7, 8 ,9, 10, 11, 12,
13, 14, 15,
16,17,18,19,20,21,22,23,24,25,26,
27,28,29, and 1
then breathe, breathe;
1, 2, 3, 4, 5, 6, 7, 8 ,9, 10, 11, 12, 13, 14,
15,
16,17,18,19,20,21,22,23,24,25,26,27,28,
29, and 1
then breathe, breathe;
TABLE OF COMPARISON ON CARDIOPULMONARY RESUSCITATION
FOR ADULT, CHILD, AND INFANT

31. Infant and Child CPR
“Infants (up to one year old)
and children (one to eight
years old) need slightly
different care.”

32. Determine unresponsiveness.

33. Open airway.

34. Determine breathlessness.

35. Ventilate.

36. Determine pulselessness.

37. Locate correct hand position.

38. Compress 1/2 to one inch.

39. 30:2

40. Child Compression

41. When to
Spontaneous signs of circulation
are restored
Turned over to medical services
or properly trained and
authorized personnel.
Operator is already exhausted and
cannot continue CPR.
Physician assumes responsibility.
( Declares death, take over)
STOP CPR

42. Bureau of Fire Protection
“To Save lives and Protect
Properties”
Thank you!