CPR Notes

CPR Notes Key Principles A--airway B--breathing C--circulation D--defibrillation Compression Technique is most important aspect of CPR PUSH HARD AND FAST !!!!!! Adult compression depth is 1 ½ to 2 inches; child & infant 1/3-1/2 depth of chest Compression rate is 100 compressions per minute Allow for complete chest recoil after each compression Never interrupt compressions for more than 10 seconds—interruption reduces blood pressure and coronary perfusion pressure Ventilations Ventilations must be controlled—do not hyperventilate Hyperventilation interferes with compressions Deliver breaths over 1 second to obtain visible chest rise—not to deep AED Automated External Defibrillator Follow AED’s voice prompts; each AED is different Updated AED’s should deliver one shock at a time Apply AED pads while continuing to perform compressions Shock only when prompted; make sure all persons are clear of the victim prior to shocking Compression-Ventilation Ratio The lone rescuer should use a universal compression-ventilation ratio of 30 compressions to 2 breaths when giving CPR to victims of all ages. With HeartSaver CPR, A child is described as ages 1 through 8. Infant is less than 1 year. Adult and older children are 8 yrs of age and older. CPR Sequences 1-Rescuer Adult CPR Sequence Assess the victim for a response. If no response, shout for help. If you are alone, activate the emergency response system and get an AED if available. Open the victim’s airway using a head tilt-chin lift (jaw thrust for patient’s with possible spinal cord injury) and check breathing. Take at least 5 seconds and no more than 10 seconds. If no adequate breathing, give 2 breaths that make the chest rise. Perform compressions and ventilations (ratio 30:2) at a rate of 100 compressions per minute. Perform compressions and ventilations (ratio 30:2) until assistance arrives. 1-Rescuer Child CPR Sequence Assess the victim for a response. If no response shout for help. If someone responds, send that person to activate the emergency response system and get an AED (if available). If you are alone and did not witness the child collapse, you will perform 5 cycles of CPR prior to activating EMS yourself. Open the victim’s airway using a head- tilt, chin-lift and check breathing. Take at least 5 seconds and no more than 10 seconds. If no adequate breathing, give 2 breaths that make the chest rise. Perform 5 cycles of compressions and ventilations (ratio 30:2) at a rate of 100 compressions per minute. If you are alone, after 5 cycles of CPR activate the emergency response system and get an AED if available. Note: If the lone rescuer witnesses the child suddenly collapse, the lone rescuer should follow activate the emergency response system (and get an AED if available) first, and then return as soon as possible to initiate CPR. Perform compressions and ventilations (ratio 30:2) until assistance arrives. ADULT/CHILD CHOKING: When food or another object gets in the airway, it can block the airway. If the block in the airway is severe you must act quickly to remove the block, so to help the victim breathe. If the victim makes sounds and coughs loudly stand by and let the victim cough. If you are worried about the victim’s breathing call 911! If the victim can’t breathe, has a cough that is quiet or has no sound, can’t talk, can’t cry, has high-pitched noisy breathing, bluish lips or skin, makes the choking sign then they have SEVERE choking………..act quickly and do the Heimlich maneuver. The Heimlich: Ask are you choking, kneel or stand firmly behind victim and wrap your arms around him so that your hands are in front. Make a fist with one hand. Put the thumb side of your fist slightly above his navel (belly button) and well below the breastbone. Grasp the fist with your other hand and give quick upward thrusts into his abdomen. Give thrust until the object is forced out and he can breathe, cough, or talk or until he stops responding. If you cannot remove the object, the victim will stop responding. When he stops responding follow these steps. Yell for help, tell someone to call 911 and get the AED. Lower victim to ground, face up. If you are alone phone 911 and get AED if available. Start the steps of CPR. Every time you open the airway to give breaths, open the victim’s mouth and look for the object. If you see an object, remove it with your fingers. If you do NOT see an object keep giving 30 compressions and 2 breaths until help arrives, the victim starts to move or an AED becomes available. After 5 cycles of CPR, and you are alone with a child……leave the child to phone 911 and get an AED if available. Return to the child and continue the steps of CPR. AED Operations Power on the AED. This activates voice prompts for guidance in all subsequent steps. Some AED voice prompts will begin once you open the case. Attach electrode pads to the victim’s bare chest. Choose correct pads (adult vs child) for size/age of victim. Use child pads or a child system for children less than 8 years of age if available. Do not use child pads or child systems for victims 8 years and older. Quickly wipe the victim’s chest if it is covered with water or chest. Attach the AED connecting cables to the AED box. Some are preconnected. “Clear” the victim and ANALYZE the rhythm. Some AEDs will automatically analyze the rhythm once the pads are on. Some will advise you to push an “ANALYZE” button. Do not touch the patient while the AED is analyzing the patient’s rhythm. It will take 5-15 seconds to analyze. The AED will tell you if a shock is needed or to continue CPR. If the AED advises a shock, it will tell you to be sure to clear the victim. To “clear the victim” make sure no one is touching the victim (“I’m clear, you’re clear, everybody’s clear”). Do a visual check to ensure no one is touching the victim Once everyone is clear press the SHOCK button on the AED. The shock will produce a sudden contraction of the victim’s muscles. As soon as the AED delivers the shock, begin CPR starting with chest compressions. After 2 minutes of CPR, the AED will prompt you to repeat the “ANAYLZE” and “SHOCK” steps above. 1-Rescuer Infant CPR Sequence Assess the victim for a response. If no response shout for help. If someone responds, send that person to activate the emergency response system. If you are alone and did not witness the child collapse, you will perform 5 cycles of CPR prior to activating EMS yourself. Open the victim’s airway using a head tilt-chin lift and check breathing. Take at least 5 seconds and no more than 10 seconds. If no adequate breathing, give 2 breaths that make the chest rise. Perform 5 cycles of compressions and ventilations (ratio 30:2) at a rate of 100 compressions per minute. If you are alone, after 5 cycles of CPR activate the emergency response system and get an AED if available. Note: If the lone rescuer witnesses the child suddenly collapse, the lone rescuer should do the following: activate the emergency response system (and get an AED if available) first, and then return as soon as possible to initiate CPR. Perform compressions and ventilations (ratio 30:2) until assistance arrives. Relieving Choking in the Responsive Infant Kneel or sit in a chair with the infant in your lap. If easy to do, bare the infant’s chest. Hold the infant facedown with the head slightly lower than the chest, resting on your forearm. Support the infant’s head and jaw with your hand. Take care to avoid compressing the soft tissues of the infant’s throat. Rest your forearm on your lap or thigh to support the infant. Deliver up to 5 back slaps forcefully in the middle of the back between the infant’s shoulder blades, using the heel of your hand. Deliver each slap with sufficient force to attempt to dislodge the foreign body. After delivering up to 5 back slaps, place your free hand on the infant’s back, supporting the back of the infant’s head with the palm of your hand. The infant will be adequately cradled between your 2 forearms, with the palm of one hand supporting the face and jaw while the palm of the other hand supports the back of the infant’s head. Turn the infant as a unit while carefully supporting the head and neck. Hold the infant on his back with your forearm resting on your thigh. Keep the infant’s head lower than the thigh. Provide up to 5 quick downward chest thrusts in the same locations as chest compressions-just below the nipple line. Deliver chest thrusts at a rate of about 1 per second, each with the intention of creating enough of an “artificial cough” to dislodge the foreign body. Repeat the sequence of up to 5 back slaps and up to 5 chest thrusts until the object is removed or the infant becomes unresponsive. Relieving Choking in the Unresponsive Infant Place the infant on a firm, flat surface. Open the infant’s airway and look for an object in the pharynx. If an object is visible, remove it. DO NOT PERFORM A BLIND FINGER SWEEP. Begin CPR with 1 extra step; each time you open the airway, look for the obstructing object in the back of the throat. If you see an object, remove it. After approximately 5 cycles (about 2 minutes) of CPR, activate the emergency response system.