CPR - Assess For Breathing And Carotid Pulse

- - - - - Scene safety Check for responsiveness Assess for breathing and carotid pulse o Feel pulse in groove to the side of trachea with 2 fingers for atleast 5 secs Chest compression feedback device monitors: o Compression rate, depth and chest recoil How to use pocket mask: o Position on victims side o Place pocket mask on victim’s face (use bridge of the nose as a guide) o Seal the mask using hand that is closer to the top of the victim’s head, place index finger and thumb along the top edges of the mask and place thumb of your other hand along the bottom edge of the mask o Place remaining fingers of your second hand along the bony margin of the jaw and lift the jaw o Perform a head tilt – chin lift to open the airway o Deliver each breath over 1 second – enough to make the victims chest rise Using a bag-mask device: o Position yourself directly above the victim’s head and place mask on victim’s face o Then use E-C clamp technique; perform head tilt, place mask on the face, use the thumb and index finger of one hand to make a C on the side of the mask and use the remaining fingers to lift the angles of the jaw o Squeeze the bag to give breaths, watch for chest rise and deliver each breath over 1 second Why an AED is needed: o To analyze the heart rhythm and provide a shock o two life threating arrhythmias can cause cardiac arrest: pulseless ventricular tachycardia (pVT) and ventricular fibrillation (VF) How to use an AED: o Power on the AED o Choose adult pads for victims 8 years and older and attach the AED pads o When prompted, clear the victim during analysis and no one is touching the victim o If AED advises a shock, it will charge and then tell you to clear the victim and then press shock – after any shock delivery, immediately resume CPR o If no shock is needed, immediately resume CPR, starting with compressions  Pad placement:  Anterolateral placement: one pad right below collarbone and other pad to the side of the left nipple  Anteroposterior placement: one pad on the left side of the chest (halfway between the tip of the breastbone and left nipple) and other pad on the left side of the victim’s back (beneath shoulder blade) Rescue breathing: 1 breath q6 seconds or about 10 breaths/min - - - - - - - - Scene safety and assessment: o Look for no breathing and only gasping and check pulse o Check for responsiveness o Verify scene safety o Activate emergency response system and get an AED Pediatric out-of-hospital chain of survival: 1. Prevention 2. Activation of emergency response system 3. High quality CPR 4. Advanced resuscitation 5. Post cardiac arrest are 6. Recovery Checking brachial artery pulse in an infant: o Place 2 fingers on the inside of the upper arm (between the elbow and shoulder) then press fingers to feel for pulse for at least 5 seconds, no more than 10 seconds o If no pulse is felt within 10 seconds or heart rate is 60/min or less, begin CPR starting with compressions Checking pulse in a child, feel for carotid or femoral pulse: o Place 2 fingers in the inner thigh, midway between hip bone and pubic bone, just below the crease where the leg meets the torso o Feel for a pulse for at least 5 but no more than 10 seconds o If no pulse is felt within 10 seconds, or heart rate is 60/min or less, begin CPR starting with compressions Child chest compressions: o Rate: 100-120/min o Depth: Approx. 2 inches o 2 hands or 1 hand on the lower half of breastbone o Chest recoil: Allow complete recoil; do not lean on the chest Infant chest compressions: o Rate: 100-120/min o Depth: Approx. 1 ½ inches o 1 rescuer places 2 fingers in the center of the chest, just below the nipple line 2 rescuers use the 2 thumb – encircling hands technique in the center of the chest, just below the nipple line Compression to ventilation ratio for infants and children: o Ratio for 1 rescuer is 30:2 o Ratio for 2 or more rescuers is 15:2 For pediatrics o If no normal breathing and a pulse is felt:  Give rescue breaths every 2-3 seconds (20-30 breaths per minute)  Assess pulse rate for no more than 10 seconds o If heart rate <60/min with signs of poor perfusion  Start CPR  Heart rate >60/min  Continue rescue breathing  Check pulse every 2 minutes  If no pulse, start CPR -