LESSON 5
CARPIOPULMONARY
RESUSCITATION (CPR)
© 2011 National Safety Council
5-1
Basic Life Support (BLS)
• First aid given if victim’s breathing or heart stops
• Often needed for victims of:
-
Heart attack
Drowning
Choking
Other injuries/conditions
© 2011 National Safety Council
5-2
Overview of BLS
• CPR = chest compressions + rescue breaths
• Gets oxygen into lungs and oxygenated blood to vital
organs
© 2011 National Safety Council
5-3
Overview of BLS
continued
• Choking care
- Includes chest compressions
- Expels an obstructing object from airway
© 2011 National Safety Council
5-4
Overview of BLS
• Use of an automated
external defibrillator
(AED)
- Restores a more normal
heart rhythm
© 2011 National Safety Council
5-5
continued
BLS Age Differences
Infant = birth to 1 year
Child = age 1 to the onset of puberty (for CPR and
choking care); age 1 to 8 for AED
Adult = past the age of puberty (or over age 8 for AED)
© 2011 National Safety Council
5-6
Respiratory Emergencies
• Any illness or injury
resulting in stopped
breathing or
inadequate breathing
• Two types
- Respiratory arrest
- Respiratory distress
© 2011 National Safety Council
5-7
Respiratory Emergencies: Examples
• Obstructed airway
• Penetrating injury to chest
• Carbon monoxide poisoning
• Heart problem reducing tissue oxygen
• Electrical shock disrupting breathing or heartbeat
• Drug overdose or poisoning
© 2011 National Safety Council
5-8
Respiratory Arrest
and Respiratory Distress
• Respiratory arrest
- Breathing has completely stopped
• Respiratory distress
- Breathing is difficult and may become ineffective
© 2011 National Safety Council
5-9
Cardiac Chain of Survival
© 2011 National Safety Council
5-10
Heart Attack – Acute Myocardial
Infarction (AMI)
• Sudden reduced blood flow to heart muscle
• Medical emergency that often leads to cardiac arrest
• Can occur at any age
• Usually results from atherosclerosis
© 2011 National Safety Council
16-11
Facts About Heart Attack
• Over 1,255,000 heart attacks occur a year in the
United States, resulting in over 132,000 deaths
• Many could have been saved by first aid and medical
treatment
• More likely in those with family history
• 1/5 of victims do not have chest pain
• Victims typically deny they are having a heart attack
© 2011 National Safety Council
16-12
Symptoms of Heart Attack
• Can vary from vague chest discomfort to crushing
pain with or without other symptoms
• May have no signs and symptoms before suddenly
collapsing
• May have milder symptoms that come and go before
heart attack occurs
© 2011 National Safety Council
16-13
Symptoms of Heart Attack
continued
• In women chest pain or discomfort most common
symptom
- Also more likely to have shortness of breath, jaw or back
pain, indigestion, nausea and vomiting
- http://www.youtube.com/watch?v=t7wmPWTnDbE
© 2011 National Safety Council
16-14
Symptoms of Heart Attack
continued
• Consider possibility of heart attack with wide range of
symptoms
- Don’t expect a clearly defined situation
• Act quickly because deaths usually occur with an
hour or two of symptoms
© 2011 National Safety Council
16-15
Aspirin and Heart Attack
• Many patients at risk for cardiovascular disease
advised to take one low-dose aspirin daily unless
allergic or experience side effects
• For victims who do not need to avoid aspirin, chewing
one uncoated adult aspirin or two low-dose baby
aspirin is now recommended when experiencing
heart attack symptoms
© 2011 National Safety Council
16-16
Nitroglycerin for Heart Attack
• Increases blood flow
by dilating arteries
• Often prescribed for
angina
- Type of chest pain
caused by narrowed
coronary arteries
• Comes in tablets,
sprays and patches
© 2011 National Safety Council
16-17
Nitroglycerin for Heart Attack
• Can assist victim with
prescribed
nitroglycerine
- Follow victim’s
instructions
- Do not attempt to give if
victim unresponsive
© 2011 National Safety Council
16-18
continued
First Aid for Heart Attack
1. Call 9-1-1 immediately.
2. Help victim into comfortable position. Loosen any
tight clothing.
3. Ask victim about medications.
4. Encourage the victim to chew one uncoated adult or
two low-dose baby aspirin (unless allergic).
5. Stay with victim. Be reassuring.
© 2011 National Safety Council
16-19
Call First/Call Fast
Call First (before starting CPR):
• Any unresponsive adult who is not breathing normally
Call Fast (after giving about two minutes of CPR):
• Any infant or child who is unresponsive and not
breathing normally
© 2011 National Safety Council
5-20
Use of CPR for unresponsiveness
and lack of normal breathing caused by:
• Heart attack
• Electric shock
• Drowning
• Certain injuries
• Suffocation
• Stroke
• Allergic reaction
• Diabetic emergency
• Prolonged seizures
• Drug overdose
© 2011 National Safety Council
5-21
CPR Saves Lives
• CPR and defibrillation within 3-5 minutes can save
over 50% of cardiac arrest victims
• CPR followed by AED saves thousands of lives each
year
• In most cases CPR helps keep victim alive until EMS
or AED arrives
© 2011 National Safety Council
5-22
CPR Technique
If unresponsive and not breathing start CPR with chest
compressions:
• Find correct hand position
• Compress chest hard and fast at rate of at least 100
compressions/minute
• Alternate 30 compressions and 2 rescue breaths
• Give each breath over one second
© 2011 National Safety Council
5-23
General Technique: Rescue Breaths
• Position victim on
back
• Open airway with
head tilt–chin lift
• Use a barrier device
• Give each breath over
about one second
• Watch victim’s chest
rise
© 2011 National Safety Council
5-24
General Technique: Rescue Breaths
continued
• Do not blow harder than needed to make chest rise
• After each breath let air escape and chest fall
• Blowing in too forcefully or for too long may cause
vomiting
© 2011 National Safety Council
5-25
Mouth to Barrier
• Barrier device is
always recommended
• Position pocket mask
or face shield on
victim’s face
• Make sure it is sealed
to victim’s face
- With face shield, pinch
victim’s nose closed
when giving breaths
© 2011 National Safety Council
5-26
Potential Problem: Vomiting
• To prevent air from entering stomach and causing
vomiting
-
Open airway before giving breaths
Watch chest rise as you give breaths
Blow slowly and steadily
Stop each breath when chest rises
Let chest fall after each breath
© 2011 National Safety Council
5-27
Skill: CPR for Adults, Children and
Infants (1 Rescuer)
© 2011 National Safety Council
5-28
Assess the Victim
1 Determine that victim is unresponsive and not
breathing normally
Have someone call 9-1-1, or call yourself if alone,
and get an AED
Begin CPR
© 2011 National Safety Council
5-29
2 Put hand(s) in correct
position for chest
compressions
© 2011 National Safety Council
5-30
3 Give 30 chest compressions at rate of at least 100
per minute
Then give 2 breaths
© 2011 National Safety Council
5-31
4 Open airway
Give two rescue breaths, each lasting one second
- If first breath does not go in, reposition head and try again
- If second breath still does not go in, give care for choking
© 2011 National Safety Council
5-32
5 Continue cycles of 30 compression and two breaths
6 Continue CPR until:
• Victim wakes up
• AED brought to scene and ready to use
• Professional help arrives to take over
• Scene becomes dangerous
• You become too exhausted
© 2011 National Safety Council
5-33
7
If victim starts breathing normally but is
unresponsive, put in recovery position and monitor
breathing
When AED arrives, start AED sequence
© 2011 National Safety Council
5-34
Compression-Only CPR
• If you cannot or will not
give rescue breaths,
still give chest
compressions
© 2011 National Safety Council
5-35