PHILIPPINE
RED CROSS
OBJECTIVES
At the end of the discussion, the participants
will be able to:
Define what is CPR based on the given
definition.
Differentiate CPR to Rescue Breathing.
Enumerate the signs and symptoms of heart
attack
OBJECTIVES (Cont.)
Demonstrate how to perform CPR properly.
Operate the AED properly.
The Circulatory System
The circulatory system works with the
respiratory system to carry oxygen-rich blood to
everybody cell. It also carries other nutrients
throughout the body, removes waste and
returns oxygen-poor blood to the lungs.
Heart Attack
also called myocardial infarction,
occurs when the blood and oxygen
supply to the heart is reduced
causing damage to the heart
muscle and preventing blood from
circulating effectively. It is usually
caused by coronary heart disease.
Signs and Symptoms
Chest pain, discomfort or pressure.
The pain associated with a heart attack can range from
discomfort to an unbearable crushing sensation in the chest.
The person may describe it as pressure, squeezing, tightness,
aching or heaviness in the chest.
Many heart attacks start slowly as mild pain or discomfort.
Discomfort in other areas of the upper body in addition to the
chest.
Signs and Symptoms (Cont.)
Trouble breathing.
The pain or discomfort becomes constant.
It usually is not relieved by resting, changing position or
taking medicine.
Some individuals may show no signals at all.
Other Signals
The person’s skin may be pale or ashen (gray),
especially around the face. Some people suffering
from a heart attack may be damp with sweat or may
sweat heavily, feel dizzy, become nauseous or vomit.
They may become fatigued, lightheaded or lose
consciousness. These signals are caused by the stress
put on the body when the heart does not work as it
should. Some individuals may show no signals at all.
Differences in signals between
men and women.
Both men and women experience the most common signal
for a heart attack: chest pain or discomfort. However, it is
important to note that women are somewhat more likely to
experience some of the other warning signals, particularly
shortness of breath, nausea or vomiting, back or jaw pain
and unexplained fatigue or malaise. When they do
experience chest pain, women may have a greater tendency
to have atypical chest pain: sudden, sharp but short-lived
pain outside of the breastbone.
First Aid Management
If you suspect that someone might be having a heart
attack, you should:
Call the local emergency number immediately.
Have the person stop what he or she is doing and rest
comfortably.
Loosen any tight or uncomfortable clothing.
Closely watch the person until advanced medical
personnel take over.
First Aid Management (Cont.)
Ask the person if he or she has a history of heart disease.
Offer aspirin if it is prescribed by his/her physician for
his/her condition and only if the patient can swallow.
Be calm and reassuring. Comforting the person helps to
reduce anxiety and eases some of the discomfort.
First Aid Management (Cont.)
Talk to bystanders and if to possible the person to get
more information.
Be prepared to perform CPR and use an AED, if available,
once the person loses consciousness and stops breathing.
Cardiac Arrest
occurs when the heart stops beating
or beats too ineffectively to circulate
blood to the brain and other vital
organs. The beats, or contractions, of
the heart become ineffective if they
are weak, irregular or uncoordinated,
because at that point the blood no
longer flows through the arteries to
the rest of the body.
Cardiopulmonary Resuscitation
(CPR)
is a combination of chest compressions
and rescue breaths. When the heart is not
beating, chest compressions are needed
to circulate blood containing oxygen.
Chest Compression Technique for
Adults and Child
Proper
hand
placement is
established by
identifying the
lower half of
the sternum.
Chest Compression Technique for
Adults and Child
1. Place the heel of one hand in the center of the
chest between the nipples and the other hand on
top of the first, so that the hands are parallel.
2. Be sure the long axis of the heel of your hand is
placed on the long axis of the sternum. This will
keep the main force of compression on the sternum
and decrease the chance of rib fracture. Do not
compress over the lowest portion of the base of the
sternum (the xiphoid process).
Chest Compression Technique for
Adults and Child
3. Your fingers may be either extended or interlaced
but should be kept off the chest.
4. Lock the elbows in position, with the arms
straightened. Position your shoulders directly over
your hands so that the thrust for each chest
compression is straight down on the sternum. If the
thrust is not in a straight downward direction, the
victim’s torso has a tendency to roll; if this occurs, a
part of the force of compressions will be lost, and
the chest compressions may be less effective (Do
not be a bender, rocker & jerker).
Chest Compression Technique for
Adults and Child
5. Depress the sternum at least 2 inches (5 cm). Push
hard, push fast at a rate of at least 100
compressions per minute.
6. Release the pressure on the chest to allow blood to
flow into the chest and heart. You must release the
pressure completely and allow the chest to return
to its normal position after each compression. Keep
the heel of your hands in contact with the victim’s
sternum to maintain proper hand position, but
fingers off the chest (Do not be a massager).
Chest Compression Technique for
Adults and Child
7. To maintain correct hand position throughout
the compression cycle, do not lift your hands
from the chest or change their position in any
way (Do not be a bouncer & double crosser).
However, do allow the chest to recoil to its
normal position after each compression.
Chest Compressions Technique
for an Infant
Proper
hand
placement
is
established by
identifying the
lower half of the
sternum.
Chest Compressions Technique
for an Infant
1. Position the infant face up on a firm, flat
surface. The infant’s head must be on the
same level as the heart or lower. Stand or
kneel facing the infant from the side.
2. Keep one hand on the infant’s head to
maintain an open airway. Use your other
hand to give compressions.
Chest Compressions Technique
for an Infant
3. To find the correct place to give
compressions, imagine a line running
across the chest between the infant’s
nipples. Place your index finger on the
sternum (breastbone) just below this
imaginary line.
Chest Compressions Technique
for an Infant
4. Then place the pads of the two fingers next to
your index finger on the sternum. Raise the
index finger. If you feel the notch at the end of
the infant’s sternum, move your fingers up a
little bit.
5. Use the pads of two fingers to compress the
chest. Compress the chest ½ to 1 inch, then let
the sternum return to its normal position.
Chest Compressions Technique
for an Infant
6. When you compress, push straight down. The
down-and-up movement of your compressions
should be smooth, not jerky.
7. Keep a steady rhythm. Do not pause between
compressions. When you are coming up,
release pressure on the infant’s chest
completely, but do not let your fingers lose
contact with the chest.
Chest Compressions Technique
for an Infant
8. Keep your fingers in the compression position.
Use your other hand to keep the airway open
using a head-tilt.
Ways to ventilate the lungs
1. Mouth-to-Mouth
2. Mouth-to-Nose
3. Mouth-toMouth-and-Nose
4. Mouth-to-Stoma
Protective equipment used to
ventilate the lungs
1. Mouth-to-Face
Shield
2. Mouth-to-Mask
3. Using Bag-valve
Mask Device
When to Stop CPR?
Once you begin CPR, do not
stop except in one of these
situations:
When to Stop CPR?
You notice an obvious sign of life, such as
breathing.
An AED is available and ready to use.
Another trained responder or EMS
personnel take over.
You are too exhausted to continue.
The scene becomes unsafe.
Criteria for Not Starting CPR
Scientific evaluation has shown
that there are no clear criteria to
predict the futility of CPR
accurately.
Criteria for Not Starting CPR
Therefore, it is recommended that all patients
in cardiac arrest receive resuscitation unless:
The patient has a valid “Do Not Attempt
Resuscitation” (DNAR) order.
The patient has signs of irreversible death:
rigor mortis, decapitation, or dependent
lividity.
Criteria for Not Starting CPR
No physiological benefit can be expected
because
the
vital
functions
have
deteriorated despite maximal therapy for
such conditions as progressive septic or
cardiogenic shock.
Continuous Chest Compressions
(Hands-Only CPR)
If you are unable or unwilling for any reason
to perform full CPR (with rescue breaths), give
continuous chest compressions after calling
the local emergency number. Continue
giving chest compressions until EMS
personnel take over or you notice an obvious
sign of life, such as breathing.
Automated External Defibrillation
(AED)
If the heart is damaged
by disease or injury, its
electrical system can
be disrupted. This can
cause an abnormal
heart rhythm that can
stop the blood from
circulating.
Defibrillation
Is the treatment of irregular,
sporadic or absent heart rhythms
by an electrical current to the
heart. It is the only definitive
treatment for sudden cardiac
arrest (SCA).
Principles of Early Defibrillation
Early defibrillation is critical
for victims of sudden
cardiac arrest for the
following reasons:
Simplified Adult/Child CPR
Algorithm (Lay Rescuer)
Simplified Adult/Child CPR Algorithm
(Healthcare & Professional rescuer)
Skill 3-1 Cardiopulmonary Resuscitation
(CPR) for Adult and Child
1. Locate the correct hand position for chest
compressions.
•Kneel beside the victim.
•Place heel of one hand on the center of the chest.
•Place the heel of your hand on top of the first hand
•And interlock your fingers
•Making sure the fingers are kept off the ribs.
•Leaning forward with arms straight.
Skill 3-1 Cardiopulmonary Resuscitation
(CPR) for Adult and Child
2. Give chest compressions.
• Press down vertically on the breastbone and depress the
chest.
• Compress an adult’s chest 30 times to a depth of at least 2
inches.
• Compress a child’s chest 30 times to a depth of about 2
inches.
• Compress at a rate of at least 100 chest compressions per minute;
the 30 chest compressions should take about 18 seconds to
complete.
Skill 3-2 Cardiopulmonary
Resuscitation (CPR) for Infant
1.Locate the correct hand and
finger position for chest
compressions.
Use the same technique that is used for CPR.
Give 30 chest compressions at a rate of at
least 100 chest compressions per minute.
Each compression should be about 11⁄2 inches
deep.
Skill 3-2 Cardiopulmonary
Resuscitation (CPR) for Infant
2. Give ventilation.
 Give 2 rescue breaths. If the
breaths do not make the chest
clearly rise, repeat cycles of
chest compressions, and rescue
breaths.
Skill 3-3 Using of Automated
External Defibrillator (AED)
1.Turn on the AED
Switch on the AED and take out the pads.
Remove or Cut through the cloth and
quickly wipe the chest for sweat.
Shave the excessive hair in the chest to
prevent delay.
Skill 3-3 Using of Automated
External Defibrillator (AED)
2. Attaching the pads
 Remove the backing paper from the
pads.
 Follow diagram in the pads for
placement.
 Attach pads as soon as possible
Skill 3-3 Using of Automated
External Defibrillator (AED)
3. Analysis of the AED
Make sure that no- one is touching while the
AED analyse the victim’s condition.
It will indicate if you need to shock the
victim.
Continue the Prompt of the AED until
advance life support or emergency services
had arrived
Skill 3-4 Two Man Cardiopulmonary
Resuscitation (CPR) for Adult and Child
1. Provider no.1-Locate the correct hand
position for chest compressions.
Kneel beside the victim
Place heel of one hand on the center of the
chest.
Place the heel of your hand on top of the first
hand, and interlock your fingers, making sure
the fingers are kept off the ribs.
Leaning forward with arms straight
Skill 3-4 Two Man Cardiopulmonary
Resuscitation (CPR) for Adult and Child
2. Provider no. 2-Position on the top of the
head of the victim.
 Position your hand in the lower jaw
 Immobilize the head using the forearm
 Use index finger to push forward on the
angle of the lower jaw to open the
mouth.
Skill 3-4 Two Man Cardiopulmonary
Resuscitation (CPR) for Adult and Child
3.Provider no.1-Give chest compressions.
Press down vertically on the breastbone
and depress the chest.
Compress an adult’s chest 15 times to a
depth of at least 2 inches.
Compress a child’s chest 15 times to a
depth of about 2 inches.
QUESTIONS?