CARDIOPULMONARY RESISCITATION

It is combination of chest compression's and rescue breathing.

Area of Compression:

• Adult/child - center of the chest. Between the imaginary nipple line.
• Infant - 1 finger below the imaginary nipple line at the center of chest.

Depth:

• Adult/child - approx 2"
• Infants - approx 1 1/2"

Compression to ventilation ratio:

• Adult - 30:2 (1-2 rescuer)
• Child/infant - 30:2 (1 rescuer) (15:2 for 2 rescuers)

How to compress:

• Adult - 2 heels of the hand
• Child - 1 heel of the hand
• Infant - 2 fingers

Rate:

• Adult/child - approx 100/min
• Infant - at least 100/min

No. of Cycles/2 mins.

• Adult - 5 cycles (1 or 2 rescuers)
• Child/infant - 5 cycles (1 rescuer) (2 rescuers at 10 cycles)

Sequence of CPR

1. Survey scene/introduce self/get consent.
2. Chest of consciousness/call local emergency number (ambulance)/get an AED.
3. Open the airway/quickly scan for normal breathing and a pulse; and quickly scan for severe bleeding.
4. If no breathing and pulse - start full CPR/30 CC and 2 ventilation, if no breathing and pulse - give rescue breathing.
5. Reasons signs of circulation of 2 mins.
6. Upon recovery do a secondary survey
7. While waiting for the ambulance; place victim at recovery position and monitor vital signs.

When to stop CPR

• Spontaneous signs of circulation are restored.
• Turned over to medical service.
• Operator is already exhausted.
• Physician assumes responsibility
• Scene becomes unsafe.
• AED is available and ready to use.

RESCUE BREATHING

It is a technique of breathing air into a person's lungs to supply him or her with oxygen needed to survive. It is used when there is pulse but no breathing.

1. Mouth - to - mouth
2. Moth - to - nose
3. Mouth - to - mouth and nose
4. Mouth - to - stoma
5. Mouth - to - face shield
6. Moth - to - mask
7. Bag valve mask device

FOREIGN BODY AIRWAY OBSTRUCTION MANAGEMENT

Causes:

• Improper chewing
• Excessive intake of alcohol
• Presence of dentures
• Running while eating
• Children hand to mouth stage left unattended

Types of Obstruction:

1. Anatomical Obstruction - example: sleep apnea
2. Mechanical obstruction - any foreign object obstruction airway

Classification of Obstruction:

1. Mild airway obstruction - patient can still talk and cough. let the patient cough.
2. Severe airway obstruction - unconscious ; no air; no cough; can't talk.

Emergency Care for Airway Obstruction

• Back Blows - infants - slapping upward
• Abdominal Thrust (Heimlich maneuver)
• Chest Thrust - infant 5 Back Blows/5 chest thrust.

Conscious to unconscious victim

1. Position the victim in supine.
2. Check the mouth for any obstruction. If you see the obstruction, do manual extraction by finger sweeping. if you can't see the obstruction, do not do manual extraction.
3. Open the airway and attempt to give 1-2 rescue breaths
4. If air bounces back, do chest compression.

GOLDEN RULES IN GIVING EMERGENCY CARE

What to do:

• do obtain consent, when possible
• do think the worst
• do provide comfort and emotional support
• do be as calm and as directed as possible

What not to do:

• do not let the victim see his own injury
• do not assume that the victim's obvious injury are the only ones
• do not make promises

EMERGENCY ACTION PRINCIPLES

1. Survey the scene - is scene is safe? what happened? Number of people injured? any bystander who can help? get consent to care. Identify yourself as a trained CPR provider. check for responsiveness. protect the spine.
2. Activate medical assistance or arrange transfer facility - call ambulance. Give concise information.
3. Do a primary survey of the victim - check the mouth or nose for any obstruction. A. Open the airway - head tilt-chin lift maneuver - if there is no spine injury. Jaw -thrust maneuver - can be used if the is suspected spine injury. B. Check for breathing - signs of life: breathing, coughing, movement. LOOK, LISTEN and FEEL METHOD. C. Check signs of circulation - check pulse and severe bleeding.
4. Do a secondary survey - interview the victim; victim's name, ask what happen, ask the SAMPLE history (Signs/symptoms; Allergies; Medication; Past medical history; Last oral intake; Events leading to episode). Check vital signs. Determine the skin appearance. Do the head to toe examination for deformity, confusion, abrasion, puncture, burn, laceration etc.

TYPES OF DEATH

• Clinical Death- 0-4 min. reversible (brain damage) 4-6 min. (damage probable)
• Biological Death- 6-10 min. (brain damage prob) 10 min. and above (brain damage is certain irreversible)

Kinds of Life Support

Life Support
-is a series of emergency procedures that are carried out to prolong the life of a victim with life threatening emergencies.

KINDS OF LIFE SUPPORT
1. Basic Life Support
-recognizing respiratory arrest or cardiac arrest or both and the proper application of CPR to maintain life.
2. Advanced Cardiac Life Support
-use of special equipment to maintain breathing and circulation for the victim of cardiac emergency.
-with medication and medical equipment.
3. Prolong Life Support
-for post resuscitative and long term resuscitation.
-ICU

CHAIN OF SURVIVAL
1. Recognition of cardiac arrest and response activation of emergency system-assessment; calling for help; calling ambulance.
2. Early CPR-CAB
3. Rapid Defibrillation
4. Effective advanced cardiac life support
5. Integrated post cardiac arrest care

BASIC PRECAUTIONS PRACTICES
1. Personal hygiene- hand washing
2. Protective equipment- gloves, mask
3. Equipment cleaning- disinfecting

10 Facts About Cardiac Life Support (CPR)

1. Heart diseases are the number 1 killer.
2. Cardiac attack can occur anytime, anywhere.
3. Sudden cardiac arrest has low survival rate.
4. Majority of sudden cardiac attack occurs outside the hospital, usually at the street, at home or at work.
5. 80% of cardiac arrest are witnessed by a family member.
6. Only 4-6% survive in cardiac attack because majority of the witness doesn't know how to do the right CPR.
7. Cardio-Pulmonary Resuscitation (CPR) can be learned by anyone.
8. CPR requires no special medical skill or training.
9. Effective CPR can double the chance of survival.