CPR ( cardio pulmonary resuctation )

CPR ( cardio pulmonary resuctation )

1. CARDIO PULMONARY RESUCITATION MR .ROMAN BAJRANG BASIC BS.C NURSING 2 ND YEAR RELIANCE INSTITUTE OF NURSING LIMTARA DHAMTARI

2. INTRODUCTION There is a dose relation ship between the function of the heart ? Heart lungs ? The brain when the patient stope breathing soon his heart will stop beating because the blood beging pumed to the brain will not contain enough oxygen ? The cardiac contral center will stop sending signals to the heart causing but this heart stop beating blood willnot be sent to the lung to pick up oxygen nar will the blood be sent to the body tissue .

3. “According to Brunner & suddarh ” The cardic pulmonary resucititation (CPR) is a procedure to support & maintain is a breathing & circulation for an infants child by ar adalescent who has stopped brathing ( respiratary arrest ) & for whose heart has stopped . “According to K. P. PARK” Cartiopulmonary resuscitation (CPR) is perfarmed to restarev & maintain breath circulation & to provide oxygen & blood floure to the heart . “According to BT basavanthappa ” Resuscitation consist of mauth to respiration & chest comperession . DEFINIATION

4. TYPES OF CPR Types of CPR Mouth to Mouth to Mouth to Nose method Stoma method Barrirr device

5. MOUTH TO NOSE The mouth to nose technique is perfarm like mouth to exhaled throught the victims nose while hodding his ar her mouth closed with one hand by pusting up on the chin, then hold the victim mouth open so any nasal obstraction does not impete exhalation of air from the victim lungs .

6. MOUTH TO STOMA In mouth to stoma result breating the victin 2 nse must be closed during the delivery of breatlis because the air can flow upward in to the upper airway throught the larynx as well as downward in to the lung you can close the kictin mouth 2 nose with one hand determind breathing by locking at ligtening to 2 feeling at the stroma keep the victime head & neck level.

7. MOUTH TO BARRIER A Mouth to barrier divice is a aparatus that is placed over a viction race as a disease prevention for the resecure during resure breating . There are two type of mouth to barrier device . Mask. Face shields .

8. MASK Resuscitation mask cover the victim mouth 2 nose . Most have one way valve so exchaled air from the victim does not enter the resurers mouth .

9. FACE SHIELDS Thease clear plastic devices have a mouth piece through which the ressrav breath have a shart airway that is inseted in to the victim mouth over the tongue there are smaller 2 less around the shold . Also they cover only the victim mouth so the nose must be rinched .

10. OBJECTIVE To maintain clear airway . To restare curdical function . To retoure consciousness of life .

11. PURPOSE OF CPR To maintain bloodcirculation by external cardiac massage . To carrect the disfunction to maintain . To by using glass jaw come scale . To exse the clothes of the ph to detect any injury ar complication .

12. PRINCIPAL OF CPR To restare effective circulation & ventilation . To prevent irreversible cerebral damage due to anoxia .

13. PREPARATION OF ARTICLES Equipment :- Endotracheql tube of variiaus zes ( 6,6,5,7,7,5,8,8,5). An ampul bag with mask . Stivet Cina plastic cover. Megals percep ( in a plastic cover) . A sultion tube ar catheter . Laryngo scope with defferent size of to lodes. Oral everwary . A bowal with guaze pices . Lubricuting jelly . Adhesive tape with scissors . Local anaesthetic ( drug spreny ). Disposable syrings with needles . Gloves in cover. A kidney tray. A paper bag . Mask of sarias sizes . Local anaesthetic drug ( xybcarine 2% ,4% . An intravenous set & a cut down set .

14. STEP OF PROCEDURE

15. S. NO. STEPS RATIONALE (1) (2) (3) (4) (5) Determine unresponsiveness observe for spontaneous respiration palpate carataid pulse . Callfor help in hospital setting call a code in a pulse . Place the victims surine on a firm plat surface ar use a board . Kneel at the victime side . Open the victims air way. Place one hand on the patient for head and apply form back word apressure with the patrn to till head back . Then place finger of the other hand under the bony part of the lower law near the chin & life up to bring the jaut carward 2 the teath almost to occusism . Prevent injury 2 attempting resucitation of a person has respiratary arrest . Activetes machanism for a additionl personal . Internal between sternum seurface . Allows perfarmans of resach breath & cheast comperession without moving kness . In the absence of suffeient muscle tone the tonge ar epiglottis will obstract the pharynx & larynx .

16. (6) (7) (8) (9) Grasp the angle of the patients lower joul 2 lifting with bath hands one a each side , displace the mandible Farward which tilting the head back word . The jaw thrust technique . Observe for rise a fall of the chest wall with each respiration , if lung do not inflate , resposition head 2 neek check for visible airway obstraction such as vomitus . Sunction any secretion from the airway , sunction is airway , if sunction is unavailable trunthe victims head to one site . Assess from pressure of carotid pulse . Corotid pulse is the most central 2 accesive artery in children over one year . Now ever in an infants the short stublay neck mases carotid difficult rememner instead . Ringeris are mared up the ribcage to notch where stermum in the centre of the lower part of chest . This supports the jaw 2 helps filt the head back . Prevent over inflain of the child lung. Prevents airways of the child lung . Carod artry pulse will persist when may peripheras pulse are notonger palpable perfoming external cardiac comperession on a victim who has a pulse may result in senxir . Medical complication Result in maximum compression of heart between sternum 2 ventetzrae , if comppression occure , overy , xiphaid , yzcbces the victim liver can alerated .

17. ( c) place fect of the hand on the loewer half of sternum 2 place the other hand or top of the hand on sternum so that hand are parauel . ( d) fingers may be extended ar interlaced but should be kept off the chest . Result in maximum result . Reduce the risk of a rib fracture during comresion .

18. S.NO PROPER HAND POSITION RATIONAL (1) (2) (3) (4) (5) Draw an emaginacy line blt nipple over the breast bone ( sternum ) . Place the index finger on the hand farther from the infants hand just under the infarmmary line where if interseits sternums . Using two ar there finger compress 19- 25 cm (1/2 -1 inches ) at least 100 time /mint . At the end of very 5 compression allow a pulse for ventilation ( ½ ½ ) seconds . Re – assess the victim after 10 cyale (5 compression one ventilation each cycle . Result maximum copression . Area of compreastion is one finger with below this intersection of middle 2 ring fingers . Promotes adequels cartial out put . Promate adequate ventilation CPR . Determine returen pulse 2 respiradion 2 the need to continue CPR . INFANT (1-12) MONTH

19. S.NO PROPER HAND POSITION RATIONAL (1) (2) (3) (4) (5) Locate the loewer margin of the victims rib cage on site next to the resecrre with middle margin & index fingers . Fallow margin arib cage with the middle finger to match where ribs sternum meet . Place the index finger next to the middle finger . Place feel of the point where the index finger axistance of the need parrelled to sternum . The resecure other hand maintain the , 6 comprees sternum with one hand 2.5 – 3.8 cm. Result in maximum compression . Determines appropriate areas for a compression . Determine appropriate areas for compression . Promotes adequate cardiac out –put . Promotes adequate cardiac out –put . CHILD ( 1-7 YEAR )

20. (6) (7) At the end of every 5 compression allow a puluse forventilation . Reassess the victim after 5 comperession ventilation each cycle . Promate adequet ventilation during C.P.R. Determines rectams of pulse & respiration & the need to continue .

21. SING OF EFFETIVE RESUSCITION Constriction of pupil key sing that btain is sufficiently oxygeneted . Distint pulsation with each cardial compression . Blinking upon stimulation of the eye lid of the . Decresed cyanosis . Incarreat resuscitative technique .heart is drained of its blood by hemorrhage of cardia tamponate . Heart is drained of its blood by hemorrhage of v= cardia tamponate . Blood supply to the heart is obstructed by the presence of pulmonary embolism . Sever chronic lung disease has destroyed lungs capacity to oxygenates blood . Lungs are fluid with vomitus as a rescue of aspiration during cardial massage .

22. The circulation of blood is initiates with the external cardiac massage because the pressure external on the pliable sternum squeezes the heart against the spine fareing blood out of the heart againt the spine fareing blood out the heart in to arota . The fallows points to be taken in to consideration :- The patients should be placrd on a heart . The body of pt. should be harizontal b/c the blood pressure generate is not adequete to pump the blood up the hed . Assess property & indicate CPRwith in 3 mint of arrest . Do not interrurt CPR for more than sever second . Give CPR by maintaining basic type ABC. Give compression only over sternum not on raise . When you are giving cardiac comresion finger should be in upward direction to rib fracture . PRECAUTION

23. PAST RESUSCITATION MESURE Skilled after care is essestial For the Who has sufferd an arrest . Continuous vigilance must ensurned by skilled person for 48- 72 hrs . Monitar ECG & blood pressure . Check the oral cavity & jaw position as his tongue may fall & obstract the air way . Termp is taken every hour . A high temp usually indicates damage or certral oedema . A chest x- ray film is obtained using rratable equipment ribs often are accidently fracure during cardia massage . Insert an endatracheal tube if nit or alreacly in place ,this maintain an open airway for the unconscious pls . Who can not clear secretion by coughing . Give oxygen continuosly for 48 hrs , following . Record the procedure on the nurse record with data & time .

24. ARTICLES Defibrillatar with paddles . Interface material disposible conductive get Resuscitative article . ABC of CPR is based on asic 3 step:- A – open the airway determine breath loss ness . B- breathing determine palsdessness C- circulation begib compression .

25. ONE RESEY CPR ADULT :- Determine unresponsiveness. Shout for help . A= AIRWAY:- Open the airway using head hit than life the life head back & life the most . B = BREATHING :- Give two farm breath (time 15 -2) second breath pinch the nose & cover the mouth with your mouth give two brath watch for the chest to arise . Check for a pulse (5-10 second ) feel for the carotid pulse . C= CIRCULATION :- Locate carrect hard position ½ of sternum. compress the sternum of 100 time per minute . Do is comperession . Give & fall breath . Do 4 cycles of 15 cm . a2 breath . Recheck pulse ( time 5 second in to pulse continue compression breathing cycle .

26. Exlernally support the circulation or respiratary of a victim of cardiac ar respiratory arrest . Provide oxygen to the vital organ until treatment can restare normal heart active .

27. SIGN AND SYMPTOMS To sweat excessive . Contriction of pupils . Chest pain . No pulse. Breathless ness . Unconscious .

28. DIAGNOSTIC EVALVATION PHIYSICAL EXAMINATION :- Head to toe examininition . HISTORY TAKING :- Present & past history of the patiend .

29. CHEST X-RAY :- ELECTROCARDIOGRAM :- This first test clone dignose a heart attach recards the electrial activity of your heart via electrods attached to your skin .

30. MANAGEMENT MEDICAL MANAGEMENT :- Provide the stable position of the patient provide oxygen therapy . Provide quaely CPR procedure at pts . Condition . Stope somiking .

31. PHARMACOLOGY MANAGEMENT S .NO NAME OF THE DRUG DOSE ROUTE ACTION INDICATION (1) Atropin sulphate . 2mg . Im . Increase the heard rate Bardyarrythmiss . (2) Calcium chloride . 10 % Iv . Increase the rate of venticular contract . Arrytrias . (3) Doxamethesone 5mg. Iv . Reduce cerelzrol be oedema prodides vital the life support . Hypoxia . (4) ( Dopamine hydrochloride Increase b.p . Hypotension . (5) Frusemide ( laxis ) Increase diseresis . Premature venticular contaction .

32. NURSING MANAGEMENT Reduce the anxiety of patient . To provide clean environment . To improve the knowledge of the disease . To provide the psychological support of the patient .

33. COMPLICATION damage to myocardium due to repeated high energy electrical shocks . Chest burndue to repeated high energy discharge & poor contact betwwen the paddles & the skin . Electraction of the by standers , formation of shart amount of copnduction jelly applied on the paddlas this cause loss of electrical .

34. HEALTH EDUCATION Intake output:- Drink safe water. Drink water 50ml/dl. Use chlorine in drinking water. Hygiene:- maintain person hygiene. Wash the hand before intake water and food. Excersize :- Active and pasive excersize . To protecte the injury. To maintain health. Rest and sleep:- Giving the active in patient to feel better in rest, sleep. Rest for 8-10 hour.

35. BIBLIOGRAPHY