cpr.pptx

Its useful documentation with pictures regarding emergency medicine topic CPR

1. CARDIOPULMONARY RESUSCITATION Guided by Dr.Shyam p warma Assistant professor SDM college of Ayurveda and hospital Hassan Presenting by Adivishwanatha gupta 1 st year PG scholar

2. Cardiopulmonary resuscitation (CPR) is a lifesaving technique useful in many emergencies, including heart attack or near drowning, in which someone's breathing or heartbeat has stopped. CPR may not save the victim even when performed properly, but if started within 4 minute of cardiac arrest and defibrillation is provided within 10 minutes, a person has a of survival of 40% Introduction

3. Definition Cardio Pulmonary Resuscitation is a technique of basic life support for oxygenating the brain and heart until appropriate, definitive medical treatment can restore normal heart and ventilatory action. It is series of steps used to establish artificial ventilation and circulation in the patient who is not breathing and has no cardiac activity

4. Purpose of cpr To restore cardio and pulmonary function Prevent the irreversible damage from anoxia

5. Indications Cardiac arrest and respiratory arrest Causes of cardiac arrest Hypoxia hypotension hypothermia Hypoglycaemia Hypo kale is Acidosis Cardiac tamponade Tension pneumothorax Thrombo embolism Toxicity and etc

6. Causes for respiratory arrest Drowning Stroke Foreign body in throat Smoke inhalation Drug over dose Accident or injury Epiglottis paralysis Poisoning

7. CPR can be done by any one ,who has knowledge of it It can be classified into two method BLS – basic life support(done by any one medico or non medico without equipment’s) ACLS – advance cardiac life support Done by medico with full of equipment Done in fully equipped area like hospitals or ambulance

8. Basic life support Approach safely Check response Shout for help Open airway Check breathing Call 108 Start chest compressions

9. Check response Shake the shoulders gently Shout or speak near ear (ask are you all right ) Try to wake him up

10. Check breathing and pulse Look listen and feel for normal breathing If agonal breathing is it is sign of cardiac arrest ( Agonal breathing is a barely heavy noisy or gasping breathing ) Check pulse radial or carotid

11. Airway Check air way For any foreign body If absent start cpr chest compression followed with rescue breathing If foreign is visible do finger sweep (not in the conscious person ) (Try to remove the foreign body using fingers ) Head tilt +chin lift + jaw thrust position to clear the air way

12. Heimlich manoeuvre: if the pt is conscious or the foreign body cannot be removed by a finger sweep. It is done while the pt is standing up or lying down. This is a subdiaphragmatic abdominal thrust that elevates the diaphragm expelling a blast of air from the lungs that displaces the foreign body. In infants his can be done by a series of blows on he back and chest thrusts

13. Chest compression or cardiac massage The human brain cannot survive more than 3minutes with lack of circulation ,so chest compression must be started immediately for any patients with absent central pulsation (carotid pulse )

14. Technique of chest compression Pt should be placed on hard surface The palm of one hand is placed in the con cavity of the lower half the sternum two fingers above the xiphoid process ( xiphisternal junction) The other hand is placed over the hand which is on sternum Shoulders should be positioned directly over the hands with the elbows locked straight and arms extended. Use your upper body weight to compress. Sternum must be depressed atleast 5 cm in adults, and 2-4 cm in children, 1-2 cm in infants .

15. Push hard and push fast Must be performed at a rate of 100-120 /min During compression ventilation is provided simultaneously The ratio of chest compression and ventilation should be 30:2 when single rescuer is present when more than one chest compression should not be interrupted for ventilation Chest compressions must be continued for 2 minute before reassessment of cardiac rhythm. (2 minutes = equivalent to 5 cycles 30:2).

16. Breathing Mouth to mouth breathing: with the airway held open, pinch the nostrils closed, take a deep breath and seal your lips over he patients mouth. Blow steadily into the patients mouth watching the chest rise as if the patient was taking a deep breath Mouth to nose breathing seal the mouth shut and breath steadily though the nose Mouth to mouth and nose is used in infants and small children

17. When to terminate the cpr Pulse and respiration returns Emergency medical help arrives Physician declared patient is decease (dead) the rescuer was exhausted and physically unable to continue to perform BLS

18. A(C)LS– ADVANCE (CARDIAC)LIFE SUPPORT Includes Circulation by cardiac massage Airway management by equipment Breathing by advanced techniques Defibrillation by manual defibrillator Drugs

19. There is no change in chest compression method or rate in acls Airway and breathing method will be done by advanced equipment and techniques Use of drugs is present based on conditions

20. Airway and breathing Face mask Oropharyngeal airway Nasopharyngeal airway Laryngeal mask Endotracheal tube Combitube Cricothyrotomy Tracheostomy

21. Level of oxygen supplied by different methods Expired air = 16% O2 Ambu Bag (room air) = 21% Ambubag + O2 = 45% O2 O2 (10-15L) AmbuBag +O2+ Reservoir bag = 85% O2

22. Nasopharyngeal airway

23. Oropharyngeal airway Based of size of the person different sized mouth gag is used

24. ENDOTRACHEL TUBE INTUBATION

25. TRACHEOSTOMY Indications Laryngeal edema Where Endotrachial intubation not possible When pt is going to be ventilator for long period Paralysis of glottis

26. Defibrillator To activate the electric impulse in cardia Indicated in VT , VF,asystol etc Placement of leads is very imp Cardiac activity should be checked after each defibrillation shock used Left lead is placed on left mid clavicular line and right lid placed on right supra axillary line

27. Thank you