Lhealth and medicine and everything invluded

Medicine

1. CARDIOPULMONARY
RESUSCITATION ( CPR)

2. OBJECTIVES
By the end of this lecture, the students would be
able to:
List the sequence of CPR.
Explain the procedures for performing CPR.
Demonstrate CPR.
Know when to terminate CPR.

3. CPR is a life-saving technique.
Time is critical in starting CPR.
CPR is indicated whenever heart and/or
breathing stop (cardiac and/or respiratory
arrest).
CPR can keep a person alive until more advanced
procedures (such as defibrillation - an electric
shock to the chest) can treat the cardiac arrest.

4. CPR steps are called CAB (Chest Compression,
Airway, and then Breathing).
Providing artificial circulation via chest
compressions.
Opening and maintaining the airway.
Providing artificial ventilation through
artificial breathing.

5. CPR provides circulation of blood to the brain
and air to the lungs in order to prevent damage
to the brain.
If breathing stops → brain damage occurs
within few minutes usually 4 minutes, and
brain death could occur within 8-10 minutes.

6. STEPS BEFORE STARTING CPR
Within 5 to 10 seconds, check for (1)
responsiveness and for (2) no breathing [or
only gasping].
Check responsiveness by gently tapping on
shoulders and asking loudly “Are you OK?” or
“Do you hear me?”

Note: In infants (i.e., less than 1 year of age)
victims, you should tap on the heel of the
foot.

7. IN CPR, VICTIMS ARE DIVIDED INTO
3 CATEGORIES:
Adults (involves all adults and children who
reached the puberty.)
Puberty is defined as chest or underarm hair on
males, or any breast development on females.
Children (victims from the age of 1 to puberty.)
Infants (involves victims with less than 1 year of
age.)

8. WHAT TO DO IF THE VICTIM IS
UNRESPONSIVE AND NOT
BREATHING OR NOT BREATHING
NORMALLY (ONLY GASPING)?

9. If the victim is unresponsive and not breathing or
not breathing normally (only gasping), and
he/she is an Adult:

activate the EMS system (997) and get a
nearby Automated External Defibrillator
(AED).

10. If the victim is unresponsive and not breathing or
not breathing normally (only gasping), and
he/she is a Child or an Infant:

If you did not witness the arrest and you are
alone (single rescuer), you should perform 5
cycles (about 2 minutes) of CPR before leaving
to activate the EMS and to bring an AED.

If the arrest is sudden and witnessed, leave
the victim, activate the EMS and get the AED
and then return to the victim. However, if
someone else is present, you may ask him/her to
activate the EMS and to bring an AED.

13. CPR SEQUENCE (C-A-B)

14. CHEST COMPRESSION STEP
(ALSO CALLED CIRCULATION STEP)
oCheck for the presence of pulse:
oFor adults, carotid artery pulse may be used.
oFor children, carotid artery pulse OR femoral
artery pulse may be used.
oFor infants, brachial artery pulse may be used.

15. oIf there is no pulse, then this victim needs
cardiopulmonary resuscitation (CPR).
oIn infants, if the pulse is less then 60 beats/minute,
this victim also needs cardiopulmonary resuscitation
(CPR).
oCareful! If you are not trained to perform CPR,
then find someone who is trained.

16. CAROTID ARTERY
CHECKING

17. FEMORAL ARTERY
CHECKING

18. BRACHIAL ARTERY
CHECKING

20. Hands Placements for Compressions:
For Adults
Put the heel of one hand on the center of bared
chest over the lower half of the breastbone,
then put the heel of the other hand over the
top of the first.
Your shoulder should be right over your hands
and your elbows should be straight/extended.
Key Messages: You should deliver
compressions in a smooth fashion at a rate of
at least 100 compressions per minute. At the
end of each compression, allow the chest to
recoil completely.

21. Hands Placements for Compressions:
For Children
Similar to the Adults; but you have the option
to use 1 or 2 hands.
Remember: You should deliver compressions
in a smooth fashion at a rate of at least 100
compressions per minute. At the end of each
compression, allow the chest to recoil
completely.

22. Hands Placements for Compressions:
For Infants
1-rescure CPR

Use 2 fingers of one hand.

Place the middle and index fingers on the
breastbone just below the nipple line.
2-rescuer CPR

The compressor will place both thumbs side-
by-side in the center of the chest on the
lower half of the breastbone [nearby the
nipple line]. This technique is also called:
2-thumb encircling hands technique.

23. HANDS
PLACEMENT IN
ADULTS

24. Key Considerations
Checking the pulse should occur within a
minimum 5 seconds and a maximum 10 seconds.
Each set of 30 compressions should be done in
approximately 18 seconds.
A ventilator (the rescuer who provides
ventilations):
1.can check for a pulse during compressions to
make sure they are effective by feeling a
pulse every compression.
2.should observe for correct delivery of
compressions by the compressor.

25. AIRWAY STEP
Put the victim on his back on a firm surface.
Kneel close to the victim neck or shoulders.
To open the airway, tilt the forehead backward and
the chin upward (called head-tilt/chin-lift
maneuver) قيرطة
عفر و فلخلا ىلإ باصملا سأر ينح

ىلعأ ىلإ كفلا
.

26. Careful!
In victims with suspected head, neck or back
injuries, use a method called: jaw-thrust
maneuver
يلفسلا كفلا عفر ةقيرط
.

27. BREATHING STEP
Close the nostril and give 2 breaths (mouth to
mouth) and observe the chest rises.
Give each breath over one second to allow chest
recoil.

28. AFTER TWO (2) MINUTES OF
“COMPRESSION:VENTILATION CPR CYCLES”,
If the victim has no pulse, give chest
compressions and resume CPR.
Check for a pulse every approximately 2
minutes.

29. AFTER TWO (2) MINUTES OF
“COMPRESSION:VENTILATION CPR CYCLES”,
If the pulse is present BUT breathing is absent,
continue artificial breathing only (called rescue
breathing).
In adults:

Give 1 breath every 5 6 seconds for about 10
‐ ‐
12 breaths/minute.

Each breath should be delivered over 1
second, making the chest rise.

Re-check the pulse every two minutes.

30. AFTER TWO (2) MINUTES OF
“COMPRESSION:VENTILATION CPR CYCLES”,
If the pulse is present BUT breathing is absent,
continue artificial breathing only (called rescue
breathing).
In infants and children:

Give 1 breath every 3 5 seconds for about 12
‐ ‐
20 breaths/minute.

Each breath should be delivered over 1
second, making the chest rise.

Re-check the pulse every two minutes.

31. AFTER TWO (2) MINUTES OF
“COMPRESSION:VENTILATION CPR CYCLES”,
If the pulse and breathing returned to normal,
place the victim in recovery position.
) (
يبناجلا ناملأا ةيعضو شاعنلاا ةيعضو

32. 1 2
43

33. USING AN AED

34. USING AN AED
Put an AED on victim as soon as it arrives and
turn it on.
When an AED is analyzing the victim's data, no
one should touch the victim.

35. WHEN CAN I STOP CPR?
The victim revives.
Trained help arrives.
You are too exhausted to continue.
The victim is pronounced dead.
The cardiac arrest continues for 30 minutes
(controversial).

36. WHY CPR MAY FAIL?
Delay in starting.
Improper procedures (example, forget to pinch
nose).
Delay in defibrillation.
Improper techniques.
Terminal disease or unmanageable disease
(massive heart attack).

37. MORE INFORMATION
The first rescuer reaches the victim should
ensure safety at the scene quickly.
Hands-only CPR should be encouraged where
untrained caregivers are involved.
Performing CPR compressions on the xiphoid
process can cause internal organ damage.
Always, switch roles (compressor to ventilator,
and vice-versa) when an AED starts analyzing
the rhythm.

38. In 2-rescure adult CPR, switch roles (compressor
to ventilator, and vice-versa) every 5 cycles or 2
minutes, taking less than 5 seconds, to prevent
fatigue.
In 2-rescure child or infant CPR, switch roles
(compressor to ventilator, and vice-versa) every
10 cycles or 2 minutes, taking less than 5 seconds,
to prevent fatigue.
Note: During this 2-rescuer CPR, you are doing the
CPR cycles at 15:2 not 30:2.