cpr final x

8/13/2019 CPR FINAL X

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/#&children

/#( infant

/#)'re$nant oman

0# determine a%s in chec.in$ the effectiveness of C+

"2# list $uidelines in 'erformin$ C+""# discuss the indications and ste's for:

""#" 3eimlich maneuver

""#& 4a thrust maneuver

""#( !ac. !los for infants

""#) chest thrust

""#5 fin$er see'

" demonstrate the !e$innin$ s.ills in:

"" one man rescuer C+

"& to man rescuer C+

"( artificial res'iration


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DEFINITION OF TERMS:

o Airway

It is a tu!ular 'assa$e for movement of air into and out of the lun$# It is

also an oro'har%n$eal tu!e used for mouth to mouth resuscitation#

o

Artificial re!irati"#It is the use of cardio'ulmonar% resuscitation or the use of a mechanical

device to !reath and 'um' !lood for a 'erson hen their !od% is not a!le

to do so#


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o Baic life $!!"rt

It is an emer$enc% treatment of a victim of cardiac or res'irator% arrestthrou$h cardio'ulmonar% resuscitation and emer$enc% cardiac care#

o Car%iac arret

It is a sudden cessation of cardiac out'ut and effective circulation# It is

usuall% 'reci'itated !% ventricular fi!rillation, ventricular as%stole, deliver%

of o1%$en and removal of car!on dio1ide sto's, tissue cells7 meta!olism

!ecomes anaero!ic, meta!olic and res'irator% acidosis ensue#


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o Car%i"&eri"#

It is the restoration of the hearts normal sinus rh%thm throu$h an electricshoc. delivered !% defi!rillation# It is used to slo heart or to restore the

heart8s normal sinus rh%thm hen dru$ thera'% is ineffective at doin$ so#

o CPR

It is a !asic emer$enc% 'rocedure for life su''ort, consistin$ of artificial

res'iration and manual e1ternal cardiac massa$e# It is used in cases of

cardiac arrest to esta!lish effective circulation and ventilation to 'revent

irreversi!le cere!ral dama$e resultin$ from ano1ia# E1ternal cardiac

massa$e com'resses the heart !eteen the loer sternum and the

thoracic verte!ral column# 9urin$ com'ressions, !lood is forced into

s%stemic and 'ulmonar% circulation and venous !lood refills the heart

hen the com'ression is released# outh to mouth !reathin$ is a

mechanical form of ventilation is used concomitantl%ith cardio'ulmonar%

resuscitation to o1%$enate the !lood !ein$ 'um'ed throu$h the circulator%

s%stem#


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o Crac'le

It is a common, a!normal res'irator% sound consistin$ of discontinuous

!u!!lin$ noises heard u'on auscultation of the chest durin$ ins'iration#

o Defirillati"#

It is the termination of ventricular fi!rillation or 'ulseless ventricular

tach%cardia !% deliver% of an electric shoc. to the 'atients7 'recordium# It

is a common emer$enc% measure $enerall% 'erformed !% a 'h%sician,

s'eciall% trained nurse, or 'aramedic#


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o Eter#al car%iac c"*!rei"#

It is the action for treatin$ sudden cardiac arrest# It consists of rh%thmic

administration of 'ressure on chest all#

o +ei*lic, *a#e$&er

It is an emer$enc% 'rocedure of dislod$in$ a !olus of food or other

o!structions from the trachea to 'revent as%'h%1iation# The cho.in$

'erson is $ras'ed from !ehind !% the rescuer, hose fist, ith thum! side

in, is 'laced 4ust !elo the victim7s 1i'hoid 'rocess ith the other hand

'laced firml% over the fist# The rescuer then 'ulls the fist firml% and


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a!ru'tl% u'ard into the e'i$astrium, forcin$ the o!struction u' the

trachea#

o -aw t,r$t tec,#i.$e

It is also called mandi!le thrust, anterior dis'lacement of mandi!le, and

tri'le aira% maneuver# This 'rocedure should !e used hen the victim

has sus'ected or confirmed s'inal cord trauma, since the nec. can !e

su''orted and the aira% o'ened ith minimal movement, thus 'reventin$

further s'inal cord assault#

o Re!irat"ry arret

It can !e caused !% de'ression of the res'irator% center in the medulla


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o!lon$ata or interference ith neuromuscular transmission to res'irator%

muscles#

o Re$citati"#

It is the 'rocess of sustainin$ the vital function of a 'erson in

res'irator%;cardiac failure hile revivin$ him;her, usin$ techniue of

artificial res'iration and cardiac massa$e, correctin$ action !ase

im!alance and treatin$ the cause of failure#

o


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o R,"#c,i

It is a lo 'itched sonorous sound caused !% mucus or other fluids movin$

around in the lar$e aira%s#

o /e#tilati"#

It is the 'rocess !% hich $ases are moved into and out of lun$s#


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o 0,ee1i#2

It is a form of rhonchi, characteri6ed !% a hi$h


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C f"r CIRCULATION

It is the movement of blood through the beating of the heart or the

emergency measure of CPR.

If the 'erson is trained to ta.e the 'ulse, it is 'erformed as follos: chec.

for 'ulse, 'lace %our fin$ers on the victim7s Adam7s a''le and slide them tothe side until %ou find a $roove in the nec. a!ove the carotid arter%# Chec.

for 'ulse for no more than "2 seconds# If there is no !reathin$, cou$hin$

or movement after the rescue !reaths !ut there is circulation, continue

rescue !reathin$# Chec. for si$ns of circulation re$ularl%, the 'atient mi$ht

fall into cardiac arrest at an% time# If there is no circulation: 'osition the

hand !efore $ivin$ a C+# The hand must !e 'laced to fin$ers aa%

from here the ri!s meet to$ether#

If no circulation is detected, !e$in chest com'ressions# Correct 'osition for

C+: the arms are full% e1tended and the thrusts are $iven from the hi's,

continue until there is: !reathin$, cou$hin$ or movement or other si$ns of

circulation return# Common mista.es in 'erformin$ chest com'ressions

include loo.in$ !ac. and forth and !endin$ the el!os# It is im'ortant to

note that, 'articularl% in elderl% 'atients, cre'itations the shatterin$ if

!ones in the ri! ca$e and sternum hich can !e !oth heard and felt ill

often occur#

A f"r AIR0AY

The protection and maintenance of the patients airway including the use

of airway adjuncts such as an oral or nasal airway.

If the 'erson is unres'onsive, o'en the !loc.ed aira%, uic. ins'ection of

the mouth ma% reveal a !loc.ed aira%# If 'ossi!le, the 'atient should !e

'laced on his;her !ac. on a firm surface# The ne1t ste' is to $et a further

vie of the mouth and throat, and to ma.e as much s'ace for !reathin$ as

'ossi!le: In the 'ossi!ilit% of a nec. in4ur%, liftin$ the chin;4a ma% !e

enou$h to sta!ili6e the aira%# In other cases, tiltin$ the head !ac. ill lift

the ton$ue aa% from the !ac. of the mouth, o'enin$ the aira%#


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If the victim has no head;nec. in4ur%, $entl% tilt the head !ac. !% liftin$ the

chin ith one hand hile 'ushin$ don on the forehead ith %our other

hand# Once the aira% is o'en, lean over and 'ut %our ear close to the

victim7s mouth# "loo. at the chest for movement, &listen for the sound

of !reathin$, (feel for !reath on %our chee.# If the victim is !reathin$, rollthe 'erson onto his or her side as a unit the recover% 'osition# If none of

these si$ns is 'resent, the 'erson isn7t !reathin$# If o'enin$ the aira%

doesn7t cause the 'erson to s'ontaneousl% start !reathin$, %ou7ll have to

'rovide rescue !reathin$#

B f"r BREAT+IN3

The actual flow of air through respiration, natural, or artificial respiration

often assisted by emergency oygen.

+ro'er chec.in$ of the 'atient7s res'iration: the hel'er listen to the !reath,

tries to feel die air floin$ on her chee., the chest $oin$ u' and don and

see the movements of the chest# After o'enin$ the victim7s aira%,

!reathin$ effort is chec.ed# +lacin$ one7s chee. in front of the victim7s

mouth a!out (


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Be sure to .ee' the heel of %our hand in 'lace so the 'erson7s head

remains tilted# Dee' %our other hand under the 'erson7s chin, liftin$ u', &

as %ou .ee' an air


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mida% !eteen the el!o and the shoulder# Chec. for the 'ulse in a

small child the same a% %ou ould in an adult# or chest com'ression in

infants and small children, use onl% one hand# Gou can sli' %our other

hand under the !ac. of an infant to $ive firm su''ort# or infants, use onl%

the ti's of the middle and rin$ fin$ers to com'ress the chest at thesternum# 9e'ress the sternum !eteen H to " inch at a rate of at least

"22 times a minute# or small children, use onl% the heel of one hand#

9e'ress the sternum !eteen " and " H inches, de'endin$ on the child7s

si6e# The rate should !e /2 to "22 times a minute# In the case of !oth

infants and small children, $ive !reaths durin$ a 'ause after ever% fifth

chest com'ression#

emem!er: If the victim still isn7t !reathin$, attem't to chec. the carotid

'ulse for a fe seconds# If there7s no 'ulse or %ou can7t locate the 'ulse

and the child is still unres'onsive, !e$in " minute of C+# Then send

someone to activate the local emer$enc% num!er hile %ou 'erform C+#

Continue to do C+ until hel' arrives#

CAUSES OF RESPIRATORY ARREST:

O!struction or !loc.in$ is one of the causes of res'irator% arrest#

Anatomical o!struction occurs hen a ton$ue o!structs the 'har%n1 and

eventuall% dro's !ac.# echanical o!structions is defined hen a forei$n

o!4ect lod$es into the 'har%n1, and hen there is fluid stimulation in the

!ac. of the throat#

Other causes of res'irator% arrest include diseases such as dru$

'oisonin$, in hich the res'irator% center of the !rain !ecomes de'ressed

if one overdoses on narcotic dru$s# Common s%m'toms of narcotic dru$s

include ea. 'ulse, ver% rela1ed muscles, cold and clamm% s.in, and

dee' slee'#


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9ronin$ is a form of suffocation# The air su''l% to the lun$s is sto''ed !%

ater or s'asm of the lar%n1#

3an$in$, 'lanned or accidental, !loc.s the air 'assa$e and leads to

res'irator% and cardio'ulmonar% arrest# +ressure on the throat should !eremoved at once and a''ro'riate first aid care rendered as needed#

as 'oisonin$ most t%'icall% involves car!on mono1ide 'oisonin$# It is

created !% the incom'lete com!ustion of fossil fuels# The immediate first

aid is to remove the source of 'oisonous $as, and institution of artificial

res'iration#

Asthma and e'i$lotitis are also other causes of res'irator% arrest#

CAUSES OF CARDIAC ARREST

A cardiac arrest is the cessation of cardiac functionin$ herein the heart

sto's !eatin$# Often a cardiac arrest is une1'ected and sudden# >hen it

occurs, the heart no lon$er 'um's !lood to an% of the or$ans of the !od%#

Breathin$ then sto's, and the 'erson !ecomes unconscious and lim'#

>ithin &2 to )2 seconds of cardiac arrest, the victim is clinicall% dead# After

) to * minutes, the lac. of o1%$en su''l% to the !rain causes 'ermanent

and e1tensive dama$e#

Ventricular fi!rillation is a ra'id, irre$ular heart rh%thm 'reventin$ an%

circulation of !lood# It is also the dramatic sloin$ of heart rate due to

failure of its 'acema.er to 'ro'erl% function or severe heart !loc.#

Electrocution, 3%'othermia, sudden loss of !lood 'ressure, ischemic heart

disease, arteriosclerosis, h%'er.alemia, h%'o.alemia, ta!lets of to1ins,

and m%ocardial infection are also factors causin$ cardiac arrest#

The most common si$ns of a heart attac. is a sensation of suee6in$,

'ain, fullness, or 'ressure in the center of the chest#


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Cardiac arrest can result from man% causes, such as m%ocardial infarction

and coronar% throm!osis# These sto' the effectiveness of heart action#

Cardiac arrest is also a cause of cardiac in4ur%# It is most commonl%caused !% a ea'on, !ut could also result from chest trauma, as incurred

in an automo!ile accident#

SI3NS AND SYMPTOMS OF RESPIRATORY ARREST

A res'irator% arrest or a 'ulmonar% arrest is the cessation of !reathin$# It

often occurs as a result of a !loc.ed aira%, !ut it can occur folloin$ a

cardiac arrest and for other reasons# A res'irator% arrest is 'receded !%

short, shallo !reathin$# The !reathin$ !ecomes increasin$l% la!ored#

Then the 'erson !ecomes flushed and disoriented and e1'eriences

feelin$ of suffocation#

SI3NS AND SYMPTOMS OF CARDIAC ARREST

The three cardinal si$ns of a cardiac arrest are a'nea, or the tem'orar%

cessation of !reathin$, a!sence of a carotid or femoral 'ulse, and dilated

'u'ils# The 'erson7s s.in a''ears 'ale or $ra%ish and feels cool# C%anosis

is evident hen res'irator% function fails !efore heart failure occurs# Other

si$ns include: sudden unconsciousness, uno!taina!le !lood 'ressure,

a!sence of heart!eat, and an unres'onsive 'atient#


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MET+ODS OF ARTIFICIAL RESPIRATION

ARTIFICIAL /ENTILATION

9urin$ res'irator% arrest, %ou must 'rovide o1%$en ithin ) to * minutes,or !iolo$ical death ill follo# Gou can restore the o1%$en su''l% !%

e1halin$ into the victim7s mouth, nose, or tracheal stoma# These

'rocedures can !e used for an% victim, ith a''ro'riate modification for

the 'atient7s si6e, a$e, and res'irator% rate#

M"$t,5t"5M"$t, /e#tilati"#

Gou can restore o1%$enation throu$h mouth


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method# In these situations, mouth


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C"#trai#%icati"# "f CPR

+atient7s ith cervical in4ur% to 'revent the 'ossi!ilit% of creatin$

further dama$e to the fractures alread% 'resent#

+atient7s ith fracture in sternum, ri!s or thoracic !one to 'revent

'uncturin$ or laceratin$ an% of the visceral or$ans ithin thethoracic cavit% or a!domen#

+atient7s ith s'inal in4ur%#

If the 'h%sician has an order 9 9o ot esuscitate for the

'atient ho is unres'onsive to avoid an% le$al im'lications and

res'ect 'atient ri$hts#

Victims ith severe crushin$ in4uries to face and nec. cannot have

mechanical ventilation 'erformed as it ould further com'licate an%in4uries that ere alread% 'resent#

+eo'le ho are conscious#

>hen the 'atient is announced dead as noted or said !% the

'h%sician 'resent ith indicators or evidence such findin$s as ri$or

mortis#

Tec,#i.$e f"r eter#al car%iac c"*!rei"#

"# +osition the victim in a su'ine or firm surface#

Elevate the le$s (2 to )2 de$rees >oodard aneuver for 5 to

"5 seconds to initiate s'ontaneous cardiac activit%#

(# E1'ose the victim7s chest so that he or she can identif% the correct

hand 'osition#

)# The rescuer should choose a 'osition close to the victim7s u''er

chest so that the ei$ht of the !od% can !e used for com'ression#

5# The rescuer should ne1t identif% the loer third of the sternum, as

this is the 'oint here ventricles are most effectivel% com'ressed

!eteen the sternum and the thoracic s'ine#

*# The rescuer can locate the distal ti' of the 1%'hoid 'rocess in to

a%s:

A# The rescuer mar.s this 'oint ith three fin$ers on one hand,


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hile 'lacin$ the heel of the other hand on to' of the hand,

interloc.in$ them, on the sternum ith el!os strai$ht#

B# The rescuer identifies the loer mar$in of the 'ortion of the

victim7s ri! ca$e that is closest to the rescuer and to 'al'ate the

ri! ca$e to the midline to locate the notch here the ri!s meetthe sternum# The rescuer 'laces to fin$ers on the 4unction, and

the heel of the other hand 'ro1imal to the fin$er# Once he or she

o!tains the landmar., the rescuer 'laces the other hand on to'

of the hand on the sternum and interloc.s them#

-# The rescuer accom'lishes ECC ith ei$ht of the !od% e1ertin$

force on the outstretched arms, el!os held strai$ht# The rescuer

should .ee' the shoulders over the victim and use a roc.in$ motion

from the hi's to create donard 'ressure#

/# The rescuer should a''l% com'ression re$ularl%, rh%thmicall%, and

ithout !ouncin$#


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INDICATIONS AND STEPS IN PERFORMIN3:

+ei*lic, Ma#e$&er

Indications:

Cho.in$ adults

Cho.in$ children

Ste's:

To 'erform the 3eimlich maneuver on a conscious 'erson ho is standin$

or sittin$:


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"# Stand !ehind the 'erson and ra' %our

arms around his or her aist#

a.e a fist ith one hand, tuc. the thum!

inside the fist, and 'lace the fle1ed thum!a$ainst the 'erson7s e'i$astrium, i#e#, !elo

the 1i'hoid 'rocess# A 'rotrudin$ thum! could inflict in4ur%#

(# >ith the other hand, $ras' the fist and 'ress it into the 'erson7s

a!domen ith a firm, uic. u'ard thrust# Avoid ti$htenin$ %our

arms around the ri! ca$e, and thrust it in the direction of %our chin#

9eliver one uic. thrust#

)# 9eliver successive thrusts as se'arate and com'lete movements#

e'eat the 'rocess until o!struction is removed or the victim loses

consciousness#

5# If the 'erson !ecomes unres'onsive, the

rescuer should move the 'erson to the

$round, activate the Emer$enc% edical

Services ES S%stem, and !e$in C+#

*# If the 'erson is conscious and alone

durin$ the incident, the% can attem't to

dislod$e the forei$n !od% ith self

cpr final x

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