Health Care Provider-CPR Summary

Check the Area

  • Look for hazards. Hazards include split electrical wires, fire, unstable building structure or anything else that could present a risk to the responder. Make sure that you do not put yourself in danger
  • Put on gloves if you have them.
  • Use Pocket Mask or Face Shield, if you have access to them and need to give rescue breaths.

Check Level of Consciousness

  • If YES, check the victim for other conditions and call for help if necessary.
  • DO not give CPR to conscious victims
  • If NO call 911 -If you’re alone with the victim, try to call for help prior to starting CPR on an adult and after 2 minutes of CPR on a child.
  • DO NOT leave the victim alone.
  • DO NOT try to make the victim drink liquids.
  • DO NOT throw water on the victim’s face.
  • DO NOT move or shake victim if victim has sustained spinal or neck injury.

A B C has changed to C A B ( Compressions, Airway, Breathing)

  • Adult Victim-One or Two Rescuers: Count aloud as you compress 30 times at the rate of about 3 compressions for every 2 seconds. Finish the cycle by giving the victim 2 breaths. 30:2
  • Child Victim- Two Rescuers: Count aloud as you compress 15 times at the rate of about 3 compressions for every 2 seconds. Finish the cycle by giving the victim 2 breaths. 15:2

To prevent fatigue the rescuers should change roles every 2 minutes – the rotation should be accomplished as quickly as possible to minimize interruptions in compressions.

Note 2010 AHA guide lines call for compressions first and compression only if unwilling to give mouth-to mouth breaths. ( For Lay Rescuers only)

Compressions – begin compressions

Correct position for Adult. The arms are fully extended and the thrusts are given from the hips.

Airway – open the airway

Tilt head back lift chin up

Breathing – check for breathing

After opening the victim’s airway, check to see if the victim is breathing.

  • 1. You may Feel the victim’s breath against your cheek.
  • 2. You may Hear the air entering or escaping your victim’s lungs.
  • 3. You may See the chest rise and fall with each breath.
  • 4. You may Smell the breath of the victim as they exhale.

If victim is breathing place the victim in the Recovery position and call for help unless a spinal injury is suspected in which it is crucial to not move the patient.

If victim is Not breathing No pulse, give 30 cheats compressions, then 2 rescue breaths. Repeat cycle until EMS workers arrive or victim awakes.

Compressions to Breaths Ratio Table:

CPR Table
Age Group
Adult
Child
Infant
Single-Person
30-2 30-2 30-2
Two-Person
30-2 15-2 15-2
Technique
Both hands One hand Two fingers
  • Compressions are at a rate of 100 per minute.
  • Hand/finger placement is just below the nipple line and above the bottom of the breast bone.

 Remember Compression Depth for:

  • Adult is 2 inch
  • Child  1 inch
  • Infant 1/2 inch

Automated External Defibrillation-AED

Main Points

  • A victim’s best chance for survival is when there is revival within 5 minutes.
  • Having more people who can respond to medical emergencies and trained to use AEDs will greatly increase survival rates for people in sudden cardiac arrest.

What is an Automated External Defibrillator?

An Automated External Defibrillator (AED) is a small, lightweight device used to assess a person’s heart rhythm. If necessary, it administers an electric shock to restore a normal rhythm in victims of sudden cardiac arrest. Built-in computers assess the patient’s heart rhythm, judge whether defibrillation is needed, and administer an appropriate level of shock. Audible and/or visual prompts guide the user through the process.

How does an AED work?

A microprocessor inside the defibrillator analyzes the victim’s heart rhythm through adhesive electrodes (some AED models require the operator to press an ANALYZE button). The computer then advises the operator whether a shock is needed. When the operator responds to the prompt to give a shock, an electric current is delivered through the victim’s chest wall through adhesive electrode pads.

Why are AEDs important?

When a person suffers a sudden cardiac arrest, chances of survival are reduced by 7 to 10 percent with every minute that passes without CPR and defibrillation. AEDs can restore a normal heart rhythm in victims of sudden cardiac arrest, which may be a heart attack or sudden death. New, portable AEDs enable more people to respond to a medical emergency requiring defibrillation.

Who can use an AED?

Anyone trained to use cardiopulmonary resuscitation (CPR) can be trained to use an AED. Most AEDs are designed to be used by people without medical backgrounds, such as police, firefighters, flight attendants, security guards and lay rescuers. AEDs are most effective when standards are in place for appropriate training, equipment maintenance and ongoing quality-of-care monitoring.

When a person’s heart stops beating, why should an AED be used?

When a heart’s rhythm goes into an uncoordinated electrical activity called fibrillation, the heart twitches ineffectively and can’t pump blood. This condition often accompanies severe heart attacks when the patient’s heart appears to have stopped beating.

The AED delivers electric current to the heart muscle, momentarily stunning the heart and stopping all activity. This gives the heart an opportunity to resume beating effectively.

Will an AED always resuscitate someone in cardiac arrest?

No. The AED treats only a heart in ventricular fibrillation, which is an irregular heart rhythm. In cardiac arrest without ventricular fibrillation, the heart does not respond to electric currents, but needs medications. The victim also requires breathing support. AEDs are less successful when the victim has been in cardiac arrest for more than a few minutes, especially if no CPR was administered.

Do AEDs replace the use of CPR?

No. When a person experiences cardiac arrest, CPR will help keep oxygen flowing to the brain, but the electric shock of an AED vastly improves the chances of restarting the heart

Don’t do this!
Do not shock if:

  • The victim is close to explosive or flammable material.
  • The victim is wet (dry the victim off with a towel).
  • The victim has a medicine patch on them, however, you must remove this while wearing gloves.
  • The victim is touching an object that could conduct the charge to others. (A metal bench)

If necessary, protect the victim from water and dry them, or move the victim a few meters between each CPR cycle until the area is safe for defibrillation.

Cell phones and other electronic devices can disrupt the analyzing phase of the AED. Check for a cell phone on the patient and remove it to a distance of 6 feet or more. Remember, life over limb (or possessions, in this case.)

Electrode placement is crucial

The AED machine will clearly talk you through all steps of the process.

CPR must be stopped while the defibrillator is monitoring the victim’s heart activity. In all cases, defibrillation has priority over CPR. Do not touch the victim or the AED.

Use of Bag valve masks.. come in different sizes to fit infants, children, and adults. Some types of the device are disposable, while others are designed to be cleaned, disinfected, and reused.

The BVM directs the air inside it via a one-way valve when compressed by a rescuer; the air is then delivered through a mask and into the victim’s airway and into the lungs.

Rescuers must ensure that the mask portion of the BVM is properly sealed around the patient’s face. To make better use of available rescuers, the BVM can be operated by a single rescuer who holds the mask to the victim’s face with one hand (using a C-grip), and squeezes the bag with the other.

Rescuers must ensure that the mask portion of the BVM is properly sealed around the patient’s face. To make better use of available rescuers, the BVM can be operated by a single rescuer who holds the mask to the victim’s face with one hand (using a C-grip), and squeezes the bag with the other.

DO NOT overinflate lungs of the victim.

Calling For Help

If a bystander has not already called assistance (known as EMS, Ambulance Service, Rescue Squad, or Paramedics depending on the region) call immediately. . Ideally, someone else will be able to make the call while you continue aid. If you’re alone, you must stop and call yourself.

You will need to give the emergency services:

  • Your exact location
  • The illness or injury that the victim is having (to the best of your knowledge).
  • A telephone number you can be contacted back.

Compressions Principles

Schematic of the human heart

Chest compressions help squeeze the heart from outside the victim’s chest, helping to circulate blood around. When performing chest compressions during CPR, you are helping move the oxygen you delivered through rescue breathing where it is needed.

Chest compressions are often started before any other intervention in an emergency setting, because even blood that has already passed through the body has oxygen remaining to be used. Using compressions to pump that existing blood around can help buy the victim more time. This is the reason that CPR can be done “compression only”, or without rescue breathing for period of time. Once compressions start, they must continue for as long as possible.

Technique

The goal is always to compress in the center of the chest. This means that compressions are to performed on the sternum or breastbone of the victim, in line with the victim’s armpits or nipple line.

  • For adults (older than 12 ) – place the heel of one hand in the centre of the chest, bring your other hand to rest on top of the first hand, and interlock your fingers. Bring your shoulders directly above your hands, keeping your arms straight. You should then push down firmly onto the heel of the lower hand, depressing the chest to about one third (1/3) of its depth or 1.5 inch to 2 inches deep.
  • For children (1-12) - place the heel of one hand in the centre of the chest. Bring your shoulder directly above your hand, with your arm straight, and perform compressions to one third (1/3) the depth of the chest with one arm only.
  • For infants (<1yr) - Use (2 fingers) forefinger and middle finger only. Compressing the chest about one third (1/3) of it’s depth.

Show Me Video>>Infant CPR

You MUST allow the ribs to come all the way back out after each compression. This allows the heart’s chambers to refill.

You are aiming for a rate of 100 compressions per minute, which includes the time to give rescue breaths. In practice, you should get just over 2 cycles of 30 compressions in along with breaths per minute.

  • The victim should be on a hard surface
  • Keep your arms straight
  • If you lose count, don’t stop, just estimate

When to Stop CPR

  • If you are with someone else trained in CPR, rotate between compressions and rescue breaths.
  • You should continue giving the victim CPR until:
  • The victim starts breathing spontaneously
  • The victim vomits – If the victim vomits, roll them to their side, clear the airway and reassess ABCs.
  • If you are without barrier device and feel uncomfortable giving rescue breaths, give chest compressions only.
  • Qualified help arrives
  • DO NOT STOP until instructed to. By continuing CPR, you are keeping the medical personnel free to perform other tasks.
  • You are unable to continue. Try to change places frequently with another trained rescuer to lessen the chance of exhaustion.
  • You put yourself in danger by continuing - If your life is endangered by a new hazard, you should stop CPR. If possible, remove the victim from the hazardous situation as well, but never at the risk of your own life or health.

Contributors :Mike.lifeguard ,Mike6271,Firefighter04,Chopstick ,Owain.Davies ,Nugger,Geoff Plourde

The original work has been modified.

 
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