P R I N C I P L E S O F M E D I C A L S C I E N C E

CPR & AED

5 ELEMENTS IN CARDIAC CHAIN OF SURVIVAL

• 1. Early recognition of the signs of a heart attack• 2. Early access to medical care (911)• 3. Early CPR • 4. Early defibrillation• 5. Early advanced life support

SIGNS & SYMPTOMS OF HEART ATTACK

• May deny symptoms• Vary depending on amount of heart damage• Heart Attack• Severe pain/pressure under sternum, pain radiates to

shoulder, arm, neck, jaw• SOB• Mucous membranes pale or cyanotic • Weakness• Anxiety/Apprehensiveness• Nausea/Vomiting • Loss of Consciousness

CABChest Compressions, Airway, Breathing

UNCONSCIOUS VICTIM

• NEVER attempt CPR on person that is responsive• Establish Unresponsiveness• Shake /Shout• Tap on shoulder• Shout, “Hey, are you okay?”• Shout for help, “Call 911 and get the AED.”

• Call 911• Answer all dispatcher’s questions• Wait until dispatcher disconnects the phone• Anytime you have unresponsive victim you should call 911

ADULT VS CHILD CPR

• 8 years or older is an adult• 1-7 years old is Child• Infant CPR

CPR

• Make sure scene is safe• Is the victim in dangerous place?• Are there obvious threats?

• Lying on firm, flat surface on back• Kneel at victim’s side and open airway, using

head tilt-chin lift• Check for normal breathing• How many breaths?

CPR

• Remove clothing from front of chest• How many chest compressions?

• Ratio??

• Give CPR until AED arrives

CPR REVIEW

• Compressions: 100/min• Adults: 2.0”• Infants: 1.5”• CAB (Chest compression, Airway, Breathing)• Only do CPR if unresponsive• You must start CPR within 10 seconds. Check for

pulse, but if you are unsure, begin compressions• Start with compressions, Count OUT LOUD• Breaths should take 1 second, chest should rise• Spine injury: Use jaw thrust

AED

• Automated external defibrillator• Machine with a computer inside• Recognizes cardiac arrest that requires shock• Tells rescuer when shock is needed• Gives shock if needed• Can stop abnormal heart

rhythm and allow normal rhythm to return

• Machine is accurate and easy• Visual audible prompts• Simple steps

WHEN TO USE AED?

• Person performing CPR continues until AED arrives• When arrives,

CPR stops and AED is put into

STEPS IN USING AN AED

• Turn AED on• Attach pads to victim• Choose correct pads• Do Not use child pads on adult• Open AED pad package and peel away plastic backing• Attach sticky side of pads to victim’s bare chest• Follow the picture (upper right chest, side of left nipple)

• Attach pads to box• Clear Victim• Make sure no one is touching

• Allow AED to check heart rhythm• Push SHOCK button IF AED tells you • Immediately resume CPR with chest compressions • After 5 Cycles, AED will prompt to check rhythm• If no shock, continue CPR

SPECIAL SITUATIONS

• Water• DO NOT deliver shock if: • Lying in water• Covered with water (sweat, pool, puddle/snow)

• Move away• Wipe chest• Attach pads• Water may cause shock to flow over skin, no energy to

heart

• Medicine Patch• Do not put on top of patch• May burn person if attached to Rx• Take patch off while wearing gloves

• Wipe chest where patch was

SPECIAL SITUATIONS

• Pacemaker or Defibrillator• Look for lump under skin, smaller than deck of cards• Put pads min of 1” away from lump

• Hairy Chest• If sticks to hair instead of skin, press down firmly on each

pad• If it does not stick, quickly pull off pads to remove hair• If still a lot of hair, shave area• Put new pads on

AED REVIEW

• Infants: prefer manual defibrillator, not available use pediatric dose, those aren’t available- use what you have

CHILD 1 YR TO PUBERTY

• Ratio Compressions to Breaths – 15:2 for 2 rescuer• 1 or 2 handed compressions for small children• If you are alone and did not see what happened,

2 minutes of CPR before leaving • If you are alone and did see what happened,

activate emergency response, get AED and go back • Pulse Check: carotid or femoral pulse

CPR STEPS

• 1- Assess• 2- Activate the emergency response system• 3- Check pulse, for 5 seconds, not longer than

10sec• 4- Perform 5 cycles of compressions to breaths

(30:2)

• 2 Rescuer CPR: switch every 5 cycles (2 minutes)