© 2011 National Safety Council

CARPIOPULMONARY RESUSCITATION (CPR)

LESSON 5

5-1

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Basic Life Support (BLS)

• First aid given if victim’s breathing or heart stops

• Often needed for victims of:

- Heart attack- Drowning- Choking- Other injuries/conditions

5-2

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Overview of BLS

• CPR = chest compressions + rescue breaths

• Gets oxygen into lungs and oxygenated blood to vital organs

5-3

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Overview of BLS continued

• Choking care

- Includes chest compressions- Expels an obstructing object from airway

5-4

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Overview of BLS continued

• Use of an automated external defibrillator (AED)

- Restores a more normal heart rhythm

5-5

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BLS Age Differences

Infant = birth to 1 year

Child = age 1 to the onset of puberty (for CPR and choking care); age 1 to 8 for AED

Adult = past the age of puberty (or over age 8 for AED)

5-6

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Respiratory Emergencies

• Any illness or injury resulting in stopped breathing or inadequate breathing

• Two types

- Respiratory arrest- Respiratory distress

5-7

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Respiratory Emergencies: Examples

• Obstructed airway

• Penetrating injury to chest

• Carbon monoxide poisoning

• Heart problem reducing tissue oxygen

• Electrical shock disrupting breathing or heartbeat

• Drug overdose or poisoning

5-8

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Respiratory Arrest and Respiratory Distress

• Respiratory arrest

- Breathing has completely stopped

• Respiratory distress

- Breathing is difficult and may become ineffective

5-9

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Cardiac Chain of Survival

5-10

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Heart Attack – Acute Myocardial Infarction (AMI)

• Sudden reduced blood flow to heart muscle

• Medical emergency that often leads to cardiac arrest

• Can occur at any age

• Usually results from atherosclerosis

16-11

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Facts About Heart Attack

• Over 1,255,000 heart attacks occur a year in the United States, resulting in over 132,000 deaths

• Many could have been saved by first aid and medical treatment

• More likely in those with family history

• 1/5 of victims do not have chest pain

• Victims typically deny they are having a heart attack

16-12

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Symptoms of Heart Attack

• Can vary from vague chest discomfort to crushing pain with or without other symptoms

• May have no signs and symptoms before suddenly collapsing

• May have milder symptoms that come and go before heart attack occurs

16-13

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Symptoms of Heart Attack continued

• In women chest pain or discomfort most common symptom

- Also more likely to have shortness of breath, jaw or back pain, indigestion, nausea and vomiting

- http://www.youtube.com/watch?v=t7wmPWTnDbE

16-14

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Symptoms of Heart Attack continued

• Consider possibility of heart attack with wide range of symptoms

- Don’t expect a clearly defined situation

• Act quickly because deaths usually occur with an hour or two of symptoms

16-15

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Aspirin and Heart Attack

• Many patients at risk for cardiovascular disease advised to take one low-dose aspirin daily unless allergic or experience side effects

• For victims who do not need to avoid aspirin, chewing one uncoated adult aspirin or two low-dose baby aspirin is now recommended when experiencing heart attack symptoms

16-16

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Nitroglycerin for Heart Attack

• Increases blood flow by dilating arteries

• Often prescribed for angina

- Type of chest pain caused by narrowed coronary arteries

• Comes in tablets, sprays and patches

16-17

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Nitroglycerin for Heart Attack continued

• Can assist victim with prescribed nitroglycerine

- Follow victim’s instructions

- Do not attempt to give if victim unresponsive

16-18

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First Aid for Heart Attack

1. Call 9-1-1 immediately.

2. Help victim into comfortable position. Loosen any tight clothing.

3. Ask victim about medications.

4. Encourage the victim to chew one uncoated adult or two low-dose baby aspirin (unless allergic).

5. Stay with victim. Be reassuring.

16-19

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Call First/Call Fast

Call First (before starting CPR):

• Any unresponsive adult who is not breathing normally

Call Fast (after giving about two minutes of CPR):

• Any infant or child who is unresponsive and not breathing normally

5-20

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Use of CPR for unresponsiveness and lack of normal breathing caused by:

• Heart attack

• Drowning

• Suffocation

• Stroke

• Allergic reaction

• Diabetic emergency

• Prolonged seizures

• Drug overdose

• Electric shock

• Certain injuries

5-21

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CPR Saves Lives

• CPR and defibrillation within 3-5 minutes can save over 50% of cardiac arrest victims

• CPR followed by AED saves thousands of lives each year

• In most cases CPR helps keep victim alive until EMS or AED arrives

5-22

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CPR Technique

If unresponsive and not breathing start CPR with chest compressions:

• Find correct hand position

• Compress chest hard and fast at rate of at least 100 compressions/minute

• Alternate 30 compressions and 2 rescue breaths

• Give each breath over one second

5-23

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General Technique: Rescue Breaths

• Position victim on back

• Open airway with head tilt–chin lift

• Use a barrier device

• Give each breath over about one second

• Watch victim’s chest rise

5-24

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General Technique: Rescue Breaths continued

• Do not blow harder than needed to make chest rise

• After each breath let air escape and chest fall

• Blowing in too forcefully or for too long may cause vomiting

5-25

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Mouth to Barrier

• Barrier device is always recommended

• Position pocket mask or face shield on victim’s face

• Make sure it is sealed to victim’s face

- With face shield, pinch victim’s nose closed when giving breaths

5-26

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Potential Problem: Vomiting

• To prevent air from entering stomach and causing vomiting

- Open airway before giving breaths- Watch chest rise as you give breaths- Blow slowly and steadily- Stop each breath when chest rises- Let chest fall after each breath

5-27

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Skill: CPR for Adults, Children and Infants (1 Rescuer)

5-28

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Assess the Victim

1 Determine that victim is unresponsive and not breathing normally

Have someone call 9-1-1, or call yourself if alone, and get an AED

Begin CPR

5-29

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2 Put hand(s) in correct position for chest compressions

5-30

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3 Give 30 chest compressions at rate of at least 100 per minute

Then give 2 breaths

5-31

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4 Open airway

Give two rescue breaths, each lasting one second

- If first breath does not go in, reposition head and try again- If second breath still does not go in, give care for choking

5-32

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5 Continue cycles of 30 compression and two breaths

6 Continue CPR until:

• Victim wakes up

• AED brought to scene and ready to use

• Professional help arrives to take over

• Scene becomes dangerous

• You become too exhausted

5-33

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7 If victim starts breathing normally but is unresponsive, put in recovery position and monitor breathing

When AED arrives, start AED sequence

5-34

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Compression-Only CPR

• If you cannot or will not give rescue breaths, still give chest compressions

5-35