Chest compressions. Indication If after 30 seconds of effective bag and mask ventilation with 100%...
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![Page 1: Chest compressions. Indication If after 30 seconds of effective bag and mask ventilation with 100% oxygen, heart rate is below 60 per minute.](https://reader035.fdocuments.us/reader035/viewer/2022070306/5517cb9e550346892b8b4d16/html5/thumbnails/1.jpg)
Chest compressions
![Page 2: Chest compressions. Indication If after 30 seconds of effective bag and mask ventilation with 100% oxygen, heart rate is below 60 per minute.](https://reader035.fdocuments.us/reader035/viewer/2022070306/5517cb9e550346892b8b4d16/html5/thumbnails/2.jpg)
![Page 3: Chest compressions. Indication If after 30 seconds of effective bag and mask ventilation with 100% oxygen, heart rate is below 60 per minute.](https://reader035.fdocuments.us/reader035/viewer/2022070306/5517cb9e550346892b8b4d16/html5/thumbnails/3.jpg)
Indication
If after 30 seconds of effective bag and mask ventilation with 100% oxygen,
heart rate is below 60 per minute
![Page 4: Chest compressions. Indication If after 30 seconds of effective bag and mask ventilation with 100% oxygen, heart rate is below 60 per minute.](https://reader035.fdocuments.us/reader035/viewer/2022070306/5517cb9e550346892b8b4d16/html5/thumbnails/4.jpg)
When to stop chest compressions
When heart rate is 60 per minute or more
![Page 5: Chest compressions. Indication If after 30 seconds of effective bag and mask ventilation with 100% oxygen, heart rate is below 60 per minute.](https://reader035.fdocuments.us/reader035/viewer/2022070306/5517cb9e550346892b8b4d16/html5/thumbnails/5.jpg)
Principle
Pump out blood from the heart during compression and fill up blood in the heart during release
Must always be accompanied by ventilation with 100% oxygen
![Page 6: Chest compressions. Indication If after 30 seconds of effective bag and mask ventilation with 100% oxygen, heart rate is below 60 per minute.](https://reader035.fdocuments.us/reader035/viewer/2022070306/5517cb9e550346892b8b4d16/html5/thumbnails/6.jpg)
Mechanism of Chest Compressions
Compress Release
heart heart
sternum
![Page 7: Chest compressions. Indication If after 30 seconds of effective bag and mask ventilation with 100% oxygen, heart rate is below 60 per minute.](https://reader035.fdocuments.us/reader035/viewer/2022070306/5517cb9e550346892b8b4d16/html5/thumbnails/7.jpg)
Components
Position Neck slightly extended with firm support for the back Lower 1/3rd of sternum between nipple line & sternum
Pressure required – depth 1/3rd of the AP diameter of chest
Rate 90/min
![Page 8: Chest compressions. Indication If after 30 seconds of effective bag and mask ventilation with 100% oxygen, heart rate is below 60 per minute.](https://reader035.fdocuments.us/reader035/viewer/2022070306/5517cb9e550346892b8b4d16/html5/thumbnails/8.jpg)
Chest Compressions
Position Lower third of sternum Between nipple line and
xiphisternum
![Page 9: Chest compressions. Indication If after 30 seconds of effective bag and mask ventilation with 100% oxygen, heart rate is below 60 per minute.](https://reader035.fdocuments.us/reader035/viewer/2022070306/5517cb9e550346892b8b4d16/html5/thumbnails/9.jpg)
Techniques of Chest Compressions
Thumb method Two-finger method
![Page 10: Chest compressions. Indication If after 30 seconds of effective bag and mask ventilation with 100% oxygen, heart rate is below 60 per minute.](https://reader035.fdocuments.us/reader035/viewer/2022070306/5517cb9e550346892b8b4d16/html5/thumbnails/10.jpg)
Techniques
Thumb technique Two-finger technique
# Do not remove thumbs/finger from chest
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Thumb technique
Thumbs on sternum, hands on torso & finger supporting the back
Thumbs flexed at the first jointPressure applied vertical
![Page 12: Chest compressions. Indication If after 30 seconds of effective bag and mask ventilation with 100% oxygen, heart rate is below 60 per minute.](https://reader035.fdocuments.us/reader035/viewer/2022070306/5517cb9e550346892b8b4d16/html5/thumbnails/12.jpg)
Chest Compressions
![Page 13: Chest compressions. Indication If after 30 seconds of effective bag and mask ventilation with 100% oxygen, heart rate is below 60 per minute.](https://reader035.fdocuments.us/reader035/viewer/2022070306/5517cb9e550346892b8b4d16/html5/thumbnails/13.jpg)
2-finger technique
Easier with right hand for right handed
Index and middle or ring fingers Other hand used to support the back Pressure applied vertically
![Page 14: Chest compressions. Indication If after 30 seconds of effective bag and mask ventilation with 100% oxygen, heart rate is below 60 per minute.](https://reader035.fdocuments.us/reader035/viewer/2022070306/5517cb9e550346892b8b4d16/html5/thumbnails/14.jpg)
Chest Compressions
![Page 15: Chest compressions. Indication If after 30 seconds of effective bag and mask ventilation with 100% oxygen, heart rate is below 60 per minute.](https://reader035.fdocuments.us/reader035/viewer/2022070306/5517cb9e550346892b8b4d16/html5/thumbnails/15.jpg)
Preferred method - thumb
Advantages Better control of depth Less tiring Superior generation of peak systolic & coronary
perfusion pressure Nails do not hinder performance
Disadvantages Difficult when baby is big Umbilicus difficult to cannulate.
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Compression
One compression consists downward compression plus the release
Actual distance is not a number but depends on size of baby
Duration of the downward stroke should be shorter than release to produce max COP
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Rate & adequacy
Rate 3 CC then 1 ventilation (1:3) 90 CC to 30 ventilation in one minute
Adequacy Palpate femoral/carotid pulse
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Cycle of events
One – and – two –and – three – and – breathe – and
Consists of 3 compression & one ventilation
120 events in 60 seconds 1 cycles in 2 seconds
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Chest Compressions Dangers Broken ribs Lacerated liver Pneumothorax
Precautions No pressure on the ribs, xiphisternum,
abdomen Do not lift thumbs/fingers
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Evaluation after 30 sec of CC & BMV
HR 60 per minute or more Stop CC, continue BMV at 40-60/min
If no improvement, check :Effectiveness of BMVOxygen is 100%Technique of CC is correct
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Key points
When to do? Why to do ? How to do? Which is best ? When to stop ? What if fails ?