Cardiopulmonary Resuscitation (C.P.R)
In this blog you will get the information related to the first aid to be provided in case of cardiac arrest.
Cardiopulmonary resuscitation(CPR)
Is an emergency
procedure that
combines chest compressions often with in
an effort to manually preserve intact brain function until further
measures are taken to restore spontaneous blood circulation and
breathing in a person who is in cardiac
arrest.
It is recommended
in
those who are unresponsive with no breathing or abnormal breathing.
CPR
involves artificial
ventilation chest
compressions for adults between 5cm (2.0in) and 6cm (2.4in) deep and
at a rate of at least 100 to 120 per minute. The rescuer may also
provide artificial ventilation by either exhaling air into the
subject's mouth or nose or using a device that pushes air into the
subject's lungs. Current recommendations place emphasis on early and
high-quality chest compressions over artificial ventilation; a
simplified CPR method involving chest compressions only is
recommended for untrained rescuers.
In
children, however, only doing compressions may result in worse
outcomes.
CPR
alone is unlikely to restart the heart. Its main purpose is to
restore partial flow of oxygenated blood to the
brain and heart, he
objective is to delay and to extend the brief window of opportunity
for a successful resuscitation without permanent
brain damage.
Administration of an electric shock to the subject's heart, termed
defibrillation,
is usually needed in order to restore a viable or "perfusing"
heart rhythm. Defibrillation is effective only for certain heart
rhythms, namely venticular
fibrillation or
pulseless
venticular tachycardia rather
than asystole
pulseless electric activity. CPR
may succeed in inducing a heart rhythm that may be shockable. In
general, CPR is continued until the person has a
reture of spontaneous
circulation(ROSC)
or is declared dead.
Compressions: Restore blood circulation
-
Put the person on his or her back on a firm surface.
-
Kneel next to the person's neck and shoulders.
-
Place the heel of one hand over the center of the person's chest, between the nipples. Place your other hand on top of the first hand. Keep your elbows straight and position your shoulders directly above your hands.
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Use your upper body weight (not just your arms) as you push straight down on (compress) the chest at least 2 inches (approximately 5 centimeters) but not greater than 2.4 inches (approximately 6 centimeters). Push hard at a rate of 100 to 120 compressions a minute.
-
If you haven't been trained in CPR, continue chest compressions until there are signs of movement or until emergency medical personnel take over. If you have been trained in CPR, go on to opening the airway and rescue breathing.
CPR for Adults
Adult Basic Life Support Algorithm for Healthcare Providers
In
the algorithm for adult basic life support, emphasis is placed upon
immediate recognition of cardiac arrest and the implementation of
efficient compressions and early defibrillation. To immediately
recognize cardiac arrest, the healthcare provider is trained to
assess for unresponsiveness and/or an absence of breathing or
presence of abnormal breath sounds. Laypersons should be instructed
to use hands-only
CPR. This
approach calls for continuous compressions at a rate of 100-120 per
minute.
CPR
should be continued by a healthcare provider until return of
spontaneous circulation (ROSC) or until termination of efforts. High
quality CPR emphasizes adequate depth and number of chest
compressions.
The
pulse check has been deemphasized, and the guidelines recommend a
pulse
check for no less than 5 seconds and no more than 10 seconds.
An integrated team approach includes simultaneous compressions and
rescue breathing.
Rhythm detection should take place as soon as an AED or defibrillator
is available, with subsequent shock, as indicated, as
the survival rate from ventricular fibrillation and pulseless
ventricular tachycardia ranges from 5% to 50%, and decreases with an
increase in the length of time to the first shock.
When
a victim is unresponsive to a tap on the chest (ask “Are you ok
?”),
then the healthcare provider should observe
the victim for breathing for 5 to 10 seconds.
If respirations are present, the victim should be attached to a
cardiac monitor. Otherwise, the healthcare provider (HCP) should
activate
EMS and retrieve the AED by
himself or by sending a second rescuer.
The
pulse check is the third step in the algorithm. The pulse should be
checked for no less than 5 seconds and no more than 10 seconds. If
there
is a definite pulse, then rescue breathing should be done for
one second every six seconds with a recheck every 2 minutes.
If
the victim does not have a pulse, or there is a question as to
whether it is present, then compressions should be initiated at the
rate of 30:2,
with
2 breaths every 30 compressions. Compressions should be provided at a
rate of 100-120/min. When the AED or defibrillator is available, then
the HCP should
check
the victim’s rhythm. If it is shockable, then 1 shock should be
given
with
immediate CPR instituted for 2 minutes, beginning rapidly (within
seconds) of the shock.
If
the rhythm is not shockable, then the HCP should administer CPR for 2
minutes and recheck the rhythm every 2 minutes.
continue CPR until ALS is available.
continue CPR until ALS is available.
-
High quality chest compressions:
-
Position patient on hard surface in supine position
-
Minimal interruptions for ventilation
-
18 seconds per cycle
-
Adequate speed of compressions: >100/minute
-
Adequate depth of compressions: 2-2.4” (5-6cm)
-
Allow complete recoil of chest
-
Do not over ventilate
Phone
911 or send someone to call
Compression:
Do 30 chest compressions at a rate of 100 per minute using only one
hand.
Airway:
If trained in CPR, open the airway by tilting head back.
Breathing:
Attempt two breaths if trained in CPR, repeat steps C, A and B until
victim starts breathing or until emergency help arrives.
CPR For Infant
Phone
911 or send someone to call
Compression:
Do 30 chest compressions at a rate of 100 per minute using only one
hand.
Airway:
If trained in CPR, open the airway using a by tilt lifting of chin.
Breathing:
Attempt two gentle puffs of breath if trained in CPR, repeat steps C,
A and B until victim starts breathing or until emergency help
arrives.
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