Cardio Pulmonary Resuscitation
Procedure Rationale
Responsiveness/airway:
1 Determine unresponsiveness: tap or gently
shake patient while shouting, “Are you
okay?”
Activate emergency medical service
2 Place the patient supine on a firm, flat
surface. Kneel at the level of the patient's
shoulders. If head or neck trauma is
suspected, he should not be moved unless it
is absolutely necessary (e.g., at the site of
an accident, fire, or other unsafe
environment).
Circulation
3 While maintaining head-tilt with one hand
on the patient's forehead, palpate the
carotid or femoral pulse for no more than
10 seconds. If pulse is not palpable, start
external chest compressions.
External Chest Compression
4 Kneel as close to side of patient's chest as
possible. Place the heel of one hand on the
middle third of the sternum, The fingers
may either be extended or interlaced but
must be kept off the chest.
5 While keeping your arms straight, elbows
locked, and shoulders positioned directly
over your hands, quickly and forcefully
depress the middle third of the patient's
sternum straight down one-third the depth
- To know if the patient is conscious or not.
- Flat surface can protect the patient’s back.
And firm surface can facilitate effective
compression. By kneeling on the patient’s
shoulder level it would be easy to assess
the patient’s CAB.
- It is important to get some help, it will
increase the patient’s rate of survival after
giving CPR.
- Patient should not be moved because it
would be dangerous it will increase risk of
severe complications.
- This position is sufficient to opening the
airway.
- To help you determine the cardiac
function.
- Delaying the CPR while checking the pulse
can be life threatening to the patient.
- Proper positioning of the hand ensures the
effective compression to the patient, by
placing it in the sternum it reduces the
risk of broken ribs.
- Keeping your arms straight can ensure the
effectiveness when giving compression.
 of the chest.

6 Release the external chest compression - To check if there is a sign of circulation

and breathing of the patient.
completely and allow the chest to return to - Changing position of your hands can delay
its normal position after each compression. the procedure.
The time allowed for release should equal
the time required for compression. Do not
lift your hands from the patient's chest or
change position.

7 For cardiopulmonary resuscitation (CPR) - This will provide adequate blood flow to
the patient.
performed by one rescuer, do 30 - Giving compression and ventilation can
compressions at a rate of 100 per minute provide circulation and oxygen to the
and then perform two ventilations; patient.
reevaluate the patient. After four cycles of
30 compressions and two breaths each,
check the pulse; check again every few
minutes thereafter. Minimize interruptions
of chest compressions.

8 For CPR performed by two rescuers, the - Two rescuers can provide effective CPR,
this will facilitate continues compression
compression rate is 100 per minute. The and ventilation without pause can
compression-ventilation ratio is 30:2. Once increase the chance of the patient to
an advanced airway is in place, the survive.
compressing rescuer should give
continuous chest compressions at a rate of
100 without pauses for ventilation. The
rescuer delivering ventilation provides 8 to
10 breaths per minute.

Open the airway

9 Head-tilt/chin-lift maneuver: Place one - This technique is sufficient to open the

airway of the patient, and it would be
hand on the patient's forehead and apply easier to see if there is any obstruction.
firm backward pressure with the palm to
tilt the head back. Then, place the fingers
of the other hand under the bony part of the
lower jaw near the chin and lift up to bring
the jaw forward and the teeth almost to
 occlusion.

1 Jaw-thrust maneuver: Grasp the angles of - This technique can prevent tongue from
0 obstructing the airway of the patient.
the patient's lower jaw, lifting with both
hands, one on each side; displacing the
mandible forward, while tilting the head
backward.

Breathing

1 Place ear over patient's mouth and nose - This will simulate by listening and
1 checking the rise and fall of the chest.
while observing the chest, look for the
chest to rise and fall, listen for air escaping
during exhalation, and feel for the flow of
air.

1 Perform rescue breathing by mouth-to- - By using barrier devices this can protect
2 you and the patient safely.
mouth, using a ventilation barrier device. - By pinching the nose of the patient this
While keeping the patient's airway open, can help when you give ventilation the air
pinch the nostrils closed using the thumb won’t come out from the nostrils, thus this
will ensure the effectiveness when giving
and index finger of the hand you have ventilation.
placed on his forehead. Take a deep breath, - Two full breath can optimized the
open your mouth wide, and place it around ventilation given to the patient.
the outside edge of the patient's mouth to
create an airtight seal. Ventilate the patient
with two full breaths (each lasting 1
second), taking a breath after each
ventilation. If the initial ventilation attempt
is unsuccessful, reposition the patient's
head and repeat rescue breathing.

Usage of Special Resuscitation Equipment

1 While resuscitation proceeds, simultaneous - This will increase the chance of patient’s
3 survival by giving simultaneous efforts.
efforts are made to obtain and use special
resuscitation equipment to manage
breathing and circulation and provide
definitive care.
1 Utilize the automated external defibrillator
4
(AED) as soon as possible. Special
circumstances affecting use of AEDs
include:

a. AEDs should not be used on children

younger than age 8.

b. The victim should not be lying in water

when using an AED. Make sure the
patient's chest is dry before attaching the
AED.

c. Do not place the AED electrode directly

over an implanted pacemaker.

d. Remove any transdermal medication

patches from the patient before using the
AED.

1 The four basic steps used in AED operation

5
are:

a. Turn the power on.

b. Attach the AED pads to the patient's

chest, using the diagrams on the pads to
show you exactly where to place them.

c. Analyze the patient's rhythm by pushing

the button on the AED labeled
ANALYZES. During this time, no one
should touch the patient.

d. Charge the AED and deliver the shock if

indicated by the AED. Make sure that no
one is touching the patient. Push the shock
button; the AED will provide visual and
voice prompts to tell you what to do.