HOSPI LAB

CARDIOPULMONARY RESUSCIATTION - Patient must be placed on a hard surface

- A technique of basic life support for the purpose of - Kneel facing victim’s chest
oxygenation to the heart, lungs, and brain until and - The palm of one hand is placed in the concavity of
unless the appropriate medical treatment can come the lower half of the sternum 2 fingers above the
and restore the normal cardiopulmonary function xiphoid process
- If started within 4 minutes of cardiac arrest - The other hand is placed over the hand in the sternum
- If defibrillation is provided within 10 minutes - Shoulders should be positioned directly over the
- Chance of survival = 40% hands with the elbows locked straight and arms
- 90% of people who experienced an out of hospital extended. Use your upper body weight to compress.
cardiac arrest die - Must be performed at a rate of 100-120/min
- 70% of this cardiac arrests happen at - During CPR the ratio of chest compressions to
homes/residences ventilation should be 30:2
Purpose - If there are 2 rescuers, chest compressions should be
- Restore cardiopulmonary functioning continuous and must not be interrupted for ventilation
- Prevent irreversible brain damage from anoxia Compression depth
Indication - ADULT : At least 2-2.4 inches (5-6cm)
- Cardiac arrest - CHILDREN : About 2-2.4 inches (5-6cm)
- Respiratory arrest - INFANTS : About 1.5 inches (4cm)
- Combination of both Hand Placement:
- ADULT : 2 hands, lower half of sternum
PHASES OF CARDIOPULMONARY RESUSCITATION - CHILDREN : 1 or 2 hands, lower half of sternum
PHASE - INFANTS : 2 fingers, just below nipple line
STEPS
S Problems and complications of Chest Compressions:
C = Circulation - Rib fractures
Phase1 Basic life support A = Airway - Fractured sternum
B = Breathing - Rib separation
D = Drugs - Pneumothorax
Advanced cardiac life
Phase2 E = ECG - Hemothorax
support
F = Fibrillation - Lung contusions
Post resuscitation - Liver lacerations
Phase3 Prolonged life support - Fat emboli
care
- HIV, hepatitis
- Infections
CHAIN OF SURVIVAL
- Early Access A - AIRWAY
- Early CPR Clearing the airway
- Early Defibrillation - Head tilt, chin lift
- Early ACLS o The head is tilted upwards to cause anterior
- Early Post Resuscitative Care displacement of the tongue
- Jaw thrust
EARLY ACCESS o An alternative to head tilt-chin lift
Early recognition includes: o Technique of choice when there is a
- Checking area safety suspicion of cervical spine injury
o Is the scene/environment safe? o Place fingers posterior to the mandible of
o Is it safe to do CPR? the jaw and apply upward and forward
o What happened? pressure
- Checking responsiveness o Hold mouth slightly open using thumbs to
o Check the victim displace chin inferiorly
o Shake shoulders gently - Finger sweep
o Ask “are you all right?” o Indicated for unconscious patient only
- Calling for help o Sweep out foreign body in the mouth using
o Ambulance, emergency services the index finger
o Activate Emergency Medical Service - Heimlich maneuver
o Get AED/ Defibrillator (unresponsive) o If patient is conscious
EARLY CPR o If the foreign body cannot be removed by a
CPR sequence finger sweep
C - COMPRESSIONS o A subdiaphragmatic abdominal thrust
 HOSPI LAB

o In infants, a series of blows in the back and - Even someone without special training can respond
chest thrusts in an emergency by following the instructions relayed
B – BREATHING by the device
- Breathing for the person *when using an AED:
- 2 breaths 1 second apart - Call EMS or have someone else call EMS. If two
- Rescue breathing can be: rescuers are present, one can provide CPR while the
o Mouth to mouth other calls EMS and gets the AED
o Mouth to nose - Make sure the area around the person is clear;
o Mouth to mouth and nose touching the person could interfere with the AED’s
Ventilations for rescue breathing reading of the person’s heart
- Pocket mask - If an electric pulse or shock is needed to restore a
o Protects you from contact with a patient’s normal rhythm, the AED uses voice prompts to tell
blood, vomitus and saliva, and from you when and how to give the shock, and electrodes
breathing the air that the patient exhales deliver it. Some AEDs can deliver more than one
- Bag-valve-mask resuscitator shock with increasing energy
o A handheld device used to ventilate patients - The device may instruct you to start CPR again after
and administer higher concentrations of delivering the shock
**EARLY ACLS – with defibrillation
oxygen than a pocket mask
Assessment of restoration of breathing and circulation
EARLY POST RESUSCITATIVE CARE
- Contraction of pupil
- Improved color of the skin RECOVERY POSITION
- If the victim is breathing
- Free movement of the chest wall
- Swallowing attempts - To maintain open airway
o Roll the patient onto his side
- Struggling movements
- Return of strong pulse o Cross the legs first, then the shoulders
- Return of systemic blood pressure How to:
When to terminate CPR? - Kneel at the side of the patient
- Pulse and respiration returns - Roll the patient toward the rescuer
- Emergency medical help arrives - Place top leg on the other with both knees in a bent
- AED is ready to analyze patient’s heart rhythm position
- Physician declared patient is deceased - Align the arm on top with the upper body
- The rescuer is physically unable to continue BLS

EARLY DEFIBRILLATION
DEFIBRILLATORS
- Defibrillators are devices that restore a normal
heartbeat by sending an electric pulse or a shock to
the heart

Also known as:

- Automated External Defibrillator (AED)
- Implantable Cardioverter Defibrillator (ICD)
- Wearable Cardioverter Defibrillator (WCD)
When to use AED
- If you see a person faint or if you find a person
already unconscious, first confirm that the person
cannot respond. The person may not move, or his or
her movements may look like seizure
- You can shout at or gently shake the person to make
sure he or she is not sleeping, but NEVER shake an
infant or young child. Instead, you can gently pinch
the child to try to wake him or her up.
- Check the person’s breathing and pulse. If the person
is not breathing and has no pulse or has an irregular
heartbeat, prepare to use the AED as soon as possible
How to use AED: