Cardiopulmonary Resuscitation

(CPR)
 Learning Objectives :

At the end of this pre lab the student nurse will

be able to :
1-Define cardiopulmonary resuscitation .
2-List indications for cardiopulmonary resuscitation.
3-List signs and symptoms of cardiopulmonary arrest.
4-Identify steps for cardiopulmonary resuscitation .
5-Perform cardiopulmonary resuscitation .
6-List common causes of airway obstruction .
7-list signs of airway obstruction .
8-Perform methods for relieving airway obstruction .
 Define cardiopulmonary resuscitation .

cardiopulmonary resuscitation
an emergency procedure that combines
artificial breathing ,which supplies oxygen to
the lung and chest compression, which
manually pump the heart to circulate blood to
the body system
.
indications for cardiopulmonary
resuscitation.

1-Cardiac arrest (cessation of cardiac function)

2-Respiratory arrest (cessation of breathing)
3-Asphyxia (suffocation) –Airway obstruction
4-Drowning
5-Poisoning
6-Electrocution
7-Trauma Or Shock from massive blood loss
8-Drug overdose
9-Smoke inhalation
signs and symptoms of
cardiopulmonary arrest.
1-Unconsciousness
2-pulslessness
3-Dilated pupils
4-Minimal or absent respiration
Equipment:-
 Hared surface :client may be

placed on floor, ground ,or

backboard.

 No additional equipment is

necessary. But in the hospital

 sitting, an emergency (crash) cart usually contains.
 Airway equipment

Intravenous equipment.

 Laboratory tubes and syringes.

 Medications for advanced life support.

 Suction equipment.
 Perform cardiopulmonary
resuscitation .
Procedure

1- Assess responsiveness by :

* Tap or shake the client’s shoulder gently

.
* Shout near client’s ear “Are you ok ?”
.
 2- Call for help , if the patient is not
responsive
* Call the local emergency telephone
number(123)
3- position the patient supine on his or her back on a
firm ,flat surface ,with arms alongside the
body.
If the patient is in bed ,place a backboard or other rigid
surface under the patient .
 steps for cardiopulmonary
resuscitation .
Assess and maintain C , A, B
,

C: Refers to the circulations

A: airway
B: breathing
(C)- Assess the circulation , Check the presence of the carotid
pulse to the side of trachea

If signs of circulation are noted , & the client is breathing

,
place the patient in the recovery position .
9-If The client has a pulse , but remains with out breathing ,
continue give breathing at a rate of one breath every 5-6
seconds, for a rate of 10-12 breaths per minute
.
If The client has not a pulse ,start cardiac compression.
Position the heel of one hand in the center of the chest
between the nipples ,directly over the lower half of the
sternum .
 Place the other hand directly on the top of the first hand
.
Extend or interlace fingers to keep fingers above the chest
.
 11-Perform 30 chest compressions at a rate of 100 per
minute,
*Counting “one and , two and ,etc .” up to 30
Keeping elbows locked , arms straight ,& shoulder
directly over the hand .
Chest compressions should depress the sternum
approximately 4-5 cm
Allow full chest recoil after each compression .
*Give two breaths after each set of 30 compressions
A ratio of 30:2 whether by one or two rescuers.
Do five complete cycles of 30 compressions and two ventilation
.
 A- Open airway: a-(use the head tilt-chin lift
maneuver),
- place one hand on the client’s forehead and apply firm
backward pressure with the palm to tilt the head back ,
place the fingers of other hand under the bony part of the lower jaw near
the chin and left the jaw upward to bring the chin forward and the
teeth almost to occlusion .
 (use the jaw thrust maneuver),
if trauma to the head or neck is present or suspected to open airway
Grasp the angle of the client s lower jaw and lift with both hands
When the airway is opened ,remove any foreign material that is visible
within the client s mouth .
 ‫مجاري التنفسية وهي مغلقة بفعل اللسان الهامد في حالة‬
‫اإلغماء‪ ،‬والمرتد للخلف بعد مد العنق ترى أن اللسان أُبعد‬
‫عن المجاري التنفسية‪ ،‬وبالتالي هناك فراغ يمكن للهواء أن‬
‫يدخل من خالله‬
5- After opening the airway, Check for breathing .
Look , listen and feel
* Look : for chest movement (rising &falling).
* Listen : for expired air .
* Feel : for air motion .
 If no spontaneous breathing is noted , start
give two artificial breaths to
*open airway (use the tilt-chin .
lift maneuver),
*Pinch client s nose with fingers & occlude mouth with nurse
s mouth or use CPR pocket mask .
* Give two breaths each lasting 1 second,
making chest rise to see if your breath go in
Allow chest fall after each breath
If the patient is breathing and signs of circulation are noted , place the -
patient in the recovery position
.
 - Reassess breathing and circulations after each set of five
compressions \ breathing cycles .Take no more than 10
seconds to do this .

-Continue CPR until the client resumes spontaneous

breathing and circulation , medical help arrive ,you are too
exhausted to continue ,or a physician discontinues CPR

-Document time you discovered the client unresponsive

and started CPR .
 Heimlich maneuver

Definition:
Is a method for relieving a mechanical airway obstruction.

Common causes of airway obstruction:

1- Aspiration of vomitus
2- Insufficient chewing .
3- Consuming large pieces of food .
4- compromised swallowing.
5- Laughing or talking while chewing .
6- Inhalation foreign objects from the mouth.
Choking is :
Is the body’s way to remove foreign object .
Universal sign for choking:
* Being unable to speak .
* Being unable to breath .(Audible wheezing) .
* Coughing or gagging while eating .
* Exhibiting cyanosis (skin ,lips ,nails )
 Conscious adult foreign body airway obstruction .
If person is Conscious &can not speak ,breath or cough ,Give up to 5
abdominal thrusts .
(Heimlich maneuver )

Procedure:-
1-Stand behind the choking person.
2- wrap your arm around his or her waist.
3- Make fist with one hand .
4-Place thumb side of the fist against middle of person’s abdomen just above
the navel and well below the ribs
5- Grasp fist with other hand.
6-Press your fist into the person’s abdomen with quick, upward thrusts.
7- After every 5 abdominal thrusts, check the person.
8- Repeat abdominal thrusts until :
- Person coughs up object.
- Person starts to breath or cough frequently.
- Person becomes unconscious (use method for unconscious person ).
 Unconscious adult foreign body airway
obstruction .
If person is unconscious and breaths give up to 5
abdominal thrusts.
1-Position the victim on his back .

2-Put heel of one hand against middle of patient slightly above

navel .
3-Put other hand directly on the top first hand .

4-Press inward and upward using both hands with 6-10 quick
abdominal thrusts .
5-Keep heel of hand in contact with abdomen between abdominal
thrusts .
Perform finger sweep :
Use only on unconscious victim. On a conscious victim ,it may
cause gagging or vomiting .
• Perform finger sweep by inserting forearm into mouth in hooking
motion and sweeping finger toward you .
•Check to dislodge foreign object .
-If foreign body comes within reach ,grab and remove it.
Don’t force object deeper .
-If the above steps are unsuccessful :
• Give two breaths .
• Perform up to 5 abdominal thrusts .
• Repeat finger sweep .
-Cycle through the following steps in rapid sequence until the object is
expelled or emergency medical services arrives .
• Documentation .
Contraindication (abdominal thrust)
1- Pregnant women.
2- Markedly obese patients.
3- Patients who have recently undergone
abdominal surgery.
 Assessment-
1- Cardiac signs and symptoms (irregular pulse, rapid or slow
pulse, cyanosis, absent pulse).
2- Respiratory signs and symptoms (irregular breathing
pattern, rapid or slow shallow breathing pattern, apneic
breathing periods. inability to cough at all, in ability to speak.
3-Oral assessment (vomitus in mouth or on face) partially
chewed food in mouth, freely- floating dentures in mouth,
tongue in posterior orropharynx.
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