Principles of CPR and CARDIAC

MASSAGE
• Cardiopulmonary resuscitation (CPR) is a life
saving technique useful in many emergencies,
including heart attack or near drowning, in
which someone's breathing or heartbeat has
stopped.
 DEFINITION
• Cardio Pulmonary Resuscitation is a
technique of basic life support for oxygenating
the brain and heart until appropriate,
definitive medical treatment can restore
normal heart and ventilatory action.
 INDICATION

• Cardiac Arrest
• Ventricular fibrillation (VF)
• Ventricular tachycardia (VT)
• Asystole
• Pulse less electrical activity
 Respiratory Arresst
• This may be result of following:
• Drowning
• Stroke
• Foreign body in throat
• Smoke inhalation
• Drug overdose
• Suffocation
• Accident, injury
• Coma
• Epiglottis paralysis.
 The ABC approach
PRINCIPLES OF CPR
• Underlying principles

• Use the Airway, Breathing, Circulation (ABC)

approach to assess and treat the patient.
• Do a complete initial assessment and re-assess
regularly.
• Treat life-threatening problems before moving to
the next part of assessment.
• Assess the effects of treatment.
• Recognize when you will need extra help. Call for
appropriate help early.
• To maintain an open and clear airway (A).
• To maintain breathing by external ventilation
(B).
• To maintain Blood circulation by external
cardiac massages (C).
• To save life of the Patient.
• To provide basic life support till medical and
advanced life support arrives
 SEQUENCES OF PROCEDURES
• SEQUENCES OF PROCEDURES PERFORMED TO
RESTORE THE CIRCULATION OF OXYGENATED
BLOOD AFTER A SUDDEN PULMONARY
AND/OR CARDIAC ARREST, CHEST
COMPRESSIONS AND PULMONARY
VENTILATION PERFORMED BY ANYONE WHO
KNOWS HOW TO DO IT, ANYWHERE,
IMMEDIATELY, WITHOUT ANY OTHER
EQUIPMENT.
• Approach safely Check response
• Shout for help
• Open airway
• Check breathing
• Call AMBULANCE
• 30 chest compressions
• 2 rescue breaths
 Possible complications
• Coronary vessel injury
• Diaphragm injury
• Hemopericardium
• Hemothorax
• Interference with ventilation
• Liver injury
• Myocardial injury
• Pneumothorax
• Rib fractures
• Spleen injury
• Sternal fracture
 MEDICAL MANAGEMENT
• Adrenaline
• Adrenaline (epinephrine) is the main drug used during
resuscitation from cardiac arrest.
• Atropine
• Atropine as a single dose of 3mg is sufficient to block
vagal tone completely and should be used once in
cases of asystole. It is also indicated for symptomatic
bradycardia in a dose of 0.5mg - 1mg.
• Amiodarone
• It is an antiarrhythmic drug.
 Additional information
• Take a full clinical history from the patient, any relatives or friends,
and other staff.
• Review the patient’s notes and charts:
– Study both absolute and trended values of vital signs.
– Check that important routine medications are prescribed and being
given.
• Review the results of laboratory or radiological investigations.
• Consider which level of care is required by the patient (e.g. ward,
HDU, ICU).
• Make complete entries in the patient’s notes of your findings,
assessment and treatment. Where necessary, hand over the patient
to your colleagues.
• Record the patient’s response to therapy.
• Consider definitive treatment of the patient’s underlying condition.
 CARDIAC MASSAGE
• A rescue action, which is part of the
resuscitation procedure. The massage is
performed by serial exertion of pressure and
relaxation on the chest bone, at the rate of
about 100 per minute. The massage is kind of
external squeezing of the heart causing its
voiding and filling to a certain extent and thus
preserving cardiac output and blood flow to
vital body organs for the duration of the
resuscitation.
• The quality of cardiac massage and the
proficiency of the person performing it are
considered as having major importance on the
success of the resuscitation procedure.
• Also known as “external cardiac massage” or
“closed-chest cardiac massage” or “heart
massage”.