CARDIOPULMONARY

RESUSCITATION (CPR)
• emergency procedure for people in cardiac arrest
or respiratory arrest
• involves physical interventions to create artificial
circulation
 chest compressions - rhythmic pressing on the
patient's chest to manually pump blood through the
heart
 artificial respiration - exhaling into the patient (or using
a device to simulate this) to ventilate the lungs and
pass oxygen in to the blood
• main purpose is to maintain a flow of
oxygenated blood to the brain and the heart
• helps by delaying tissue death and extending
the brief window of opportunity for a successful
resuscitation without permanent brain damage
• generally continued until the patient regains a
heart beat (called "return of spontaneous
circulation" or "ROSC") or is declared dead
Advanced life support
• intravenous drugs
• Defibrillation
– the administration of an electric shock to the
heart
– only works for patients in certain heart rhythms,
namely ventricular fibrillation or pulseless
ventricular tachycardia
 Methods
International Liaison Committee on
Resuscitation (ILCOR)
• universal compression-ventilation ratio (30:2)
recommended for all single rescuers of infant,
child, and adult
• two hands for the chest compressions for adults,
while with children it is only one, and with
infants only two fingers (index and middle
fingers)
• taking the absence of normal breathing as the
key indicator for commencing CPR
• The removal of the protocol in which lay
rescuers provide rescue breathing without
chest compressions for an adult victim, with
all cases such as these being subject to CPR
Compression-only resuscitation/cardiocerebral
resuscitation (CCR)
• simply chest compressions without artificial
respiration
• Rhythmic abdominal compressions
– forcing blood from the blood vessels around the
abdominal organs, an area known to contain
about 25 percent of the body's total blood volume
– blood is then redirected to other sites, including
the circulation around the heart
• Internal cardiac massage - the process of
cardiac massage carried out through a surgical
incision into the chest cavity
Breathing (Rescue Breathing)
• Pinch the person’s nose shut using your thumb and
forefinger
• Keep the heel of your hand on the person’s forehead
to maintain the head tilt
• Hand should remain under the person’s chin, lifting up.
• Inhale normally (not deeply) before giving a rescue
breath to a victim.
• Immediately give two full breaths while maintaining an
air-tight seal with your mouth on the person’s mouth.
Each breath should be one second in duration and
should make the victim’s chest rise
Circulation (Chest Compressions)
• After giving two full breaths, immediately begin chest
compressions (and cycles of compressions and rescue
breaths.
• Kneel at the person’s side, near his or her chest.
• With the middle and forefingers of the hand nearest the
legs, locate the notch where the bottom rims of the rib
cage meet in the middle of the chest.
• Place the heel of the hand on the breastbone (sternum)
next to the notch, which is located in the center of the
chest, between the nipples. Place your other hand on
top of the one that is in position. Be sure to keep your
fingers up off the chest wall.
• Bring your shoulders directly over the person’s sternum.
Press downward, keeping your arms straight. Push hard and
fast. For an adult, depress the sternum about a third to a
half the depth of the chest. Then, relax pressure on the
sternum completely. Do not remove your hands from the
person’s sternum, but do allow the chest to return to its
normal position between compressions. Relaxation and
compression should be of equal duration. Avoid
interruptions in chest compressions (to prevent stoppage of
blood flow).
• Use 30 chest compressions to every two breaths (or about
five cycles of 30:2 compressions and ventilations every two
minutes) for all victims (excluding newborns). You must
compress at the rate of about 100 times per minute.
• Continue CPR until advanced life support is available.
Using an AED (Automated External
Defibrillator) in conjunction with CPR:
• single shocks should be followed by
immediate CPR for two minutes
• heart rhythm checks should be performed
every two minutes (or after giving about five
cycles of CPR
CPR for Infants (Up to One Year Old)
Airway
• be careful not to tilt the head back too far because an infant’s
neck is so pliable that forceful backward tilting might block
breathing
Breathing
• Do not pinch the nose of an infant who is not breathing.
• Cover both the mouth and the nose with your mouth and
breathe slowly (one to one and a half seconds per breath),
using enough volume and pressure to make the chest rise. 
• With a small child, pinch the nose closed, cover the mouth
with your mouth and breathe at the same rate as for an infant.
• Rescue breathing should be done in conjunction with chest
compressions