CARDIO-PULMONARY RESUSCITATION

CISF NISA HYDERABAD

 WARMING UP
• When it is required? Who can give CPR ?
 Relevance of the topic

G.Os. & S.Os. Trainees are required to have the knowledge &
exposure of CPR & its First-aid So, that in case of need they may
brief their subordinates and may deal with the cases of CPR & its
First-aid effectively.
 Learning Objectives
• At the end of the session the participants will be able
to tell:
– What is the meaning of CPR
– Indications of CPR
– Procedure of CPR
- Mouth to mouth respiration
- External cardiac massage
– CPR when one / two rescuers
 Competencies
• Capability to inculcate awareness of CPR & its First-
aid to the subordinates & dealing with the cases of
CPR effectively.
 Cardiopulmonary Resuscitation (CPR)

• Cardiopulmonary resuscitation or CPR is an

emergency life-support procedure. It includes
artificial respiration and manual cardiac
massage.
• applied to prevent irreversible brain damage
or death in the case of cardiac arrest
• The most common and efficient method of
artificial respiration is mouth-to-mouth
resuscitation.

Mouth-to-Mouth Resuscitation
• Place the victim face up on a firm surface, such as the floor or the
ground.
• Open the Airway
• To open the airway, one hand must be placed on the victim's
forehead and firm, backward pressure with the palm is applied to
tilt the head back. If there is a suspicion of neck injury, the head
should not be moved unless it is absolutely necessary to open the
airway. Place the fingers of the other hand just under the chin and
lift to bring the chin forward.
• If there is material like vomitus or any foreign body that appears to
block the air passages it must be removed.
• Ascertain whether the patient is breathing
using “Look Hear and Feel” method
• If there is no breathing, begin artificial
respiration.
 Mouth-to-Mouth Resuscitation
• Place the casualty on his back. Hold his head tilted back.
• Take a deep breath with mouth open widely.
• Keep nostrils of casualty pinched.
• Cover the mouth of the casualty with your mouth snugly.
• Watching the chest, blow into his lungs, until the chest expands. Withdraw
your mouth; note that the chest falls back (It is hygienic to cover the mouth
of casualty with your handkerchief or some clean cloth).
• Repeat the above 12 times a minute in adult.
• If the casualty is young (baby or a child), the operations are as above, but
your open mouth should cover both the mouth and nose of the casualty.
Blow gently.
 Mouth-to-Mouth Resuscitation:
• Repeat with breaths at the rate of 12 times
per minute. Children should receive smaller
breaths repeated at the rate of 20 times per
minute.
 LEARNING RE ENFORCEMENT
1. How can we administrate artificial respiration before doing
CPR?
a) Make the airway open and clear
b) Pinch the person’s nose
c) Blow in to the mouth
d) All of these
2. CPR stands for_____________
a) Cardio Pulmonary Resuscitation
b) Cardiac Pulmonary Resuscitation
c) Cardio Pulmonary Respiration
d) Cardiac Pulmonary respiration
 External Cardiac Massage
• The aim of external cardiac massage is to cause the heart
to pump blood to the other parts of the body. It should
be started simultaneously with artificial respiration in a
victim whose heart has stopped beating
• If the heart is not working, you will notice the following
The face is blue or pale.
Pupils are dilated.
Heart beats and pulse at root of neck (carotid) are not felt
• The rescuer should place the heel of the palm
of one hand parallel to and over the lower
part of the victim's sternum (breastbone), 1 to
1.5 inches from its tip. The rescuer puts the
other hand on top of the first and brings the
shoulders directly over the sternum. The
rescuer's fingers should not touch the victim's
chest.
• Keeping the arms straight, the rescuer pushes down
forcefully on the sternum. This action, called external
cardiac compression, results in blood flow from the heart
to other parts of the body.
• The rescuer alternately applies and releases the
pressure.
• For children from two to ten years , pressures with one hand (heel) will
be enough;
• For babies up to two years, the pressure is exerted using the index
and middle fingers at the middle of the sternum.
• In all cases, the compressions must be accompanied by
artificial respiration.
• Treatment should continue until medical help arrives.
• CPR is best performed by two trained persons.
One should administer external cardiac
compression, and the other should provide
artificial respiration. The rescuers should
position themselves on opposite sides of the
victim so they can switch roles easily if either
becomes fatigued.
 External Heart Compression
(if there are two trained person)
• This should go on along with artificial respiration therefore ask the First Aider giving
mouth-to-mouth breathing to sit to the right of the casualty and place yourself on the
left side.

• Press firmly but carefully; carelessness may cause injury to ribs and deeper tissues.

• If the treatment is effective,

– Colour will become normal
– Pupil will contract as improvement begins and
– Carotid pulse begins with each pressure.

• If there are two First Aiders, No.1 makes heart compressions and then No.2 given
lung inflation. These are repeated, At the same time No.1 can watch the pupils and
No.2 can feel the carotid pulse.
• Inflation's of lungs to heart pressure should be as 2:15.
If there is only one First Aider, he has to be very smart
and active. Finish 15 heart compressions, rush to head-
side, give two inflation's to the lungs, and get back to
the heart and give 15 compressions.
• Repeat these
• If there are two First Aiders, No.1 makes 5 heart
compressions and then No.2 given one lung inflation.
These are repeated, At the same time No.1 can watch
the pupils and No.2 can feel the carotid pulse.
 LEARNING RE ENFORCEMENT
1. How many time we can do CPR in an emergency?
a) 20 times
b) 60 times
c) 40 times
d) None of these
2. While on CPR the chest push down up to __________
a) 2-3 cm
b) 3-4 cm
c) 4-5 cm
d) 5-6 cm
 Summary

• Today we discussed
– What is CPR
– Its indications and importance
– Procedure of CPR
- Mouth to mouth respiration
- External cardiac massage
– CPR when one / two rescuers