Download CardioPulmonary Resuscitation

CardioPulmonary
Resuscitation
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Legal considerations
Standard precautions
Heart disease and stroke
Sequence of survival
Assess>Alert>Attend (ABCs)
CPR
FBAO/Choking
ASHI certification
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Conducts thorough review of all relevant literature
and developed standards in collaboration with the
American Heart Association (AHA) and other
organizations
Course includes same content as American Heart
Association, American Safety and Health Institute,
American Red Cross, and the National Safety
Council basic CPR courses
Need to renew ever two years
LEGAL CONSIDERATIONS
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Good Samaritan laws protect you if:
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Avoid recklessness and negligence.
Act prudently.
Act within the scope of your training.
Don’t stop until a trained professional relieves you,
never allow for a degradation in level of care
Do not accept anything in return for services.
If you are at work and if it is expected in your
normal work duties to provide first aid to your
level of training you and your employer will not
necessarily be protected from liability
Standard Precautions
(aka Universal Precautions or Body Substance Isolation)
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ALL blood and other body fluids should be
considered potentially infections.
One of the biggest transmission risk is
Hepatitis, very hardy virus that can live in a
drop of blood for > 16 hrs
Take precautions to protect yourself:
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Use latex gloves, eyewear, & rescue breathing
mask/device, when assisting ANYONENO
EXCEPTIONS
Sequence of Survival
(S.O.S.)
1.
2.
3.
4.
5.
6.
Recognition of an emergency
Rapid activation of EMS (911)
Citizen responder provides life-sustaining
care (CPR).
Automated External Defibrillation (AED)
EMS arrives and transports
Hospital care (ALS/ACLS)
Heart Attack
[aka myocardial infarction (MI)]
1st Aid
Signs and Symptoms
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Chest discomfort/severe
chest pain & light
headedness, fainting,
sweating,
nausea/vomiting,
difficulty breathing.
Pressure or pain in chest
that lasts more than a
few minutes.
Pain may spread to
shoulders, neck, back,
jaw or arms.
Pale or ashen skin.
Unconscious
 Access ABC’s
 CPR if needed
 Alert EMS
 Defibrillation if needed and
trained
 Transport to Hospital
Conscious
 Oxygen
 Place position of comfort
(POC)
 Comfort patient
 Help with medication
 Transport to Hospital
Stroke
Symptoms
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Sudden numbness of
face, arm or leg,
especially on one side of
the body.
Sudden dizziness or lack
of balance
Sudden confusion,
trouble speaking, or
slurred speech
Sudden loss of vision,
usually in one eye
Loss of consciousness.
A sudden and intense
headache (worst one
ever!)
1st Aid
Unconscious
 Access ABC’s
 Alert EMS
 Transport to Hospital
Conscious
 Maintain Airway
 Alert EMS
 Place patient on affected
side
 Comfort patient
 Oxygen
 Give nothing by Mouth
What is CPR?
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CardioPulmonary Resuscitation.
Used when a patient is not breathing and
has no pulse.
Usually, not enough alone to save a
patient.
Important step while waiting for EMS to
arrive. Buys patient time, 4-7 mins.
before irreversible brain damage occurs.
Basic Life Support (BLS)
Assess> Alert > Attend
1. Assess
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Assess scene for safety
Assess patient for life-threatening
conditions
Alert
2.
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Alert EMS – If alone, give 2 mins of
CPR than call 911.
Attend
3.
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Attend to patient and provided
necessary care.
Positioning the Patient
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To properly assess and provide care, patient
should be lying on back (if conscious and verbal
position of comfort may be appropriate)
Only move patient to provide necessary care or
avoid imminent danger
Patient should be moved if:
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Unconscious and lying face down
Patient is breathing but unconscious
If you have to leave an unconscious breathing victim
unattended
Vomiting patient
Imminent danger
Log Roll/Recovery position
If alone:
1.
Kneel down at waistline
of patient.
2.
Attempt to roll the
patient as a single unit.
3.
Grasp the patient’s
opposite shoulder and
hip and roll the patient
towards you. As soon
as movement begins,
remove your hand from
the patients shoulder
and support his head
and neck until the
patient is flat on back
If you have assistance:
 One person should
stabilize head and neck
as the other responder
rolls the patients’ body.
Recovery Position (for breathing victim)
For use with a breathing patient with no suspected spinal
injury
1.
Kneel at the patient’s waist.
2.
Place the arm of the patient that is closest to you up
and out.
3.
Bend the leg of the patient that is opposite you
upward.
4.
Grasp the patient’s hip and shoulders and roll them
toward you, resting the patient’s head on the extended
arm. The patient’s bent leg should help keep the
patient from rolling over.
HAINES – High Arm IN Endangered Spine
position
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Use this position WHENEVER you come
upon an injured person
Preferable to traditional recovery
position because there is less head and
neck movement
ASSESS>
Check for Responsiveness:
Shake or tap victim’s shoulder, ask loudly “Are you OK?”
No response (unconscious)
Responsive (Conscious)
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Call 911, if alone
 Introduction/request for
ALERT>
assist for 2 mins
consent
then call 911
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ATTEND>  Assess adequateness of
Open Airway
Check for Breathing for 6 – 10
secs
2 breaths if needed so chest
visible rises
DO NOT check for
Circulation/pulse go straight to
CPR or rescue breathing if needed
If additional help is available:
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Control bleeding(?)
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Care for shock(?)
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breathing (Adult 12-20 bpm or
~ 1 breath 3 secs)
Control bleeding
Complete head to toe exam
Check vitals
Care for shock
Administer O2 if available
ASSESS>ALERT>ATTEND
Assess>Alert>Attend
The ABC’s of BLS
A = Airway
Is Airway open?
B = Breathing
Check for breathing for 6-10 seconds.
C = Compressions
GO STRAIGHT TO COMPRESSIONS
Open Airway
Head tilt-chin lift:
 Place one hand on patients forehead and
place fingers of other hand on patients
chin.
 Tilt head back and lift chin up.
Assess Breathing
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Place side of face over victims mouth,
facing down body and…
LOOK and patients chest for movement
LISTEN for sounds of breathing
FEEL for air on your cheek
Do this for up to 10 seconds
***If there is any doubt about the rate
and quality of the patients breathing, give
rescue breaths 1 every 5 secs for adults
NO BREATH 
Start Rescue Breathing
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Maintain open airway
Place mouth to mask barrier on person’s
face
Provide 2 slow breaths of 1.5-2 seconds
Look for chest to rise and fall
NO breathing  Start CPR
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1.
2.
3.
4.
5.
6.
7.
8.
After 2 breaths if no breathing detected
Find lower half of breastbone/sternum and place heel of hand
there (between nipple line). Place other hand on top of first.
Interlock fingers of both hands and position self directly above the
patient’s chest.
With arms straight and elbows locked, press down on the breast
bone and deliver 30 compressions, depressing the sternum 1.5-2
inches.
Count 1 and 2 and 3 and 4 and 5 and 6 and 7 and 8 and 9 and
(then drop and) 10, 11, 12, 13, 14, 15.
After 15 compressions, tilt head, lift chin, and deliver 2 slow
breaths.
Continue CPR in ratio of 30:2 until the patient shows obvious signs
of circulation, you are relieved by another rescuer, EMS arrives,
you are too exhausted to continue, or a physician instructs you to
stop.
After 4 cycles of CPR, rescuer should re-assess victim for signs of
circulation.
SPEED IS THE KEY 100 X MIN!!!
Location of Sternum
Place heel of hand here
X
Rescue Breathing
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Patient is NOT breathing,
but DOES have a pulse.
For adults, 1 breath/5 seconds
 For Child (Age 1-8)  1 every 3 secs
 For Infant (Age< 1)  1 every 3 secs
Watch for patient’s chest to rise gently
and fall
Foreign Body Airway Obstruction
(Choking)
Partial Airway Obstruction
 Person is still conscious and can breath
 Encourage person to cough forcefully
 A good cough maybe life saving, especially
if you are alone and choking.
Foreign Body Airway Obstruction
(Choking)
Complete Airway Obstruction
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Victim cannot breath and thus cannot cough
If Conscious:
1.
Look for choking signal (hands on throat)
2.
Introduce self and ask for consent
3.
Administer abdominal thrusts
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Stand behind patient and wrap arms around patient’s
waist.
Make a fist with one hand, place it 2 fingers above the
naval with thumb towards naval.
Place other hand on fist and perform quick inward and
upward thrusts until foreign body is expelled or the
patient becomes unconscious.
Foreign Body Airway Obstruction
(Choking)
For Unconscious Victim:
Assess>Alert>Attend
A = Airway
B = Breathing
Step 1
 Using tongue-jaw lift, look in mouth
 Perform finger sweep to remove object, avoid blind sweeps
Step 2
 Attempt to ventilate patient.
 If unsuccessful, reopen airway and try again.
Step 3
 Perform Chest Compressions (30 compressions)
 Repeat steps 1, 2 and 3 until airway clear of EMS takes over
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If object is removed, clear mouth, give two ventilations that produce
visible chest rise
C = Compressions
BLS Flow Chart
Assess Victim
“Are you Okay?”
Assess 
Alert 
Attend 
Conscious
• Introduce Self
• Ask consent
Choking
• Encourage to cough
Victim goes unconscious
• Access breathing
•Attempt rescue breaths
*** ALL breaths should be
accompanied by Emergency O2
if available.
ACTIVATE EMS/CALL 911
Unconscious
• A = Airway
• B = Breathing
If Breathing:
• recovery position
• O2&1st Aid as needed
•Secondary assessment
If breaths don’t work:
• re-tilt head
• finger sweep
• chest compressions
If Pulse
• give rescue breaths
• 1/5 sec
If Not Breathing:
• give 2 breaths
If breaths work
• check for pulse
No Pulse
• CPR @ 30/2
Sudden Cardiac Arrest
• Claims more than 350,000 lives a year, according to the
American Heart Association and can happen to anyone
• Second most frequent cause of death in dive accidents
after drowning, according to DAN
• CARDIOVASCULAR DISEASE IS THE MOST COMMON
HEALTH PROBLEM/CONCERN IN DIVE FATALITIES
What's Happening?
• Heart pumps oxygenated blood throughout the body
• Most common cause of Sudden Cardiac Arrest is
ventricular fibrillation (VF)
VF – a breakup of the heart rhythm that keeps blood flowing.
What do you do if you think someone is having a heart attack?
•Sit or lay them down in a position of comfort
•CALL 911
•Administer O2 if available
•Calm and reassure victim
•Gather all available basic life support equipment and ready it for use