Adult Basic Life Support for the Health Care

Worker

Adult Basic Life Support for the Health Care

Worker

Philippine Heart Association, Inc.

Council on Cardio Pulmonary Resuscitation

Philippine Heart Association, Inc.

Council on Cardio Pulmonary Resuscitation

A Full Member of the

The Asian Representative of

Based on the New 2010 CPR Guidelines of the AHA and ILCOR

The Burden: Heart Diseases are the #1 cause of death in the Philippines

Sudden Cardiac Arrest – A Health Burden

• Approximately 50% of deaths from cardiovascular disease occur as SUDDEN CARDIAC ARREST.

Sudden Cardiac Arrest is the most common mode of death in patients with coronary artery disease.

• Almost 80 percent of out-of-hospital cardiac arrests occur at home and are witnessed by a family member.

• Only 4-6 % of sudden cardiac arrest victims survive because majority of those witnessing the arrest do not know how to perform CPR .

American Heart Association

Health Burden of Sudden Cardiac Arrest

Sudden Cardiac Arrest• Unpredictable and can happen to anyone,

anywhere, at anytime

• Risk increases with age

• Pre-existing heart disease is a common cause

• May strike people with no history of cardiac disease or cardiac symptoms

Effective CPR done immediately after cardiac arrest can double a victim’s chance of survival.

If sudden cardiac death occurs outside the hospital setting, cardiopulmonary resuscitation (CPR) must begin within 4 to 6 minutes and advanced life support measures must begin within 8 minutes, to avoid brain death.

Objectives of this Presentation

• To increase awareness and knowledge on Basic Cardiopulmonary Resuscitation (CPR) as a life-saving procedure for victims of sudden cardiac arrest.

• To demonstrate the different steps and techniques of CPR.

What is C P R ?

• CPR = Cardio-Pulmonary Resuscitation

The NEW Chain of Survival

• Early access: immediate recognition and activation

• Early CPR

• Early defibrillation

• Early advanced care

• Integrated post-cardiac arrest care

A well-informed lay person - key in the early access link.

Recognition of signs of heart attack and respiratory failure

Call for help immediately if needed

Activate the Emergency Medical System

The First Link- Early Access

EARLY WARNING SIGNS OF HEART ATTACK

prolonged compressing pain or unusual discomfort in the center of the chest

may radiate to shoulder, arm, neck or jaw, usually on the left side

may be accompanied by sweating, nausea, vomiting and shortness of breath

EARLY WARNING SIGNS OFRESPIRATORY FAILURE

unable to speak, breath or cough

clutches neck (universal distress signal)

bluish color of skin and lips

Life saving technique for cardiac & respiratory arrest

Chest compressions +/- Rescue breathing

Lay persons and medical personnel

Second Link - Early CPR

Why is early CPR important? CPR is the best treatment for cardiac

arrest until the arrival of ACLS care. prevents VF from deteriorating to

asystole may increase the chance of

defibrillation It significantly improves survival.

Brain(Cerebral)

Heart(Cardiac)

Lungs(Pulmonary)

How does CPR work?

All the living cells of our body need a steady supply of oxygen to keep us alive.

During CPR, you can breathe air into the victim’s lungs to provide oxygen into the blood.

When you press on the chest, you move oxygen - carrying blood through the body.

When will you do CPR?

AS SOON AS POSSIBLE!

Brain cells begin to die after

4-6 minutes without oxygen.

Who may learn about CPR?

• CPR is an easy and life saving procedure and can be learned by anyone.

• One does not need to be a doctor to learn how to do CPR.

THE TECHNIQUE AND STEPS IN CPR

IF YOU WITNESS A CARDIAC ARREST

CHECK AREA SAFETY.

Survey the scene.See if the scene is safe to do CPR.Get an idea of what happened.

CHECK UNRESPONSIVENESS.Tap or gently shake the victim

Rescuer shouts “Are you OK?”

Quick check for normal breathing

If the victim is unconscious, rescuer calls for help.

CALL FOR HELP:Ambulance, Emergency Services, Doctor

Rescuer ACTIVATES the EMERGENCY MEDICAL SERVICES.

Get AED/Defibrillator!

1

2

3

NON-RESPONSIVE,NO NORMAL BREATHING

Get a Defibrillator!A E D !

PULSE CHECK

Palpate for Carotid Pulse within 10 seconds

(at the same time CHECK FOR BREATHING)

For trained healthcare providers only

Do Mouth to MouthBreathing

Give one breath every 5-6 secs (about 12 breaths/min)

Recheck pulse every 2 minutes

If with definite pulse but no breathing

MOUTH TO MOUTH BREATHING and PULSE CHECK

• Deemphasized in the new guidelines• For trained healthcare providers only• As short and quick as possible• Pulse check not more than 10 seconds• If unsure, proceed directly to CHEST

COMPRESSIONS!

C – A – B C. COMPRESSION Do chest

compressions first

A. AIRWAY Does the victim have an open airway (air passage

that allows the victim to breathe)?

B. BREATHING Is the victim breathing?

After determining unconsciousness,

After determining unconsciousness and calling for help,

proceed immediately to do

CHEST

COMPRESSIONS!

C – COMPRESSION

(to assist CIRCULATION)

Chest Compressions

Hand Location

• Kneel facing

victim’s chest

• Place the heel of your hand on the center of the victim's chest. Put your other hand on top of the first with your fingers interlaced.

Place the heel of one hand on the sternum in the center of the chest between the nipples and then place the heel of the second hand on top of the first so that the hands are overlapped and parallel.

Chest Compressions

Position shoulders over hands with

elbows locked and arms straight

Give Chest Compressions at 100 per minuteCompress breastbone at least 2 inches deep

Compress at a rate of 100 per minute or more

Compress 30 times initially

Allow the chest to return to its normal position

Compress down and release pressure

smoothly, keeping hand contact with chest at all t imes

Give 30 Compressions Compress breastbone at least 2

inches

(30 compressions should take 15-18 sec)

Count aloud “1, 2, 3, 4, 5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29, and ONE!”

Minimize interruptions

Allow recoil after each compression

A - AIRWAY Open the Airway: Use the head tilt/chin lift method

Place one hand on the victim’s forehead

Place fingers of other hand under the bony part of lower jaw near chin

Tilt head and lift jaw--avoid closing victim’s mouth

Head Tilt Chin Lift Maneuver

This maneuver prevents airway obstruction by the epiglottis.

B - BREATHINGGive 2 one-second breaths

• Maintain airway• Pinch nose shut• Open your mouth

wide, take a normal breath, and make a tight seal around outside of victim’s mouth

• Give 2 full breaths

(1 sec/ breath)• Observe chest rise &

fall; listen & feel for escaping air

Repeat cycles of 30 compressions & 2 breaths

PULSE CHECK• RECHECK PULSE EVERY 2 MINUTES

(equivalent to 5 cycles CPR)• Very brief pulse check – should take

less than 10 seconds (at the same time check for normal breathing)

• In case there is any doubt about the presence or absence of pulse, CONTINUE CHEST COMPRESSIONS

• For trained healthcare providers only

UNTIL…

•HELP ARRIVES. (Emergency Services, Ambulance, Doctor, AED)

•PERSON IS REVIVED.

CONTINUE CPR

If the victim is breathing

The unresponsive victim with spontaneous respirations should be placed in the recovery position if no cervical trauma is suspected.

Placement in this position consists of rolling the victim onto his or her side to help protect the airway.

Maintain open airway & position the victim

THE RECOVERY POSITION

Maneuvers Adults ChildrenRECOGNITION UNRESPONSIVE

No breathing, not breathing normally (eg. only gasping)

No breathing or only gasping

CPR Sequence CAB CAB

Compression Rate At least 100/min

Compression Depth At least 2 inches (5 cm) At least 1/3 AP depth; About 2 inches

Chest wall Recoil Allow complete recoil between compressionsHCPs rotate compressors every 2 minutes

Compression interruptions

Minimize interruptions in chest compressionsAttempt to limit interruptions to less than 10 seconds

Airway Head tilt chin lift (HCP suspected trauma: jaw thrust)

Compression-Ventilation ratio

30 : 2 (one or 2 rescuers) 30:2(single rescuer); 15:2(2 rescuer)

Ventilations: when rescuer untrained or

trained and not proficient

Compressions only Compressions only

Ventilations with advanced airway (HCP)

1 breath every 6-8 seconds (8-10 breaths/min)Asynchronous with chest compressions

About 1 second per breathVisible chest rise

DEFIBRILLATION ( AED ) Attach and use AED as soon as available. Minimize interruptions in chest compressions before and after shock, resume CPR beginning with compressions

immediately after each shock

Summary of Key BLS Components for Adults and Children

• NOT TRAINED• DO NOT KNOW MOUTH TO MOUTH

VENTILATION• NOT SURE ABOUT MOUTH TO MOUTH

VENTILATION• HESITANT TO DO MOUTH TO MOUTH

VENTILATION• DO NOT WANT TO DO MOUTH TO MOUTH

VENTILATION

IF YOU ARE…

Compression-only bystander CPR

Hands Only CPR

Hands Only CPR should only be used for adult victims who have suddenly collapsed or

become unresponsive.

Recommendations:• All victims of cardiac arrest should receive

high-quality chest compressions

• When an adult suddenly collapses, all bystanders should activate their community EMS and provide high-quality chest compressions, minimizing interruptions (Class I).

Hands Only CPR

Recommendations:• If not trained in CPR, provide hands-only

CPR (Class IIa) until – AED arrives– EMS providers take over care of the victim

• If trained in CPR, provide either conventional CPR using a 30:2 compression-to-ventilation ratio (Class IIa) or handsonly CPR (Class IIa)

Hands Only CPR

Key Changes in the New Guidelines

• CAB instead of ABC• Compress first• No more Look Listen and Feel• Harder! At least 2 inches compression (old: 1 ½ to 2

inches)

• Faster! At least 100/min compression (old: up to 100/min)

• Deemphasize pulse checks– For trained healthcare providers not more than 10 secs

• Check for normal breathing together with check for unresponsiveness

• Hands only CPR for the untrained lay rescuer

Important Points• There are no mistakes when you perform CPR.

The only harm is to delay responding.Start chest compressions now viewed as the most

effective procedure

All victims in cardiac arrest need chest compressions.

• Don't stop pushing.

Keep pushing as long as you can. Push until the AED is in place and ready to analyze the heart. When it is time to do mouth to mouth, do it quick and get right back on the chest.

• 80-90% of cardiac emergencies occur at home.

• Training is now simpler and more accessibleReduced number of steps and simplified process

• Being trained to do CPR can save a loved one.

• Effective CPR done immediately after cardiac arrest can double a victim’s chance of survival.

LEARN CPR TODAY!

INQUIRE FROM THE PHILIPPINE HEART ASSOCIATION!www.philheart.org

CPR SAVES LIVES.

If you want know more about Sudden Cardiac Arrest and CardioPulmonary Resuscitation,

contact the

Philippine Heart Association Council on CPR

 

PHA Heart HouseSuite 1108, 11th Flr. East Tower, PSE Centre Exchange Road,

Ortigas Center, Pasig City Philippines

Tel. +63 2 470-5525; +63 2 687-7797

www.philheart.org