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Ch. 5-CardiopulmonaryCh. 5-CardiopulmonaryResuscitationResuscitation

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5.2 Basic Life Support 5.2 Basic Life Support SequenceSequence

Determining ResponsivenessDetermining Responsiveness Activating the EMS SystemActivating the EMS System Opening the AirwayOpening the Airway Determining BreathlessnessDetermining Breathlessness Providing Rescue BreathingProviding Rescue Breathing Determining PulselessnessDetermining Pulselessness Deliver Chest CompressionsDeliver Chest Compressions Defibrillation Where AvailableDefibrillation Where Available

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VocabularyVocabularyCardiac arrest- Cardiac arrest- A condition in which the heart stops A condition in which the heart stops

beatingbeatingDefibrillation-Defibrillation- The application of electricity to the The application of electricity to the

chest of a victim whose heart has stoppedchest of a victim whose heart has stoppedLarynx- Larynx- The voice boxThe voice box

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PROGRESS CHECKPROGRESS CHECK1. In cardiac arrest, the heart stops because it is not 1. In cardiac arrest, the heart stops because it is not

getting the ____________ it needs. getting the ____________ it needs. (electrical (electrical stimulation/rest/oxygen)stimulation/rest/oxygen)

2.CPR consists of opening the airway, providing rescue 2.CPR consists of opening the airway, providing rescue breathing, and providing ____________.breathing, and providing ____________.

(chest compressions/defibrillation/intrathoracic massage)(chest compressions/defibrillation/intrathoracic massage)3. The key objectives of CPR are to ____________ and 3. The key objectives of CPR are to ____________ and

circulate the blood. circulate the blood. (provide rescue (provide rescue breathing/defibrillate/oxygenate)breathing/defibrillate/oxygenate)

4. For each minute a heart is stopped, a victim loses 4. For each minute a heart is stopped, a victim loses approximately ___________ % from his chance of survival.approximately ___________ % from his chance of survival.

(5/10/25)(5/10/25)5. A key to survival in cardiac arrest is ___________ CPR.5. A key to survival in cardiac arrest is ___________ CPR.(early/effective/prolonged)(early/effective/prolonged)

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Determining Determining BreathlessnessBreathlessness

Look Look for the chest to rise and fallfor the chest to rise and fall Listen Listen for air escaping during for air escaping during

exhalationexhalation Feel Feel for the breath against your cheekfor the breath against your cheek

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Determining PulselessnessDetermining Pulselessness1.1. Maintain the head tilt with one hand on the victim’s Maintain the head tilt with one hand on the victim’s

forehead, and place the first two fingers of other forehead, and place the first two fingers of other hand on the larynx (voice box).hand on the larynx (voice box).

2.2. Locate the carotid artery. Locate the carotid artery.3.3. Exert only gentle pressure to avoid compressing the Exert only gentle pressure to avoid compressing the

carotid artery, and feel for a pulse for as long as 10 carotid artery, and feel for a pulse for as long as 10 seconds.seconds.

4.4. While checking pulse, be alert for other signs of life While checking pulse, be alert for other signs of life—including movements, breathing, gasping, or —including movements, breathing, gasping, or coughing—that could indicate a pulse is present.coughing—that could indicate a pulse is present.

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PROGRESS CHECKPROGRESS CHECK1. The first step in the basic life support sequence is to1. The first step in the basic life support sequence is todetermine ____________.determine ____________.(responsiveness/breathlessness/pulselessness)(responsiveness/breathlessness/pulselessness)2. If you determine that the victim is unresponsive, you2. If you determine that the victim is unresponsive, youshould immediately ____________.should immediately ____________.(open the airway/start CPR/activate the EMS system)(open the airway/start CPR/activate the EMS system)3. Before you can determine whether the victim is3. Before you can determine whether the victim isbreathing, you need to ____________.breathing, you need to ____________.(open the airway/provide two rescue breaths/start CPR)(open the airway/provide two rescue breaths/start CPR)4. Before you can determine whether the heart is beating,4. Before you can determine whether the heart is beating,you need to ____________.you need to ____________.(position the victim/provide two rescue breaths/start CPR)(position the victim/provide two rescue breaths/start CPR)

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5.3 Chest Compressions5.3 Chest Compressions Positioning Your HandsPositioning Your Hands Delivering Chest CompressionsDelivering Chest Compressions

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Proper Hand Placement for Proper Hand Placement for Adult CPRAdult CPR

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1111

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VocabularyVocabularyXiphoid process-Xiphoid process- The lower tip of the The lower tip of the sternumsternumSubsternal notch-Substernal notch- The notch at the spot The notch at the spot where the ribs join the sternumwhere the ribs join the sternumVentricular fibrillation- Ventricular fibrillation- A chaotic, A chaotic, unorganized beating effort of the heart that is unorganized beating effort of the heart that is incapable of producing a pulse or circulationincapable of producing a pulse or circulation

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Performing One-Rescuer Performing One-Rescuer Adult CPRAdult CPR

1.1. Position your hands properly on the victim’s Position your hands properly on the victim’s chest as described above.chest as described above.

2. Deliver 15 chest compressions at the rate of 2. Deliver 15 chest compressions at the rate of about 100 per minute. Count aloud to keep about 100 per minute. Count aloud to keep track of the compressions.track of the compressions.

3. Remove your hands from the victim’s chest, 3. Remove your hands from the victim’s chest, open the airway, and deliver two rescue open the airway, and deliver two rescue breathsbreaths

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Terminating CPRTerminating CPR

Breathing and heartbeat start again spontaneously (this Breathing and heartbeat start again spontaneously (this is unusual; most cases of cardiac arrest require is unusual; most cases of cardiac arrest require defibrillation and advanced life support procedures)defibrillation and advanced life support procedures)

Another trained rescuer, a physician, or an individual or Another trained rescuer, a physician, or an individual or team directed by a physician assumes responsibility for team directed by a physician assumes responsibility for basic life support basic life support

A physician tells you to stopA physician tells you to stop The victim is transferred to an appropriate medical care The victim is transferred to an appropriate medical care

facilityfacility You are exhausted and unable to continue life supportYou are exhausted and unable to continue life support Conditions (such as a fire, noxious fumes, or an unstableConditions (such as a fire, noxious fumes, or an unstable building) make it unsafe for you to continuebuilding) make it unsafe for you to continue The victim is declared dead by a physicianThe victim is declared dead by a physician

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PROGRESS CHECKPROGRESS CHECK1. You must properly position your ____________ during chest 1. You must properly position your ____________ during chest

compressions, or you can injure the victim. compressions, or you can injure the victim. (shoulders/hands/knees)(shoulders/hands/knees)

2. The xiphoid process is the tip of the ___________. 2. The xiphoid process is the tip of the ___________. (rib/clavicle/sternum)(rib/clavicle/sternum)

3. The substernal notch is the notch where the ____________ 3. The substernal notch is the notch where the ____________ meet(s) the sternum. meet(s) the sternum. (ribs/clavicle/xiphoid)(ribs/clavicle/xiphoid)

4. During chest compressions, keep your shoulders straight and 4. During chest compressions, keep your shoulders straight and your elbows ____________. your elbows ____________. (bent/locked/aligned)(bent/locked/aligned)

5. After every two rescue breaths, deliver __________ chest 5. After every two rescue breaths, deliver __________ chest compressions. compressions. (10/15/20)(10/15/20)

6. Once you start CPR, you must continue it until breathing and 6. Once you start CPR, you must continue it until breathing and pulse return, someone else takes over, or ____________. pulse return, someone else takes over, or ____________. (you are (you are told to stop/you are too tired to continue/you injure the victim)told to stop/you are too tired to continue/you injure the victim)

7. During two-rescuer CPR, the First Aider at the victim’s side 7. During two-rescuer CPR, the First Aider at the victim’s side should never ____________. should never ____________. (lift hands off the chest/deliver (lift hands off the chest/deliver rescue breaths)rescue breaths)

8. If delivering chest compressions to an infant, use ____________.8. If delivering chest compressions to an infant, use ____________.(two fingers/one hand/both hands)(two fingers/one hand/both hands)

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5.4 Mistakes, 5.4 Mistakes, Complications,Complications,

and When to Withholdand When to Withhold Complications Caused by CPRComplications Caused by CPR

Fracture of the ribs or sternumFracture of the ribs or sternum Separation of rib cartilage (common in Separation of rib cartilage (common in

the elderly)the elderly) PneumothoraxPneumothorax

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Withholding CPRWithholding CPR

There is rigor mortis or other signs of There is rigor mortis or other signs of death.death.

The victim is decapitated.The victim is decapitated. The victim has wounds that will The victim has wounds that will

certainly cause death.certainly cause death.

2020

5.5 Defibrillation5.5 Defibrillation Defibrillation is done by automated Defibrillation is done by automated

external defibrillators (AEDs)external defibrillators (AEDs) Ventricular fibrillation is a chaotic, Ventricular fibrillation is a chaotic,

unorganized beating of the heart unorganized beating of the heart that is incapable of producing a that is incapable of producing a pulse or contractionpulse or contraction

Defibrillation literally shocks the Defibrillation literally shocks the heart into the proper organized heart into the proper organized rhythmrhythm

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Cardiac Arrest in Pediatric Cardiac Arrest in Pediatric PatientsPatients

In the event of cardiac arrest in In the event of cardiac arrest in pediatric patients 1 year or older, pediatric patients 1 year or older, defibrillate with adult pads if defibrillate with adult pads if pediatric-specific pads or devices are pediatric-specific pads or devices are unavailable. Pediatric pads should unavailable. Pediatric pads should not be used on adult patients.not be used on adult patients.

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PROGRESS CHECKPROGRESS CHECK

1. Ventricular fibrillation is an ________ beating 1. Ventricular fibrillation is an ________ beating effort of the heart. effort of the heart. (accelerated/unorganized/ordinary)(accelerated/unorganized/ordinary)

2. If you are alone with a victim in cardiac arrest 2. If you are alone with a victim in cardiac arrest and you have an AED available, you should and you have an AED available, you should perform _________ first. perform _________ first. (CPR/defibrillation/a (CPR/defibrillation/a neuro exam)neuro exam)

3. Before analyzing or shocking a victim with an 3. Before analyzing or shocking a victim with an AED you should _______ the victim. AED you should _______ the victim. (roll/clear/ventilate)(roll/clear/ventilate)