CPR CHECKLIST
DEFINITION
CPR is a series of steps to help a person who has stopped breathing and has no heartbeat. It
manually delivers oxygen to the lungs and temporarily restores heartbeat.
Cardiopulmonary resuscitation (CPR) is an emergency procedure the process of externally
supporting the circulation and respiration of the person who has cardiac arrest .
-Lewis et. al.(2002)
PURPOSE
• To restore partial flow of oxygenated blood to the brain and heart.
• CPR is performed to restore and maintain breathing and circulation.
• To provide oxygen and blood flow to the heart, brain and other vital organs.
OBJECTIVES
• To delay tissue death and to extend the opportunity for a successful resuscitation without
permanent brain damage.
• To maintain airway.
• To restore cardiac and pulmonary function.
• To provide basic life support till advanced life support measures are carried out.
• To restore consciousness or life.
INDICATIONS
• CPR should be performed immediately on any person who has become unconscious and is
found to be pulseless.
• Cardiac arrest (can be caused by allergic reactions, an ineffective heartbeat, asphyxiation,
breathing passage that are blocked, chocking, drowning, drug reactions or overdoses,
electric shock, exposure to cold, sever shock or trauma).
CONTRAINDICATIONS
• According to red cross, all patients in cardiac arrest may receive resuscitation unless the
patient has a valid “ do not attempt resuscitation” (DNAR) order.
• Patients dying on unexpected death from chronic life limiting medical illness .
Predictors of near 0% survival and never living the hospital include : metastatic cancer, renal failure,
sepsis, multiple organ failure , acute stroke, and a CPR event >30 minutes.
BASIC PRINCIPLES
• The American heart association now recommends “push hard and push fast” with
compressions. Infants and children should have a compression rate of at least 100 per
minutes.
• In lone- rescuer CPR, the compression to ventillation ratio is 30:2.
• There should be full recoil of the chest after each compression.
PREPARATION OF EQUIPMENTS
• Oxygen administration set
• IV infusion set
• AMBU bag and mask devices
• Endotracheal tubes of different sizes
• Oral and nasal airways
• Laryngoscopes of different sizes
• Suction apparatus
• Tracheostomy set
• Cardiac monitor and defibrillator
MEDICATIONS USED FOR CPR
• Oxygen- improves tissue and correct hypoxemia.
• epinephrine- increases systemic vascular resistance and blood pressure: improve coronary
and cerebral perfusion and myocardial contractility.
• Vasopressin- increases systemic vascular resistance and blood pressure.
• Atropine- blocks parasympathetic action : increases SA node automaticity and AV
conduction.
• Sodium bicarbonate(NAHCO3)- corrects acidosis.
• Magnesium- promotes adequate functioning of cellular sodium-potassium pump.
CHEST COMPRESSION ALERT
• Be careful with your hand position.
• For adults or children, keep your fingers off patient’s chest.
• Do not give compression over bottom tip on breastbone.
When compressing, keep elbows straight and hands in contact with patient’s chest at all times.
• Compress chest hard and fast, but let chest recoil completely between compressions.
Minimize amount of time used giving ventilations between sets of compressions.
• While pushing on back on the forehead, use your other hand to lift the chin forward.
• Place your mouth over the victim’s mouth and exhale.
IMPORTANT INSTRUCTIONS
• “Push hard and push fast”.
• At least 100 compressions /minute.
• Allow the chest to recoil equal compression and relaxation times.
• <10 seconds for pulse checks or rescue breathe.
• Compression depth
-child/infant 1/3 depth of chest. ---
infant 1.5” and child 2”.
STEPS OF PROCEDURE
STEPS RATIONALE
Determine the unresponsiveness;-
Tap or gently shake the patient while shouting “ARE YOU OK”.
Determine pulselessness :-
- Check for carotid pulse on one side for not more than 5
seconds.
- Call for help in hospital set up
A. Circulation
1. Place victim on firm, flat surface.
2. Kneel at victim’s side.
3. Using index finger of the hand, locate the lower rib
margin and move the fingers up to where the ribs connect
to the sternum . Place the middle finger of this hand on
the notch and index finger next to it . Place the heel of
the opposite hand next to the index finger on the sternum.
Remove the first hand from the notch and place on top of the hand that
is on the sternum. Extend or interlace the fingers, do not allow them to
touch the chest. Keep the arm straight with shoulders directly over the
hands on the sternum and lock elbows.
4. Compress the adult chest at least 2 inches (5cm.) at the rate of at least 100
per minute.
5. Release the chest compression completely and allow the chest to
return to its normal position after each compression. The time allowed for
release should be equal to the time required for compression. Do not lift
hands off chest.
6. Do 30 compressions and then perform 2 ventilations, re- evaluate the
patient after four cycles ( use the mnemonic “ 1, 2, and 3, to keep rhythm
and timing).
7. For CPR performed by one or two rescuers, the compression rate is
100 per minute.
(B.) AIRWAY
1. Open the victim’s airway by using one of the maneuvers:-
(a) Head tilt chin lift maneuver:- place one hand on victim’s forehead and
apply firm backward pressure with the palm to
(C) Breathing
1. Occlude nostrils with thumb and index finger of the hand on forehead that is
tilting the head back . form a tight seal over the patient’s mouth or place an
appropriate respiratory arrest device ( AMBU bag and mask) and give two
full breaths of approximately 0.5 to 2 seconds allowing time for both
inspiration and expiration.
WHEN TO STOP CPR