CPR
(Cardiopulmonary
Resuscitation)
Definition
An emergency procedure in which
the heart and lungs are made to
work by manually compressing the
chest overlying the heart and forcing
air into the lungs
Use when there is no breathing and
no pulse
The 5 links in the adult Chain of
Survival
Successful resuscitation following
cardiac arrest requires an integrated
set of coordinated actions
represented by the links in the adult
chain of survival
Start CPR Immediately
Better chance of survival
Brain damage starts in 4-6
minutes
Survey The Scene, then: RAP
RResponsivenes
s
Tap shoulder
and shout Are
you ok?
RAP
A - Activate EMS ( if unresponsive)
SEND SOMEONE TO GET HELP!
Call for ambulance and return to the
victim
RAP
P - Position on back
All body parts rolled over
at the same time
Always be aware of head
and spinal cord injuries
Support neck and spinal
column
ABCD
Airway
Breathing
Circulation
Disability
New CPR sequence
A (Airway) ensure open airway by preventing
the falling back of tongue
B (Breathing) start artificial ventilation of
lungs
C (Circulation) restore the circulation by
external cardiac massage
D (Disability) quickly perform differential
diagnosis of cardiac arrest, use different
medication and electric defibrillation in case
of ventricular fibrillation
10
Compressions
Locate proper hand position for
chest compressions
Place heel of one hand on center of
chest between the nipples
Chest compressions should be performed on the lower of the
sternum
Compressions
Using both hands,
give 30 chest
compressions
Count 1, 2, 3
Depth of
compressions: 1 .5 to
2 inches
For children: to 1/3
of chest depth and
A Airway
Open the airway
Head tilt chin lift
Open the airway using a head
tilt lifting of chin. Do not tilt the
head too far back
16
B Check For
Breathing
Look, listen
and feel for
breathing
No longer
than 10
seconds
Breathing
If the victim is not
breathing, give two
breaths (1 second or
longer)
Pinch the nose
Seal the mouth with yours
If the first two dont go
in, re-tilt and give two
more breaths (if breaths
still do not go in,
suspect choking)
Breathing: Mouth To
Nose (when to use)
Cant open mouth
Cant make a good
seal
Severely injured
mouth
Stomach distension
CPR
After 30 chest compressions
give:
2 slow breaths (30:2)
Continue until help arrives or
victim recovers
If the victim starts moving:
check breathing
Two Partner
CPR
Rescuer 1:
RAPABC
Rescuer 2:
place hands for compressions
Compression rate: 30:2
Switch off when tired
Algorithm
for artificial ventilation
mouth to mouth or mouth to nose
respiration
ventilation by a face mask and a selfinflating bag with oxygen
2 initial subsequent breaths
wait for the end of expiration
10-12 breaths per minute with a volume of app. 800 ml, each
breath should take 1,5-2 seconds
Control over the ventilation
check chest movements during ventilation
check the air return
22
Drugs used in CPR
Atropine can be injected bolus, max 3 mg to
block vagal tone, which plays significant role in
some cases of cardiac arrest
Adrenaline large doses have been
withdrawn from the algorithm. The
recommended dose is 1 mg in each 3-5 min.
Vasopresine in some cases 40 U can
replace adrenaline
Amiodarone - should be included in algorithm
Lidocaine should be used only in ventricular
fibrillation
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