Cardiopulmonary Resuscitation Summary Notes

CARDIOPULMONARY RESUSCITATION


 It is a n emergency lifesaving procedure performed when the heart s tops beating

Chain of Survival
 AHA recommended two chain of survival that aims to identify the different pathways of care for patients who
experience cardiac arrest in the hospital in comparison to out-of-hospital settings
 Out-of-hospital Cardiac arrest (OHCA)
Chain of Survival:
o Recognition of cardiac arrest and
activation of the emergency response
system
o Early CPR with an emphasis on chest
compressions
o Rapid defibrillation
o Basic and advanced emergency
medical services
o Advanced life support and post-cardiac
arrest care
 In-hospital Cardiac Arrest (IHCA) Chain of
Survival:
o Highly dependent on a system of
appropriate surveillance (eg, rapid
response or early warning system) that
helps prevent the occurrence of
cardiac arrest.
o If cardiac arrest occurs
 Patients life depends on the following
 smooth interaction of the institution‟s various departments and services
 smooth interactions of multidisciplinary team of professional prov iders (eg, physicians,
nurses, respiratory therapists, and others)

Warning Signs where CPR Might Be Needed:

(a ) Sudden Collapse
(b ) Unconsciousne ss
(c ) Breathing Problems
(d ) No Pulse
( e) Electrocution Injurie s: If you witness an electrical injury. Do not touch the victim. Try to kill the power source or
remove the victim from the electrical contact, but be sure to use something that doesn‟t conduct electricity , like a
wooden broom or stick.
(f) Drowning, Drugs, Exposure to Smoke or Inhalants:.

Adult Basic Life Support and CPR Quality: Lay Rescuer CPR
A.
 In areas where relatively high likelihood of witnessed cardiac arrest (eg, airports, casinos, sports facilities)
the presence of a Public-Access Debrillation (PAD) is highly recommended.
 Immediate access to a defibrillator after performing a CPR can improve further the survival of a patient
from cardiac arrest
 The implementation of a PAD program requires 4 essential components:
o a planned and practiced response, which ideally includes identification of locations and
neighborhoods where there is high risk of cardiac arrest, placement of automated external
debrillators (AEDs) in those areas and ensuring that bystanders are aware of the location of the
AEDs
o training of anticipated rescuers in CPR and use of the AED
o an integrated link with the local Emergency medical service (EMS) system
o a program of ongoing quality improvement.
 A system-of-care approach for OHCA might include public policy that encourages reporting of public AED
locations to public service access points (PSAPs)

, CARDIOPULMONARY RESUSCITATION

o This policy directs bystanders to retrieve nearby AEDs when OHCA occurs.

B.
 Untrained lay rescuers
o provide compression-only (Hands-Only) CPR, with or without guidance, for adult victims of
cardiac arrest
o continue compression-only CPR until the arrival of an AED or rescuers.
o Goal: provide chest compressions only
 Trained lay rescuer
o Provide compression and add rescue breaths in a ratio of 30 compressions to 2 breaths.
o continue CPR until:




 Compression-only CPR
o Is easy for an untrained rescuer to perform and can be more effectively guided by rescue teams
over the telephone.

C.
 Adult victim: perform chest compressions at a rate of 100 to 120/min.

Rationale:
 Number of chest compressions delivered per minute during CPR is an important determinant of:
o return of spontaneous circulation (ROSC)
o survival with good neurologic function.
 Actual number of chest compressions delivered per minute is determined by:
o the rate of chest compressions
o the number and duration of interruptions in compressions (eg, to open the airway, deliver rescue
breaths, allow AED analysis)

Concept:
 more compressions = higher survival rates; fewer compressions = lower survival rates (AHA, 2015).

Stipulation:
 adequate chest compressions requires an emphasis not only on an adequate compression rate but also
on minimizing interruptions to this critical component of CPR.
 An inadequate compression rate or frequent interruptions (or both) will reduce the total number of
compressions delivered per minute.
 Additional components of high-quality CPR include allowing complete chest recoil after each compression
and avoiding excessive ventilation.

D.
 Average adult: depth of at least 2 inches (5cm)
o Avoid giving excessive chest compression depths (greater than 2.4 inches [6 cm]).

Rationale:
 Compressions create blood flow primarily by increasing intrathoracic pressure and directly compressing
the heart, which in turn results in critical blood flow and oxygen delivery to the heart and brain.

Stipulation:
 Rescuers often do not compress the chest deeply enough despite the recommendation to “push hard.”