✓ Blood will only be delivered to the

Central Mindanao University brain on the 14th to 15th compression

College of Nursing ✓ CPR was classified into 2 levels:
1. Pro CPR
2. Lay CPR
BASIC LIFE SUPPORT ✓ No “Look, Listen & Feel”

I. History of CPR • 2010:

✓ ABC intervention was changed to CAB
• 18th Century: - CAB- very easy to perform CPR; to
✓ It started in Europe- They have more encourage everyone to do CPR
drowning victim (but did not call it CPR ✓ Chain of survival was classified into 2:
back then). 1. In-Hospital
✓ CPR by Horses and rescue breath by the 2. Out of Hospital
umbrella like in brick oven (Leaf blower)

• 1950s:
✓ James Elam (American doctor) - read a
European article (Rescue Breath)
✓ He then applied it during the polio
outbreak and saved lives.
✓ Dr. William Bennet Kouwenhoven
(German Electrical Engineer) – Father of
CPR
✓ He was inventing defibrillator for 10yrs-
then in 1950 he puts paddles- CPR was
born
✓ With research of external and internal
Compressor • 2015/2020
✓ Sudden Cardiac Arrest/ Early
• 1960- they came together and make CPR Defibrillation:
✓ First CPR happened in Maryland ❖ On witness arrest go for defibrillation.
✓ Rate: 60bpm ❖ What happens is the mechanical
✓ Ratio: 15:2 x 4cycles contraction muscle tone will be lost.
✓ Later part of 1960 they have applied ❖ CPR is only temporary measure
military time with thousands. ❖ Every min that shock is delayed- survival
is reduced by 10%; After 10minutes,
• 1965: defib is rarely successful
✓ no changes but to propagate and came ❖ Immediate high-quality CPR and
nation to worldwide. defibrillation with AED can double or
even triple the chance for survival.
• 1992: ✓ Rate is changed to 100-120= average of
✓ ILCOR (International Liaison committee 110
on resuscitation)
✓ to provide a forum for liaison between Treatment guidelines by AGE (infant, child, adult)
principal resuscitation organizations Personal Safety- Scene Safety (Dead Heroes
worldwide. cannot save)
✓ ILCOR- AHA, HSFC, RCA, ERC
✓ CPR Update every 5yrs. WHEN to DO CPR:
●No responsive
• 2000: ●No breathing
✓ same rate: 60bpm, with 15:2 x 4 cycles ●No pulse
thousands were changed to "and" ●No signs of life (Eye opening, Cough, Breathing)
✓ USA- PAD (public access of defib)
WHEN to STOP CPR:
• 2005: H- Help arrives
✓ from 60bpm it was changed to 100cpm. E- Exhausted
✓ Ratio: 30:2 x 5 cycles L- Life appears

Basic Life Support | CMU-CON | S.Y. 22-23

 P- Pronounced dead by MD
IV. AIRWAY:
S- Spontaneous breathing is achieved 1. Head Tilt Chin Lift Maneuver
T- Turnover to the rescuer ✓ The tongue is blocking the airway (when
O- Operator rescuer is exhausted the pt. is unconscious the tongue is
P- Physician advised to stop care unconscious)
✓ 1 hand on forehead- 2-3 finger in the chin
WHEN NOT to do CPR: 2. Jaw Thrust Maneuver- Suspected C-Spine
[Link] DNR Injury
[Link] obviously dead:
●Massive trauma to head/chest V. BREATHING
●Decomposition 1. 1 Rescuer- Use Pocket Mask
●Decapitation 2. Bagging on the head side
●Transection- Cervical Cut 3. Jaw thrust- 2 persons (thumbs seal- jaw
●Rigor mortis thrust)
●Lividity- state of livor mortis
●Incineration- burned completely Quality of bagging- 1 sec. per bag.

II. PATIENT ASSESSMENT: HANDS ON TIME:

1. Scene safe- pause and assess scene ✓ 30 compressions in 15-18secs.
2. Responsiveness- tap the shoulder or shake ✓ Lay-persons- Baby shark is 110bpm
the patient and shout “hey are you okay? ✓ Always check output- Pulse in femoral pulse
3. Airway- Open and check airway for any to know if CPR is effective instead of 2-
obstruction. 2.4inches
4. Breathing- Quickly look at face and chest for
normal breathing and signs of life. HANDS PLACEMENT:
5. Circulation- check for pulse (Carotid Pulse) ✓ Any hand, use middle finger and find
✓ Keep the thumb away. standard nipple line.

check in 5secs and no more than 10secs HANDS OFF TIME:

(No breathing, No pulse, No signs of Life) ✓ 5 seconds - time devoted to bagging
✓ the only exception:
Alert EMS and Start CPR 1. Transferring but not more than 10 secs;
2. CPR on Progress but have to stop to
III. CHEST COMPRESSION: Intubate (Max 10 secs.);
✓ When you are doing CPR, you are creating
blood pressure- 120 CPR TIME:
✓ 2 minutes - good output; BP is good; the
[Link] fast and deep moment you give epi it will reach heart to
[Link] interruption 2minutes
-30 compression provides good output
[Link] 2 inches – 2.4 inches Number of rescuers and roles:
[Link] at a rate of 100-120bpm ✓ 1 rescuer: pocket mask
✓ 2 rescuers: Mandatory switch after 5 cycles;
Child/infant: 15:2 x 10cycles
SYSTOLIC BP by palpation:
o Radial-80 mmHg
✓ 3 rescuers: 3rd person on standby; to take
o Femoral- 70-80 mmHg next role (complete rest)
o Brachial- 60-70 mmHg
o Carotid- 40-60 mmHg Child/infant:
✓ if pulse is present <60bpm with poor
*If ribs break that’s ok- what's important is for blood perfusion= do CPR
to reach the brain ✓ Breathing of >10cpm = do rescue breathing

Alternative Technique on doing Compression Infant CPR:

- a provider can grasp the wrist of one hand with ✓ place 2 fingers on the breastbone just below the
the other to compress when it is difficult to use nipple line.
the standard technique ✓ Responsiveness- sole of the feet.
- disability CPR certificate (you can teach) ✓ Airway- sniffing position

Basic Life Support | CMU-CON | S.Y. 22-23

 ✓ Breathing- No breathing; No life. instructions guide an operator in using the
✓ Circulation- Brachial pulse device.
✓ Infant Rescuer: • There are many different brands AED, but
- 1 rescuer- 2 finger technique the same basic steps for operation apply to
- 2 rescuer- 2 thumb encircling hands all of them.
technique. • 3 components- machine, pads, connector.
- 2020- two thumbs; two finer; heel of the hand • How to use AED:
1. Place AED near you and near the head.
Coordinate compressions and breaths so that it will 2. Turn on the machine
not be delivered simultaneously!! - Voice prompts- call help now, remove
clothing, attach pads to pt. chest as
Assessment Intervention Reassessment shown on picture.
A- Airway C-Compression C- Circulation - Do not touch patient, analyzing rhythm.
B- Breathing A- Airway B- Breathing No shock advised continue CPR.
C- Circulation B- Breathing (Listen-Look-
3. Do not use AED when chest is wet; it can
Feel)
A- Airway cause burn up to 2nd degree
4. Do not put AED on top of nitroglycerine
Reassessment: patch
1. Without pulse- Continue CPR 5. Do not put AED on top of pacemaker
2. With pulse, no breathing, unresponsive: implant: place it 1inch is good but3
- Adult- 1 rescue breath every 5-6secs (10- inches the best away from the implant
12 per minute) 6. Shave the hair
- Children/ infants- 1 breath every 2-3secs 7. Implanted defibrillator- it’s not enough to
(20-30secs) kill you- 2joules per shock
- Give each breath in 1second. Make the
chest visibly rise VIII. Choking
3. Reassess pulse about every 2 mins. Take no ✓ Chocking patient may lose consciousness
longer than 10secs. after 30 seconds.
4. With pulse, with breathing = Maintain airway ✓ Know the universal sign of chocking:
✓ Lay-Rescuer- Recovery position- By
gravity for stomach and heart.
- Hand near you- L
- Hand away- to the neck
- Raise knee, move back, and bring
patient towards you
✓ In-hospital- Suction; Check VS

✓ Air consists of 21% vol. oxygen and ✓ Do Heimlich Maneuver:

78% vol. of nitrogen.
✓ Our body only uses 5% vol. oxygen
so you still have 16% vol. oxygen for
rescue breath

VI. Special CPR Precaution:

[Link]:
✓ chest compression is not be effective when
1. Position: Stand behind the person with
a woman is 6months pregnant.
one leg forward between the person's
✓ Left Uterine Displacement; Left Lateral Tilt legs.
(vein is in the right) 2. For a child, move down to their level and
2. Drowning: Intervention: ABC keep your head to one side.
3. Hunchback: roll blanket or pillow both sides 3. Put your arms around the person and
4. Cleft Lip/Palate: Cover the mouth and blow the locate their belly button.
nose 4. Place the thumb side of one fist against
the stomach just above their belly button.
5. Grasp your fist with your other hand and
VII. AED- Automated External Defibrillators thrust inward and upward into the
• AEDS are designed to be simple to person's stomach. Use quick, thrusting
operate. Voice, lights and screen
Basic Life Support | CMU-CON | S.Y. 22-23
 movements five times or until they expel 3. Oxygen Delivery Devices
the item. a. Nasal Cannula
6. Continue thrusts until the person expels • 0.25-8lmp flow
the object or becomes unresponsive.
7. If the person becomes unresponsive, • Oxygen concentration of
begin CPR. approximately 22% to 45%

• No ABC and go directly to 30 b. Simple Face Mask

compressions. • 5-10lmp, this device delivers an
• After 30 compressions; open the inspired oxygen concentration of
airway and check obstruction; if approximately 35% to 60%
you can see it then remove
obstruction and pick it up.
c. Partial Rebreather Mask
• If there is no obstruction give; give
1 blow; if you can’t observe the • Similar to simple face mask, with
chest rise, re-tilt then gives the 2nd added reservoir
blow. • Delivers approximately 35% to
• Give compressions again and 60% O2 with flow rates of 6-10lmp.
continue doing BLS until help
arrives.
d. Nonrebreather mask
• Unwitnessed choking: do the
BLS; you can have an idea that it • Can deliver up to 60% to 80% O2
is choking after the 1st blow. concentration
• Flow rate 10-12lmp
8. Seek medical attention as soon as
possible. e. Bag Valve Mask (BVM)
• Can deliver up to 100 O2
✓ Infant: 5 back blow and 5 chests
concentration
thrust as long as the infant is
• Flow rate 12-15lmp
conscious.
✓ Pregnant & Obese: Give chests
thrust from behind. Avoid
squeezing the ribs with your
arms.
✓ Yourself: you can thrust yourself
against the edge of the table or
bag of a chair to expel the object.

IX. Devices for Assessing Oxygen and

Ventilation:
1. Pulse Oximetry
a. A non-invasive method of measuring
the oxygen saturation of functional
hemoglobin
b. Possible indications for continuous
pulse oximetry monitoring include the
following:
i. A patient with a critical or
unstable airway
ii. A patient who requires
oxygen therapy
c. Normal Value: 95%-100%
2. Capnography
a. The normal value for end-tidal CO2
range between 33mmHg and
43mmHg.
b. This is dependent upon adequate
ventilation and adequate perfusion.
c. A change in either factor will increase
or decrease the amount of exhaled
CO2

Basic Life Support | CMU-CON | S.Y. 22-23

 Summary of High-Quality CPR Components for BLS Providers

Infants
Adults and Children
Components (Age Less Than 1 Year,
Adolescents (Age 1 Year to Puberty)
Excluding Newborn)
Scene Safety Make sure the environment is safe for rescuers and victim
Recognition of cardiac Check for responsiveness
arrest No breathing or only gasping (i.e., no normal breathing)
No definite pulse felt within 10 seconds
(Breathing and pulse check can be performed simultaneously in less than 10
seconds)
Activation of If you are alone with no Witnessed collapse
emergency response mobile phone, leave the Follow steps for adults and adolescents on the left
system victim to activate the
emergency response Unwitnessed collapse
system and get the AED Give 2 minutes for CPR
before beginning CPR Leave victim to activate the emergency response
Otherwise, send system and get the AED
someone and begin Return to the child or infant and resume CPR;
CPR immediately; use Use the AED as soon as it is available.
the AED as soon as it is
available
Compression- 1 or 2 rescuers 1 rescuer
ventilation ration 30:2 30:2
without advanced 2 or more rescuers
airway 15:2
Compression- Continuous compressions at a rate of 100-120/min
ventilation ration with
advanced airway Give 1 breath every 6 seconds (10breaths/min)
Compression rate 100-120/min
Compression depth At least 2 inches (5cm) * At least one third AP At least one third AP
diameter of chest diameter of chest
About 2 inches (5cm) About 1 ½ inches (4cm)
Hand placement 2 hands on the lower 2 hands or 1 hand 1 rescuer
half of the breastbone (optional for very small 2 fingers in the center of
(Sternum) child) on the lower half the chest, just below the
of the breastbone nipple line
(Sternum)
1 or more rescuers
2 thumb-encircling
hands in the center of
the chest just below the
nipple line
Chest recoil Allow full recoil of chest after each compression;
Do not lean on the chest after each compression
Minimizing Limit interruptions in the chest compression to less than 10 seconds
interruptions

*Compression depth should be no more than 2.4inches (6cm)

Abbreviations: AED, Automated external defibrillator; AP: Anteroposterior; CPR: cardiopulmonary resuscitation.

Basic Life Support | CMU-CON | S.Y. 22-23

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Basic Life Support | CMU-CON | S.Y. 22-23