PHILIPPINE

RED CROSS
Cardiac Emergencies
And
Cardiopulmonary
Resuscitation
(CPR)
 OBJECTIVES
At the end of the discussion, the
participants will be able to:
Define what is CPR based on the given
definition.
Differentiate CPR to Rescue Breathing.
Enumerate the signs and symptoms of
heart attack
 OBJECTIVES (Cont.)
Demonstrate how to perform CPR
properly.
Operate the AED properly.
 The Circulatory System
The circulatory system works with the
respiratory system to carry oxygen-rich blood to
everybody cell. It also carries other nutrients
throughout the body, removes waste and
returns oxygen-poor blood to the lungs.
 Heart Attack
also called myocardial infarction,
occurs when the blood and oxygen
supply to the heart is reduced
causing damage to the heart
muscle and preventing blood from
circulating effectively. It is usually
caused by coronary heart disease.
Signs and Symptoms
Chest pain, discomfort or pressure.
The pain associated with a heart attack can range
from discomfort to an unbearable crushing sensation
in the chest.
The person may describe it as pressure, squeezing,
tightness, aching or heaviness in the chest.
Many heart attacks start slowly as mild pain or
discomfort.
Discomfort in other areas of the upper body in
addition to the chest.
Signs and Symptoms (Cont.)
Trouble breathing.
The pain or discomfort becomes constant.
It usually is not relieved by resting, changing
position or taking medicine.
Some individuals may show no signals at all.
Other Signals
The person’s skin may be pale or ashen (gray),
especially around the face. Some people suffering
from a heart attack may be damp with sweat or may
sweat heavily, feel dizzy, become nauseous or vomit.
They may become fatigued, lightheaded or lose
consciousness. These signals are caused by the stress
put on the body when the heart does not work as it
should. Some individuals may show no signals at all.
Differences in signals
between men and women.
Both men and women experience the most common signal
for a heart attack: chest pain or discomfort. However, it is
important to note that women are somewhat more likely to
experience some of the other warning signals, particularly
shortness of breath, nausea or vomiting, back or jaw pain
and unexplained fatigue or malaise. When they do
experience chest pain, women may have a greater tendency
to have atypical chest pain: sudden, sharp but short-lived
pain outside of the breastbone.
First Aid Management
If you suspect that someone might be having a heart attack,
you should:
Call the local emergency number immediately.
Have the person stop what he or she is doing and rest
comfortably.
Loosen any tight or uncomfortable clothing.
Closely watch the person until advanced medical personnel
take over.
First Aid Management
(Cont.)
Ask the person if he or she has a history of heart disease.
Offer aspirin if it is prescribed by his/her physician for
his/her condition and only if the patient can swallow.
Be calm and reassuring. Comforting the person helps to
reduce anxiety and eases some of the discomfort.
First Aid Management
(Cont.)
Talk to bystanders and if to possible the person to get
more information.
Be prepared to perform CPR and use an AED, if available,
once the person loses consciousness and stops breathing.
Cardiac Arrest
occurs when the heart stops beating
or beats too ineffectively to circulate
blood to the brain and other vital
organs. The beats, or contractions, of
the heart become ineffective if they
are weak, irregular or uncoordinated,
because at that point the blood no
longer flows through the arteries to
the rest of the body.
Cardiopulmonary
Resuscitation (CPR)
is a combination of chest
compressions and rescue breaths.
When the heart is not beating, chest
compressions are needed to
circulate blood containing oxygen.
Chest Compression
Technique for Adults and
Child
Proper hand
placement is
established
by
identifying
the lower
Chest Compression
Technique for Adults and
Child
1. Place the heel of one hand in the center of the
chest between the nipples and the other hand
on top of the first, so that the hands are parallel.
2. Be sure the long axis of the heel of your hand is
placed on the long axis of the sternum. This will
keep the main force of compression on the
sternum and decrease the chance of rib fracture.
Do not compress over the lowest portion of the
base of the sternum (the xiphoid process).
Chest Compression
Technique for Adults and
Child
3. Your fingers may be either extended or interlaced
but should be kept off the chest.
4. Lock the elbows in position, with the arms
straightened. Position your shoulders directly over
your hands so that the thrust for each chest
compression is straight down on the sternum. If the
thrust is not in a straight downward direction, the
victim’s torso has a tendency to roll; if this occurs, a
part of the force of compressions will be lost, and
the chest compressions may be less effective (Do not
be a bender, rocker & jerker).
Chest Compression
Technique for Adults and
Child
5. Depress the sternum at least 2 inches (5 cm).
Push hard, push fast at a rate of at least 100
compressions per minute.
6. Release the pressure on the chest to allow blood
to flow into the chest and heart. You must release
the pressure completely and allow the chest to
return to its normal position after each
compression. Keep the heel of your hands in
contact with the victim’s sternum to maintain
proper hand position, but fingers off the chest (Do
not be a massager).
Chest Compression
Technique for Adults and
Child
7. To maintain correct hand position
throughout the compression cycle, do
not lift your hands from the chest or
change their position in any way (Do not
be a bouncer & double crosser).
However, do allow the chest to recoil to
its normal position after each
compression.
Chest Compressions
Technique for an Infant
Proper hand
placement is
established by
identifying the
lower half of
the sternum.
Chest Compressions
Technique for an Infant
1.Position the infant face up on a firm,
flat surface. The infant’s head must
be on the same level as the heart or
lower. Stand or kneel facing the
infant from the side.
2.Keep one hand on the infant’s head
to maintain an open airway. Use
your other hand to give
compressions.
Chest Compressions
Technique for an Infant
3. To find the correct place to give
compressions, imagine a line
running across the chest between
the infant’s nipples. Place your
index finger on the sternum
(breastbone) just below this
imaginary line.
Chest Compressions
Technique for an Infant
4. Then place the pads of the two fingers
next to your index finger on the
sternum. Raise the index finger. If you
feel the notch at the end of the infant’s
sternum, move your fingers up a little
bit.
5. Use the pads of two fingers to compress
the chest. Compress the chest ½ to 1
inch, then let the sternum return to its
normal position.
Chest Compressions
Technique for an Infant
6. When you compress, push straight
down. The down-and-up movement of
your compressions should be smooth,
not jerky.
7. Keep a steady rhythm. Do not pause
between compressions. When you are
coming up, release pressure on the
infant’s chest completely, but do not let
your fingers lose contact with the chest.
Chest Compressions
Technique for an Infant
8. Keep your fingers in the compression
position. Use your other hand to keep
the airway open using a head-tilt.
Ways to ventilate the lungs
1. Mouth-to-Mouth
2. Mouth-to-Nose
3. Mouth-to-Mouth-
and-Nose
4. Mouth-to-Stoma
Protective equipment used
to ventilate the lungs
1. Mouth-to-Face
Shield
2. Mouth-to-Mask
3. Using Bag-
valve Mask
Device
When to Stop CPR?
Once you begin CPR, do
not stop except in one of
these situations:
When to Stop CPR?
You notice an obvious sign of life, such
as breathing.
An AED is available and ready to use.
Another trained responder or EMS
personnel take over.
You are too exhausted to continue.
The scene becomes unsafe.
Criteria for Not Starting CPR
Scientific evaluation has
shown that there are no
clear criteria to predict the
futility of CPR accurately.
Criteria for Not Starting CPR
Therefore, it is recommended that all
patients in cardiac arrest receive
resuscitation unless:
The patient has a valid “Do Not Attempt
Resuscitation” (DNAR) order.
The patient has signs of irreversible
death: rigor mortis, decapitation, or
dependent lividity.
Criteria for Not Starting CPR
No physiological benefit can be
expected because the vital functions
have deteriorated despite maximal
therapy for such conditions as
progressive septic or cardiogenic
shock.
Continuous Chest
Compressions
(Hands-Only CPR)
If you are unable or unwilling for any
reason to perform full CPR (with
rescue breaths), give continuous
chest compressions after calling the
local emergency number. Continue
giving chest compressions until EMS
personnel take over or you notice an
obvious sign of life, such as breathing.
Automated External
Defibrillation (AED)
If the heart is
damaged by disease
or injury, its
electrical system
can be disrupted.
This can cause an
abnormal heart
rhythm that can
stop the blood from
Defibrillation
Is the treatment of irregular,
sporadic or absent heart
rhythms by an electrical
current to the heart. It is the
only definitive treatment for
sudden cardiac arrest (SCA).
Principles of Early
Defibrillation
Early defibrillation is
critical for victims of
sudden cardiac arrest
for the following
reasons:
Simplified Adult/Child CPR
Algorithm (Lay Rescuer)
Simplified Adult/Child CPR Algorithm
(Healthcare & Professional rescuer)
Skill 3-1 Cardiopulmonary
Resuscitation (CPR) for Adult and
Child
1. Locate the correct hand position for chest
compressions.
• Kneel beside the victim.
• Place heel of one hand on the center of the chest.
• Place the heel of your hand on top of the first hand
• And interlock your fingers
• Making sure the fingers are kept off the ribs.
• Leaning forward with arms straight.
Skill 3-1 Cardiopulmonary
Resuscitation (CPR) for Adult and
Child
2. Give chest compressions.
• Press down vertically on the breastbone and depress the
chest.
• Compress an adult’s chest 30 times to a depth of at least 2
inches.
• Compress a child’s chest 30 times to a depth of about 2
inches.
• Compress at a rate of at least 100 chest compressions per minute;
the 30 chest compressions should take about 18 seconds to
complete.
Skill 3-2 Cardiopulmonary
Resuscitation (CPR) for
Infant
1.Locate the correct hand and
finger position for chest
compressions.
Use the same technique that is used for CPR.
Give 30 chest compressions at a rate of at
least 100 chest compressions per minute.
Each compression should be about 11⁄2
inches deep.
Skill 3-2 Cardiopulmonary
Resuscitation (CPR) for
Infant
2. Give ventilation.
 Give 2 rescue breaths. If the
breaths do not make the
chest clearly rise, repeat
cycles of chest compressions,
and rescue breaths.
Skill 3-3 Using of Automated
External Defibrillator (AED)
1.Turn on the AED
Switch on the AED and take out the
pads.
Remove or Cut through the cloth
and quickly wipe the chest for sweat.
Shave the excessive hair in the
chest to prevent delay.
Skill 3-3 Using of Automated
External Defibrillator (AED)
2. Attaching the pads
 Remove the backing paper from
the pads.
 Follow diagram in the pads for
placement.
 Attach pads as soon as possible
Skill 3-3 Using of Automated
External Defibrillator (AED)
3. Analysis of the AED
Make sure that no- one is touching while
the AED analyse the victim’s condition.
It will indicate if you need to shock the
victim.
Continue the Prompt of the AED until
advance life support or emergency
services had arrived
Skill 3-4 Two Man Cardiopulmonary
Resuscitation (CPR) for Adult and
Child
1.Provider no.1-Locate the correct
hand position for chest
compressions.
Kneel beside the victim
Place heel of one hand on the center of
the chest.
Place the heel of your hand on top of the
first hand, and interlock your fingers,
making sure the fingers are kept off the
ribs.
Skill 3-4 Two Man Cardiopulmonary
Resuscitation (CPR) for Adult and
Child
2. Provider no. 2-Position on the
top of the head of the victim.
 Position your hand in the lower
jaw
 Immobilize the head using the
forearm
 Use index finger to push forward
on the angle of the lower jaw to
Skill 3-4 Two Man Cardiopulmonary
Resuscitation (CPR) for Adult and
Child
3.Provider no.1-Give chest
compressions.
Press down vertically on the
breastbone and depress the chest.
Compress an adult’s chest 15 times
to a depth of at least 2 inches.
Compress a child’s chest 15 times to
a depth of about 2 inches.
QUESTIONS
?