CPR Course Emergency medicine department

1. CPR Course Emergency medicine department

2. At the end of this course participants should be able to demonstrate: How to assess the collapsed victim. How to perform chest compression and use AED. How to approach to the pulseless arrest patients. OBJECTIVES

3. Basic Life Support

4. Approximately 700,000 cardiac arrests per year in Europe Survival to hospital discharge presently approximately 5-10% Bystander CPR vital intervention before arrival of emergency services Early resuscitation and prompt defibrillation (within 1-2 minutes) can result in >60% survival BACKGROUND

5. CHAIN OF SURVIVAL

6. Approach safely Approach safely Check response Check response Call 115 Call 115 - AED AED Check pulse Check pulse 30 chest compressions 30 chest compressions Open airway Open airway 2 rescue breaths 2 rescue breaths

7. Scene Rescuer Victim Bystanders APPROACH SAFELY! Approach safely Check response Call 115 AED Check pulse 30 chest compressions Open airway 2 rescue breaths

8. CHECK RESPONSE Approach safely Check response Call 115 AED Check pulse 30 chest compressions Open airway 2 rescue breaths

9. CHECK RESPONSE • Shake shoulders gently • Ask “Are you all right?” • If he responds: • Leave as you find him. • Find out what is wrong. • Reassess regularly.

10. CHECK RESPONSE • If he dose not respond: • Check breathing quickly. • No or agonal breathing means cardiac arrest.

11. Occurs shortly after the heart stops in up to 40% of cardiac arrests Described as barely, heavy, noisy or gasping breathing Recognise as a sign of cardiac arrest AGONAL BREATHING

12. SHOUT FOR HELP – CALL 115 Approach safely Check response Call 115 AED Check pulse 30 chest compressions Open airway 2 rescue breaths

13. AED Approach safely Check response Call 115 AED Check pulse 30 chest compressions Open airway 2 rescue breath

14. CHECK PULSE Approach safely Check response Call 115 AED Check pulse 30 chest compressions Open airway 10 seconds 2 rescue breath

15. CHECK PULSE • The lay rescuer should not check for a pulse and should assume that cardiac arrest is present if an adult suddenly collapses or an unresponsive victim is not breathing normally.

16. CHEST COMPRESSIONS Approach safely Check response Call 115 AED Check pulse 30 chest compressions Open airway 2 rescue breaths

17. CHEST COMPRESSIONS • Place the heel of one hand in the centre of the chest • Place other hand on top • Interlock fingers • Compress the chest • Rate 100 per min • Depth 5 cm • Equal compression : relaxation • When possible change CPR operator every 2 min

18. OPEN AIRWAY Approach safely Check response Call 115 AED Check pulse 30 chest compressions Open airway 2 rescue breaths

19. RESCUE BREATHS Approach safely Check response Call 115 AED Check pulse 30 chest compressions Open airway 2 rescue breaths

20. Pinch the nose Take a normal breath Place lips over mouth Blow until the chest rises Avoid excessive ventilation Take about 1 second Allow chest to fall Repeat RESCUE BREATHS

21. JAW THRUST(IN TRAUMATIC PATIENT)

22. 30 2 CONTINUE CPR

23. IF YOU HAVE NOT TENDENCY TO BREATHE Chest compression only

25. PEDIATRIC BLS • One rescuer: 30 compressions 2 breaths • Two rescuer: 15 compressions 2 breaths

26. METHODS Child 1-8 Years Infant < 1 Year

27. BREATHING

28. Recognition of cardiac arrest based on assessing unresponsiveness and absence of normal breathing. KEY CHANGES

29. Recognition of cardiac arrest based on assessing unresponsiveness and absence of normal breathing. Look, listen and feel removed from the algorithm. KEY CHANGES

30. Recognition of cardiac arrest based on assessing unresponsiveness and absence of normal breathing. Look, listen and feel removed from the algorithm. Sequences change to CAB rather than ABC. KEY CHANGES

31. Recognition of cardiac arrest based on assessing unresponsiveness and absence of normal breathing. Look, listen and feel removed from the algorithm. Sequences change to CAB rather than ABC. High quality CPR. KEY CHANGES

32. Recognition of cardiac arrest based on assessing unresponsiveness and absence of normal breathing. Look, listen and feel removed from the algorithm. Sequences change to CAB rather than ABC. High quality CPR. Continued de-emphasis on pulse check for health care providers. KEY CHANGES

33. ANY QUESTIONS?

34. DEFIBRILLATION

35. Approach safely Check response Shout for help Call 115 AED Attach AED Follow voice prompts Start CPR after shock

36. SWITCH ON AED Some AEDs will automatically switch themselves on when the lid is opened

37. ATTACH PADS TO CASUALTY’S BARE CHEST

38. ANALYSING RHYTHM DO NOT TOUCH VICTIM

39. Stand clear Deliver shock SHOCK INDICATED

40. SHOCK DELIVEREDFOLLOW AED INSTRUCTIONS 30 2

41. NO SHOCK ADVISEDFOLLOW AED INSTRUCTIONS 30 2

42. IF VICTIM STARTS TO BREATHE NORMALLY PLACE IN RECOVERY POSITION

45. Approach safely Approach safely Check response Check response Shout for help Shout for help Call 115 - AED Call 115 Check pulse AED 30 chest compressions Attach AED Open airway Follow voice prompts 2 rescue breaths Start CPR after shock

46. ANY QUESTIONS?

47. PULSELESS ARREST

48. Central IV Line Peripheral IV Line IV Line

49. Endotracheal route • Lidocaine, Epinephrine, Naloxone, Vasopressin • Dose given by the endotracheal route is 2 to 2.5 times the recommended IV dose. • Providers should dilutethe recommended dose in 5 to10mL of water or normal saline.

50. Rhythm In Monitor PEA Or Asystole VF Or VT