Cardiopulmonary Resuscitation (CPR)

What are CPR's core objectives?

Cardiopulmonary Resuscitation (CPR) aims to assess collapsed victims, perform chest compressions and rescue breathing, and ensure proper recovery positioning for breathing individuals.

• Assess collapsed victims.
• Perform chest compressions and rescue breathing.
• Place unconscious breathing victims in recovery.

What is the background and importance of CPR?

Cardiac arrests are prevalent, with low survival rates, highlighting CPR's critical role. Bystander CPR is a vital intervention, significantly improving survival chances.

• 700,000 cardiac arrests annually in Europe.
• 5-10% survival to hospital discharge.
• Bystander CPR doubles/triples survival.
• Early resuscitation and defibrillation increase survival to >60%.

What does Basic Life Support (BLS) involve?

Basic Life Support (BLS) focuses on maintaining vital functions through airway management, breathing support, and circulation efforts during an emergency.

• Airway management.
• Breathing support.
• Circulation maintenance.

What is the Chain of Survival in CPR?

The Chain of Survival outlines critical steps for improving cardiac arrest outcomes, from early recognition to post-resuscitation care, ensuring timely intervention.

• Early recognition and call for help.
• Early CPR to buy time.
• Early defibrillation to restart the heart.
• Post-resuscitation care to restore quality of life.

How is Basic Life Support performed?

Basic Life Support involves a sequence of procedures to restore circulation of oxygenated blood after sudden cardiac or pulmonary arrest, performed by anyone.

• Sequences restore circulation.
• Chest compressions and ventilation by anyone.
• Utilize protective devices.

Why is scene safety crucial before CPR?

Approaching safely is paramount to protect the rescuer, victim, and bystanders. Assess the scene for hazards before initiating any intervention.

• Assess the scene.
• Protect the rescuer.
• Ensure victim safety.
• Consider bystanders' safety.

How do you check a victim's response?

To check for responsiveness, gently shake the victim's shoulders and ask loudly, 'Are you all right?' This assesses their conscious state.

• Shake shoulders gently.
• Ask 'Are you all right?'.
• If responsive, leave as found, assess, reassess regularly.

When should you shout for help during an emergency?

Shout for help immediately after checking for response and confirming the victim is unresponsive. This alerts others to assist or call emergency services.

How do you properly open a victim's airway?

Opening the airway is crucial for breathing. Techniques vary based on rescuer training, primarily involving neck extension and chin lift maneuvers.

• Airway opening by neck extension.
• Head tilt and chin lift for lay rescuers.
• No finger sweep unless visible material.
• Head tilt, chin lift + jaw thrust for healthcare professionals.

How do you check for normal breathing?

Check for normal breathing by looking, listening, and feeling for breath. Distinguish normal breathing from abnormal or agonal patterns.

• Look, listen, and feel for normal breathing.
• Do not confuse agonal breathing with normal breathing.

What is agonal breathing?

Agonal breathing is an abnormal breathing pattern that can occur shortly after cardiac arrest, often described as gasping or noisy breaths.

• Occurs in up to 40% of cardiac arrests.
• Described as barely, heavy, noisy, or gasping.

What are the reversible causes of cardiac arrest?

Cardiac arrest can stem from reversible causes, categorized as the 5 H's (Hypoxia, Hypovolemia, Hypothermia, Hyper/hypoK+, H+ ions) and 5 T's (Tension pneumothorax, Tamponade, Toxic/therap. disturbances, Thrombosis coronary, Thrombosis pulmonary).

• Hypoxia, Hypovolemia, Hypothermia, Hyper/hypoK+, H+ ions.
• Tension pneumothorax, Tamponade, Toxic/therap. disturbances, Thrombosis coronary, Thrombosis pulmonary.

When should you call emergency services (997)?

Call emergency services (997) immediately after determining unresponsiveness and abnormal breathing, or after initial CPR steps, to ensure professional help arrives.

What is Foreign-Body Airway Obstruction (FBAO)?

FBAO occurs when a foreign object blocks the airway, leading to choking. It affects many individuals annually and requires prompt recognition and intervention.

• Approximately 16,000 adults and children treated yearly in UK.
• Signs include inability to speak, cough, or breathe.

How is adult FBAO treated?

Adult FBAO treatment depends on severity. Mild obstruction requires encouraging cough, while severe obstruction necessitates back blows and abdominal thrusts, or CPR if unconscious.

• Assess severity: mild (effective cough) or severe (ineffective cough).
• Mild: Encourage cough.
• Severe (conscious): 5 back blows, 5 abdominal thrusts.
• Severe (unconscious): Start CPR.

How are back blows performed for FBAO?

Back blows are a first-line treatment for conscious adults with severe FBAO. Deliver sharp blows between the shoulder blades to dislodge the obstruction.

How are abdominal thrusts performed?

Abdominal thrusts are used for conscious adults with severe FBAO when back blows are ineffective. They create pressure to expel the foreign body.

How are chest compressions performed?

Chest compressions are a core component of CPR, requiring proper hand placement, rate, and depth to effectively circulate blood.

• Place heel of one hand in chest center.
• Place other hand on top, interlock fingers.
• Compress chest at 100 min-1 rate, 4-5 cm depth.
• Equal compression:relaxation.
• Change operator every 2 minutes if possible.

How are rescue breaths administered?

Rescue breaths provide oxygen to the victim. Proper technique ensures effective ventilation, including pinching the nose and creating a seal.

• Pinch the nose.
• Take a normal breath.
• Place lips over mouth.
• Blow until chest rises (1 second).
• Allow chest to fall, then repeat.

When is mouth-to-nose breathing used?

Mouth-to-nose breathing is an alternative rescue breath technique used when mouth-to-mouth is not feasible due to specific victim conditions.

• Cannot open mouth.
• Cannot make a good seal.
• Severely injured mouth.
• Stomach distension.
• Mouth to stoma (tracheotomy).

What are the recommendations for rescue breaths?

Rescue breath recommendations specify appropriate tidal volume and respiratory rate to ensure effective ventilation during CPR.

• Tidal volume: 500-600 ml.
• Respiratory rate: Each breath over ~1s, chest rise.
• Chest-compression-only: Continuously at 100 min-1.

How do you continue CPR?

Continue CPR by alternating cycles of 30 chest compressions and 2 rescue breaths, maintaining a consistent rhythm and depth.

• 30 Chest compressions.
• 2 Rescue Breaths.

What is the sequence for continuing CPR?

The ongoing sequence for CPR involves continuous cycles of chest compressions followed by rescue breaths to maintain circulation and oxygenation.

• 30 Chest compressions.
• 2 Rescue Breaths.

What is the process of defibrillation?

Defibrillation involves using an Automated External Defibrillator (AED) to deliver an electrical shock, aiming to restore a normal heart rhythm.

• Attach AED.
• Follow voice prompts.

How does an Automated External Defibrillator (AED) work?

An AED is a portable device that analyzes heart rhythm and delivers an electrical shock if needed. Some activate automatically upon opening.

• Some AEDs switch on when lid is opened.

How do you attach AED pads?

Properly attach AED pads directly to the casualty's bare chest according to the device's instructions to ensure effective electrical contact.

Why is it crucial not to touch the victim during AED analysis?

During AED rhythm analysis, it is critical not to touch the victim. Any contact can interfere with the AED's reading, leading to inaccurate results.

What happens when an AED indicates a shock?

If an AED indicates a shock, ensure everyone stands clear of the victim before pressing the button to deliver the electrical discharge.

• Stand clear.
• Deliver shock.

What steps follow an AED shock delivery?

After an AED delivers a shock, immediately follow the AED's instructions, typically resuming chest compressions and rescue breaths.

• Follow AED Instructions.
• 30 Chest compressions.
• 2 Rescue Breaths.

What if the AED advises no shock?

If the AED advises no shock, continue following its instructions, which usually means resuming chest compressions and rescue breaths without interruption.

• Follow AED Instructions.
• 30 Chest compressions.
• 2 Rescue Breaths.

When should a victim be placed in the recovery position?

Place a victim in the recovery position if they start breathing normally after resuscitation efforts. This helps maintain an open airway and prevents aspiration.

What is the recovery position?

The recovery position is a stable, side-lying posture designed to keep an unconscious, breathing person's airway open and prevent choking on fluids.

When should resuscitation efforts continue?

Continue resuscitation until qualified help arrives and takes over, the victim starts breathing normally, or the rescuer becomes exhausted and cannot continue.

• Qualified help arrives and takes over.
• Victim starts breathing normally.
• Rescuer becomes exhausted.

Under what conditions can CPR be stopped?

CPR can be stopped if the victim revives, trained help arrives, the rescuer is exhausted, the scene becomes unsafe, or physician orders dictate.

• Victim revives.
• Trained help arrives.
• Too exhausted to continue.
• Unsafe scene.
• Physician directed (DNR orders).
• Cardiac arrest >30 minutes (controversial).

What are common reasons for CPR failure?

CPR may fail due to delays in starting, improper procedures, lack of advanced care follow-up, or underlying terminal/unmanageable diseases.

• Delay in starting.
• Improper procedures (e.g., forgetting to pinch nose).
• No ACLS follow-up, delayed defibrillation.
• Terminal or unmanageable disease.

What injuries can occur during CPR?

While CPR is life-saving, it can cause injuries such as rib fractures or lacerations to internal organs from sternum tip pressure.

• Rib fractures.
• Laceration related to sternum tip (liver, lung, spleen).

What are potential complications of CPR?

Complications of CPR include vomiting and aspiration. If vomiting occurs, place the victim on their side, clear the mouth, and resume CPR.

• Vomiting.
• Aspiration (place victim on left side, wipe mouth, resume CPR).