Cardiopulmonary Resuscitation (CPR)

Cardiopulmonary Resuscitation (CPR) is the combination of artificial respiration and manual artificial circulation that is recommended for the use in cases of cardiac arrest. It requires special supplemental training in the recognition of cardiac arrest and the performance of CPR.

CPR is the combination of mouth to mouth breathing which supplies oxygen to the lungs and chest compression which circulates blood.


Purpose of Cardiopulmonary Resuscitation:

To provide oxygen to the brain, heart and to vital organs until appropriate definite medical treatment can restore the heart and ventilatory function.




Equipment:

Cardiac board
Oral airway
Bag and mask device


Procedure:

1. Assume rescuer's position.

2. Determine patient's level of consciousness: Tap or gently shake while shouting, "Hey, hey, are you okay?"

3. Call for help or activate EMS (Emergency Medical System) to transfer or refer him to other healthcare staff.

4. To ease the pain of the patient, place patient in a supine position on a firm flat surface. Kneel at the level of patient's shoulder.

5. Open the airway.
    a.) Head tilt and chin lift maneuver:
         Place one hand on the patient's forehead and apply firm back pressure to tilt the head back. Then place the fingers of the other hand on the underside of the chin and lift it up to bring the jaw forward and the teeth almost to occlusion.


Breathing:
Determine presence or absence of spontaneous breathing to know if you have to do CPR.

1. Place cheek over patient's mouth and nose while observing the rise and fall of the chest. Listen for air escaping during exhalation and feel for the flow.

2. Perform rescue breathing (mouth to mouth). While keeping the air open, pinch the nostrils with the thumb and index finger of the hand that is placed on the forehead. Take a deep breath and open mouth wide and give two full breaths (1- 1 1/2 seconds each breath). Take a deep breath after ventilation.

If the ventilation is successful, re position the patient's head and repeat the mouth to mouth breathing.


Circulation:
Determine pulse.

1. While maintaining head tilt with one hand on the forehead, palpate the carotid pulse with the other hand. In the absence of the carotid pulse, start external chest compression.


External Chest Compression:
Consist of serial, rhythmic application of pressure over the lower half of the sternum.

1. To avoid muscle tension, kneel as close to side of the patient's head as possible. Trace rib-cage with the left fingers towards the xiphoid process.

2. Place the heel of the left hand on the sternum just above two fingers from the xiphoid process, where the heart is located. The heel of the right hand is placed on top of the left keeping fingers of both hands raised.

3. While keeping your arms straight, elbows locked and shoulders positioned directly over your hands, quickly and forcefully depress the lower half of the patients's sternum straight down 1 1/2- 2 inches.

4. Release the external chest compression completely and allow the chest to return to its normal position after each compression. The time allowed for release must be equal to the time required for compression. Do not lift hands off the chest or change position.

5. For one rescuer, do 15 compressions at a rate of 80-100/min and then perform 2 ventilations.

6. For Cardiopulmonary Resuscitation (CPR) performed by 2 rescuers, the compression rate is 80-100/min. The compression-ventilation ration is 5:1.

7. While resuscitation proceeds, simultaneous efforts are made to obtain and use resuscitation equipment for better management of situation and to provide definitive care.