8323597.ppt
- 1. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Cardiopulmonary Resuscitation and AED Chapter 8
- 2. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Outline • Introduction to CPR • Review of the Circulatory System • Causes of Cardiac Arrest • CPR • AED
- 3. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Introduction to CPR
- 4. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Time is Critical! • > 300,000 people experience sudden cardiac death in prehospital settings each year. • If resuscitation begins within a few minutes, many of these individuals have a chance for survival.
- 5. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Time is Critical! To begin resuscitation within a few minutes: • Patient’s collapse witnessed • EMS immediately activated • CPR started immediately • Defibrillation within minutes
- 6. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Trained bystanders are not always available or willing to do CPR. The role of the FR is critical in reaching the patient quickly and beginning resuscitation.
- 7. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Review of the Circulatory System
- 8. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. What is the function of the circulatory system?
- 9. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. The Circulatory System • Delivers O2 and nutrients • Removes CO2 and wastes
- 10. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Why is the function of the circulatory system critical to our survival?
- 11. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. If the heart stops pumping • Lack of O2 and accumulation of wastes quickly lead to death
- 12. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
- 13. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Major Arteries
- 14. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Where are capillaries found and what is their purpose?
- 15. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Capillaries • Found throughout the body • Connect smallest arteries to smallest veins • O2, nutrients, and wastes move through thin walls • Microscopic
- 16. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. How does a vein differ from an artery?
- 17. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Veins • Carry blood back to heart • Lower pressure
- 18. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. What is the function of blood?
- 19. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Blood • The fluid of the circulatory system • Carries O2, nutrients, and wastes
- 20. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Heart Physiology • LV contracts – sends wave of blood • Pressure wave felt as pulse • No contraction = No blood flow = cardiac arrest
- 21. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Time is Critical! • Brain damage begins in 4–6 min • Brain damage irreversible in 8–10 min Circulation must be restored within 4– 6 minutes.
- 22. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. CPR • Provides minimal amount of circulation/oxygenation until cause of cardiac arrest corrected • External chest compressions circulate blood • Artificial ventilations provide O2 to lungs
- 23. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Causes of Cardiac Arrest
- 24. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Causes of Cardiac Arrest • Heart disease • Respiratory arrest • Medical emergencies • Drowning and suffocation • Congenital heart defects • Trauma
- 25. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. The cause of cardiac arrest is important BUT do not delay CPR to obtain history
- 26. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. CPR
- 27. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. CPR • Combines external chest compressions with artificial ventilation • Provides 30% (or less) of normal circulation • Only effective for short period of time
- 28. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. CPR – 1 Rescuer • Assess responsiveness • Summon EMS • Position the patient Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
- 29. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. CPR – 1 Rescuer • Open the airway Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
- 30. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. CPR – 1 Rescuer • Look, listen, and feel for breathing Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
- 31. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. CPR – 1 Rescuer • If there is no breathing, give two breaths, each lasting 1 second Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
- 32. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. CPR – 1 Rescuer • Check for a pulse (≤ 10 seconds) Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
- 33. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. CPR – 1 Rescuer • If there is no pulse, find your landmarks, lower half of the sternum, between the nipples Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
- 34. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. CPR – 1 Rescuer • Begin chest compressions Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
- 35. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. CPR – 1 Rescuer • Perform 30 chest compressions • Push hard • Push fast • Allow the chest to recoil after each compression Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
- 36. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. CPR – 1 Rescuer • Administer two ventilations then return to compressions Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
- 37. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. CPR – 2 Rescuer 1 2 3 4 Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
- 38. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. CPR - Children • Use heel of one hand • Keep airway open with other hand • 30 compressions:2 ventilations if alone (2 rescuers use 15:2)
- 39. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. CPR - Infant • Give chest thrusts and puffs of air • 30 compressions:2 ventilations if alone • 15 compressions: 2 ventilations with 2 rescuers
- 40. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Sequence of Survival
- 41. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. The chances of survival from cardiac arrest depend upon the sequence (chain) of survival being intact. All links are equally important and one weak link can break the chain.
- 42. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Sequence of Survival Also known as Chain of Survival • Recognition and Early Access • Early CPR • Defibrillation • Early Advanced Care
- 43. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Recognition and Early Access • Depends on public education • EMS must be immediately notified • 9-1-1 dispatchers can provide CPR instructions Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
- 44. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Early CPR • Must begin within 4-6 minutes of collapse • Public training is necessary • FR have a critical role Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
- 45. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Copyright © 2004 Elsevier (USA). All Rights Reserved Defibrillation •Ventricular fibrillation a common cause of arrest •Can only correct with defibrillation Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
- 46. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Copyright © 2004 Elsevier (USA). All Rights Reserved • Chance of success decreases with time • AEDs save lives! Defibrillation Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
- 47. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Ventricular Fibrillation • The most common cause of sudden cardiac death – Chaotic, disorganized heart activity – Heart muscle cannot pump blood
- 48. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Ventricular Fibrillation • Requires immediate defibrillation • CPR lengthens window of survival
- 49. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Early Advanced Care • Medication • Advanced airway management • Post-resuscitation care Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
- 50. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. AED
- 51. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. AEDs • Safe, accurate & lightweight • Easy to operate What is public access defibrillation?
- 52. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. PAD • AEDs in public places • Training the public in CPR/AED
- 53. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Special Considerations • Children • Clothing • Body hair • Water • Transdermal medication patches • Implanted defibrillators or pacemakers • Metal surfaces • Jewelry and glasses
- 54. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. AED Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
- 55. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Assess • Check your patient Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
- 56. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Universal Steps Power ↓ Patient ↓ Analyze ↓ Shock
- 57. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Power • Turn the power on Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
- 58. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Patient • Apply pads to patient Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
- 59. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Analyze • Stay clear while patient’s heart rhythm analyzed Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
- 60. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Clear • Head to toe and toe to head: everyone is clear! Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
- 61. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Shock • Defibrillate Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
- 62. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Patient • Standard is set of 1 shock • Immediately restart CPR for 2 minutes then check pulse Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
- 63. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Summary • Continual beating, or contracting, of the heart is necessary to keep blood circulating throughout the body. • Brain damage begins in 4 to 6 minutes of cardiac arrest. • There are many causes of sudden cardiac death, but the most common is ventricular fibrillation.
- 64. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Summary • Survival from cardiac arrest depends on the sequence (chain) of survival. • First Responders are critically important in maintaining the sequence (chain) of survival.
- 65. Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Shock, Shock, Shock! Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.