١
٢
At the end of this course participants should be able to demonstrate: How to assess the collapsed victim. How to perform chest compression and rescue breathing. How to place an unconscious breathing victim in the recovery position. ٣
Despite important advances in prevention, cardiac arrest remains a substantial public health problem and a leading cause of death in many parts of the world. Cardiac arrest occurs both in and out of the hospital. In the US and Canada, approximately 350 000 people/year (approximately half of them in-hospital) suffer a cardiac arrest and receive attempted resuscitation. The estimated incidence of EMS-treated out-of-hospital cardiac arrest in the US and Canada is about 50 to 55/100 000 persons/year and approximately 25% of these present with pulseless ventricular arrhythmias. The estimated incidence of in-hospital cardiac arrest is 3 to 6/1000 admissions and similarly, approximately 25% of these present with pulseless ventricular arrhythmias. ۴
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 ۵
The links in this Chain are: Immediate recognition and activation, early CPR, rapid defibrillation, effective advanced life support and integrated post-cardiac arrest care.
١٠
* Approach safely Check response Check breathing Shout for help & Call 115 30 chest compressions 2 rescue breaths ١١
Scene Rescuer Approach safely Check response Check breathing Victim Bystanders Shout for help & Call 115 30 chest compressions 2 rescue breaths ١٢
Approach safely Check response Check breathing Shout for help & Call 115 30 chest compressions 2 rescue breaths ١٣
Shake shoulders gently Ask Are you all right? If he responds Leave as you find him. Find out what is wrong. Reassess regularly. ١۴
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 ١۵
Approach safely Check response Check breathing Shout for help & Call 115 30 chest compressions 2 rescue breaths ١۶
LOOK, LISTEN,FEEL ١٧
Approach safely Check response Check breathing Shout for help & Call 115 30 chest compressions 2 rescue breaths ١٨
What happened, location, number and condition of victims type of aid provided ١٩
Feel within 1. definite pulse give 1 breath / q 5-6 s 2. recheck pulse q 2 min. 3. no pulse next step ٢٠
Chest compressions are the foundation of CPR All rescuers, regardless of training, should provide chest compressions to all cardiac arrest victims. ٢١
Approach safely Check response Check breathing Shout for help & Call 115 30 chest compressions 2 rescue breaths ٢٢
supine victim on a hard surface Place the heel of one hand in the centre of the chest ( lower half ) Place other hand on top Interlock fingers ٢٣
30 2 ٢۴
Push hard and fast the chest Rate 100 /min Depth 4-5 cm Equal compression / relaxation Minimize interruptions in chest compressions. When possible change CPR operator every 2 min ٢۵
٢۶
Approach safely Check response Check breathing Shout for help & Call 115 30 chest compressions 2 rescue breaths ٢٧
٢٨
٢٩
In traumatic patient ; JAW THRUST + neck immobilization Cervical collar within transport ٣٠
٣١
If you do not detect adequate breathing within 10 seconds, give 2 breaths. Deliver each breath over 1 second. Give a sufficient tidal volume produce visible chest rise. Avoid rapid or forceful breaths. ٣٢
Pinch the nose Take a normal breath Place lips over mouth Blow until the chest rises Take about 1 second Allow chest to fall Repeat ٣٣
٣۴
٣۵
Ventilation with bag valve mask: Vol. 1-2 lit. O2 15 lit/min ٣۶
Approach safely Check response Check breathing Shout for help & Call 115 30 chest compressions 2 rescue breaths ٣٧
Approach safely Check response Check breathing Shout for help & Call 115 30 chest compressions 2 rescue breaths ٣٨
٣٩
۴٠
* For adult out-of-hospital cardiac arrest that is not witnessed by the EMS provider, rescuers may give a period of CPR (eg, about 5 cycles or about 2 minutes) before checking the rhythm and attempting defibrillation. ۴١
* In settings with lay rescuer AED programs (AED on-site and available) and for in-hospital environments or if the EMS rescuer witnesses the collapse, the rescuer should use the defibrillator as soon as( within first 3-5 min) it is available for children and adults. ۴٢
*Approach safely Check response Shout for help and call 115, get AED for age > 1 y Open airway Check breathing Attach AED Follow voice prompts ۴٣
Some AEDs will automatically switch themselves on when the lid is opened ۴۵
۴۶
۴٧
Stand clear Deliver shock ۴٨
30 2 ۴٩
30 2 ۵٠
۵١
Approach safely Check response Check breathing Shout for help & Call 115 30 chest compressions 2 rescue breaths Approach safely Check response Check breathing Shout for help and call 115, get AED Attach AED Follow voice prompts ۵٣