CPR is a process of oxygenating heart, lung through external cardiac massage and artificial respiration until the definite medical treatment can restore the normal functioning of heart, lung and brain.

1. CARDIO PULMONARY RESUSCITATION
By :
Sayantani Mondal
Faculty
Govt. College of Nursing, DH, Howrah

2. Definition of CPR: Cardio-Pulmonary
Resuscitation is the technique of basic
life support for the purpose of
oxygenating heart, lung, brain and other
vital organs as long as appropriate
medical treatment can restore the heart
function and ventilatory action.

3. CPR is a process of oxygenating heart,
lung through external cardiac massage
and artificial respiration until the definite
medical treatment can restore the normal
functioning of heart, lung and brain.

4. The condition requiring CPR
1. Cardiac arrest: when heart stops its
circulatory function.
2. Respiratory arrest: when heart continues but
lungs stops its function. It is also called
pulmonary arrest.
3. Cardio-pulmonary arrest: sudden cessation
of heart function and ventilator action.

5. Condition 6H Condition 5T
• Hypovolemia Toxins
• Hypoxia Tamponade (Cardiac)
• Hydrogen ion (Acidosis) Tension pneumothorax
• Hyperkalaemia Thrombosis (acute/ Massive MI)
• Hypokalaemia Thrombosis(lung)
• Hypothermia Trauma
• Hypoglycaemia
Causes of Cardio Pulmonary Arrest
The causes can be divided as 6H’s and 5T’s

6.  Cardiac Temponade : A serious condition that occurs from
pericardial effusion.
S/S of Cardiac Temponade :
 Hypotension
 Buldging Neck veins
 Sharp Chest Pain
 Rapid Breathing
 Palpitations
 Tension Pneumothorax : Air accumulates between chest wall
and lungs and increases pressure of chest, reducing the amount
of blood returned to the heart.

8. SIGNS AND SYMPTOMS OF CARDIAC ARREST
Cardiac arrest is sometimes preceded by certain signs
and symptoms, such as-
• Unresponsiveness
• Ventricular stand-still (Stops beating and
stands perfectly still)
• Extreme fatigue
• Constant dizziness
• A fast heart rate
• A new, irregular heart beat
• Chest pain

9. • Respiratory distress
• Restlessness or confusion
• Cold clammy skin
• Decreased blood pressure
• Fainting
• Blackouts
• Vomiting

10. The arrest may also occur with no warning.
The most obvious sign of cardiac arrest is-
• Lack of palpable pulse.
• Patient will quickly become unconscious
and will have cessation of respiration due
to inadequate cerebral perfusion as a
consequence of decreased cardiac output.

13. Chain of survival:
The term chain of survival provides a
useful metaphor for the elements of the
ECC (Emergency Cardiovascular Care)
systems of care concept
Two chains are known as-
In- hospital cardiac arrest (IHCA)
Out of hospital cardiac arrest (OHCA)

16. High quality CPR
• Start compressions within 10 seconds recognition of cardiac arrest.
• Push hard, push fast: Compress at a rate of 100-120/ min with a
depth of
 at least 5 cm for adults.
 At least one third the depth of the chest, about 5 cm for children
 At least one third the depth of the chest, about 4 cm for infants.
• Allow complete chest recoil after each compression
• Minimize interruptions in compressions (try to limit interruptions
to less than 10 seconds).
• Give effective breaths that make the chest rise
• Avoid excessive ventilation

18. BLS for Adult
It is the sequences of procedures performed
to restore the circulation of oxygenated blood
after a sudden pulmonary and / or cardiac
arrest.
Chest compressions and pulmonary
ventilation performed by anyone who knows
how to do it. Anywhere, immediately, without
any other equipment.

19. Aims of basic life support
• To ensure open airway and adequate
ventilation.
• To maintain circulation until help comes
and definite treatment with advanced
life support can be administered.
Components of CPR
Chest compressions, Airway, Breathing

22. Steps of BLS

28. C A B

29. COMPRESSION

39. Position your hand
 Position your free hand on the top of the hand
that placed on the hand.
 Interlock your finger
 Elbow of the hand should be straight and shoulder
is directly over hands.
 Perform chest compressions
 Apply firm, heavy pressure depress the sternum
 After each compression allow chest to return
normal position

40. Perform chest compressions
 apply firm, heavy pressure depress the sternum
 after each compression allow chest to return
normal position

42. AIRWAY

43. Adult Breathing
Opening the airway
For breaths to be effective, the victim’s airway must be
open. Two methods for opening the airway are
• Head tilt-chin lift
• Jaw thrust
If a head or neck injury is suspected, use the jaw-thrust
maneuver to reduce neck and spine movement. Switch to a
head tilt – chin lift maneuver if the jaw thrust does not open
the airway.
If multiple rescuers are available, one rescuer can perform a
jaw thrust while another rescuer provides breaths with a bag-
mask device. The third rescuer will give chest compressions.

44. Step Action
1
Place one hand on the victim’s forehead and push
with your palm to tilt the head back.
2
Place the fingers of the other hand under the
bony part of the lower jaw near the chin.
3 Lift the jaw to bring the chin forward.
Head tilt-chin lift

46. Step Action
1 Place one hand on each side of the victim’s head. Rest
your elbows on the surface on which the victim is lying.
2 Place finger under the angles of the victim’s lower jaw
and lift with both hands, displacing the jaw forward.
3 If the lips close, push the lower lip with thumb to open
lips.
Jaw thrust maneuver

48. BREATHING

52. PINCH NOSE AND GIVE RESCUE BREATH

54. HOLD MASK IN ‘C’ AND ‘E’ SHAPE

55.  5 CYCLE OF 30 COMPRESSION AND TWO
BREATH IN 2 MINUTES.
 RE-ASSESS AFTER 5 CYCLE.
 IF TWO RESCUER, SWITCH ROLE AFTER 5
CYCLE.

57. Characteristics of High Quality CPR
• Give chest compression at the rate of 100 beats
per minute at the depth of 1.5 to 2 inches.
• Push hard and push fast
• Allow full chest recoil.
• Minimal hyperventilation
• Minimal interruption.
• For cervical injury -
 Do not go for head tilt and chin lift
 Do jaw thrust maneuver

58. Adult Cardiac arrest algorithm
1. Verify scene safety, check for responsiveness,
and get help.
2. Assess for breathing and pulse (look, listen, feel)
3. Determine next action
4. Begin high quality CPR, starting with chest
compressions
5. Attempt defibrillation with the AED
6. Resume high quality CPR

59. Step Action
1 Locate the trachea (on the side closest to you), using 2 or 3 fingers.
2
Slide these 2 or 3 fingers into the groove between the trachea and
the muscles at the side of the neck, where you can feel the carotid
pulse.
3
Feel for a pulse for at least 5 but no more than 10 seconds. If you
do not definitely feel a pulse, begin CPR, starting with chest
compressions.
Location the carotid pulse

61. Step Action
1 Position yourself at the victim’s side.
2
Make sure the victim is lying face up on a firm, flat surface. If the victim is lying face down,
carefully roll him face up. If you suspect the victim has a head or neck injury, try to keep the
head, neck, and torso in a line when rolling the victim to a face up position.
3
Position your hands and body to perform chest compression:
● Put the heel of one hand in the centre of the victim’s chest, on the lower half of the breastbone
(sternum).
● Put the heel of dominant hander hand on top of the non dominant hand.
● Straighten arms and position shoulders directly over the hands.
4 Give chest compressions at a rate of 100 to 120/min.
5
Press down at least 5 cm with each compression. For each chest compression, make sure to push
straight down on the victim’s breastbone.
6 At the end of each compression, make sure to allow the chest to recoil completely.
7 Minimize interruptions of chest compressions.
Chest Compression Technique