CPR or defibrrilation first? and why? Dr Abd ELAal elbahnasy American Heart Association Instructor

1. CPR or defibrillation
first? And why?
Abd El Aal Elbahnasy, MD

2. WHAT IS CPR ????.........
Cardio pulmonary resuscitation is a series of
steps used to establish artificial ventilation
and circulation in the patient who is not
breathing and has no pulse.

3. WHEN YOU HAVE TO START CPR ????.......
1-No response
2-If the victim is not breathing
normally such as gasping for
breath or not breathing at all
3-No pulse
4- heart rate less than 60 beatm

4. CHAIN OF SURVIVAL

7. STEPS OF CPR
1- Check the scene safety
2- Check for consciousness
3- check breathing
4- call for help
5- check pulse
6- start chest compression

8. CHECK RESPONSE
• Gentle taping the foot of baby
• And call him baby baby……
No response

9. Check breathing
• Look for chest rise
• Hear agonal breathing
No breathing
Agonal breathing

10. Activate emergency response
• If the infant not respond
&no breathing
Immediately call for help
and get automated
external defibrillator (AED)

11. Check pulse
• Check pulse in
brachial artery
within 10 seconds
No pulse

12. Start compression
One rescuer
By two fingers at
lower 1|2 of breast
bone (sternum)
30 compression to 2
breaths
Depth about 4 cm

13. Two rescuer
Encircle the chest by
both hands
15 compression to 2
breaths
Switch every 2
minutes or 10 cycle

14. Hand placement
 Infant:
compress the sternum with 2 fingers
placed just below the inter-mammary
line
 Child:
compress the lower half of the
sternum at least one third of the AP
diameter of the chest (2 inches) with
one or two hands
 Note: do not compress over the
xiphoid or ribs

15. High quality C P R
Start chest compression within 10 second
of recognition
Push hard about 4 cm, push fast at least
100 compression in minute
Avoid interruption
Give effective breath
Avoid excessive ventilation
Count out loud

17. Defibrillator
• Defibrillators are either
manual or automated (AED).
• AED can be used for infants
and children up to
approximately 25 kg (8 years
of age).
• In infants 1 year of age a
manual defibrillator is
preferred.

18. Paddle Size
Two sizes of hand-held paddle
“Adult” size : 8 to 10 cm for
children > 10 kg
( approximately 1 year)
“Infant” size :4-5 cm for
infants < 10 kg

19. Paddle Position:
Place over the right
side of the upper chest
and the apex of the
heart (to the left of the
nipple over the left
lower ribs) so the heart
is between the two
paddles.
 Apply firm pressure

20. Defibrillation sequence
Switch ON the device
Apply Paddles
Clear the patient for analyzing
the rhythm
Charging if shock needed
Clear patients before applying
the shock
Continue CPR

21. DEFIBRRILATION

22. Manual Defibrillation Dosing
The recommended first energy dose
for defibrillation is 2 J/kg.
If second dose is required, it should
be doubled to 4 J/kg.
AED with pediatric attenuator is preferred
for children < 8 years of age.

23. If I heard “I will forgot”
If I saw “I will remember”
If I did “I will become perfect”
SO you must practice
CPR

24. CPR OR DEFIBLLITAION FIRST?

27. END RESULT

29. Take home message
Infant not small adult
C A B not A B C nothing delay compression
HIGH QUALITY C P R
CPR is so easy only you want 2 hands &training
CPR before defibrillation improving outcome