Cardio pulmonary resustitation (CPR) Cardiac arrest:
Resustitation includes that are applied to revive patients who have stopped breathing suddenly and unexpectedly due to either respiratory or cardiac failure. Cardiac arrest is one of the common causes.
Major causes are
2. Myocardial infection
3. Anesthetic depression
4. Electric shock
6. Pulmonary embolism
7. Brain injury
Signs and symptoms:
2. Abscemnce of carotid and femoral pulse
3. Dilated pupils
Sequence of cardio pulmonary resuscitation is
A - Airway
B - Breathing
C - Circulation
Airway, Breathing And Circulation (ABC):
Checking of Airway, breathing and circulation is the priority assessment of and treatment of any casualty or emergencies. ABC must be established with in three minutes if the casualty is unconscious in order to prevent permanent injury.
A - Airway
Airway is the passage between the mouth, nose and throat. It must be opened and kept open if the casualty is unconscious or choking.
· Opening the Airway:
If the casualty is unconscious and particularly if he or she is lying face up, air cannot get through to the lungs for the reasons described opposite. Therefore one thing is essential. [The head must be tilted right back with lower jaw passed well forward. This moves the tongue, forward thus opening the airway.]
Place one hand on the casualty' s forehead and the other under her neck and tilt the head back so that the nostrils are pointing upward.
Push the lower jaw up and forward so that the chin lifts up.
Look, listen and feel to see if the casualty is now breathing. If she is, place her in the recovery position.
Clearing the airway:
If the casualty is not breathing after the airway has been opened, it may be because the airway is blocked by broken teeth, mud, weeds or vomit.
Turn the casualty' s heads to one side. Keep it well back as described and with one quick sweep round the mouth with the index finger, lift out any foreign matter one find. Make sure that by doing this; you do not push the object further down the airway.
The alternate inspiration and expiration of air into and out of the lungs. Before placing a casualty in the recovery position one must first satisfy oneself that he or she is breathing normally and that the heart is breathing.
1. Turn the casualty' s head towards you and tilt it back slightly to open the airway.
2. Place the arm nearest you by the casualty' s side. Keeping his hand flat, slide it well under his buttock.
3. Being the casualty' s other arm up and lay it across his chest. Then slightly raise the leg, bring it towards you and cross it over his other leg.
4. Kneel bedside the casualty, about 22.5 cm(9in) from his chest and support his head with one hand. Grasp the casualty' s clothes at the hip farthest from you and pull him towards you until he is resting against your kneels.
5. Re-adjust the casualty' s head so that it is now well back to make sure the airway stays open.
6. Working on the uppermost limbs, bend first the arm, then the leg into a convenient position to prevent the casualty rolling on to his face.
7. The arm behind the casualty should now be free, if it is not, carefully ease it out from under his back and leave it lying parallel to his body to prevent him rolling on to his back.
Mouth to mouth ventilation
The following instructions are for giving mouth to mouth to unconscious adults who are not breathing.
1. Clear the casualty' s airway keeping her head well back, jaw forward and the mouth open, pinch her nostrils shut with fingers and thumb by one hand: Maintain this position through out.
2. Take deep breaths, open your mouth wide and seal your lips around the casualty' s mouth.
3. Blow firmly but gently into the casualty' s mouth blow from your chest not your cheeks and blow hard enough to make her chest raise.
4. Lift your mouth away from the casualty' s and turn your head toward her chest.
5. If you have been successful you will see that her chest movement occurs.
6. Give the casualty three more full breathes as quickly as possible.
7. Then check the skin colour and watch casualty' s heart rate.
8. If casualty is breathing, continue mouth-to-mouth breathe, at a rate of one every three or four seconds. (About the times per minute) keep watching the chest movements.
9. If there is no pulse you must begin external chest compression.
10. When breathing returns, place the casualty in the recovery position.
The circulation can fail because of two basic reasons.
The heart may stop working (or)
The volume of blood circulating in the body may be drastically reduced as result of severe bleeding.
Check the pulse in the carotid arteries of the neck. If there is no pulse or breathing, it means that the heart has stopped pumping and you must immediately begin to give external chest compression.
External chest compression:
It means applying pressure to the lower half of the breastbone (Sternum) which in turn causes blood to be pushed (pumped out) of the heart, each time you release the pressure, the heart refills. In this way you can maintain the casualty' s circulation.
This technique must be taught by a trained instructor and should never be practiced on any one whose heart is beating because, you can easily upset the rhythm of the person' s heart rate.
Lay the casualty flat on the ground kneel bedside him facing his chest.
Find the breastbone (the bone which runs down the center
of the chest.], and find its center by measuring it with both hands. Place the heart of one hand on the center of the lower half, keeping your finger off the ribs.
Cover your hand with the heel of your other hand and lock your fingers together.