cardiopulmonary resuscitation and aed. remember the basics!
TRANSCRIPT
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Cardiopulmonary Resuscitation and AED
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Remember the BASICS!
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Outline
• Introduction to CPR• History• Review of the Circulatory System• Causes of Cardiac Arrest• CPR• AED
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Introduction to CPR
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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.
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Time is Critical!
Begin resuscitation within minutes:
• Patient’s collapse witnessed
• EMS immediately activated
• CPR started immediately
• Defibrillation within minutes
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Trained bystanders are not always available or willing to do CPR.
The role of the rescuer is critical in reaching the patient quickly and beginning
resuscitation.
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Historical Perspective
• Early 1900s: Shafer Method
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Historical Perspective
• 1960s – Peter Safar– Prone position inadequate– Expired air did provide sufficient O2.– Head tilt, chin lift kept patent airway
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Historical Perspective
• 1955: Paul Zoll: 1st successful closed chest defibrillation, external pacing
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Historical Perspective
• 1930s: In hospital resuscitation team• 1960s: MICU with physicians• 1970: Education in Seattle
– 100,000 laypersons CPR– 911 dispatch education– Paramedic training
• 1979: 1st AED developed– Sensing electrode in pharynx– Shocking electrode on tongue and abdomen
• 1974: Training of laypersons formally sanctioned
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Review of the Circulatory System
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What is the function of the circulatory system?
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The Circulatory System
• Delivers O2 and nutrients
• Removes CO2 and wastes
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Why is the function of the circulatory system critical to our survival?
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If the heart stops pumping
• Lack of O2 and accumulation of wastes quickly lead to death
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Major Arteries
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Where are capillaries found and what is their purpose?
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Capillaries
• Found throughout the body• Connect smallest arteries to smallest veins• O2, nutrients, and
wastes move through thin walls
• Microscopic
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How does a vein differ from an artery?
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Veins
• Carry blood back to heart
• Lower pressure
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What is the function of blood?
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Blood
• The fluid of the circulatory system
• Carries O2, nutrients, and wastes
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Heart Physiology
• Left Ventricle contracts – sends wave of blood
• Pressure wave felt as pulse
• No contraction = No blood flow = cardiac arrest
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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.
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CPR
• Provides minimal amount of circulation/oxygenation until cause of cardiac arrest corrected
• External chest compressions circulate blood
• Artificial ventilations provide O2 to lungs
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Causes of Cardiac Arrest
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Causes of Cardiac Arrest
• Heart disease• Respiratory arrest• Medical emergencies• Drowning and suffocation• Congenital heart defects• Trauma
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The cause of cardiac arrest is
important
BUT
do not delay CPR to obtain history
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CPR
• Combines external chest compressions with artificial ventilation
• Provides 30% (or less) of normal circulation
• Only effective for short period of time
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CPR – 1 Rescuer
• Assess responsiveness
• Summon EMS• Position the
patient
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CPR – 1 Rescuer
• Check for a pulse (≤ 10 seconds)
No pulse..activate EMS…Get AED
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CPR – 1 Rescuer
• If there is no pulse, find your landmarks, lower half of the sternum, between the nipples
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CPR – 1 Rescuer
• Begin chest compressions
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CPR – 1 Rescuer
• Perform 30 chest compressions
• Push hard• Push fast• Allow the chest to
recoil after each compression
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CPR – 1 Rescuer
• Administer two ventilations then return to compressions
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CPR – 2 Rescuer
1 2
3 4
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CPR - Children
• Use heel of one hand
• Keep airway open with other hand
• 30 compressions:2 ventilations if alone (2 rescuers use 15:2)
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CPR - Infant
• Give chest thrusts and puffs of air
• 30 compressions:2 ventilations if alone
• 15 compressions: 2 ventilations with 2 rescuers
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Sequence of Survival
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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.
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Sequence of Survival Also known as Chain of Survival
• Recognition and Early Access
• Early CPR
• Defibrillation
• Early Advanced Care
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Recognition and Early Access
• Depends on public education
• EMS must be immediately notified
• 9-1-1 dispatchers can provide CPR instructions
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Early CPR
• Must begin within 4-6 minutes of collapse
• Public training is necessary
• Rescuers have a critical role
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Copyright © 2004 Elsevier (USA). All Rights Reserved
DefibrillationDefibrillation
•Ventricular fibrillationa common cause
ofCardiac arrest•Can only be
corrected with defibrillation
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Copyright © 2004 Elsevier (USA). All Rights Reserved
• Chance of success decreases with time
• AEDs save lives!
• Chance of success decreases with time
• AEDs save lives!
DefibrillationDefibrillation
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Ventricular FibrillationV-Fib
• The most common cause of sudden cardiac death– Chaotic, disorganized heart activity– Heart muscle cannot pump blood
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Ventricular FibrillationV-Fib
• Requires immediate defibrillation
• CPR lengthens window of survival
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Early Advanced Care
• Medication• Advanced airway
management• Post-resuscitation
care
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AED
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AEDs
• Safe, accurate & lightweight
• Easy to operate
What is public access defibrillation?
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PAD
• AEDs in public places
• Training the public in CPR/AED
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Special Considerations
• Children• Clothing• Body hair• Water• Transdermal
medication patches
• Implanted defibrillators or pacemakers
• Metal surfaces• Jewelry and glasses
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AED
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Assess • Check your patient
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Universal Steps
Power
↓
Patient
↓
Analyze
↓
Shock
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Power
• Turn the power on
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Patient
• Apply pads to patient
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Analyze• Stay clear while
patient’s heart rhythm is analyzed
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Clear
• Head to toe and toe to head: everyone is clear!
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Shock
• Defibrillate
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Patient
• Standard is set of 1 shock
• Immediately restart CPR for 2 minutes then check pulse
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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.
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Summary
• Survival from cardiac arrest depends on the sequence (chain) of survival.
• Rescuers are critically important in maintaining the sequence (chain) of survival.
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CPR Video
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Remember Hard and Fast !!
Keep the Beat of Staying Alive !!!