cpr training module

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    CPR

    BASIC LIFE SUPPORT

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    AIM

    TO MAINTAIN ADEQUATE VENTILATIONAND CIRCULATION UNTIL UNDERLYING

    CAUSE FOR ARREST CAN BE REVERSED. 3-4 MINUTES WITHOUT ADEQUATE

    PERFUSION (Less if patient is hypoxic)

    LEADS TO IRREVERSIBLE DAMAGE.

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    STEPS

    A FOR AIRWAYS

    B FOR BREATHING

    C FOR CIRCULATION

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    STEPS

    ASSESS PATIENT

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    ASSESS PATIENT

    Check if patient is responsive by gentlyshaking patient/ giving noxious stimuli as

    pinching sternum.Avoid shaking patient if suspected for

    head/Cervical cord injury

    IF PATIENT UNRESPONSIVE SHOUT FORHELP AND ALERT CODE BLUE

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    As fast as possible position patient on flathard surface such as on the floor. If the

    patient must be moved from face-downposition, roll the patient as a unit so thatthe head, neck and torso move

    simultaneously.

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    A FOR AIRWAYS

    A ; Open Airway: With two fingertipsunder point of chin tilt head up.

    (Remove ill fitting dentures/ obviousobstruction.)

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    B FOR BREATHING

    If patient starts breathing roll the patientover into recovery position and try to keep

    airway open until an oro-pharyngealairway can be inserted.

    Watch the chest movement and listen and

    feel at the mouth for breath sounds for afew seconds.

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    C: Feel the carotid pulse: Check bothsides SEPERATELY.

    If the pulse is absent shout for help andget someone to alert for code blue/cardiacarrest team.

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    CPR

    Open Airway (Tilt chin) and blow 2 SLOWbreaths into patient AT rate of 1.5-2.0

    seconds per breath. Allow chest to fallafter each ventilation. Each ventilationshould be performed to make patients

    chest rise.

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    Start Chest compression with theheel of the hand over the middle of

    the lower half of the sternum.

    Aim to depress sternum about 4-5

    cm at rate of approx 80compressions per minute.

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    If patient is on bed positionyourself on bed with your legs

    folded under you and give chestcompression.

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    If you are alone, after every 5compressions give 1 ventilation by Ambu

    bag/ Mouth to Mouth until further helparrives./ If patient has been intubated onenurse ventilation by ambu bag.

    If 2 persons are there, nominate one tobreathing and other to compression

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    Give 1 full breath after every 5

    compressions stopping compressions onlyjust long enough for the breaths.(Compression: Ventilation Ratio to be 5:1)

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    If extra nurse /doctor is present CANNULATEPATIENT AS FAST AS POSSIBLE and arrange forfully equipped crash cart, Suction machine.

    Keep the following injections loaded insyringes:

    Adrenaline

    Lignocaine

    Atropine

    Amiodorone/Cardarone

    Hydrocortisone

    Deriphylline

    Soda bicorb

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    Once patient is intubated ventilation can

    be performed at a rate of 12-15/minutewithout pausing for compressions.

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    STOP BLS FOR 5 SECONDS: at the end ofthe first minute and every 1-2 minutes

    thereafter to determine whether patienthas resumed spontaneous breathing orcirculation

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    If a spontaneous pulse has returned,check BP and continue ventilation.

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    BLS should not be withheld for more than5 seconds other than to intubate or

    defibrillate the patient.Attempt at intubations should not exceed

    30 seconds before CPR is resumed.

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    If an unconscious patient cannot beventilated after two attempts at

    positioning the head and chin and alaryngoscope is unavailable 6-10abdominal thrusts (Heimlich Maneuver)

    should be performed without damagingany organs.

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    After this maneuver is performed, debrisshould be swept from the patients mouth

    with a finger, and then one shouldattempt to ventilate patient.

    This sequence should continue to be

    repeated until ventilation issuccessful.

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    THANK-YOU