fo1 marko d mission emt-b bureau of fire protection
TRANSCRIPT
FO1 Marko D Mission EMT-BFO1 Marko D Mission EMT-BBureau of Fire ProtectionBureau of Fire Protection
Emphasis on, and recommendations to improve, delivery of effective chest compression
A single compression-to-ventilation ratio for all single rescuers for all victims
Recommendation that each rescue breath be given over 1 second and should produce visible chest rise
A new recommendation that single shocks, followed by immediate CPR, be used to attempt defibrillation for VF cardiac arrest. Rhythm checks should be performed every two minutes.
Simplified Hand Placement
Give effective chest compressions all rescuers should “push hard and push fast”
Allow the chest to recoil completely after each compression, and use approximately equal compression and relaxation times.
Limit interruptions in chest compressions
The AHA recommends a compression-to ventilation ratio of 30:2
Breathing and CirculationBreathing and Circulation
• Air that enters the lungs contains:Air that enters the lungs contains:– 21% O221% O2– trace of CO2trace of CO2
• Air exhaled from the lungs contains:Air exhaled from the lungs contains:– 16% O216% O2– 4% CO24% CO2
• Clinical deathClinical death (0 - 4 min. - brain damage not (0 - 4 min. - brain damage not likely, 4 - 6 min. - damage probable).likely, 4 - 6 min. - damage probable).
• Biological deathBiological death (6 - 10 min. - brain damage (6 - 10 min. - brain damage probable; over 10 min. - brain damage is certain).probable; over 10 min. - brain damage is certain).
Body SystemBody System
HUMAN BODYHUMAN BODY
The Heart
The Circulatory System
The Circulatory System
Delivers oxygen and nutrients to the tissues.
Removes waste products from the tissues
Pulse Left ventricle contracts, sending a wave of blood through the arteries. This can be felt anywhere an artery passes near
the skin surface over a bone.
Carotid
Radial
Femoral
When the patient has lost a pulse, they are in cardiac arrest. Brain damage begins in 4 - 6 minutes and becomes irreversible in 8 - 10 minutes.
Pulse
Reasons the Heart will Stop
Sudden Death and Heart Disease
Respiratory Arrest, Especially in children
Medical Emergencies
Drowning, Suffocation, Trauma, Bleeding
Regardless of the Regardless of the reason, the First reason, the First
Responder’s emergency Responder’s emergency medical care of cardiac medical care of cardiac
arrest is CPR.arrest is CPR.
Regardless of the Regardless of the reason, the First reason, the First
Responder’s emergency Responder’s emergency medical care of cardiac medical care of cardiac
arrest is CPR.arrest is CPR.
Cardiopulmonary Resuscitation
“The combination of artificial ventilation and external chest
compressions is called cardiopulmonary resuscitation
(CPR).”
CPR Cannot sustain life indefinitely
Must be started as early as possible.
CPR increases the amount of time that defibrillation will be effective.
Chain of Survival
Check the Scene SafetyCheck the Scene Safety
Check for ResponsivenessCheck for ResponsivenessResponseResponseMonitorMonitor
No ResponseNo Response
Activate Medical AssistanceActivate Medical Assistance
Check for Signs of LifeCheck for Signs of LifeIs BreathingIs BreathingMonitor/Monitor/Recovery PositionRecovery Position
No Sign of LifeNo Sign of Life
Give 2 BreathsGive 2 BreathsChest does not rise,Chest does not rise,Retilt the head and ventilateRetilt the head and ventilate
Still chest does not riseStill chest does not risePerform unconscious chokingPerform unconscious choking
Check for pulseCheck for pulse
No Pulse/Not SureNo Pulse/Not Sure
Give cycles of 30ECC and 2RBGive cycles of 30ECC and 2RB
If definite Pulse, BeginIf definite Pulse, BeginRB: 1 breath every RB: 1 breath every
5 seconds for 1 minute5 seconds for 1 minute
Establish unresponsiveness.
Open airway.
Look, listen, feel.
Ventilate.
Check pulse.
Locate compression site.
Begin compressions.
One-Rescuer CPR for Two Minutes
Recheck pulse.
Two-rescuer CPR
RESCUE BREATHING ADULT CHILD INFANT
Opening of airway (Head-Tilt-Chin Lift Maneuver) Maximum tilt of the head Neutral plus position Neutral position
Location for checking of signs of circulation
Carotid pulse (Side of the neck) Carotid pulse Brachial pulse (inner aspect of
upper arm)
Method Mouth-to-mouth or Mouth-to-noseMouth-to-mouth or Mouth-to-
noseMouth-to-mouth & nose
BreathsNormal breath (1 second per breath) Normal breath (1 second per
breath) Gentle, slow breath (1 to 1.5 seconds per breath)
Rate10 to 12 breaths per minute (1 breath
every 4 to 5 seconds)12 breaths in 1 minute
20 breaths per minute (1 breath every 3 seconds)20 breaths in 1 minute
Counting for standardization purposes: Mnemonic ADULT-1 breathe every 5 seconds ; CHILD / INFANT -1 breath every 3 seconds.
Breath 1, 1002, 1003, 1001, breath 1, 1002, 1003, 1002, breath 1, 1002, 1003, 1003, breath… 10010 or up to 10012, breath
Breath 1, 1001, breath 1, 1002, breath 1, 1003, breath…1, 1020, breath
TABLE OF COMPARISON ON RESCUE BREATHING FOR ADULT, CHILD, and INFANT
TABLE OF COMPARISON ON CARDIOPULMONARY RESUSCITATIONFOR ADULT, CHILD, AND INFANT
CPR ADULT CHILD INFANT
Compression Area Center of Chest, between nipplesJust below the nipple
line
DepthApproximately 1 ½ to
2 inches.1/3 to ½ the depth of the chest
How to Compress2 hands. Heel of 1
hand, other hand on top
2 hands1 hand
2 fingers (middle & ring
fingertips).
ADULT CHILD INFANT
RateApproximately 100/min
Compression-ventilation ratio.
30:2 (1 or 2 rescuers)
30:2 (1 rescuer)15:2 (2 rescuer)
Counting for standardization purposes.
1, 2, 3, 4, 5, 6, 7, 8 ,9, 10, 11, 12, 13, 14, 15, 16,17,18,19,20,21,22,23,24,25,26,27,28,29, and 1 then breathe, breathe;
1, 2, 3, 4, 5, 6, 7, 8 ,9, 10, 11, 12, 13, 14, 15, 16,17,18,19,20,21,22,23,24,25,26,27,28,29, and 1 then breathe, breathe;
TABLE OF COMPARISON ON CARDIOPULMONARY RESUSCITATIONFOR ADULT, CHILD, AND INFANT
Infant and Child CPR
“Infants (up to one year old) and children (one to eight
years old) need slightly different care.”
Determine unresponsiveness.
Open airway.
Determine breathlessness.
Ventilate.
Determine pulselessness.
Locate correct hand position.
Compress 1/2 to one inch.
30:2
Child Compression
When to When to Spontaneous signs of Spontaneous signs of circulation are restoredcirculation are restored
Turned over to medical Turned over to medical services or properly trained services or properly trained and authorized personnel.and authorized personnel.
Operator is already exhausted Operator is already exhausted and cannot continue CPR.and cannot continue CPR.
Physician assumes responsibility. Physician assumes responsibility. ( Declares death, take over) ( Declares death, take over)
STOP STOP CPR CPR
Bureau of Fire Protection
“To Save lives and Protect Properties”
Thank you!