1. BY
ASHOK BISHNOI
Lcturer,JINR

2. INTRODUCTION:-
 Sudden death occur when heartbeat &
breathing stop suddenly or unexpectedly.
the major role of CPR is to provide oxygen to
heart ,brain,& the other vital organ until
medical treatment (advance cardiac life
support-ACLS) can restore normal heart
action.

3. DEFINITION:-
 Angela Morrow RN
Cardiopulmonary resuscitation
(CPR) is a procedure used when a patient's heart stops
beating and breathing stops. It can involve
compressions of the chest or electrical shocks along
with rescue breathing.
 Mosby medical dictionary
CPR is a basic emergency
procedure for life support consisting of artificial and
manual external cardiac massage
.

4. CHAIN OF SURVIVAL:-

5. INDICATIONS:-
 Cardio vascular disorders
CAD, congenital heart diseases , coronary
embolism, cardiac rupture & dissection
 Pulmonary causes
pulmonary embolism, pulmonary edema, asphyxia
 Metabolic causes
hypoglycemia, electrolyte imbalances

6.  Fluid imbalance
extensive hemorrhage, hypotension, shock
 Neurological causes
brain injuries, massive cva
 Poisons substance and drug overdose
co poisoning, propanolol over dose
 Other causes
electrical shock, hypothermia, narcotic overdose

7. WARNING SIGNS OF CARDIO
PULMONARY ARREST:-
 Early signs:
. loss of consciousness & convulsions
 Late signs:
. Apnoea
.Dilated pupils
.Absence of heart sounds

8.  Other signs
 Changes in respiratory rate
 A weak or irregular pulse
 Bradycardia
 Cyanosis
 Hypothermia

9. CPR PROCEDURE

10. EQUIPMENTS
i. Ambu bag and masks with different size.
ii. Oropharyngeal airways.
iii. Endotracheal tubes of appropriate
sizes and stillet.
E
T
T
U
B
E

11. iv. Paediatric laryngoscope
with straight (Miller) and
curved (McIntosh)
blade – Appropriate sizes.
v. Suction apparatus.
vi. NG tube.

12. i. IV equipments & fluids
ii. Pulse-oxymetry
iii. Oxygen sources
iv. Automated external defibrillator
v. Emergency drugs
vi. Cardiac monitor

13. STEPS FOR CPR:-
Airway:-Maintaining an open airway.
Breathing:-Providing artificial ventilation by rescue
breathing.
Circulation:-Promoting artificial circulation by
external cardiac compression.
Defibrillation:-Restoring the heart beat.

14. Shake shoulders gently
Ask “Are you all right?”
If he responds
• Leave as you find him.
• Find out what is wrong.
• Reassess regularly.
CHECK RESPONSE

15. (A) AIRWAY :-
 Head tilt chin lift manoeuvre
 Jaw thrust manoeuvre

16.  HEAD TILT CHIN LIFT MANOEUVRE

17.  JAW THRUST MANOEUVRE

18. (B) Breathing:-
Look Listen Feel

19. Method:
 Mouth to mouth ventilation
 Mouth to mask ventilation
 Bag mask ventilation

20.  MOUTH TO MOUTH VENTILATION

21. MOUTH TO MASK VENTILATION

22. BAG MASK VENTILATION

23. NEONATAL PEDIATRIC ADULT

24. (C) Circulation:-
Assess pulse
{Adult}

25. Assess pulse (infant)

26. CHEST COMPRESSIONS

27. • Place the heel of one hand in
the centre of the chest
• Place other hand on top
• Interlock fingers
• Compress the chest
– Rate 100 min-1
– Depth 3-5 cm(1.5 to 2 inches)
– Equal compression : relaxation
• When possible change CPR
operator every 2 min
CHEST COMPRESSIONS

28. IN ADULT

29.  IN CHILD

30.  IN INFANT

31. (D) DEFIBRILLATION:-
 Device that delivers direct electrical current
across the myocardium. The aim is to produce
synchronous depolarization of cardiac muscle
STRATEGIES:
Test defibrillate for
 full battery charge
 switch on power button
 change paddle mode

33.  Key issues:
Paddle site: Rt intraclavicular region
lt lower axillary region
Paddle size: 8cm -12 cm
wave form patterns :
monophasic
biphasic truncated exponential
biphastic rectilinear

34. Energy level:
Pediatric : 2-4 J/kg
Adult: Monophasic=> 360J
Biphasic truncated=> 150-200J
Biphasic rectilinear=> 120 J

36.  STEPS:-
 switch on
 select paddle mode
 assess rhythm
 press paddles firmly over the chest
 deliver the shock
 resume cpr

37. Intensive care:-(shifting in ICU)
 transfer to ICU
 monitor closely and continuously
 monitor vital signs every hour
 watch for convulsions
 intubate if necessary
 catheterize the patient and monitor output
 record the procedure

38. POST CARDIAC ARREST MANAGEMENT:-
Continued care
 To ensure hemodynamic monitoring
 To minimize the effect of loss of spontaneous
circulation of various organs
 To recognize and treat recurrent cardiac arrests
Objectives:
 Optimize cardio pulmonary function& systemic
perfusion
 Transport victim out of hospital
 Identify and treat thre precipating factor
 Intitute measure to prevent recurrence and improve
neurological function

39.  Respiratory system;
 Intubate & mechanically ventilate until they are stable
 Administer supplemental oxygen
 Obtain chest x ray
 Administer drugs
 Avoid hyperventilation
 Cardio vascular system:
 Obtain expert consultation
 Monitor ecg , x-ray, lab analysis,
 Monitor intra arterial blood pressure
 Administer drugs

40. COMPLICATIONS OF CPR:-:-
 Rib fractures
 Laceration related to the tip of the
sternum
 Liver, lung, spleen
 Aspiration
 Vmiting