Speedy patient rehabilitation by Panchmukhi Train Ambulance Services in Patna...
CPR, AED, and Choking Training- By Richard Garrity 2015
1. CPR, AED, & Choking Training
By, Mr. Richard Garrity
2. This presentation is proprietary information and can’t
be copied or reproduced in any fashion without consent
from the publisher owner, Richard Garrity
7. Some brief history & facts on
the evolution of CPR and AED
1740- The Paris Academy of Sciences
officially recommended mouth-to-
mouth resuscitation for drowning
victims. Since the Paris Academy of
Science’s archives are closed to online
researchers, a quick perusal through
the Society for the Recovery of
Drowned Persons’ website offers the
most accurate clarification of the
matter.
8. Some brief history & facts on
the evolution of CPR and AED
1767- The first attempts to deal
with sudden cardiac arrests or
heart attacks started in the mid
1700’s in Amsterdam, where a
group of wealthy and civil minded
citizens had organized a group
named Society for Recovery of
Drowned Persons.
9. Some brief history & facts on
the evolution of CPR and AED
1767- The group developed a set
of rules and procedures to follow
in case of drowning. This was the
first time an organization
addressed near death situations.
In that time, in Europe, swimming
was not a sport or common
practice. Very few Europeans
knew how to swim-
10. Some brief history & facts on
the evolution of CPR and AED
1891- Dr. Friedrich Maass performed
the first equivocally documented chest
compression in humans. Even though
the first chest compressions were
performed by Dr. Maass, the first
successful chest compression came in
1903 by Dr. George Crile. He also
performed chest compressions on the
first American in 1904.
11. Some brief history & facts on
the evolution of CPR and AED
However, closed chest
massage, or chest
compressions, were not
an excepted practice by
physicians, generally
worldwide, until 1958.
12. Some brief history & facts on
the evolution of CPR and AED
1954- James Elam was the first to
demonstrate experimentally that
cardiopulmonary resuscitation
(CPR) was a sound technique
and, with Dr. Peter Safar, he
demonstrated its superiority to
previous methods. Peter Safar
wrote the book “ABC of
Resuscitation” in 1957.
13. Some brief history & facts on
the evolution of CPR and AED
In the United States, it was
first promoted as a
technique for the public to
learn in the 1970’s.
Amazingly, the common
practice of CPR action is
less than 50 years in use!
14. Some brief history & facts on
the evolution of CPR and AED
In 1957, The United States
military adopted the
mouth-to-mouth
resuscitation method to
revive unresponsive
victims in the war zone and
during peace times.
15. Some brief history & facts on
the evolution of CPR and AED
1960- Cardiopulmonary
resuscitation (CPR) was
developed. The American Heart
Association started a program to
acquaint physicians with close-
chest cardiac resuscitation and
became the forerunner of CPR
training for the general public.
16. Some brief history & facts on
the evolution of CPR and AED
1972- Leonard Cobb held the
world's first mass citizen
training in CPR in Seattle,
Washington called Medic 2.
He helped train over 100,000
people the first two years of
the programs.
17. Some brief history & facts on
the evolution of CPR and AED
1979- the first portable automatic
external defibrillator (AED) was
developed, with a pharyngeal
electrode for sensing, shocking
electrodes on the abdomen and
tongue, and a simple algorithm to
detect abnormal rhythms and
automatically deliver rescue
pacing or a defibrillation shock.
18. Some brief history & facts on
the evolution of CPR and AED
1981- A program to provide
telephone instructions in CPR began in
King County, Washington. The
program used emergency dispatchers
to give instant directions while the fire
department and EMT personnel were in
route to the scene. Dispatcher-assisted
CPR is now standard care for
dispatcher centers throughout the
United States.
19. Some brief history & facts on
the evolution of CPR and AED
1990’s- Standard deployment
and use of Automated External
Defibrillators (AED) are in full use
by emergency responders and
becoming (slowly) standard
medical emergency equipment by
government and private business
entities.
20. Some brief history & facts on
the evolution of CPR and AED
2004- AHA and ILCOR releases a
statement regarding the use of
AEDs on children. It is determined
that an AED may be used for
children 1 to 8 years of age who
have no signs of circulation.
Although not medically sound,
there is no enhanced danger to
the unresponsive child.
22. What is CPR exactly?
Cardiopulmonary resuscitation (CPR)
is a lifesaving technique useful in
many emergencies, including heart
attack or near drowning, in which
someone's breathing or heartbeat has
stopped. The American Heart
Association recommends that
everyone — untrained bystanders and
medical personnel alike — begin CPR
with chest compressions.
23. What is CPR exactly?
It's far better to do something
than to do nothing at all if you're
fearful that your knowledge or
abilities aren't 100 percent
complete. Remember, the
difference between your doing
something and doing nothing
could be someone's life.
28. What is an AED exactly?
An automated external
defibrillator (AED) is a portable
electronic device that
automatically diagnoses the life-
threatening cardiac arrhythmias
of ventricular fibrillation and
ventricular tachycardia in a
patient, and is able to treat them
through defibrillation,
29. What is an AED exactly?
the application of
electrical therapy which
stops the arrhythmia,
allowing the heart to
reestablish an effective
rhythm.
31. Some quick facts about CPR:
Sudden cardiac arrest is the
leading cause of death in
adults. Most cardiac arrests
occur in persons with
underlying heart disease.
CPR doubles a person's
chance of survival from
sudden cardiac arrest.
32. Some quick facts about CPR:
75% of all cardiac arrests
happen in people's own
homes.
The typical victim of
cardiac arrest is a man in
his early 60's and a
woman in her late 60's.
33. Some quick facts about CPR:
Cardiac arrest occurs
twice as frequently in men
compared to women.
There has never been a
case of HIV transmitted by
mouth-to-mouth CPR.
34. Some quick facts about CPR:
In sudden cardiac arrest the
heart goes from a normal
heartbeat to a quivering
rhythm called ventricular
fibrillation (VF). This happens
in approximately 2/3rds of all
cardiac arrests.
35. Some quick facts about CPR:
Ventricular fibrillation (VF) is
fatal unless an electric shock,
called defibrillation, can be
given. CPR does not stop VF
but CPR extends the window
of time in which defibrillation
can be effective.
36. Some quick facts about CPR:
CPR provides a trickle of
oxygenated blood to the
brain and heart and keeps
these organs alive until
defibrillation can shock
the heart into a normal
rhythm.
37. Some quick facts about CPR:
If CPR is started within
4 minutes of collapse
and defibrillation
provided within 10
minutes a person has a
40% chance of survival.
39. CPR: How to effectively execute:
1. CALL- Check the victim for
unresponsiveness. If the person is
not responsive and not breathing
or not breathing normally, call 911
and return to the victim. In most
locations the emergency
dispatcher can assist you with
CPR instructions
40. CPR: How to effectively execute:
2. PUMP- If the victim is still not
breathing normally, coughing or
moving, begin chest
compressions. Push down in the
center of the chest 2 inches 30
times. Pump hard and fast at the
rate of at least 100/minute, faster
than once per second. REPEAT-
41. CPR: How to effectively execute:
3. TILT- Tilt the head back and
lift the chin. Pinch nose and
cover the mouth with yours
and blow until you see the
chest rise. Give 2 breaths.
Each breath should take 1
second. Look for the chest to
rise to confirm intake.
52. CPR Recap:
1. CPR will not restart a heart. Instead,
it manually pumps blood through the
heart and enables oxygen to reach the
brain. This is absolutely vital for
someone experiencing cardiac arrest.
According to the America Heart
Association, if CPR is administered
immediately, it doubles or even triples
the victim's rate of survival.
53. CPR Recap:
2. CPR is hard work. Pushing hard
on the victim's chest (at a depth of
about 2 inches) at a rate of 100
compressions per minute can
quickly become exhausting. If
another person is available to help
give CPR, you should switch out
every 2 minutes.
54. CPR Recap:
3. Both CPR and AEDs are safe. It
is unlikely you'll hurt someone by
performing CPR. Because CPR is
so critical in the first minutes
someone experiences cardiac
arrest, you should administer this
life-saving action even if you're
not absolutely sure whether the
victim is breathing or has a
heartbeat.
60. Conditions that the device treats:
An automated external
defibrillator (AED) is used in
cases of life-threatening
cardiac arrhythmias which
lead to cardiac arrest. The
rhythms that the device will
treat are usually limited to:
61. Conditions that the device treats:
1. Pulseless Ventricular
tachycardia (shortened to
VT or V-Tach)
2. Ventricular fibrillation
(shortened to VF or V-
Fib)
62. Conditions that the device treats:
In each of these two types of
shockable cardiac arrhythmia, the
heart is electrically active, but in a
dysfunctional pattern that does
not allow it to pump and circulate
blood. In ventricular tachycardia,
the heart beats too fast to
effectively pump blood.
63. Conditions that the device treats:
AEDs are designed to be used by
laypersons (average civilian) who
ideally should have received AED
training. However, sixth-grade
students have been reported to
begin defibrillation within 90
seconds, as opposed to a trained
AED operator beginning within 67
seconds.
65. AED use- clothing- safety
Bras with a metal underwire and
piercings on the torso should be
removed before using the AED on
someone to avoid interference.
Evidence has found that use of a
defibrillator on a woman wearing
an underwire bra can lead to
arcing or fire but only in unusual
and unlikely circumstances.
66. AED use- clothing- safety
However, as long as the AED
pads are on the skin and not the
clothing material, especially the
under wire of the bra, you do not
have to remove the bra. You must
though make sure the upper
clothing is completely removed or
cut off to avoid potential burning.
67. AED use- clothing- safety
The AED pads go just below
the right shoulder up above
the breast, and on the left side
below the left breast and
wrapping part way onto the
side of the torso. If a strap is
in the way, remove to prevent
burns to the victim.
68. Automated External Defibrillator
Unlike regular defibrillators, an
automated external defibrillator
requires minimal training to use. It
automatically diagnoses the heart
rhythm and determines if a shock
is needed. Automatic models will
administer the shock without the
user's command. Further prompts
will indicate follow up instructions
69. Automated External Defibrillator
All AEDs approved for use in
the United States use an
electronic voice to prompt
users through each step. The
user begins by turning on the
defibrillator and applying
conductive gel on the patient’s
chest or paddle electrodes.
84. AED’s- Battery Life:
AED batteries must be tested
monthly. They have a shelf life of
3-5 years. It is a very serious
violation of law to use an AED
that has expired batteries, even if
the device is still operable. It may
seem operable, but highly
probable the device may
malfunction or quit during
sequence operation.
85. AED’s- Battery Life:
Batteries must be replaced
after 3 years regardless of
current charge, condition,
expiration, or use. Don’t
take chances with
someone’s life or safety~
92. Oxygen and Time-
Time is very important and of
the essence when an
unconscious person is not
breathing. Permanent brain
damage begins after only 4
minutes without oxygen, and
death can occur as soon as 4
- 6 minutes later.