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Chest compressions. Indication. If after 30 seconds of effective bag and mask ventilation with 100% oxygen, heart rate is below 60 per minute. When to stop chest compressions. When heart rate is 60 per minute or more. Principle.

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Presentation Transcript
indication
Indication
  • If after 30 seconds of effective bag and mask ventilation with 100% oxygen,

heart rate is

below 60 per minute

when to stop chest compressions
When to stop chest compressions
  • When heart rate is 60 per minute or more
principle
Principle
  • Pump out blood from the heart during compression and fill up blood in the heart during release
  • Must always be accompanied by ventilation with 100% oxygen
mechanism of chest compressions
Mechanism of Chest Compressions

CompressRelease

sternum

heart

heart

components
Components
  • Position
    • Neck slightly extended with firm support for the back
    • Lower 1/3rd of sternum between nipple line & sternum
  • Pressure required – depth
    • 1/3rd of the AP diameter of chest
  • Rate
    • 90/min
chest compressions1
Chest Compressions

Position

  • Lower third of sternum
  • Between nipple line and xiphisternum
techniques
Techniques
  • Thumb technique
  • Two-finger technique

# Do not remove thumbs/finger from chest

thumb technique
Thumb technique
  • Thumbs on sternum, hands on torso & finger supporting the back
  • Thumbs flexed at the first joint
  • Pressure applied vertical
2 finger technique
2-finger technique
  • Easier with right hand for right handed
  • Index and middle or ring fingers
  • Other hand used to support the back
  • Pressure applied vertically
preferred method thumb
Preferred method - thumb
  • Advantages
      • Better control of depth
      • Less tiring
      • Superior generation of peak systolic & coronary perfusion pressure
      • Nails do not hinder performance
  • Disadvantages
      • Difficult when baby is big
      • Umbilicus difficult to cannulate.
compression
Compression
  • One compression consists downward compression plus the release
  • Actual distance is not a number but depends on size of baby
  • Duration of the downward stroke should be shorter than release to produce max COP
rate adequacy
Rate & adequacy

Rate

  • 3 CC then 1 ventilation (1:3)
  • 90 CC to 30 ventilation in one minute

Adequacy

  • Palpate femoral/carotid pulse
cycle of events
Cycle of events
  • One – and – two –and – three – and – breathe – and
  • Consists of 3 compression & one ventilation
  • 120 events in 60 seconds
  • 1 cycles in 2 seconds
chest compressions4
Chest Compressions

Dangers

  • Broken ribs
  • Lacerated liver
  • Pneumothorax

Precautions

  • No pressure on the ribs, xiphisternum, abdomen
  • Do not lift thumbs/fingers
evaluation after 30 sec of cc bmv
Evaluation after 30 sec of CC & BMV
  • HR 60 per minute or more Stop CC, continue BMV at 40-60/min
  • If no improvement, check :
    • Effectiveness of BMV
    • Oxygen is 100%
    • Technique of CC is correct
key points
Key points
  • When to do?
  • Why to do ?
  • How to do?
  • Which is best ?
  • When to stop ?
  • What if fails ?