Until Help Arrives

1. Adult CPR Until Help Arrives http://www.firstaidweb.com

3. CPR? What is that? • Cardio- : heart • Pulmonary: lungs • Resuscitation : restore life

4. Can you save a life? EMS response may take 6-10 min… or even longer When the heart stops pumping the brain isn’t getting oxygen. CPR helps to manually pumpoxygen to the brain and heart until additional help arrives.

5. DO NOT… • Leavethe victim alone • Try to make the victim drink water • Throw water on victim’s face • Prompt the victim into a sitting position • Try to revive the victim by slapping face

6. First steps (Adults: over 10-14yrs) • Always check that the scene is safe. • There should be nothing hazardous to your safety or others while performing CPR. • Check for responsiveness • If you think they’ve suffered a spinal injury (do not move them!) otherwise give them a light shake and shout “are you ok?” • If no response dial 911

7. BEFORE CPR • If someone besides you is present, they should call 911 immediately • If you’re alone, try to callfor help.. • PRIOR to starting CPR on an adult

8. Next… C.A.B. • "C" is for CIRCULATION/COMPRESSIONS. In order to determine if the victim's heart is beating, place two fingertips onhis carotid artery, located in the depression between the windpipe and the neck muscles, andapply slight pressurefor several seconds. Ifthere is no pulse then the victim's heart is not beating, and you will have to perform chest compressions.

9. COMPRESSIONS • When performing chest compressions, proper hand placement isvery important. • To locate the correct hand position place two fingers at the bottom of sternum(spot wherelower ribs meet)then put the heel of your other hand next toyour fingers

10. Compressions • Place one hand on top of the other and interlace the fingers (Figure 2). • Lock your elbows and useyour body weight • compress victim's chest • depth of compressions should be at least 2 in - remember: 2 hands, 2 inches

11. Compressions • Count aloud as you compress30 times at the rate of about 100 compressions per minute. • To the beat of “Stayin’ alive”

12. C.A.B. – A is for Airway • If the victim is unconscious and is unresponsive, you need to make sure that his airway is clear of any obstructions. • If you determine that the victim is not breathing,then something may be blocking his air passage. • tongue is the most common airway obstruction in an unconscious person.

13. C.A.B. • With the victim lying flat on his back,placeyour hand on his forehead and your other hand under the tip of the chin. Gently tilt the victim's head backward. • In this position the weight of the tongue will force it to shift away from the back of the throat, opening the airway.

14. C.A.B. – B is for Breathing • Note: you may skip this step if performing "compression only" CPR • With the victim's airway clear of any obstructions, gently supporthis chinso as to keep it lifted up and the head tilted back. Pinch his nosewith your fingertipsto prevent air from escapingonce you begin to ventilate and place your mouth overthe victim's, creatinga tight seal

15. C.A.B. • As you assist the person in breathing, keep an eye on his chest.Try not to over-inflate the victim's lungs as this may force air into the stomach,causinghim to vomit. • If this happens, turn the person's head to the side and sweep any obstructions out of the mouth before proceeding. • Give two full breaths. • Betweenbreaths allow the victim's lungs to relax- place your ear near his mouth and listen for air to escape and watch the chest fall as the victim exhales

16. Quick Review of C.A.B. • Remember C-A-B: • Circulation/Compressions: if there is no pulse, perform 30 chest compressions at the rate of at least 100/minute - 2 hands, 2 inches. • Airway: tilt the head back and lift the neck to clear the airway. • Breathing: pinch the victim's nose and give 2 breaths, watching for the chest to rise with each breath.

17. Video Clip https://www.youtube.com/watch?v=-ihf6pHYNj4 https://www.youtube.com/watch?v=OaSovqEimyA

18. Child CPR : over 12 months to 10-14yrs Until Help Arrives

19. Cardiac Arrest in Children?! • Rarely caused by heart failure, usually caused by injury that stops the breathing first. • Poisoning • Smoke Inhalation • Head trauma • Children are more resilient so they respond to CPRmuch better if administered ASAP

20. What’s first? • Check to see if child is responsive. • Give slight shake and shout “are you ok?” • If victim is not responsive, IMMEDIATELY begin CPR • Ifyou’re aloneperform CPR for at least 3-5 cycles BEFORE calling 911

21. Check Circulation • Check the child's carotid artery for pulseby placing two fingertips and applying slight pressure on his carotid artery for 5 to 10 seconds • If you don't feel a pulsethenthe victim's heart is not beating, and you will have to perform chest compressions

22. C.A.B. : Compressions • When performing chest compressions on a child, proper hand placement is even more crucial than with adults. • Using two fingers locate the victim's sternum at the bottom of the rib cage where the lower ribs meet, and then put the heel of your other hand directly next to your fingers on the sternum • Use only the heel of one hand to perform compressions.

23. Compressions • A child's smallerand more fragile body requires less pressure. • The depth of compressions for a child is about 2 inches. • If you feel or hear slight cracking sound, you may be pressing too hard and may need to apply less pressure as you continue.

24. Compressions • Count aloud as you compress 30 times at 100-120 compressions per minute (with minimal pauses between compressions), followed by 2 breaths. • Perform 5 cycles of 30 compressions and 2 breaths before checking the child's carotid arteryfor pulse as well as any signs of consciousness. • DO NOT FORGET TO DIAL 9-1-1.

25. C.A.B. • Chest compressions will supply blood flow to the heart and the brain but if victim remains unresponsive you will need to check their airway. • A child's breaths may beextremely faint and shallow - look, listen and feel foranysigns of breathing. • Ifthere are none,thetongue may be obstructing theairwayand preventing the child from breathing on his own.

26. C.A.B. : Airway • Exercise extra caution when you open the victim's air passage using the head tilt/chin lift technique. This will shift the tongue away from the airway. • If the child is still not breathing after his airway has been cleared, you will have to assist him in breathing

27. C.A.B. : Breathing • If the child remains unresponsive and still not breathing on his own, pinch his nose with your fingertips or cover his mouth and nose with your mouth creating a tight seal,andgive two breaths

28. Breathing • Keep in mind that children's lungs have much smaller capacity than those of adults. When ventilating a child, be sure to use shallower breaths and keep an eye on the victim's chestto prevent stomach distention. • If this happens and the child vomits, turn his head sidewaysand sweepall obstructions out of the mouth before proceeding.

29. Review • Check for responsiveness by shouting and shaking the victim. Do NOT shake the child if he has sustained a spinal injury. • Remember C-A-B: • Circulation: if there is no pulse, administer 30 chest compressions of about 2 inches. • Airway: tilt the head back and lift the neck to clear the airway. • Breathing: pinch the child's nose or cover his mouth and nose with your mouth making a tight seal, and give two breaths, watching for the chest to rise with each breath. • Continue to perform CPR for 1 to 2 minutes before dialing 9-1-1. • Check for pulse and if necessary perform the cycle again, checking for pulse every minute.

30. Video Clip • Child CPR demo

31. Infant CPR Until Help Arrives

32. Infant CPR • According to AHA guidelines, Infant CPR is administered to any victim under the age of 12 months exceptfor newborns in the first hours after birth. • Infants, just as children, have a much better chance of survival if CPR is performed immediately. • If you are alone with the infant, do not dial 9-1-1 until after you have made an attempt to resuscitatethe victim. • Check the infant for responsiveness by pattinghis feetandgently tapping his chest or shoulders. • If he doesnot react (stirring, crying, etc.), immediately check his circulation

33. C.A.B.: Circulation • An infant's pulse is checked at the brachial artery, which is located inside of the upper arm, between the elbow and the shoulder. • Place two fingers onthe brachial artery applying slight pressure for 3 to 5 seconds. • If you do not feel a pulse within that time, then the infant's heart is not beating, and you will need to perform chest compressions

34. Compressions • An infant's delicate ribcageis especially susceptible to damageif chest compressions are improperly performed, therefore it is important to use caution when rescuing an infant. • Place three fingers in the center of the infant's chest with the top finger on an imaginary line between the infant's nipples. • Raisethe top finger up and compress withthe bottom two fingers.

35. Compressions Cont. • The compression should be approximately1/3 to 1/2 the depth of the infant's chest. • Count aloud as you perform 5 cycles of 30 compressions and 2 breathsbefore checking the infant for breathing and pulse. • REMEMBER TO DIAL 9-1-1

36. Airway • It is normal for an infant to take shallow and rapid breaths, so carefully look, listen and feel for breathing. • If you cannot detect any signs of breathing, the tongue may be obstructing the infant's airway.

37. Airway • Although the head tilt/chin lift technique is similar to adults and children, when clearingan infant's airway it's important not to tilt the head too far back. An infant's airwayis extremely narrow and overextending the neck may actually close offthe air passage. • Tilt the head back intowhat is called the "sniffer's position" - far enough to make the infant look as if he is sniffing

38. Breathing • Cover the infant's mouth and nose with your mouth creating a seal, and give a quick, gentle puff from your cheeks. • Let the victim exhale on his own - watchhis chest, listen and feel for breathing. • Ifhe does not breathe on his own, again place your mouth over his mouth and nose and give another small puff

39. Review • Infant CPR should be administered to any victim under the age of 12 months (except for newborns in the first hours after birth). • The procedure is as follows: • 1. Check for responsiveness by patting the infant's shoulders or chest. • 2. Remember C-A-B: • Circulation/Compressions • Airway: "sniffer position". Do not overextend. • Breathing: use gentle puffs, breathing from cheeks, not lungs. • 3. Perform rescue efforts for 1 to 2 minutes before dialing 9-1-1. • 4. Continue performing rescue efforts, checking for pulse every minute until help arrives.

40. Video Clip • Aunt Saves Infant on side of Highway

41. Compare and Review