MODULE-17

CPR(Cardio Pulmonary
Resuscitation) &
AED (Automated External
Defibrillator)
 TOPICS

Introduction – Cardiac Arrest

Giving CPR (CPR for an Adult)
 How to perform CPR on an Adult
 Locate the correct hand position
 Locate the correct body position
 Different techniques
 Rescue breaths
 Procedure
 When to Stop CPR
 Special Considerations
Automated External Defibrillators
 INTRODUCTION – CARDIAC ARREST

 Cardiac arrest occurs when the heart stops beating or beats too
ineffectively and blood cannot be circulated to the brain and other vital
organs.
 Cardiac arrest is a life-threatening emergency because the body’s vital
organs are no longer receiving oxygen-rich blood.
 Without oxygen, brain damage can begin in about 4 to 6 minutes, and
the damage can become irreversible after about 10 minutes.
 Cardiovascular disease is the most common cause of cardiac arrest in
adults. In addition, drowning, choking and certain drugs can cause
breathing to stop, which will soon lead to cardiac arrest.
 INTRODUCTION – CARDIAC ARREST
 Severe injuries to the chest or severe blood loss can cause the heart to
stop beating. Electrocution disrupts the heart’s electrical activity and
can cause the heart to stop beating. Stroke or other types of brain
damage can also stop the heart.
 Cardiac arrest is fatal without emergency care and can happen
suddenly, without any of the warning signals usually seen in heart
attack. The most common life-threatening abnormal arrhythmia is
ventricular fibrillation.
 Signals of Cardiac Arrest - A person in cardiac arrest will be unconscious
and will not be breathing. These are the primary signals of cardiac
arrest. In addition, the person’s skin may be pale, ashen or bluish,
particularly around the face. The skin may also be moist from
perspiration
 The Cardiac Chain of Survival The cells of the brain and other vital
organs in a person who is not breathing and is unconscious will continue
to live for a short period of time until oxygen is depleted. However,
without immediate emergency intervention, a person will not survive.
 INTRODUCTION – CARDIAC ARREST

 A person in cardiac arrest needs cardiopulmonary resuscitation (CPR),

which is a combination of chest compressions and rescue breaths.
 (The term “cardio” refers to the heart, and “pulmonary” refers to the
lungs.) Performed together, chest compressions and rescue breaths
artificially take over the functions of the lungs and heart, increasing the
person’s chance of survival by keeping the brain supplied with oxygen
until advanced medical care can be provided. However, even under the
best of conditions, CPR only generates about one-third of the normal
blood flow to the brain. Therefore, CPR alone may not be enough to
help someone survive cardiac arrest. Early CPR given by citizen
responders or bystanders, combined with early defibrillation (use of an
AED) and advanced cardiac life support by EMS (Emergency
Management System) personnel, give the person with cardiac arrest
the best chance for survival. This concept is known as the Cardiac Chain
of Survival.
 INTRODUCTION – CARDIAC ARREST
The greatest chance of survival from cardiac arrest occurs when you follow the
four links in the Cardiac Chain of Survival as rapidly as possible.
 Early recognition and early access to the EMS system. The sooner 108 or the
local emergency number is called, the sooner early advanced medical care
arrives to take over
 Early CPR. Early CPR helps circulate blood that contains oxygen to the vital
organs until an AED is ready to use or advanced medical personnel arrive.
 Early defibrillation. An electrical shock, called defibrillation, may help to
restore an effective heart rhythm.
 Early advanced medical care. This is given by trained medical personnel,
such as paramedics, who provide further care and transport the person to
the hospital.
 INTRODUCTION – CARDIAC ARREST

 For each minute that CPR and defibrillation are delayed, the
chance for survival is reduced by about 10 percent. Each link in
the Cardiac Chain of Survival depends on, and is connected to,
the other links. Taking quick action by calling 108 or the local
emergency number, starting CPR immediately and using an
AED, if one is available, make it more likely that a person in
cardiac arrest will survive. Remember, you are the first link in
the Cardiac Chain of Survival. By acting quickly, you can make a
positive difference for someone experiencing a cardiac
emergency.
 GIVING CPR- FOR AN ADULT

Follow the emergency action steps, CHECK—CALL—CARE, to

determine whether an unconscious adult needs CPR.
 CHECK the scene and the injured or ill person.
 If the person is unconscious, send someone or CALL 108 or
the local emergency number.
 CHECK for breathing for no more than 10 seconds.
 Quickly CHECK for severe bleeding.
 If the person is not breathing, give CARE by beginning CPR
with 30 chest compressions followed by 2 rescue breaths.
 GIVING CPR- FOR AN ADULT

For chest compressions to be effective,

the person should be on his or her back
on a firm, flat surface.
CPR is not effective if the person is on a
soft surface, like a sofa or mattress, or if
the person is sitting up in a chair. If
necessary, quickly move the person to a
firm, flat surface before you begin
HOW TO PERFORM CPR – ON ADULT
HOW TO PERFORM CPR – ON ADULT
HOW TO PERFORM CPR – ON ADULT
HOW TO PERFORM CPR – ON ADULT
 WHEN TO STOP - CPR
Once you begin CPR on an adult, child or infant, do not
stop except in one of these situations:
 You notice an obvious sign of life, such as breathing.
 An AED becomes available and is ready to use.
 Another trained responder or EMS personnel arrive
and take over.
 You are too exhausted to continue.
 The scene becomes unsafe.
 If at any time the adult, child or infant begins to
breathe or show another sign of life, stop CPR, keep
the airway open, and closely monitor breathing and
any changes in the person’s condition until EMS
personnel take over.
 SPECIAL CONSIDERATIONS
Multiple Responders If two responders
trained in CPR are at the scene, you should
both identify yourselves as CPR-trained
responders. One of you should then call 108
or the local emergency number for help (if
this has not been done) and get an AED,
while the other begins CPR. If the first
responder is tired and needs help, the first
responder should tell the second responder
to take over. The second responder should
immediately begin CPR, starting with chest
compressions.
 SPECIAL CONSIDERATIONS
If you are unable or unwilling for any reason
to perform full CPR (with rescue breaths),
give continuous chest compressions.
Steps include:
CHECK the scene for safety and then see if
the person responds when prompted.
Briefly CHECK for breathing.
If the person doesn’t respond, send
someone or CALL 108 or the local
emergency number.
 SPECIAL CONSIDERATIONS
Prepare to give chest compressions using the
techniques described earlier in the chapter
Give continuous chest compressions,
pushing hard and fast at the proper depth
and speed. Continue giving chest
compressions until you notice an obvious
sign of life, such as breathing, an AED is
ready to use, another trained responder or
EMS personnel arrive and take over, you
are too exhausted to continue or the scene
becomes unsafe.
AUTOMATED EXTERNAL
DEFIBRILLATORS
 WHEN HEART FAILS
 Any damage to the heart from disease or injury can disrupt the
heart’s electrical system. This disruption can result in an abnormal
heart rhythm that can stop circulation. The two most common
abnormal rhythms leading to cardiac arrest are ventricular fibrillation
(V-fib) and ventricular tachycardia (V-tach).
 V-fib is a state of totally disorganized electrical activity in the heart. It
results in fibrillation, or quivering, of the ventricles. In V-fib, the
electrical impulses fire at random, creating chaos and preventing the
heart from pumping and circulating blood. A person with V-fib will
suddenly collapse unconscious and stop breathing.
 V-tach refers to a very rapid contraction of the ventricles. Although
there is electrical activity resulting in a regular rhythm, the rate is
often so fast that the heart is unable to pump blood properly. As with
V-fib, the person with V-tach may collapse, become unconscious and
stop breathing.
 DEFIBRILLATION
In many cases, V-fib and V-tach rhythms can be corrected
by early defibrillation. Delivering an electrical shock with
an AED disrupts the electrical activity of V-fib and V-tach
long enough to allow the heart to spontaneously develop
an effective rhythm on its own. If V-fib or V-tach is not
interrupted, all electrical activity will eventually cease, a
condition called asystole. Asystole cannot be corrected by
defibrillation. Remember that you cannot tell what
rhythm, if any, the heart has by checking for signs of life.
CPR, started immediately and continued until
defibrillation, helps maintain a low level of circulation in
the body until the abnormal rhythm can be corrected by
defibrillation.
 USING AN AED - ADULT
With cardiac arrest, an AED should be used as soon as it is
available and safe to do so. Be sure to call 108 or the local
emergency number and start CPR immediately. CPR in
progress is stopped only when the AED is ready to use.
Different types of AEDs are available, but all are similar to
operate and have some common features, such as
electrode (AED or defibrillation) pads, voice prompts,
visual displays and/or lighted buttons to guide the
responder through the steps of the AED operation. Most
AEDs can be operated by following these simple steps:
 USING AN AED - ADULT
Turn on the AED.
Expose the person’s chest and wipe the bare chest dry
with a small towel or gauze pads. This ensures that the
AED pads will stick to the chest properly.
Apply the pads to the person’s bare, dry chest. (Make
sure to peel the backing off each pad, one at a time, to
expose the adhesive surface of the pad before applying
it to the person’s bare chest.) Place one pad on the
person’s upper right chest and the other pad on the left
side of the chest
 USING AN AED - ADULT

If the AED advises that a shock is needed:

 Ensure that no one, including you, is touching
the person.
 Say, “EVERYONE, STAND CLEAR.”
 Deliver a shock by pushing the shock button,
if necessary. (Some models can deliver the
shock automatically, while others have a
“shock” button that must be pushed
manually to deliver the shock.)
 USING AN AED - ADULT

After delivering the shock, or if no shock is

advised:
 Perform about 2 minutes (or 5 cycles) of CPR.
 Continue to follow the prompts of the AED.
 If at any time you notice an obvious sign of
life, such as breathing, stop performing CPR
and monitor the person’s breathing and any
changes in his or her condition.
 AED PRECAUTIONS
When operating an AED, you should avoid certain actions and
situations that could harm you, other responders or
bystanders and the person. The following precautions should
be taken when operating an AED:
Do not use alcohol to wipe the person’s chest dry. Alcohol is
flammable.
Do not use incorrect size pads, unless there are no other pads
available. Persons older than 8 years of age or weighing more
than 55 pounds should have adult AED pads. Children under
age 8 or less than 55 pounds should have pediatric pads,
which provide a lower dose of electricity. If there are no
correctly sized pads available, then you may use the other
sized pads.
Do not touch the person while the AED is analyzing. Touching
or moving the person may affect analysis.
 AED PRECAUTIONS
Before shocking a person with an AED, make sure that no one
is touching or is in contact with the person or any resuscitation
equipment.
 Do not touch the person while the AED is defibrillating. You or
others could be shocked.
Do not defibrillate someone when around flammable or
combustible materials, such as gasoline or free-flowing
oxygen.
Do not use an AED in a moving vehicle. Movement may affect
the analysis.
Do not use an AED on a person who is in contact with water.
Move the person and AED away from puddles of water or out
of the rain before defibrillating (see the section on the next
page on AEDs Around Water for more information).
 AED PRECAUTIONS

Do not use an AED on a person wearing a nitro-glycerine patch

or other medical patch on the chest. With a gloved hand,
remove any patches from the chest before attaching the
device (see the section on the next page on AEDs and
Transdermal Medication Patches for more information).
Do not use a mobile phone or radio within 6 feet of the AED.
Radiofrequency interference, electromagnetic interference
and infrared interference, generated by radio signals, can
disrupt analysis.