MODULE 4:

CIRCULATION

Chapter 8

CPR and Circulation

Circulatory System
Consists of heart, blood vessels, blood.
Heart pumps blood to lungs and rest of
body.
Pulse is generated when heart contracts.
Major pulse points include: carotid,
femoral, brachial, and radial pulse.

Component of circulaion system

Locations for Assessing

Patients Pulse

Neck or carotid pulse

Wrist or radial pulse
Arm or brachial pulse
Groin or femoral pulse

Cardiac Arrest
May be caused by:
Heart attack or stroke
Untreated respiratory arrest
Medical emergencies (electrical shock,
epilepsy, poisoning, etc.)
Drowning
Suffocation
Trauma or shock from massive blood loss

When to Start CPR

CPR should be started on any
pulseless patient, except when any
of the following exist:
Decapitation
Rigor mortis
Tissue decomposition
Dependent lividity

When to Stop CPR

Patients pulse returns.

Care is transferred to another trained person.
Physician assumes responsibility.
Transfer to EMS personnel occurs.
Obvious death is recognized.
You are too exhausted to continue or
continuing would place you or others in
danger.

Skill Drill:
One-Rescuer Adult CPR
1. Establish responsiveness.
2. Open airway.
3. Check for breathing.
4. Perform rescue breathing.
5. Check for circulation.
6. Perform chest compressions.

Establish Unresponsiveness
Call, tap, or gently shake the
person

Asking for Help

Give the following information
- Location
- The telephone number from which
the call is made
- What happened ?
- How many people need help ?
- Condition of the victims ?
- What aid is being given to the
victims ?
- Any other information requested ?

Open the Airway

Do a slight head tilt
chin lift maneuver
Do not over extend
the head.

Check for Breathing

& Perform rescue breathing.
Look, Listen, Feel
for breathing 3-5
secs
If there is no
breathing, give 2
slow breaths 1.5
2 sec / breath &
watch chest rise.

Check for circulation.

Check carotid pulse

Locate land mark

& palpate

5-10 seconds

If no pulse, start
CPR

Skill Drill: Steps in Performing

Chest Compressions

1. Locate top and bottom of sternum.

2. Place heel of hand on lower half of sternum.
3. Place other hand on top of first hand.

Compression
Correct body and hand
position
Compress vertically 4-5
cm downwards
Say mnemonic (1-5, 110, 1-15 )
Give cycles of 15 chest
compressions followed
by

2 slow breaths

Assessment
Assess pulse and breathing after every
one minute
Or after 4 cycles
(cycles of 15 chest compressions
followed by 2 slow breaths )

Recovery Position

Switching Rescuers 1 of 2
Rescuer Two, giving compressions,
calls for switch.
Rescuer One delivers 2 breaths after
15th compression.
Rescuer Two completes one last set of
15 compressions and moves to head to
maintain the airway and ventilation.

Switching Rescuers 2 of 2
Rescuer Two checks carotid pulse.
If absent, Rescuer Two ventilates
patient twice.
Rescuer One begins chest
compressions.

Infant CPR

Position infant on firm surface.

Determine responsiveness.
Open airway.
Check for breathing.
Deliver two slow breaths.
Check brachial artery for pulse.
Begin chest compressions.

Child CPR

Locate top and bottom of sternum.

Place one hand on lower half of sternum, two
finger widths above xiphoid process.

Signs of Effective CPR

Pulse is felt during chest
compressions.
Patients pupils begin to constrict.
Patients skin color improves.
Patient regains own pulse and
breathing.
Independent heartbeat begins.

Complications of CPR
Broken bones
Gastric distention
Vomiting