Adult Basic Life Support for

the Health Care Worker

Adult Basic Life Support for
the Health Care Worker
PhiIippine Heart Association, Inc.
CounciI on Cardio PuImonary Resuscitation
PhiIippine Heart Association, Inc.
CounciI on Cardio PuImonary Resuscitation
A Full Member of the A Full Member of the
The Asian Representative of The Asian Representative of
ased on the New 2010 6PR Cu|de||nes of the AhA and |L60R
11ective CPR
done
immediateIy
a1ter cardiac
arrest can
doubIe a
victim's chance
o1 survivaI.
11ective CPR
done
immediateIy
a1ter cardiac
arrest can
doubIe a
victim's chance
o1 survivaI.
What is C P R ?
CPR = Cardio-
Pulmonary
Resuscitation
'he NEW Chain of Survival 'he NEW Chain of Survival
arIy access: arIy access: immediate recognition and activation immediate recognition and activation
arIy CPR arIy CPR
arIy de1ibriIIation arIy de1ibriIIation
arIy advanced care arIy advanced care
Integrated post Integrated post- -
cardiac arrest care cardiac arrest care
A A weII weII- -in1ormed Iay person in1ormed Iay person
- - key in the earIy access key in the earIy access
Iink. Iink.
Recognition o1 signs o1 Recognition o1 signs o1
heart attack and heart attack and
respiratory 1aiIure respiratory 1aiIure
CaII 1or heIp immediateIy i1 CaII 1or heIp immediateIy i1
needed needed
Activate the mergency Activate the mergency
MedicaI System MedicaI System
'he First Link 'he First Link Early Access Early Access
EARLY WARN!NC S!CNS OF EARLY WARN!NC S!CNS OF
RESP!RA'ORY FA!LURE RESP!RA'ORY FA!LURE
unabIe to speak, unabIe to speak,
breath or cough breath or cough
cIutches neck cIutches neck
(universaI (universaI
distress signaI) distress signaI)
bIuish coIor o1 bIuish coIor o1
skin and Iips skin and Iips
i1e saving technique i1e saving technique
1or cardiac & respiratory 1or cardiac & respiratory
arrest arrest
Chest compressions Chest compressions +/ +/- -
Rescue breathing Rescue breathing
ay persons and ay persons and
medicaI personneI medicaI personneI
Second Link Second Link Early CPR Early CPR
Why is early CPR important?
CPR is the best treatment for cardiac
arrest until the arrival of ACLS care.
prevents VF 1rom deteriorating to
asystoIe
may increase the chance o1
de1ibriIIation
It signi1icantIy improves survivaI.
Brain Brain
(Cerebral) (Cerebral)
Heart Heart
(Cardiac (Cardiac
Lungs Lungs
(Pulmonary) (Pulmonary)
How does CPR work?
A|| lre ||v|rg ce||s ol our A|| lre ||v|rg ce||s ol our
oody reed a sleady oody reed a sleady
supp|y ol oxyger lo supp|y ol oxyger lo
|eep us a||ve. |eep us a||ve.
0ur|rg CPR, you car orealre a|r |rlo 0ur|rg CPR, you car orealre a|r |rlo
lre v|cl|r's |urgs lo prov|de oxyger lre v|cl|r's |urgs lo prov|de oxyger
|rlo lre o|ood. |rlo lre o|ood.
wrer you press or lre cresl, you rove wrer you press or lre cresl, you rove
oxyger oxyger -- carry|rg o|ood lrrougr lre carry|rg o|ood lrrougr lre
oody. oody.
When will you do CPR? When will you do CPR?
AS SOON AS POSSIB AS SOON AS POSSIB
rain cells begin to die after rain cells begin to die after
4 4- -6 minutes 6 minutes without oxygen. without oxygen.
ho may Iearn about CPR?
CPR is an easy and life saving
procedure and can be learned by
anyone.
One does not need to be a doctor to
learn how to do CPR.
'HE 'ECHN!QUE AND S'EPS 'HE 'ECHN!QUE AND S'EPS
!N CPR !N CPR
YOU W%SS A YOU W%SS A
CARDAC ARRS% CARDAC ARRS%
CHCK CHCK ARA ARA
SA%Y. SA%Y.
Survey Survey the scene. the scene.
See See if the scene is safe to do CPR. if the scene is safe to do CPR.
Get an idea of what happened. Get an idea of what happened.
CHCK CHCK URSPOS'SS. URSPOS'SS.
%ap or gently shake %ap or gently shake the victim the victim
Rescuer shouts Rescuer shouts 'Are you OK?" 'Are you OK?"
Quick check for normal breathing Quick check for normal breathing
f the victim is unconscious, f the victim is unconscious,
rescuer rescuer calls for help calls for help..
CALL OR CALL OR HLP: HLP:
Ambulance, Ambulance,
mergency Services, mergency Services,
Doctor Doctor
Rescuer Rescuer AC%'A%S AC%'A%S the the
RGCY DCAL RGCY DCAL
SR'CS SR'CS..
Get Get AD/Defibrillator AD/Defibrillator! !
NON-RSPONSIV,
NO NORMA BRATHING
PULSE CHECK PULSE CHECK
Palpate for Carotid Pulse Palpate for Carotid Pulse
within 10 seconds within 10 seconds
(at the same time (at the same time
CHECK FOR CHECK FOR
BREATHNG) BREATHNG)
For trained heaIthcare For trained heaIthcare
providers onIy providers onIy
o Mouth to Mouth o Mouth to Mouth
Breathing Breathing
Give one breath every Give one breath every
5 5- -6 6 secs secs (about 12 (about 12
breaths/min) breaths/min)
Recheck pulse every 2 Recheck pulse every 2
minutes minutes
!f with !f with definite pulse definite pulse
but no breathing but no breathing
MOUTH TO MOUTH BRATHING
and PUS CHCK
eemphasized in the new guidelines
For trained healthcare providers only
As short and quick as possible
Pulse check not more than 10 seconds
f unsure, proceed directly to CHEST
COMPRESSONS!
C C -- A A -- B B
C. COMPRSSION Do chest C. COMPRSSION Do chest
compressions 1irst compressions 1irst
A. A. AIRAY AIRAY Does the victim have an Does the victim have an
open airway (air passage open airway (air passage
that aIIows the victim to that aIIows the victim to
breathe)? breathe)?
B. BRATHING B. BRATHING Is the victim breathing? Is the victim breathing?
A1ter A1ter determining unconsciousness determining unconsciousness, ,
A1ter determining unconsciousness A1ter determining unconsciousness
and caIIing 1or heIp, and caIIing 1or heIp,
proceed immediateIy to do proceed immediateIy to do
C CHES' HES'
C CONPRESS!ONS! ONPRESS!ONS!
C C -- C CONPRESS!ON ONPRESS!ON
(to assist (to assist C C!RCULA'!ON) !RCULA'!ON)
Chest Compressions Chest Compressions
KneeI 1acing KneeI 1acing
victim's chest victim's chest
PIace the heeI o1
your hand on the
center o1 the victim's
chest. Put your other
hand on top o1 the
1irst with your
1ingers interIaced.
PIace the
heeI o1 one
hand on the
sternum in
the center o1
the chest
between the
nippIes and
then pIace
the heeI o1
the second
hand on top
o1 the 1irst so
that the
hands are
overIapped
and paraIIeI.
Chest Compressions Chest Compressions
Cive Chest Compressions at 100 per minute Cive Chest Compressions at 100 per minute
Compress breastbone at Ieast Compress breastbone at Ieast 2 inches deep 2 inches deep
Compress at a rate o1 Compress at a rate o1 100 per minute or more 100 per minute or more
Compress 30 times initiaIIy Compress 30 times initiaIIy
AIIow AIIow the chest to return to its normaI position
Cive 30 Compressions Cive 30 Compressions
Compress breastbone at least Compress breastbone at least 2 2
inches inches
(30 compressions should take 1S (30 compressions should take 1S18 18
sec) sec)
Count aloud Count aloud "1, 2, 3, 4, "1, 2, 3, 4,
5,6,7,8,9,10,11,12,13,14,15,16,17,1 5,6,7,8,9,10,11,12,13,14,15,16,17,1
8,19,20,21,22,23,24,25,26,27,28,29, 8,19,20,21,22,23,24,25,26,27,28,29,
and ONE! and ONE!
Minimize interruptions Minimize interruptions
Allow recoil after each compression Allow recoil after each compression
A A A!RWAY A!RWAY
Open the Airway: Open the Airway:
Use the head tiIt/chin Use the head tiIt/chin
Ii1t method Ii1t method
#lace one hand on #lace one hand on
the victim's forehead the victim's forehead
#lace fingers of other #lace fingers of other
hand under the bony hand under the bony
part of lower jaw part of lower jaw
near chin near chin
Tilt head and lift jaw Tilt head and lift jaw
avoid closing avoid closing
victim's mouth victim's mouth
Head 'ilt Chin Lift Naneuver
This maneuver prevents airway obstruction
by the epiglottis.
B B BREA'H!NC BREA'H!NC
Give 2 one Give 2 one- -second second
breaths breaths
Maintain airway Maintain airway
Pinch nose shut Pinch nose shut
Open your mouth Open your mouth
wide, take a normal wide, take a normal
breath, and make a breath, and make a
tight seal around tight seal around
outside of victim's outside of victim's
mouth mouth
Give 2 full breaths Give 2 full breaths
(1 sec/ breath) (1 sec/ breath)
Observe chest rise & Observe chest rise &
fall; listen & feel for fall; listen & feel for
escaping air escaping air
PUS CHCK
RCHCK PUS VRY 2 MINUTS
equivalent to 5 cycles CPR)
Very brie1 puIse check - shouId take
Iess than 10 seconds (at the same time
check 1or normaI breathing)
In case there is any doubt about the
presence or absence o1 puIse,
CONTINU CHST COMPRSSIONS
For trained heaIthcare providers onIy
UNTI UNTI
HELP ARRVES. HELP ARRVES.
(Emergency Services, Ambulance, octor, (Emergency Services, Ambulance, octor, AD AD) )
PERSON S REVVE. PERSON S REVVE.
!f the victim is breathing !f the victim is breathing
The unresponsive victim with spontaneous The unresponsive victim with spontaneous
respirations should be placed in the recovery respirations should be placed in the recovery
position position if no cervical trauma if no cervical trauma is suspected. is suspected.
Placement in this position consists of rolling the Placement in this position consists of rolling the
victim onto his or her side victim onto his or her side to help protect the to help protect the
airway. airway.
Maintain open airway & position the victim Maintain open airway & position the victim
TH RCOVRY POSITION TH RCOVRY POSITION
Maneuvers AduIts ChiIdren
RCOGNITION
UNRSPONSIV
No breathing,
not breathing normaIIy (eg. onIy gasping)
No breathing or onIy gasping
CPR Sequence CAB CAB
Compression Rate At Ieast 100/min
Compression Depth At Ieast 2 inches (5 cm)
At Ieast 1/3 AP depth; About 2 inches
Chest waII RecoiI
AIIow compIete recoiI between compressions
HCPs rotate compressors every 2 minutes
Compression
interruptions
Minimize interruptions in chest compressions
Attempt to Iimit interruptions to Iess than 10 seconds
Airway Head tiIt chin Ii1t (HCP suspected trauma: jaw thrust)
Compression-VentiIation
ratio
30 : 2 (one or 2 rescuers) 30:2(singIe rescuer); 15:2(2 rescuer) 30:2(singIe rescuer); 15:2(2 rescuer)
VentiIations: when rescuer
untrained or trained and
not proficient
Compressions onIy Compressions onIy
VentiIations with
advanced airway (HCP)
1 breath every 6-8 seconds (8-10 breaths/min)
Asynchronous with chest compressions
About 1 second per breath
VisibIe chest rise
DFIBRIATION ( AD ) Attach and use AE as soon as available. Minimize interruptions in chest
compressions before and after shock, resume CPR beginning with compressions
immediately after each shock
Summary o1 Key BS Components 1or AduIts and ChiIdren
MMORIZ TH STPS
Survey the scene.
Check responsiveness hey hey are you ok?
Call for help! Activate EMS
[Quick check pulse within 10 secs]
C Chest Compressions: 30 x; 100/min; 2 inches
deep; push hard and fast
A - Airway: head tilt chin lift
B Breathing: 2 breaths (1 second/breath)
Chest compressions 30 x
Continue cycles 30:2 compression-ventilation
[Quick check pulse every 2 mins]
Until:
EMS arrives (AE, doctor, ambulance)
Patient has signs of life
NOT TRAIND
DO NOT KNO MOUTH TO MOUTH
VNTIATION
NOT SUR ABOUT MOUTH TO MOUTH
VNTIATION
HSITANT TO DO MOUTH TO MOUTH
VNTIATION
DO NOT ANT TO DO MOUTH TO MOUTH
VNTIATION
Compression-onIy bystander CPR
Hands OnIy CPR
Hands OnIy CPR shouId onIy
be used 1or aduIt victims who
have suddenIy coIIapsed or
become unresponsive.
Recommendations:
AII victims o1 cardiac arrest shouId receive
high-quaIity chest compressions
hen an aduIt suddenIy coIIapses, aII
bystanders shouId activate their community
MS and provide high-quaIity chest
compressions, minimizing interruptions
(CIass I).
Hands OnIy CPR
Recommendations:
f not trained in CPR, provide hands-only
CPR (Class a) until
AE arrives
EMS providers take over care of the victim
f trained in CPR, provide either
conventional CPR using a 30:2
compression-to-ventilation ratio (Class
a) or handsonly CPR (Class a)
Hands OnIy CPR
Key Changes in the New GuideIines
CAB instead of ABC
Compress first
No more Look Listen and Feel
Harder! At least 2 inches compression (old: 1 to 2
inches)
Faster! At least 100/min compression (old: up to
100/min)
eemphasize pulse checks
For trained healthcare providers not more than 10 secs
Check for normal breathing together with check for
unresponsiveness
Hands only CPR for the untrained lay rescuer
Important Points
There are no mistakes when you per1orm CPR.
The onIy harm is to deIay responding.
Start chest compressions now viewed as the most
e11ective procedure
AII victims in cardiac arrest need chest compressions.
Don't stop pushing.
Keep pushing as long as you can. Push until the AE is in
place and ready to analyze the heart. When it is time to do mouth
to mouth, do it quick and get right back on the chest.
80-90% o1 cardiac emergencies occur at home.
Training is now simpIer and more accessibIe
Reduced number of steps and simplified process
Being trained to do CPR can save a Being trained to do CPR can save a
Ioved one. Ioved one.
11ective CPR done immediateIy a1ter 11ective CPR done immediateIy a1ter
cardiac arrest can doubIe a victim's cardiac arrest can doubIe a victim's
chance o1 survivaI. chance o1 survivaI.
Being trained to do CPR can save a Being trained to do CPR can save a
Ioved one. Ioved one.
11ective CPR done immediateIy a1ter 11ective CPR done immediateIy a1ter
cardiac arrest can doubIe a victim's cardiac arrest can doubIe a victim's
chance o1 survivaI. chance o1 survivaI.
LEARN CPR TODAY| LEARN CPR TODAY|
INQUIRE FROM THE PHILIPPINE HEART ASSOCIATION INQUIRE FROM THE PHILIPPINE HEART ASSOCIATION||
www,phiIheurt,org www,phiIheurt,org
f you want know more about Sudden Cardiac
Arrest and CardioPulmonary Resuscitation,
contact the
Philippine Heart Association Council on CPR
PHA Heart House
Suite 1108, 11th Flr. East Tower, PSE Centre Exchange Road,
Ortigas Center, Pasig City Philippines
Tel. +63 2 470-5525; +63 2 687-7797
www.philheart.org