LESSON 5

CARPIOPULMONARY
RESUSCITATION (CPR)

© 2011 National Safety Council

5-1
 Basic Life Support (BLS)

• First aid given if victim’s breathing or heart stops

• Often needed for victims of:
- Heart attack
- Drowning
- Choking
- Other injuries/conditions

© 2011 National Safety Council 5-2

 Overview of BLS

• CPR = chest compressions + rescue breaths

• Gets oxygen into lungs and oxygenated blood to vital
organs

© 2011 National Safety Council 5-3

 Overview of BLS continued

• Choking care
- Includes chest compressions
- Expels an obstructing object from airway

© 2011 National Safety Council 5-4

 Overview of BLS continued

• Use of an automated
external defibrillator
(AED)
- Restores a more normal
heart rhythm

© 2011 National Safety Council 5-5

 BLS Age Differences

Infant = birth to 1 year

Child = age 1 to the onset of puberty (for CPR and
choking care); age 1 to 8 for AED
Adult = past the age of puberty (or over age 8 for AED)

© 2011 National Safety Council 5-6

 Respiratory Emergencies
• Any illness or injury
resulting in stopped
breathing or
inadequate breathing
• Two types
- Respiratory arrest
- Respiratory distress

© 2011 National Safety Council 5-7

 Respiratory Emergencies: Examples

• Obstructed airway
• Penetrating injury to chest
• Carbon monoxide poisoning
• Heart problem reducing tissue oxygen
• Electrical shock disrupting breathing or heartbeat
• Drug overdose or poisoning

© 2011 National Safety Council 5-8

 Respiratory Arrest
and Respiratory Distress
• Respiratory arrest
- Breathing has completely stopped
• Respiratory distress
- Breathing is difficult and may become ineffective

© 2011 National Safety Council 5-9

 Cardiac Chain of Survival

© 2011 National Safety Council 5-10

 Heart Attack – Acute Myocardial
Infarction (AMI)
• Sudden reduced blood flow to heart muscle
• Medical emergency that often leads to cardiac arrest
• Can occur at any age
• Usually results from atherosclerosis

© 2011 National Safety Council 16-11

 Facts About Heart Attack
• Over 1,255,000 heart attacks occur a year in the
United States, resulting in over 132,000 deaths
• Many could have been saved by first aid and medical
treatment
• More likely in those with family history
• 1/5 of victims do not have chest pain
• Victims typically deny they are having a heart attack

© 2011 National Safety Council 16-12

 Symptoms of Heart Attack

• Can vary from vague chest discomfort to crushing

pain with or without other symptoms
• May have no signs and symptoms before suddenly
collapsing
• May have milder symptoms that come and go before
heart attack occurs

© 2011 National Safety Council 16-13

 Symptoms of Heart Attack continued

• In women chest pain or discomfort most common

symptom
- Also more likely to have shortness of breath, jaw or back
pain, indigestion, nausea and vomiting

- http://www.youtube.com/watch?v=t7wmPWTnDbE

© 2011 National Safety Council 16-14

 Symptoms of Heart Attack continued

• Consider possibility of heart attack with wide range of

symptoms
- Don’t expect a clearly defined situation
• Act quickly because deaths usually occur with an
hour or two of symptoms

© 2011 National Safety Council 16-15

 Aspirin and Heart Attack
• Many patients at risk for cardiovascular disease
advised to take one low-dose aspirin daily unless
allergic or experience side effects
• For victims who do not need to avoid aspirin, chewing
one uncoated adult aspirin or two low-dose baby
aspirin is now recommended when experiencing
heart attack symptoms

© 2011 National Safety Council 16-16

 Nitroglycerin for Heart Attack

• Increases blood flow

by dilating arteries
• Often prescribed for
angina
- Type of chest pain
caused by narrowed
coronary arteries
• Comes in tablets,
sprays and patches

© 2011 National Safety Council 16-17

 Nitroglycerin for Heart Attack continued

• Can assist victim with

prescribed
nitroglycerine
- Follow victim’s
instructions
- Do not attempt to give if
victim unresponsive

© 2011 National Safety Council 16-18

 First Aid for Heart Attack

1. Call 9-1-1 immediately.

2. Help victim into comfortable position. Loosen any
tight clothing.
3. Ask victim about medications.
4. Encourage the victim to chew one uncoated adult or
two low-dose baby aspirin (unless allergic).
5. Stay with victim. Be reassuring.

© 2011 National Safety Council 16-19

 Call First/Call Fast

Call First (before starting CPR):

• Any unresponsive adult who is not breathing normally

Call Fast (after giving about two minutes of CPR):

• Any infant or child who is unresponsive and not
breathing normally

© 2011 National Safety Council 5-20

 Use of CPR for unresponsiveness
and lack of normal breathing caused by:
• Heart attack • Electric shock
• Drowning • Certain injuries
• Suffocation
• Stroke
• Allergic reaction
• Diabetic emergency
• Prolonged seizures
• Drug overdose

© 2011 National Safety Council 5-21

 CPR Saves Lives

• CPR and defibrillation within 3-5 minutes can save

over 50% of cardiac arrest victims
• CPR followed by AED saves thousands of lives each
year
• In most cases CPR helps keep victim alive until EMS
or AED arrives

© 2011 National Safety Council 5-22

 CPR Technique

If unresponsive and not breathing start CPR with chest

compressions:
• Find correct hand position
• Compress chest hard and fast at rate of at least 100
compressions/minute
• Alternate 30 compressions and 2 rescue breaths
• Give each breath over one second

© 2011 National Safety Council 5-23

 General Technique: Rescue Breaths
• Position victim on
back
• Open airway with
head tilt–chin lift
• Use a barrier device
• Give each breath over
about one second
• Watch victim’s chest
rise

© 2011 National Safety Council 5-24

 General Technique: Rescue Breaths
continued

• Do not blow harder than needed to make chest rise

• After each breath let air escape and chest fall
• Blowing in too forcefully or for too long may cause
vomiting

© 2011 National Safety Council 5-25

 Mouth to Barrier
• Barrier device is
always recommended
• Position pocket mask
or face shield on
victim’s face
• Make sure it is sealed
to victim’s face
- With face shield, pinch
victim’s nose closed
when giving breaths

© 2011 National Safety Council 5-26

 Potential Problem: Vomiting

• To prevent air from entering stomach and causing

vomiting
- Open airway before giving breaths
- Watch chest rise as you give breaths
- Blow slowly and steadily
- Stop each breath when chest rises
- Let chest fall after each breath

© 2011 National Safety Council 5-27

 Skill: CPR for Adults, Children and
Infants (1 Rescuer)

© 2011 National Safety Council

5-28
 Assess the Victim

1 Determine that victim is unresponsive and not

breathing normally
Have someone call 9-1-1, or call yourself if alone,
and get an AED
Begin CPR

© 2011 National Safety Council 5-29

 2 Put hand(s) in correct
position for chest
compressions

© 2011 National Safety Council 5-30

 3 Give 30 chest compressions at rate of at least 100
per minute
Then give 2 breaths

© 2011 National Safety Council 5-31

 4 Open airway
Give two rescue breaths, each lasting one second
- If first breath does not go in, reposition head and try again
- If second breath still does not go in, give care for choking

© 2011 National Safety Council 5-32

 5 Continue cycles of 30 compression and two breaths
6 Continue CPR until:
• Victim wakes up
• AED brought to scene and ready to use
• Professional help arrives to take over
• Scene becomes dangerous
• You become too exhausted

© 2011 National Safety Council 5-33

 7 If victim starts breathing normally but is
unresponsive, put in recovery position and monitor
breathing
When AED arrives, start AED sequence

© 2011 National Safety Council 5-34

 Compression-Only CPR

• If you cannot or will not

give rescue breaths,
still give chest
compressions

© 2011 National Safety Council 5-35