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Khalid Ibrahim Aljonaieh, MD, MS

Lecturer

Registrar

كلية الطب
New ICU building, 2nd floor, Anesthesia Department
ملحق المادة الدراسية

Cardiopulmonary Resuscitation

المقرر الدراسي

 review. We urge, encourage and require all foster families to take a formal class that meets all the appropriate guidelines.  
This lesson is not intended as a substitute for formal training. The lesson is simply for review or to try and gain some knowledge regarding CPR.
 

 

 and it definitely is not to take the place of formal training. It’s intended to facilitate remembering some of the steps and to give the general public an idea of what CPR entails. A refresher! 
 
 
 
 
   As we stated earlier, this session is not intended to teach you how to perform CPR     
 
 
According to international studies, approximately 50% of all deaths are due to cardiovascular disease. For the most part this means heart attacks. Heart attacks are the
greatest killer in the United States; more people die of heart attacks than of gun shots, cancer, AIDS, or car accidents. The same studies indicate that 60-70% of these deaths occur prior to ever reaching the hospital. It’s widely accepted belief that community
trained in recognizing the signs and symptoms of heart attack, and the steps of performing CPR could help keep many of these people alive.
 

 

  Smoking  serious consequences. Most people when confronted with a medical emergency will seek help by calling 911.  This is a critical step in caring for an individual, but it may not be 
enough. Response times will vary depending on your location. Obviously those that live near more urban areas will typically get advance care quicker than those that live in more 
rural locations. If you wait and don’t take action to assist an individual in need, it’s possible that by the time help arrives the person may be brain dead. 
 
When do I Perform CPR? 
 
 those initial 4-6 minutes. If prompt attention is delayed the person could suffer some    It’s imperative that we provide help to someone whose heart has stopped within  Clinical death and Biological death. Our primary  non-controllable and controllable risk factors. 
 
  
  
  
 
  Our Window of Opportunity

 

concern in terms of initiating CPR is the stage called Clinical death. Clinical death occurs during the first 4-6 minutes and is not necessarily permanent. At this stage it is still possible to have someone recover completely from heart attack with no long term damage to the person.
 

 

CPR stands for Cardiopulmonary Resuscitation, which means Heart and Lung Resuscitation. When an individual’s heart beat and breathing have stopped, it becomes your job to
breathe for them and to beat their heart in order to keep them alive. These are the two functions that aren’t working, and these
are the two functions you’re going to attempt to replace.  Activate 911 first, but if you want to keep
this person alive long enough for the fire department and paramedics to arrive, CPR may be the key to their survival.  
 
Risk Factors
 

 

Let’s start with controllable risk factors:

 

It’s no surprise to most people that smoking is bad for your health and for those around you as well. Most people are aware of lung and respiratory
diseases that are caused by smoking but what many people aren’t aware of is that smoking is also leading cause of heart attacks
as well! Nicotine is highly addictive stuff and is what keeps you coming back for more. It’s also vasodilator which means that it
makes your blood vessels tighten up and get smaller thereby decreasing the amount of blood flow to various parts of the body
including the heart. The heart needs oxygen to survive!

 

 The best type of exercise for your heart is aerobic exercise. This type of exercise will increase your heart beat and respirations for a prolonged period of time. It will also 
make your heart a more efficient ‘pump’. A good aerobic program could help eliminate some if not all the dangers associated with controllable risk factors. It can help improve 
circulation, lower blood pressure and occasionally develop new blood vessels. Be sure to check with your physician before starting a fitness program. 
 
 children that live among us. 
 
Diet 
 
    Think twice before taking that next smoke break!! Especially think about the   
Heredity 
 
 these blood clots gets lose and gets stuck in the brain causing a stroke or block an artery in the heart causing a heart attack, it increases the chances of death. 
 
   Smoking will also make the smoker more susceptible to blood clots. If one of    Did you also know that the same stuff that comes out of your cars tailpipe is also  We all know that a diet high in fat can cause a  If any of the previous topics concern you, maybe you would benefit from little  to a heart attack. 
 Gender 
  
 Whether you’re male or female also plays a part  lower risk of having a heart attack because of the estrogen in their bodies. 
 
  
         found in cigarettes? It’s called carbon monoxide. This chemical robs oxygen from the red blood cells in your blood. The red blood cells are like bus that delivers oxygen. The problem is that the stuff that carries the oxygen is 250 times more attracted to carbon monoxide (the bad stuff) than oxygen (life sustaining stuff). So now we’ve decreased the amount oxygen within our blood!
 

 

heart attack. Too much fat in the body will simply move to the bloodstream making it white milky substance that
will tend to stick to your arteries thicken the walls and diminish the free flow of blood. Control the amount of fat you put into your body.
 Exercise
 

 

exercise. Exercising will help alleviate stress and will also increase the function of your heart.
 

 

If your family is prone to having heart attacks, then you will be more susceptible

 

in your chances of having heart attack. Women are at

 

 Signs and symptoms of a heart attack   
Recognizing a Heart Attack 
 
 healthy we are when we get there. By assuring a healthy life style now we can avoid problems in the future. 
 
 can be the most critical step in saving your life or the life of a loved one. If an artery  We cannot control how old we get. But we can control how  Recognizing the signs and symptoms of a heart attack and knowing what to do  Age         
 
Our advice is to reduce the controllable risk factors every day. By stopping or slowing your smoking, by increasing your activity level and
reducing the amount of fat and cholesterol in your diet, you may reduce the chances of having heart attack.

 

leading to the heart becomes blocked it will prevent blood from getting to certain parts of the heart. The tissue of the heart will almost instantly start to die. This is called heart
attack. heart attack does not mean that the heart has stopped. Rather it’s warning; indicating that the heart may stop at any moment. DO NOT perform CPR on person
that is still breathing or has an obvious pulse. Call 911 immediately!
 

 

1) Pain in the chest. This is the most common sign. The pain may move around to other parts of the body. You may begin feeling pain in the jaw or arms. Women especially may feel pain in other parts of the body such as in the belly or back.
2) Tightness of the chest. The person may describe sensation as if someone were sitting on their chest, causing difficulty breathing. Any chest pain or
breathing difficulty should be reported to 911.
3) Sweating along with cool, pale skin is another sign.  4) Nausea or vomiting.
5) Denial. Who wants to admit that they’re having heart problem? Usually no one. Denial is another sign usually accompanied by anyone of the signs listed above. Heart attack victims often say that they’re having pains due
to indigestion, heartburn, asthma, or illness. The longer you argue with the person about the validity of their symptoms the less time they may have to
live. Go to the other room if necessary and call 911 from there. Don’t wait until the heart stops.
As the heart tissue continues to die, the heart may actually stop beating. This is called Cardiac Arrest. If the person in cardiac arrest doesn’t get help immediately
they will likely die. Do not hesitate to call 911.
 

 

 begin the ABC’s of CPR. Before we go into details with numbers, the ABC’s apply to everyone, whether they’re an adult, child or 
an infant. Lets’ go over them first. 
 
  
 
    
 
 person really requires help. Approach the victim cautiously and tap them as you ask, “Are you O.K.?”. If the person does not respond, Activate 911 immediately. Call 911 or have a bystander call for 
you. Make eye contact and shout’ “Call 911 and come back”. 
 
 Airway  Breathing  rise. Listen for air movement and feel for air movement. If the victim is not breathing, continue tilting the head back, pinch the nostrils and administer 2 effective rescue 
breaths. You should blow until the victims chest slowly stops rising.  
  Circulation 
 victims pulse, look to see if there’s movement, listen for sounds of movements or  The first step in determining if there is a true emergency is to find out if the  Open the airway. Place on hand over the  Lean over the victim’s face and look, listen and feel. Look for the chest to  Look, listen and feel for signs of circulation. While attempting to find the   
 
        Performing CPR

 

It may take several minutes for help to arrive, so you should

 

victim’s forehead, and two fingers under the bony part of the chin. Gently tilt the head backward. This will open the airway and lift the tongue off the back of the throat.  
 

 

moaning, and feel for movement and pulse. If the victim has pulse but is not breathing begin Rescue Breathing for the victim by giving them one breath every seconds. If there’s no pulse present begin CPR. You should wait no more than 10 seconds to find a
pulse. If you don’t know or are just unsure begin CPR.
 
Let’s now look at the details of administering CPR. We’ve divided the lesson into three separate tables. Each table will give details about administering CPR to an adult, child
and to an infant. All of them will begin the same. Remember, the initial ABC’s check will be the same for all victims regardless of age.

 

 Child 1breath/5compressions 100 beats/min 1-1.5     CPR TABLE

 

Ratio

Rate Beats per Minute

Depth

 

Adult

2breaths/15compressions

100 beats/min
 

1.5-2 inches

 

(1-8 years)

inches

 

Infant 1breath/5compressions 100+beats/min .5-1 inch

 

 1  3  2  4        5     Adult CPR

 

     Is the victim unconscious?

     Open the victim's airway

 

Tap the victim, and ask "Are you OK?". If there's no response, call 911, or ask someone
else to call.

Open the victim's airway by tilting his/her chin gently with one hand, while pushing back on
his/her forehead with the other hand.

 

 head-tilt/chin-lift maneuver

 

     Is the victim breathing normally?

     Start mouth-to-mouth resuscitation

 

Check the victim's breathing. Sometimes, a person in cardiac arrest will make grunting,
gasping or snoring sounds. Don't confuse this with normal breathing.

Pinch the person's nose, take deep breath, and blow into the victim's mouth. Pause and
repeat. Look for signs of circulation and/or pulse. If there's no pulse go on to the next step.
If there is pulse but the victim is not breathing, give the victim breath every seconds for 1
minute and then check for circulation again.

 

     Start compressions

 

Find the xiphoid process at the end of the sternum where the ribs meet and place the heel of one hand two finger widths above this point.
Place your other hand on top and interlace your fingers.
Now, straighten your arms, lock your elbow, and position your shoulders directly over your hands. Push down on the victim's chest 1.5 to inches for an adult.
Do four sets of 15 compressions and breaths over 1-minute period.
Do not stop to check for pulse during your four sets. After four sets, check for signs of circulation and/or pulse (no more than 10 sec)
If there's no pulse continue CPR. If there's pulse but no breathing return to step 4.

 

hand position

 

find the xiphoid process

 

 1  3  2  4    5     
 
 
 
 
Child CPR (1-8years)
 
 

 

     Is the victim unconscious?

     Open the victim's airway

 

Tap the child victim, and ask "Are you OK?". If there's no response, call 911, or ask someone else to call.

Open the child victim's airway by tilting his/her chin gently with one hand, while pushing back
on his/her forehead with the other hand.

 

 head-tilt/chin-lift maneuver

 

     Is the victim breathing normally?

     Start mouth-to-mouth resuscitation

 

Check the child victim's breathing. Sometimes, a child in cardiac arrest will make grunting,
gasping or snoring sounds. Don't confuse this with normal breathing.

Pinch the child's nose, take deep breath, and blow into the victim's mouth. Pause and repeat.
Look for signs of circulation and/or pulse. If there's no pulse go on to the next step. If there
is pulse but the child victim is not breathing, give the victim breath every seconds for 1
minute and then check for circulation again.

 

     Start compressions

 

Find the xiphoid process at the end of the sternum where the ribs meet and place the heel of one hand two finger widths above this point.
Place your other hand on the child's forehead and maintain an open airway.
Now, straighten out your arm, lock tour elbow and position your shoulder directly above your hand. Push dow on the victim's chest to 1.5 inches for child.
Give compressions and breath for about minute
Do not stop and check for pulse during that minute of CPR. After the minute stop and check for signs of circulation and/or pulse (no more than 10 seconds)
If there's no pulse, continue CPR. If there's pulse but no breathing, return to step 4.

 

find the xiphoid process

Use one hand for child.

 

 1  3  2  4  5     Infant CPR

 

     Is the victim unconscious?

     Open the victim's airway

 

Tap the infant victim, and attempt to arouse him/her. If there's no response, call 911, or ask someone else to call.

Open the infant victim's airway by tilting his/her chin gently with one hand, while pushing back
on his/her forehead with the other hand. Don't over extend the neck. Maintain "sniffing"
position.

 

     Is the victim breathing normally?

     Start mouth-to-mouth resuscitation

 

Check the infant victim's breathing. Sometimes, child in cardiac arrest will make
grunting, gasping or snoring sounds. Don't confuse this with normal breathing. If there's
no breathing proceed.

Cover the infants nose and mouth with your own. Blow gently into the baby's mouth. Pause
and repeat. Look for signs of circulation and/or pulse. If there's no pulse go on to the next step.
If there is pulse but the infant is not breathing, give the infant breath every seconds for 1
minute and then check for circulation again.

 

Finding pulse on an infant

 

The best way to find an infants pulse is to fe be tw the bice nd trice p.
Right in the middle of the arm. Use two fingers.(No more than 10 seconds)

 

     Start compressions

 

Picture an imaginary line across the baby's nipples and place two fingers slightly below that line in the center of the chest.
Begin pushing downward at rate of 100+ beats per minute. Push down on the victim's chest .5 to 1 inch for an infant.
Do 20 sets of compressions and breath over 1-minute period.
Do not stop to check for pulse during your 20 sets. After 20 sets, check for signs of circulation and/or pulse (no more than 10 sec).
If there's no pulse continue CPR. If there's pulse but no breathing return to step 4.

Use fingers for an infant