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Chapter 5CPR
Heart Attack and Cardiac Arrest
• Heart attack occurs when heart muscle tissue dies because its blood supply is severely reduced or stopped.
• Cardiac arrest results when the heart stops beating.
Caring for Cardiac Arrest
• Chain of survival: Five events that must occur rapidly and in an integrated manner during cardiac arrest
Reprinted with permission. 2015 American Heart Association Guidelines: Update for CPR and ECC. Part 4: Systems of Care & Continuous Quality Improvement. Circulation. 2015; 132:S397-S413. © 2015, American Heart Association, Inc.
Purpose of CPR
• CPR moves blood to the heart and brain by giving chest compressions.
• CPR provides periodic breaths to place oxygen into the person’s lungs.
Age Classifications
• Adults: Puberty and older• Children: 1 year to puberty• Infants: Younger than 1 year
Check for Responsiveness
• Tap the person’s shoulder and ask if he or she is okay.
• If the person does not respond, he or she is said to be unresponsive.
Activate the EMS System
• Call or ask a bystander to call 9-1-1.− If a mobile phone is used, it should be kept by
the person’s side.− If a mobile phone is not available, leave the
person to call 9-1-1 and get an AED.• If alone with a child or infant, give CPR for
five cycles, and then call 9-1-1.
Check for Breathing
• Check breathing for 5 to 10 seconds by looking for the rise and fall of the person’s chest.
Give Chest Compressions
• Perform on a firm, flat surface whenever possible.
• For an adult:− Use two hands.− Compress at least
2 inches.
• For a child:− Use one or two
hands.− Compress about 2
inches.• For an infant:
− Use two fingers.− Compress about 1.5
inches.
Give Chest Compressions
• Place hands in the center of the chest.• Give 100 to 120 compressions per minute
(speed not rate).
© Jones & Bartlett Learning.
Open the Airway
• Use the head tilt–chin lift maneuver.• Place one hand on the person’s forehead
and the fingertips of the other hand on the bony part of the chin.
• Lift the chin upward to help tilt the person’s head back.
Give Rescue Breaths
• Keep the person’s airway open using the head tilt–chin lift maneuver.
© Jones & Bartlett Learning. © Jones & Bartlett Learning.
Give Rescue Breaths
• Pinch the person’s nose shut.• Take a normal breath, and blow into the
person’s mouth for one (1) second.• Take a breath for yourself.• Give another 1-second breath.
Continue CPR Until…
• An automated external defibrillator (AED) is available.
• Person shows signs of life.• Emergency medical services (EMS)
personnel take over.• You become too tired to continue.
Methods of Rescue Breathing
• Mouth-to-mouth breathing• Mouth-to-mask breathing• Mouth-to-face shield breathing
© Jones & Bartlett Learning.
© Jones & Bartlett Learning.
Adult and Child CPR
• Check for responsiveness.• Activate EMS.• Breathing?
− Observe chest for movement.
© Jones & Bartlett Learning. © Jones & Bartlett Learning.© Aleksandra Gigowska/Shutterstock.
Adult and Child CPR
• Provide chest compressions hard and fast.• Open airway.• Give two rescue breaths.
© Jones & Bartlett Learning. © Jones & Bartlett Learning.© Jones & Bartlett Learning.
Adult and Child CPR
• Repeat compression and breath cycles until an AED arrives.
• Use an AED as soon as it arrives.
© Jones & Bartlett Learning. © Jones & Bartlett Learning.
Infant CPR
• Check for responsiveness.• Activate EMS.
− If you are alone, give 5 sets of CPR first.• Check for breathing.
© Jones & Bartlett Learning.© Aleksandra Gigowska/Shutterstock.
© Jones & Bartlett Learning.
Infant CPR
• Give chest compressions.• Open the airway.• Give two rescue breaths.
© Jones & Bartlett Learning. © Jones & Bartlett Learning.© Jones & Bartlett Learning.
Recognizing Airway Obstruction
• Mild obstruction− Good air exchange − Forceful coughing
efforts− Person should be
encouraged to cough.
• Severe obstruction− Poor air exchange− Breathing difficulty− Weak and
ineffective cough− Inability to speak or
breath− Cyanosis
Adult and Child Choking• Ask, “Are you
choking?”• If the person nods
yes, provide care.
© Jones & Bartlett Learning.
Adult and Child Choking• Perform the
Heimlich maneuver by moving behind the person.
• Reach around the person’s waist with both arms and locate the navel.
© Jones & Bartlett Learning.
Adult and Child Choking• Place a fist with the
thumb side against the person’s abdomen, just above the navel.
© Jones & Bartlett Learning.
Adult and Child Choking• Grasp the fist with
your other hand.• Press into the abdomen
with quick, inward and upward thrusts.
• Continue until the object is removed or the person becomes unresponsive.
© Jones & Bartlett Learning.
Infant Choking• Support the infant’s head and neck.• Lay the infant face down on the forearm.• Lower the arm to the leg. • Give five back blows
between the shoulder blades with the heel of the hand.
© Jones & Bartlett Learning.
Infant Choking• Roll the infant face up.• Give five chest compressions on the
infant’s sternum using two fingers.• Repeat until the object
is removed or the infant becomes unresponsive.
© Jones & Bartlett Learning.
If a Person Becomes Unresponsive…
• Immediately call 9-1-1.• Begin CPR.• Look for an object in the person’s mouth
during CPR.