- C-CPR:



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- Do not rely on a palpable carotid ofeffective arterial flow.



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- Sequence:


1- Check the victim for a response.


2- If he responds and breathing normally: Leave hem in his position, provided there is no further danger.


3- If he is Unresponsive, but breathing normally: Turn him into the recovery position & call for an ambulance.


4- If he is Unresponsive and not breathing normally: Shout for help.



- Start CPR:


- Turn the victim onto his back.


- Open the airway using head tilt and chin lift.


- How CPR Works:


- Effective CPR provides 1/4 to 1/3 normal blood flow.


- Start CPR Immediately --> Better chance of survival.


- Brain damage starts in 4-6 m.


- Brain damage is certain after 10 minutes without CPR.



- Compressions:


- Rescuers should place their hands in the centre of the chest, rather than to spend more time using the ‘rib margin’ method.



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- Kneel by the side of the victim.


- Place the heel of one hand in the centre of the victim’s chest.



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- Place the heel of your other hand on top of the first hand.



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- Position yourself vertically above the victim's chest.




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- A 100 times /min.


- Equal Compression and release.


- A compression depth of 4-5 cm.


- Allow the chest to recoil completely after each compression.



- A Combine chest compression with rescue breaths:


- After 30 compressions open the airway again using head tilt and chin lift.


- Blow steadily into his mouth whilst watching for his chest to rise;


- Give each rescue breath over 1 sec.


- Maintaining head tilt and chin lift, take your mouth away and watch for his chest to fall as air comes out.



- Breathing: Mouth To Nose (when to use):


1- Can’t open mouth.


2- Can’t make a good seal.


3- Severely injured mouth.


4- Stomach distension.


5- Mouth to stoma (tracheotomy).



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- Stop to recheck the victim only if he starts breathing normally; otherwise do not interrupt resuscitation.


- Continue until help arrives or victim recovers.


- If the victim starts moving: check breathing.



- When Can I Stop CPR?


1- Victim recovers.


2- Trained help arrives.


3-Too exhausted to continue.


4- Unsafe scene.


5- Cardiac arrest of longer than 30 minutes.



- Why CPR May Fail?


1- Delay in starting.


2- Improper techniques .


3- No ACLS follow-up and delay in defibrillation.


4- Only 15% who receive CPR live to go home.


5- Terminal disease (massive heart attack).



- Injuries Related to CPR:


1- Rib fractures .


2- Laceration to: liver, lung, spleen.



- Complications of CPR:


1- Vomiting --> Aspiration.


- Prevention:


1- Place victim on left side.


2- Wipe vomit from mouth with fingers wrapped in a cloth.


3- Reposition and resume CPR .


2- Stomach Distension.


- Prevention:


1- Don’t blow too hard.


2- Slow rescue breathing .


3- Re-tilt the head to make sure the airway is open.


4- Use mouth to nose method.



- CPR for Infants (Under 1 Year of Age):


- Same procedures except:


1- Seal nose and mouth or nose only.


2- Give shallow “puffs”.


3- Use middle and ring finger.


4- Press sternum 1/2 to 1/3 depth of the chest.



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- CPR - Recovery position:



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- When circulation and breathing have been restored, it is important to:


1- Maintain a good airway.


2- Minimize the risk of inhalation of gastric *******s.


- For this reason the victim should be placed in the recovery position.


- Sequence of the recovery position:


1- Place the arm nearest to you out at right angles to his body, elbow bent with the hand palm uppermost.


2- Bring the far arm across the chest.


3- With your other hand, grasp the far leg just above the knee and pull it up.





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