Athens-Limestone Hospital



Athens-Limestone Hospital

Education Department

CPR Study Guide

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Updated with The American Heart Association’s 2010 Guidelines and Recommendations

ADULT

Chain of Survival:

Immediate recognition of cardiac arrest and activation of the EMS/911

Early CPR that emphasizes chest compressions

Rapid defibrillation if indicated

Effective advanced life support

Integrated post-cardiac arrest care

Choking

1. Conscious Choking

a. “Are you choking?”- YES

b. “Can you speak?”- NO

c. “Can I help you?”- YES

d. Provide inward and upward abdominal thrust, just above the navel.

e. Continue until the object is removed or they become unconscious

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2. Unconscious choking

a. Call 911 or send bystander

b. Begin CPR, starting with compressions

c. Open the airway, remove the object if you see it (DO NOT do a blind finger sweep on any age victim)

d. Attempt 2 breaths (if the 1st breath does not go in, reposition the head and try again), then resume compressions

e. Prior to each breath, look in the airway for the object

f. Continue CPR (30:2)

g. If you are alone, perform CPR for 2 minutes, then go call 911

3. Adult rescue breathing

a. Performed when the victim is not breathing adequately, but has a pulse

b. For adults- 1 breath every 5-6 seconds (10-12 per minute)

c. Recheck pulse every 2 minutes

d. Breaths are effective with chest rising and falling

C-A-B

Chest Compressions, Airway, Breathing

Adult CPR

1. Determine unresponsiveness, no breathing or no normal breathing (i.e, gasping)

2. Activate EMS, get AED/defibrillator

a. Send 2nd rescuer, if available

3. Check pulse within 10 seconds

4. No pulse- begin cycles of 30 compressions and 2 breaths

5. AED/defibrillator arrives- Turn on and follow instructions

6. Check rhythm- shockable?

a. Yes- give 1 shock and resume CPR

b. No- resume CPR immediately for 2 minutes

7. Check rhythm/pulse every 2 minutes

High-quality CPR

Rate of at least 100/min

Compression depth at least 2 inches (5 cm)

Allow complete chest recoil after each compression

Minimize interruptions in chest compressions

Avoid excessive ventilation

Advance Airway

Once in place, do not stop compressions for breaths. Continuously perform compression and give 8-10 breaths per minute (one breath every 6-8 seconds).

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Child and Infant

Chain of Survival:

Community effort that includes prevention

Early CPR

Prompt access to EMS

Rapid advanced life support

Integrated post-cardiac arrest care

Child Choking

1. Conscious Choking

a. “Are you choking?”- YES

b. “Can you speak?”- NO

c. “I can help you.” (Ask the parent for permission to help.)

d. Provide inward and upward abdominal thrust, just above the navel.

e. Continue until the object is removed or they become unconscious

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2. Unconscious choking

a. Call for help, send bystander to call 911

b. Start chest compressions

c. Open the airway, remove the object if you see it (DO NOT do a blind finger sweep on any age victim)

d. Attempt 2 breaths (if the 1st breath does not go in, reposition the head and try again), then resume compressions (30:2)

e. Prior to each breath, look in the airway for the object

f. If you are alone, perform 2 minutes of CPR, then go call 911

3. Child and Infant Rescue Breathing

a. Performed when the victim is not breathing adequately, and has a pulse of >60 per minute

b. 1 breath every 3-5 seconds (12-20 per minute)

c. Recheck pulse every 2 minutes

d. Breaths are effective with chest rising and falling

Infant Choking

1. Conscious Choking

a. Look for signs of choking (bluish skin/lips or high-pitched noises when breathing)

b. Pick up infant and give 5 back blows between the shoulder blades, with the head supported and lower than the infant’s legs

c. Flip the infant and provide 5 chest thrusts, with 2 fingers, just below the nipple line

d. Repeat until the infant is able to cry or becomes unconscious

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2. Unconscious Choking

a. Call for help, send bystander to call 911

b. Start chest compressions

c. Open the airway, remove the object if you see it (DO NOT do a blind finger sweep on any age victim)

d. Attempt 2 breaths (if the 1st breath does not go in, reposition the head and try again), then resume compressions (30:2)

e. Prior to each breath, look in the airway for the object

f. If you are alone, perform 2 minutes of CPR, then go call 911

Child and Infant CPR

1. Determine unresponsiveness, not breathing or only gasping

a. Send someone to activate EMS, get AED/defibrillator

b. If alone and child suddenly collapses- activate EMS, get AED/defibrillator

2. Check pulse within 10 seconds

a. Carotid for child over 1 year old, under check brachial pulse

3. No pulse- begin cycles of 30 compressions and 2 breaths

a. Two healthcare providers may do cycles of 15 compressions and 2 breaths

4. After 2 minutes, if EMS had not been activated, then stop call 911 and get AED/defibrillator

5. Check rhythm- shockable?

a. Yes- give 1 shock and resume CPR for minutes

b. No- resume CPR immediately for 2 minutes

6. Check rhythm/pulse every 2 minutes

High-quality CPR

Rate of at least 100/min

Compression depth of at least 1/3 anterior-posterior diameter of chest,

about 1 ½ inches (4 cm) in infants and 2 inches (5 cm) in

children

Allow complete chest recoil after each compression

Minimize interruptions in chest compressions

Avoid excessive ventilation

Automatic External Defibrillator (AED)

Used when the heart stops beating normally and is in ventricular fibrillation or ventricular tachycardia. Asystole is not a shockable rhythm.

AEDs are generally used on adults, but may be used on pediatric patients.

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“If one is available, the rescuer should use a pediatric dose-attenuator system for attempted defibrillation of children 1-8 years of age with an AED. If the rescuer does not have an AED with pediatric dose-attenuator system, the rescuer should use a standard AED. For infants ( ................
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