American Heart Association, San Diego County
Outline For Basic Life Support


I. BASIC INFORMATION

  1. Why CPR? Nearly 50% of all deaths are due to cardiovascular disease (978,000), 60%-70% before hospitalization, often within 2 hours...."The communty has the potential for being the ultimate coronary care unit."
  2. Basic Life Support: The basic life saving first aid technique-recognition & prevention of heart disease, management of heart and lung cessation, application of the ABCs of cardiopulmonary resuscitation (CPR) until help arrives.
  3. Anatomic/Physiologic basis for sudden death and CPR.
  1. Call For Help, who responds, information required, what response to expect.
  2. Emergency Phone Numbers, the 911 system, paramedics, local numbers.

II. HEART ATTACKS-RECOGNITION AND PREVENTION

  1. Early Warning Signs and Symptoms Of Heart Attack:
  1. Actions To Take if Suspected:
  1. May Progress To Cardiac Arrest: No pulse, No breathing. Some have a good prognosis, others poor. CPR is not 100% successful, but is the only alternative.
  2. Cardiac Risk Factors:
  1. Prudent Heart Living: "prevention" of heart attacks.

III. STARTING AND STOPPING CPR

  1. CPR Is Rarely Not lndicated: the following are not contraindications, flail chest, broken ribs, open chest wounds, pacemakers, neck injuries, mouth or throat wounds-the alternative is death.
  2. If Obviously Dead: (Beyond doubt; decapitation, rigor mortis, etc.) if unsure, always begin CPR
  3. CPR Should Be Stopped By Non-physician Only If:

IV. BASIC LIFE SUPPORT AND CARDIOPULMONARY' RESUSCITATION (ABC'S)

  1. Check For Unresponsiveness: gently shake and shout
  2. Call For Help: Dial 911, Return and start CPR
  3. Establish An Airway:
  1. Check For Breathing: 3-5 seconds
  1. Initiate VentiIations: Rescue Breathing
  1. Check Circulation and Activate EMS: Carotid or Brachial pulse for 5-1O seconds on adult; Peds, Quick check.
  1. Administering External Chest Compressions
  1. One Rescuer CPR:
  1. lnfant and Child Variations: infant 0-1 year, child ages one to puberty.

V.OBSTRUCTED AIRWAY

    1. International Distress Signal For Choking: throat grasped between thumb and forefinger.
    2. Airway Anatomy - Susceptibility To Choking: the leading cause of accidental death.
    3. "Cafe Coronary"actually airway problem - drinking, inattention, poor dentures/teeth.
    4. If victim Is Conscious:

o        Inquire: (Are you choking??)-assess good or poor air exchange?

o        If good: do not interfere unless it becomes total, or condition worsens to poor air exchange (turns blue, weak cough, whistling)-encourage coughing.

o        If poor air exchange or total obstructions send for help and begin Heimlich Maneuver.

    1. If Victim Is Unconscious:

o        Victim flat on back-open airway by head tilt: tongue is the #1 airway obstructor!

o        Do not waste time looking for obstruction, unless very obvious-immediately attempt to ventilate.

o        If unsuccessful, reposition head and try again.

o        Open mouth and finger sweep the throat attempting to hook object and pull out.

o        Open airway (head-tilt, chin-lift) and attempt to breathe.

o        If unsuccessful. continue alternation of steps until EMS response arrives.

    1. Infant and Child Modification: 90% of deaths in this group are caused by airway obstruction.

o        No blind finger sweeps, in infants and children, (visualize and grasp): Infants only-5 back slaps and 5 chest thrusts,



SPECIAL SITUATlONS

    1. Near Drowning: cold water (hypothermia), salt/fresh water differences, don't compress in water, possible neck injury.
    2. Electric Shock: victim may still be electrified so turn off power. Use non-conductor to remove wires, burns, falls.
    3. Neck Injury: don't tilt head, use Jaw-Thrust technique only.
    4. Gastric Distention: don't relieve unless ventilations are compromised.
    5. Traumatic Injury: direct pressure for serious bleeding, If pinned in vehicle don't move unless victim is in immediate danger.
    6. Vomiting. turn entire victim onto side and turn as a unit.

VII. HEALTHCARE PROVIDER SKILLS (PROFESSIONAL RESCUER)

    1. Two Rescuer CPR:

o        Opposite sides of victim is best; at end of 30:2 compression/ventilation cycle, rescuer #1 opens airway and verifies lack of pulse and breathing for 5 seconds if no pulse, give I breath.

o        Rescuer #2 may come in at any point.

o        30:2 compression-to-ventilation cycle (100 compressions/minute).

    1. Changing Position: If compressor becomes fatigued, rescuers should exchange positions as soon as possible.
    2. Cricoid Pressure: area of adams apple on throat, two+ rescuers only.
    3. Mouth to Mask: Insure tight seal over mouth (and nose). Watch for adequate ventilation.

Comparison Chart

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History of CPR