CPR

(Cardiopulmonary
Resuscitation)

Definition
An emergency procedure in which
the heart and lungs are made to
work by manually compressing the
chest overlying the heart and forcing
air into the lungs
Use when there is no breathing and
no pulse

The 5 links in the adult Chain of

Survival
Successful resuscitation following
cardiac arrest requires an integrated
set of coordinated actions
represented by the links in the adult
chain of survival

Start CPR Immediately

Better chance of survival
Brain damage starts in 4-6
minutes

Survey The Scene, then: RAP

RResponsivenes
s
Tap shoulder
and shout Are
you ok?

RAP
A - Activate EMS ( if unresponsive)
SEND SOMEONE TO GET HELP!
Call for ambulance and return to the
victim

RAP
P - Position on back
All body parts rolled over
at the same time
Always be aware of head
and spinal cord injuries
Support neck and spinal
column

ABCD

Airway
Breathing
Circulation
Disability

New CPR sequence

A (Airway) ensure open airway by preventing

the falling back of tongue
B (Breathing) start artificial ventilation of
lungs
C (Circulation) restore the circulation by
external cardiac massage
D (Disability) quickly perform differential
diagnosis of cardiac arrest, use different
medication and electric defibrillation in case
of ventricular fibrillation

10

Compressions
Locate proper hand position for
chest compressions
Place heel of one hand on center of
chest between the nipples

Chest compressions should be performed on the lower of the

sternum

Compressions
Using both hands,
give 30 chest
compressions
Count 1, 2, 3

Depth of
compressions: 1 .5 to
2 inches
For children: to 1/3
of chest depth and

 A Airway
Open the airway
Head tilt chin lift

Open the airway using a head

tilt lifting of chin. Do not tilt the
head too far back

16

B Check For
Breathing
Look, listen
and feel for
breathing
No longer
than 10
seconds

Breathing
If the victim is not
breathing, give two
breaths (1 second or
longer)
Pinch the nose
Seal the mouth with yours

If the first two dont go

in, re-tilt and give two
more breaths (if breaths
still do not go in,
suspect choking)

Breathing: Mouth To
Nose (when to use)
Cant open mouth
Cant make a good
seal
Severely injured
mouth
Stomach distension

CPR
After 30 chest compressions
give:
2 slow breaths (30:2)
Continue until help arrives or
victim recovers
If the victim starts moving:
check breathing

Two Partner
CPR

Rescuer 1:
RAPABC

Rescuer 2:
place hands for compressions

Compression rate: 30:2

Switch off when tired

Algorithm
for artificial ventilation
mouth to mouth or mouth to nose
respiration

ventilation by a face mask and a selfinflating bag with oxygen

2 initial subsequent breaths

wait for the end of expiration
10-12 breaths per minute with a volume of app. 800 ml, each
breath should take 1,5-2 seconds
Control over the ventilation
check chest movements during ventilation

check the air return

22

Drugs used in CPR

Atropine can be injected bolus, max 3 mg to
block vagal tone, which plays significant role in
some cases of cardiac arrest
Adrenaline large doses have been
withdrawn from the algorithm. The
recommended dose is 1 mg in each 3-5 min.
Vasopresine in some cases 40 U can
replace adrenaline
Amiodarone - should be included in algorithm
Lidocaine should be used only in ventricular
fibrillation
24