CardiacEmergenciesandCPRPPT教學(xué)課件

1、Introduction Basic Life Support needed for patient whose breathing or heart has stopped Ventilations are given to oxygenate blood when breathing is inadequate or has stopped If heart has stopped, chest compressions are given to circulate blood to vital organs Ventilation combined with chest compress

2、ions is called cardiopulmonary resuscitation (CPR) CPR is commonly given to patients in cardiac arrest as a result of heart attack第1頁/共57頁Review of Circulatory System Circulatory system consists of heart, blood, and blood vessels. 第2頁/共57頁Cardiovascular System: Primary Functions Transports blood to

3、lungs Delivers carbon dioxide and picks up oxygen Transports oxygen and nutrients to all parts of body Helps regulate body temperature Helps maintain bodys fluid balance第3頁/共57頁Anatomy and Physiology of the Heart Ventricles pump blood through two loops or cycles in body Right ventricle pumps blood t

4、o lungs to pick up oxygen and release carbon dioxide Blood returns to left atrium and then flows into left ventricle Left ventricle pumps oxygenated blood through arteries to all areas of body Blood returns through veins to right atrium, to be pumped again to lungs Within heart, valves prevent back

5、flow of blood so that it moves only in one direction through these cycles第4頁/共57頁 Heart is composed of a unique type of muscle (myocardium) that contracts to make pumping action. Heart Muscle第5頁/共57頁 Contractions are controlled by electrical signals under nervous system controlHeart Muscle 第6頁/共57頁A

6、rteries Arterial blood is oxygenated, bright red, and under pressure Carotid arteriesmajor arteries passing through neck to head Femoral arteriesmajor arteries to legs passing through thigh Brachial arteriesin upper arm Radial arteriesmajor artery of lower arm Arteries are generally deeper in body t

7、han veins and more protected第7頁/共57頁Pulse When left ventricle contracts, wave of blood is sent through arteries causing pulsing blood pressure changes in arteries that can be palpated in certain body locations A pulse can be felt anywhere an artery passes near skin surface and over a bone Palpate ca

8、rotid pulse on either side of neck 第8頁/共57頁Pulse continued Palpate femoral pulse in crease between abdomen and thigh Palpate radial pulse on the palm side of wrist proximal to base of thumb Palpate brachial pulse on the inside of arm between elbow and shoulder第9頁/共57頁Capillaries Arteries progressive

9、ly branch into smaller vessels that eventually reach capillaries Capillaries are very small blood vessels connecting arteries with veins throughout body Capillaries have thin walls through which oxygen and carbon dioxide are exchanged with body cells第10頁/共57頁Veins From capillaries, blood drains back

10、 to heart through extensive system of veins Venous blood is dark red, deoxygenated, and under less pressure than arterial blood Blood flows more evenly through veins, which dont have a pulse Veins have valves that prevent blood backflow第11頁/共57頁Heart Rate Heart rate, measured as pulse, is affected b

11、y many factors With exercise, fever, or emotional excitement, heart rate increases to meet bodys greater need for oxygen Various injuries and illnesses may either increase or decrease heart rate 第12頁/共57頁Circulatory System: Emergencies Any condition that affects respiration Reduces ability to delive

12、r oxygen Severe bleeding Shock Stroke Reduces blood flow to brain Heart conditions Reduce tissue oxygenation第13頁/共57頁Circulatory System: Emergencies continued Heart attack Can lead to cardiac arrest Ventricular fibrillation Heart muscle flutters rather than pumping blood第14頁/共57頁Cardiac Arrest Heart

13、 may stop (cardiac arrest) as a result of heart attack Brain damage begins 4 - 6 minutes after cardiac arrest Brain damage becomes irreversible in 8 - 10 minutes Dysrhythmia, an abnormal heartbeat, may also reduce hearts pumping effectiveness第15頁/共57頁Causes of Cardiac Arrest Heart attack Drowning Su

14、ffocation Stroke Allergic reaction Diabetic emergency Prolonged seizures Drug overdose Electric shock Certain injuries第16頁/共57頁Cardiac Chain of Survival第17頁/共57頁Call First vs. Call Fast Call First If alone with adult victim Any victim of any age seen to collapse suddenly Call Fast If alone with chil

15、d victim Unresponsive victim in cardiac arrest because of respiratory arrest第18頁/共57頁Cardiopulmonary Resuscitation (CPR) CPR helps keep patient alive by circulating some oxygenated blood to vital organs Ventilations move oxygen into lungs where it is picked up by blood Compressions on sternum increa

16、se pressure inside chest, moving some blood to brain/other tissues第19頁/共57頁Cardiopulmonary Resuscitation (CPR) continued Blood circulation resulting from chest compressions not as strong as circulation from heartbeat Can help keep brain/other tissues alive until normal heart rhythm restored第20頁/共57頁

17、Cardiopulmonary Resuscitation (CPR) continued Often electric shock from AED is needed to restore a heartbeatand CPR can keep patient viable until then CPR effective only for a short time CPR should be started as soon as possible In some instances, the heart may start again spontaneously with CPR第21頁

18、/共57頁CPR Saves Lives CPR and defibrillation within 3-5 minutes can save over 50% of cardiac arrest victims CPR followed by AED saves thousands of lives each year In most cases CPR helps keep victim alive until EMS or AED arrives第22頁/共57頁General Technique of CPR If unresponsive, not breathing, and no

19、 pulse, start chest compressions Find the correct hand position Two hands for adults One or 2 hands for child Two fingers for infant 第23頁/共57頁General Technique of CPR continued Compress chest hard and fast at a rate of 100 compressions/minute Adult = 1 1/2 to 2 inches deep Infant/child = 1/3 to 1/2

20、chest depth Release completely between compressions第24頁/共57頁General Technique of CPR continued If alone, alternate 30 chest compressions and 2 ventilations for any age patient In two-rescuer CPR for infant/child, alternate 15 compressions and 2 ventilations Chest-encircling method in infant Give eac

21、h ventilation over 1 second Follow local protocol regarding oxygen第25頁/共57頁Single-Rescuer CPR1.Check patients responsiveness, open airway, and determine that patient is not breathing adequately2.Give 2 ventilations, each lasting 1 second 3.Determine victim has no pulse 第26頁/共57頁 Single-Rescuer CPR2.

22、Give 2 ventilations, each lasting 1 second 3.Determine victim has no pulse 第27頁/共57頁 Put hand(s) in correct position for chest compressions第28頁/共57頁 Give 30 chest compressions at rate of 100 per minute Then give 2 ventilations第29頁/共57頁Continue CPR until:Patient begins to moveAED brought to scene and

23、 ready to useProfessional help arrives to take overYou are too exhausted to continue第30頁/共57頁If patient starts moving, check for adequate breathingIf patient is breathing adequately, put patient in recovery position and monitor breathingWhen AED arrives, start AED sequence第31頁/共57頁Chest Compressions

24、 Alert Be careful with your hand position For adults/children, keep your fingers off patients chest Do not give compressions over bottom tip of breastbone第32頁/共57頁Chest Compressions Alert When compressing, keep elbows straight and hands in contact with patients chest at all times第33頁/共57頁Chest Compr

25、essions Alert Compress chest hard and fast, but let chest recoil completely between compressions.Minimize amount of time used giving ventilations between sets of compressions.第34頁/共57頁Problems with CPR Technique CPR often ineffective because of poor technique Compressions not delivered steadily and

26、constantly during resuscitation efforts Often compressions are too shallow, resulting in ineffective blood flow Compressions may be given at too fast a rate Only good-quality CPR improves chances of survival第35頁/共57頁Chest Compressions: Bradycardia in Child Infant or child being given rescue breaths

27、or oxygen may have a pulse but still inadequate perfusion If pulse 60 beats/minute and infant or child has signs of poor perfusion, provide CPR第36頁/共57頁Two-Rescuer CPR for Adults and Children Minimizes time between rescue breaths and compressions CPR becomes more effective Can more quickly set up AE

28、D Reduces rescuer fatigue第37頁/共57頁Two-Rescuer CPR Performed in cycles of 30:2 for adult (15:2 for infant or child) One rescuer provides breaths, second rescuer gives chest compressions Rescuers switch positions every 2 minutes Change done after full CPR cycle Accomplish change in 5 seconds第38頁/共57頁T

29、wo-Rescuer CPR continued If AED present, one rescuer gives CPR while the other sets up unit If unit advises CPR, rescuers give CPR together Third rescuer can apply cricoid pressure第39頁/共57頁Two-Rescuer CPR continued If you are assisting another trained rescuer who places an advanced airway: Chest com

30、pressions given continually No pauses for ventilations Give ventilations at rate of 8 10 breaths/ minute第40頁/共57頁Transitioning from One-Rescuer CPR to Two-Rescuer CPR Second rescuer moves into position on other side to prepare to take over chest compressions First rescuer completes a cycle of compre

31、ssions and ventilations While first rescuer pauses to check for a pulse, second rescuer finds correct hand position for compressions第41頁/共57頁Transitioning from One-Rescuer CPR to Two-Rescuer CPRWhen first rescuer says, “No pulse, continue CPR,” second rescuer begins chest compressions and first resc

32、uer then gives only ventilations第42頁/共57頁Differences in Two-Rescuer Training If First Responder started CPR, arriving second rescuer may have a higher level of training Rescuer with greater training determines how CPR should best be continued第43頁/共57頁Skill:CPR For Adult or Child (Two Rescuers)第44頁/共

33、57頁 Rescuer 1 checks ABCs. Rescuer 2 locates site for chest compressions.第45頁/共57頁 If no pulse, rescuer 2 gives 30 compressions for adult (15 for child) at rate of 100/minute.第46頁/共57頁Rescuer 1 gives 2 breaths.第47頁/共57頁 Continue cycles of 30:2 for adults (15:2 for child). After 5 cycles ( 2 minutes) switch positions.第48頁/共57頁Adult or Child Two-Rescuer CPR Continued Continue CPR until: Patient moves AED brought to scene and ready to use Advanced help arrives and takes over If patient starts breathing and has