BASIC LIFE SUPPORT

CARDIOPULMONARY
RESUSCITATION

CARDIOVASCULAR RISK
FACTORS:
Non-modifiable:
Heredity
Gender
Age
Modifiable:
Cigarette smoking
Hypertension
Elevated cholesterol and triglyceride level
Lack of exercise
Obesity
Stress
Diabetes

Other causes of cardiac arrest:

1.
2.
3.
4.
5.
6.
7.
8.
9.

Drowning
Electrocution
Trauma
Poisoning
Epilepsy
Allergy
Suffocation
Smoke inhalation
Lightning strikes

In children the following are prone to life threatening

conditions:
Children less than one year of age who suffer mostly
from falls and burns usually at home.
One to four-years old children who suffer above
injuries and who may inhale/ingest foreign bodies.
School age children (5-7 years) involved in traffic and
school accidents.
Children, 8-20 years of age who are victim of physical
abuse.

WHY THE NEED FOR CPR TRAINING?

Cardiovascular diseases (diseases of the heart
and blood vessels) are now the leading causes
of death in the country.

Most people die of heart attack before they

ever reach a hospital.

There are other situations aside from heart

attack that can lead to cardiorespiratory arrest
and therefore need CPR.

 Since these events can occur anytime and

anywhere, it is the person nearest the victim
who may witness this arrest. This person must
be able to recognize this emergency and must
be able to institute CPR immediately.

This person could be you!

In pediatrics, basic life support course

should be undertaken by expectant parents,
parents of young children, and others into
whose care children are entrusted.

CHAINS OF SURVIVAL
Immediate Recognition of cardiac arrest
and activation of the emergency response
system.
Early CPR
Rapid defibrillation
Effective advance life support
Integrated Post cardiac arrest care

Early Warning signs of

Heart attack
Prolonged compressing pain or unusual
discomfort in the center of the chest,
behind the breastbone.
Pain may radiate to shoulder, arm, neck or
jaw, usually on the left side.
May be accompanied by sweating, nausea,
vomiting and shortness of breath.

Early Warning signs of

Respiratory failure
Unable to speak, breathe or cough

Clutches neck (universal distress

signal)
Bluish color of skin and lips.

CARDIOPULMONARY
RESUSCITATION
It is a life-saving technique performed on a person
who is not breathing and whose heart has stopped
pumping.
This procedure involves a combination of rescue
breathing and chest compression. It should be done
until defibrillation and advance cardiac life support
(ACLS) can restore normal heart and lung functions.
CPR- basic life support can be performed by both lay
persons and medical personnel.

How does CPR works?

All the living cells of our body needed a
steady supply of oxygen to keep us alive
CPR works because you can breathe air
into the victims lungs to provide oxygen
into the blood. Then when you press the
chest, you move oxygen-carrying blood
through the body.

When will you do CPR?

CPR must be started as soon as possible
when the carotid pulse is not appreciated
or if breathing either stops or ineffective.
In case of doubt, do CPR. Any delay in
starting CPR reduces the chances of
survival. In addition, the brain cells begin
to die after four to six minutes without
oxygen.

The CABs of CPR

After determining unconsciousness, you should
evaluate the condition of the bodys two most
vital systems: the circulatory system and the
respiratory system. This is done by checking the
CAB
C 4 Circulation
does the victim has pulse (for HCP)
Is the victim moving, coughing and
breathing normally (lay personnel)
Is the victim bleeding severely?
A 4 Airway does the victim have open airway?
B 4 Breathing is the victim breathing?

You find a person lying on the ground, not moving. You

survey the scene if it is safe and get some idea of what
happened. Then begin doing a primary survey by
checking for unresponsiveness.

To check for unresponsiveness

Tap or gently shake the victim
Rescuer shout are you ok?
Check for medical alert, tag, bracelet,
necklace or any other indicators.
He should activate the EMS system if
available in the community
He then proceeds with CPR.

CPR first or Call First?

Call first call for help immediately before doing
CPR.
For Adult victims
>12 years old HCP
>8 years old LAY
Pediatric victims with associated cardiac-origin
arrests.
CPR first do 5 cycles CPR then call for help
Children
Unresponsive victims <12 years old HCP; < 8
years old LAY
Submersion/drowning of all ages
Arrest Associated with trauma of all ages
Drug overdose of all ages.

Circulation
(health care providers)
Check for pulse:
Adult/child Carotid pulse for 10
seconds
Infant Brachial pulse for 10
seconds

Circulation
(Lay rescuers)
Quickly scan if the victim is moving,
breathing normally or coughing or
signs of life.

IF THE VICTIM HAS NO PULSE OR NO

SIGNS OF CIRCULATION,
PROCEED TO:

C-IRCULATION
Locate the compression area

Chest compression (ADULT)

A. Give 30 chest compressions
B. Kneel facing victims chest at the level of
victims shoulder

In the center of the chest in between

the nipple area, and lower half of the
sternum.

Place heel of hand directly on the top

of heel of the other hand.

Keep fingers off victims chest.

 Position shoulder over hands with elbows

locked and arms straight.
Compress breastbone at least 2 inches
(5cm) deep, at least 100 compressions per
minute. Count aloud one, two,
threethirty push hard and push fast.
Compress down and release pressure
smoothly, keeping hand in contact with
chest at all times.

Chest Compression (Child)

Same as adult.

You may use heel of one hand or as in

adult. Depth is about 2 inches (5cm).

Chest Compression (Infant)

Locating proper finger position for chest

compression in infant. Note that the
rescuers other hand is used to maintain
head position to facilitate ventilation.

The rescuers 2 to 3 fingers compress the

sternum, just below the inter-mammary line
with chest depth of about 1-1/2inches (4cm)
at the rate of at least 100 per minute.
Smooth compression with equal time for
compression and relaxation is done.

Recheck pulse after chest compressions

Locate carotid pulse (adult and child) or
brachial pulse (infant) and feel for 10 seconds.

Look for signs of circulation

Breathing normally
Moving

Coughing

A-IRWAY
ADULT

Lay rescuer age >8 years old

HCP age >12 years old

Open airway using head tilt chin lift

Place fingers of other hand under

bony part of lower jaw near chin.

Tilt head and lift the jaw.

CHILD Same as adult
INFANT < 1 year old; head in neutral position

airway
(health care providers)
Head tilt chin lift maneuver (medical
or non-trauma)

Jaw trust maneuver

airway
(Lay rescuers)
Use only head tilt chin lift maneuver.

Check for breathing

Victim may either be:
Breathing
Not breathing
If the victim is breathing
Maintain open airway and position the victim.
The unresponsive victim with spontaneous
respirations should be placed in the recovery
position if no cervical trauma is suspected.
Placement in this position consists of rolling
the victim to his or her side to help protect the
airway.

B-REATHING
ADULT

Give 2 breaths each breath over 1 second and

should produce visible chest rise.

Maintain open airway.

Pinch the nose

Open your mouth wide, take a deep breath,

and make tight seal around outside of victims
mouth.

Give 2 breaths (1 second per breath)

Observe chest rise and fall; listen and feel for

escaping air

Allow for exhalation between breaths.

CHILD

Mouth to mouth

INFANT

Mouth to nose and mouth

Rescue breathing in an infant. The

rescuers mouth covers the infants nose
and mouth, creating a seal.

If not breathing, but pulse is present or with signs

of circulation, performs rescue breathing (For
HCP only):
Adult give one breath every 6 seconds (about 10
breaths per minute)
Child/infant Give one breath every 3-5 seconds
(about 12-20 breaths per minute)

With advance airway adult, child, and infant: Give

one breath every 6-8 seconds, about 8-10 breaths per
minute.

Adult chest compression-to-ventilation ratio

(one and two rescuer CPR)
If pulseless, perform cycles of 30
compressions followed by 2 breaths.
After 5 cycles of 30:2 (about 2 minutes)
check pulse or signs of circulation.
If still no pulse, continue 30:2 cycles
beginning with chest compression.
Re check pulse every about 2 minutes.

Pediatric chest
compression-to-ventilation ratio
Infant and child (1 rescuer) - same as adult
Infant and child (2 rescuers)
If pulse is not palpable, chest
compressions must be initiated at 15:2
The child in a supine position should lie
on hard surface such as a rescuers forearm
or thigh so allowing the head to tilt back
the airway patency.

Foreign Body airway obstruction

Most common cause in unconscious
victim is tongue.
Could be mild or severe.
Clutching neck is the universal
distress sign
Look for the presence or absence of
breathing, coughing or speaking.

Severe airway obstruction (conscious adult)

Determine if victim is chocking
Ask are you choking?
- If yes perform abdominal thrust
Stand behind the victim
Wrap arms around victims waist
Make a fist with one hand and place
thumb side of fist against middle of
victims abdomen just above naval and
well below lower tip of breastbone.

 Grasp your fist with your other hand.

Keeping elbows out, press fist into victims
abdomen with a quick upward thrust.
Each thrust should be a separate and distinct
attempt to dislodge the object
Repeat thrusts until obstruction is cleared or
victim becomes conscious.

Foreign Body airway obstruction (conscious

infant)
Back slaps and chest thrust to relieve foreign body
airway obstruction in the infant.
If the rescuer breathing does not affect a chest rise
despite opening airway, do back slaps and chest
thrust especially if a child has a history of sudden
respiratory distress with ineffective coughing
without sound, gagging, high pitched noise, or
wheezing of unconscious. Repeat up to 5 times to
open airway.
For unresponsive patients perform CPR

Severe airway obstruction (conscious adult)

Call for help
Move from straddle position and kneel beside
victims head.
With victims face up, open mouth and grasp both
tongue and lower jaw between thumb and fingers of
hand nearest victims legs; lift jaw
Insert index finger into mouth along inside of cheek
and deep throat to base of the tongue.
Use hooking action to dislodge and move into
mouth for removal.
Open airway to ventilate; it still obstructed, reposition
head and try to ventilate again.