Learning Material 1 Adult CPR
Learning Material 1 Adult CPR
Learning Material 1 Adult CPR
This course deals with the principles, theories and techniques in the nursing care of
clients with life threatening conditions, acutely ill and multi-organ problems focusing on
emergency management. The learners are expected to provide safe, appropriate and holistic
nursing care to clients utilizing the nursing process.
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NCN-118- SKILLS Module
ADULT CARDIOPULMONARY RESUSCITATION (CPR)
Despite advances in Emergency Medical Systems and in the technology of resuscitation, sudden cardiac
arrest remains a major public health problem. It is associated with low survival rate, and major long term
severe mental impairment due to delays in cardiopulmonary resuscitation (CPR) and treatment.
Majority of cardiac arrest occur outside the hospital – at home, in the workplace, in public institutions.
Almost 70% of out-of-hospital cardiac arrests occur at home and are witnesses by a family member
and approximately 50% are unwitnessed.
Only 10.8% of Out of Hospital Cardiac Arrest (OHCA) who have received CPR from EMS survive
to hospital discharge.
In-Hospital Cardiac Arrest (IHCA) has a better outcome, with 22.3% to 25.5% of adults surviving
to discharge.
Unfortunately, approximately less than 10 percent of sudden cardiac arrest victims survive because majority
of those witnessing the arrest are people who do not know how to perform CPR.
Cardiopulmonary Resuscitation is an emergency procedure used when someone’s heart stops beating.
It is a simple inexpensive procedure that can be learned by anyone, and consists of a manual
technique using repetitive pressing to the chest and breathing into the person’s airways that keeps
enough oxygen and blood flowing to the brain.
Requires no special medical skills and training is available for the ordinary person nationwide.
If effectively done immediately after cardiac arrest, it can double a victim’s chance of survival.
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NCN-118- SKILLS Module
ADULT CARDIOPULMONARY RESUSCITATION (CPR)
Early CPR and defibrillation within the first 3-5 minutes after collapse, plus early advanced care can result
in high (greater than 50 percent) long-term survival rates for witnessed ventricular fibrillation (VF).
If bystander CPR is not provided, a cardiac arrest victim’s chances of survival fall 7% to 10% for every
minute of delay until defibrillation.
This is a concept which aims to improve the outcome for victims of cardiopulmonary arrest.
It involves a series of events which are interconnected to each other like the links of a chain.
The 5 links in the Chain of Survival are described specifically as:
1) Early access
2) Early CPR
3) Early Defibrillation
4) Early ACLS
5) Integrated Post-Cardiac Arrest Care
Based on the new 2015 AHA CPR/ECC Guidelines, they have recommended Separate Chains of Survival
that identify the different pathways of care for patients who experienced Cardiac Arrest in the Hospital
(IHCA) and Out of Hospital Cardiac Arrest (OHCA) settings.
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NCN-118- SKILLS Module
ADULT CARDIOPULMONARY RESUSCITATION (CPR)
The care for all post cardiac arrest patients (IHCA and OHCA) all converge in the hospital ICU setting.
Patients who had an OHCA depend on their community for support where Lay rescuers must recognize
the arrest, call for help and initiate CPR and apply Public AED protocols until EMS arrives and patient
ultimately transferred to hospital. The patients who had IHCA depend on a system of appropriate
surveillance (e.g., rapid response or early warning system) to prevent cardiac arrest. All IHCA patients
depend on a smooth multidisciplinary interaction among the department services and allied health
providers including physicians, nurses, respiratory therapists and others.
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NCN-118- SKILLS Module
ADULT CARDIOPULMONARY RESUSCITATION (CPR)
2. Check unresponsiveness.
Tap or gently shake the victim.
Rescuer shouts “Are you OK?”
Quick check for normal breathing.
If the victim is unconscious, rescuer calls for help.
Pulse Check:
o Palpate for carotid pulse within 10 seconds
o At the same time, check for breathing.
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NCN-118- SKILLS Module
ADULT CARDIOPULMONARY RESUSCITATION (CPR)
4. CHEST COMPRESSION
a) Kneel facing victim’s chest
b) Place the heel of your hand on the center of the victim’s chest. Put your other hand on top
of the fist with your fingers interlaced.
c) Position shoulders over hands with elbows locked and arms straight.
d) Compress down and release pressure smoothly, keeping hand contact with chest at all
times.
e) Give chest compressions at 100-120 per
minute
Push hard and fast.
Compress breast bone 2-2.4
inches deep (5-6 cm)
Compress at a rate of 100-120
per minute or more
Compress 30 times initially
o 30 compressions should
take 15-18 secs
o Count aloud
“1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27
,28,29, and ONE.
o Minimize interruptions
Allow chest recoil after each compression.
5. AIRWAY
Open the airway: Use the
head tilt/ chin lift method
Place on hand on
the victim’s
forehead
Place the fingers of
other hand under
the bony part of
lower jaw near chin
Tilt head and lift
jaw – avoid closing
victim’s mouth.
6. BREATHING
Give 2 one-second breaths
Maintain airway
Pinch nose shut
Open your mouth wide, take a normal breath, and make a tight seal around
outside of the victim’s mouth
Give 2 full breaths (1 sec/breath)
Observe chest rise & fall; listen & feel for escaping air
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NCN-118- SKILLS Module
ADULT CARDIOPULMONARY RESUSCITATION (CPR)
7. Recheck Pulse
Recheck pulse every 2 minutes (equivalent to 5 cycles CPR)
Very brief pulse check – should take less than 10 seconds (at the same time check for
normal breathing)
In case there is any doubt about the presence or absence of pulse, continue chest
compressions.
For trained healthcare providers only.
8. Continue CPR until help arrives.
9. Victim is revived:
Return of Spontaneous Circulation (ROSC)
10. If the victim is breathing:
Put him in a RECOVERY POSITION:
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 onto his or her side to
help protect the airway.
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NCN-118- SKILLS Module
ADULT CARDIOPULMONARY RESUSCITATION (CPR)
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NCN-118- SKILLS Module
ADULT CARDIOPULMONARY RESUSCITATION (CPR)
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NCN-118- SKILLS Module
ADULT CARDIOPULMONARY RESUSCITATION (CPR)
REFERENCE
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NCN-118- SKILLS Module