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FOUNDATION OF NURSING III GNS211

GROUP ONE PRESENTATION

ON

TOPIC:
CARDIO-PULMONARY RESUSCITATION
CPR

3RD COHORT NURSING, NURSING DEPARTMENT

1st SEMESTER, 200 LEVEL.
EDO STATE COLLEGE OF NURSING SCIENCES.

OCTOBER, 2023.
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GROUP ONE MEMBERS AND MATRICULATION NUMBERS.

NAMES OF MEMBERS MATRICULATION

NUMBER

TRACY OMOZUSI IGHODALO NUR/22B/00204

OKUNGBOWA STACIE NUR/22B/00206

OLUOMA CHINAEMELUM OJIEGO NUR/22B/00207

FAITH EZIOR NUR/22B/00205

EROMOSELE OMOYE VICTORY NUR/22B/00202

OMOKARO JENNIFER NUR/22B/00210

OSEMWENGIE OGHOMWEN COMFORT NUR/22B/00209

OSUNDE OMOSEFE PEACE NUR/22B/00208

NORUWA ERONMWON NUR/22B/00203

OSAGIE OSAGA WALTER NUR/22B/211
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CONTENTS.
CONTENTS ………………………………………………………………….2
INTRODUCTION ………………………………………………………….. 4
1. Definition of Cardio-pulmonary resuscitation………………………………….. ….5
2. Purpose of Cardio-pulmonary resuscitation ………………………………………. 5
3. Indications for Cardio-pulmonary resuscitation ……………………………………5
4. Contra-indications of Cardio-pulmonary resuscitation ……………………………..5
5. Types of Cardio-pulmonary resuscitation …………………………………………..6
6. Techniques used in Cardio-pulmonary resuscitation ……………………………….7
6.1) About the ABCs of CPR …………………………………………….........7
6.2) Assessing the level of consciousness of a casualty ……………………….8
6.3) General procedure of CPR …………………………………………..........8
6.4) General CPR for children including babies and infants ………………….9
7. Equipment for Cardio-pulmonary resuscitation ……………………………….........9
8. Complications of Cardio-pulmonary resuscitation …………………………………10
9. Nursing responsibilities during CPR ……………………………………………… 10
9.1) After care of patients ……………………………………………………..10
10. SUMMARY ………………………………………………………………………11
11. CONCLUSION ……………………………………………………………………11
12. REFERENCE ………………………………………………………………………12
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INTRODUCTION OF CARDIO-PULMONARY RESUSCITATION.

CARDIO-PULMONARY RESUSCITATION also called CPR is a lifesaving
technique useful in many emergencies, including heart attack or near drowning in which
a person’s breathing or heartbeat has stopped. Simply put, CPR keep oxygen rich blood
flowing to the brain and other vital organs if the heart or lungs stop working on their own.
CPR performed in real life is nothing compared to the ones we see in movies. The real
CPR is messy and extremely tiring and the chance of the individual regain consciousness
is slim. It is a profoundly physical act that requires a tremendous amount of exertion
especially when giving chest compressions. The main purpose or reason for CPR is
simply to prevent irreversible heart damage or death in the case of cardiac arrest.
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DEFINITION OF CARDIO-PULMONARY RESUSCITATION.

CARDIO-PULMONARY RESUSCITATION is an emergency procedure
consisting of chest compression often combined with artificial ventilation to revive a
patient who has stopped breathing due to a respiratory or cardiac problem. In essence,
cardio {heart} pulmonary {lungs} resuscitation {revive} serves as an artificial heartbeat
and artificial respirator. It includes artificial respiration and manual cardiac massage. The
physiology of CPR involves generating a pressure gradient between the arterial and
venous vascular beds; CPR achieves this via multiple mechanisms. The brain may
sustain damage after blood flow has been stopped for about four minutes and
irreversible damage after about seven minutes. Typically if blood flow ceases for one to
two hours, then body cells die. Therefore, in general CPR is effective only if performed
within seven minutes of the stoppage of blood flow.[14] The heart also rapidly loses the
ability to maintain a normal rhythm. Effective CPR enables enough oxygen to reach the
brain to delay brain stem death, and allows the heart to remain responsive
to defibrillation attempts.

PURPOSE OF CARDIO-PULMONARY RESUSCITATION.

The main purpose of CPR is to: reestablish effective ventilation and circulation.

INDICATIONS FOR CARDIO-PULMONARY RESUSCITATION.

The indications for CPR include the following:
1) During cardiac arrest, Pericardial tamponade.
2) Choking, Poisoning, Suffocation, Smoke inhalation.
3) Near-drowning.
4) Drug or alcohol overdose.
5) Ventricular fibrillation.
6) Asystole (when the heart electrical system fails, thereby resulting to heart failure).

CONTRA-INDICATIONS FOR CARDIO-PULMONARY

RESUSCITATION.
1) When there is a signed DNR order {Do not resuscitate}.
2) Rigor mortis {A postmortem changes or recognizable signs of death
characterized by stiffening of the limbs of the body due to chemical changes}.
3) Decapitation {Total separation of the head from the body}.
4) Patient present with fractured ribs.
5) Spontaneous breathing or recovery.
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TYPES OF CARDIO-PULMONARY RESUSCITATION.

The types of cardio-pulmonary resuscitation are:
 HANDS-ONLY CPR(Compression-only): Hands-only CPR is an easy-to-learn skill
that could save a life. It involves chest compression without artificial ventilation. It is
easy and it is mostly recommended for untrained rescuer or those who are not proficient
when it comes to CPR. It is mostly used for patients with cardiac arrest. However, it is an
exception when it comes to: children, near drowning victims, drug overdose.

 STANDARD CPR (Compressions with rescue breath): This involves performing CPR
using chest compression and rescue breaths. The compression speed is of at least 100
chest compressions per minute in a continual cycle of 30 rhythmic chest compression
before each 2 rescue breaths {general compression-to-ventilation ratio of 30:2}.
However, the compression-to-ventilation ratio varies depending on the number of rescuer
available. Compressions with rescue breath involve at least two trained rescuers. If one
rescuer is present, the ratio preferred is 30:2, but when two rescuers are present the
preferred ratio is 15:2. The rescue breath can be mouth-to-mouth rescue or using the
BAG VALVE MASK (BVM) commonly known as the Ambu bag.

 PAEDIATRIC CPR- This technique is specially used for infants and children. This rate
of compression to rescue breaths is 15 compressions followed by 2 rescue breaths.
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 HANDS-ONLY CPR WITH AED (Automated external defibrillator): Automated

external defibrillator devices are used to deliver an electric shock to the heart during
cardiac arrest. Hands-only CPR can be performed till the time AED is being prepared. It
is mainly used for patients experiencing cardiac arrest.

TECHNIQUES USED IN CARDIO-PULMONARY RESUSCITATION.

The cardio-pulmonary resuscitation techniques simply involve the Airway,
Breathing and Circulation commonly known as the ABC technique. However, in the year
2010, the American Heart Association updated the recommendation and changed the
ABC to CAB {Circulation, Airway, and Breathing}. Different Studies have showed the
CAB to be more effective and favorable in providing a timely intervention. Despite the
adaptation and changes, the ABC technique is still widely used by healthcare providers or
trained rescuers when carrying out CPR procedure.

About the ABCs of CPR.

The ABCs of the CPR consists of three different components which include:

1. AIRWAY: A blocked airway can hamper a person’s ability to breathe. The

airway management is paramount is paramount in victims suffering from
respiratory and cardiac failures. Before CPR is done on an individual, the airway
is checked and freed of any obstructions thereby keeping the airway patent.
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2. BREATHING: After the airway comes the breathing. Signs of breathing are
checked for in the individual. The rescuer is expected to tilt the head of the
casualty back and look, listen and feel for breathing for 10 seconds.
3. CIRCULATION: For the circulation, the signs of a working circulation is
checked by assessing the carotid artery for at least 10 seconds. If there are none,
then begin compressions.

ASSESSING THE LEVEL OF CONSCIOUSNESS OF A CASUALTY.

When assessing the level of consciousness of a casualty for CPR, the AVPU is
used.
 A stands for ALERT
 V stands for VERBAL.
 P stands for PAIN or PAINFUL
 U stands for UNRESPONSIVE.
a) ALERT: A casualty may be alert or may or may not be alert. When a casualty is
alert, they will respond spontaneously.
b) VERBAL: Casualty may seem to be unconscious but can sometimes respond to a
verbal prompt when a loud shout close to the ear, tapping the shoulder or giving
gentle shake.
c) PAIN: When shouting, gentle tapping, or shaking does not wake the casualty,
they might respond to a painful stimulus such as rubbing hard on their breastbone
with the knuckles of the fingers or giving a gentle pinch. Do not prick the casualty
with a needle or any sharp object that will draw blood.
d) UNRESPONSIVE: This is when the casualty does not respond and the ABC of
the DRSABC is expected to be carried out.

GENERAL PROCEDURE OF CARDIO-PULMONARY RESUSCITATION.

Performing CPR is an important life-saving process and it can help in emergencies to
provide basic life support. CPR is carried out by following the steps: (DRSABC)
i. Step 1- Assess the Scene (Danger): ensure that the area is safe for the victim.
Look for any potential dangers or hazards before approaching the person in need.
Check the casualty neck, wrists and ankle for a medical ID tag that pass on
information. This is very important before starting CPR.
ii. Step 2- Check for Responsiveness (Response): gently tap the patient or casualty
and ask out loud if they are fine and then check for the signs of any response such
as a movement or a response.
iii. Step 3- Call for Help (Shout): if the patient is unresponsive or having difficulty
breathing immediately call for emergency medical services.
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iv. Step 4- Open the Airway (Airway): Tilt the patient's head backward by slightly
lifting the chin with one hand and pushing down on the forehead with the other
hand. This process helps in opening up the airways.
v. Step 5- Check for Breathing (Breathing): carefully examine the patient by
trying to look or feel the breathing of the patient. This is done by LOOKING,
FEELING, and LISTENING for the breathing sounds.
 LOOK: For chest movement or expansion.
 FEEL: For the breath using your fingers. Place your fingers close to the
nostril of the casualty or use your cheek to feel the breath.
 LISTEN: For breath sounds.
vi. Step 6- Begin Chest Compressions (Circulation): if the chest is in a gasping
condition or if not breathing then start chest compressions. Place the heel of one
hand on the top of the other and interlock the fingers. The elbow should be
straight and the shoulders should be positioned directly over the hands.
vii. Step 7- Compress the Chest: Push the chest hard at the rate of 100-120
compressions per minute. Depress the chest at least 2 inches with each
compression allowing the full chest to recoil in between these compressions.
viii. Step 8- Give Rescue Breaths: After 30 compressions, 2 resume breaths should
be provided. Maintain the open airway by tilting the head back and lifting the
chin. Pinch the nose of the patient, take a normal breath, and cover the mouth of
the patient with yours to create a seal. Give a breath that lasts for about one
second and wait for the chest to rise. Continue cycles of compressions and breaths
until professional help arrives.

GENERAL CPR FOR CHILDREN INCLUDING BABIES AND INFANTS.

1) Place the child on their back on a firm surface.

2) Kneel next to the child's neck and shoulders. If it is an infant, carry the infant using
one hand with your forearm and fingers supporting the infant’s body and head.
3) Head-tilt and chin-lift maneuver to open the airway.
4) Place two hands or one hand if the child is very small, on the lower half of the
child's breastbone. If it is an infant, draw an imaginary line between the nipples and
place two fingers of one hand just below the line in the center of the chest.
5) Using the heel of one or both hands, press straight down on the chest about 2 inches
but not greater than 2.4 inches. For an infant, gently compress the chest about 1.5
inches. Push hard and fast,100 to 120 compressions a minute. Give two breaths after
every 30 chest compressions.
6) Breathe into the child's mouth for one second. Watch to see if the chest rises. If it
rises, give a second breath. If the chest doesn't rise, repeat the head-tilt, chin-lift
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maneuver first. Then give the second breath. Be careful not to provide too many
breaths or to breathe with too much force.
7) After the two breaths, immediately begin the next cycle of compressions and
breaths. Continue CPR until signs of life becomes present or medical personnel
arrive.

EQUUIPMENTS FOR CPR.

Some of the equipment used for CPR includes the following:

 Oxygen mask with reservoir bag.
 Automated External Defibrillator (AED) with electrodes.
 Syringe and needles.
 Oxygen cylinder (of suitable size to deliver high flow o2 for a minimum of 30
minutes).
 Epinephrine/Adrenaline.
 Atropine.
 Tape.
 Gloves.
 Scissors.
 Suction machine.
 IV fluids.

COMPLICATIONS OF CARDIO-PULMONARY RESUSCITATION.

I. Rib fractures.
II. Internal organ injuries.
III. Vomiting and aspiration as result of pressure from the chest compression.
IV. Brain damage.
V. Tissue injuries.

NURSING RESPONSIBILITIES DURING CARDIO-PULMONARY

RESUSCITATION.
1) To recognize the signs of cardiac arrest.
2) Protect the patient’s brain from anoxia by immediately starting the artificial
ventilation of the lungs and cardiac massage.
3) Call for help.
4) Clear the airway of false teeth, vomitus, food material.
5) Start the CPR procedure.
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AFTER CARE OF THE PATIENT.

1) Watch the patient continually for over a period of 48-72 hours.
2) Give oxygen administration continuously for 48 hours.
3) Frequently check the victim’s head and jaw position to prevent the tongue from
blocking the airway.
4) Assess the patient respiration.
5) Check the color of the skin for cyanosis.
6) Watch for signs of convulsions.
7) Administer IV infusions as prescribed.
8) Record the procedure on the nurse’s record note with date and time.
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SUMMARY:
Cardio-pulmonary resuscitation is a procedure that combines rescue breathing and chest
compressions to temporarily pump enough blood to the brain until specialized treatment is
available. It is done on victims of cardiac arrest and respiratory failure. CPR involves the ABCs
technique that stands for “Airway, Breathing and Circulation”. When carrying out CPR, the
acronym DRSABC is used. However, the CPR performed on adult and children are similar but
with a bit differences. Several equipment is used for CPR and examples of such equipment
include; Oxygen mask and cylinder, epinephrine, suction machine e.t.c. CPR also has its
complications and the most common complication is the rib fracture.

CONCLUSION:
In conclusion, the CPR is a lifesaving technique that is performed by healthcare
providers in many emergencies, including heart attack or near drowning in which a person’s
breathing or heartbeat has stopped. Simply put, CPR keep oxygen rich blood flowing to the brain
and other vital organs if the heart or lungs stop working on their own. CPR achieves this via
multiple mechanisms.
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REFERENCES:
❖ Crane Star Organization. (May 23, 2020). Cardio-Pulmonary Resuscitation.
❖ Mayo Clinic Organization. (August 17, 2019). Hands-Only CPR: American Heart
Association.
❖ I Clement. (October 22, 2018). Foundation of Nursing: CPR Procedure for
Nurses.
❖ Minnesota Department of Health sciences.(April 24,2020). CPR Procedure for
Children (Infants and Babies).
❖ World Health Organization.(October 4,2019). Resuscitation Council for Pediatrics
CPR Guidelines.