CPR

Question 1

What is CPR

Answer 1

Cardio-pulmonary resuscitation

Question 2

What is cardiac arrest (3)

Answer 2

1. Abnormal heart rhythm leading to sudden cessation of heartbeat, with absence of (or abnormal) breathing (Cardio-respiratory arrest)
2. In a patient with a cardiac arrest, death occurs within minutes unless treated promptly.
3. Treatment through CPR, and defibrillation (where available)

Question 3

What can lead to cardiac arrest (4)

Answer 3

1. Myocardial Infarction/Heart attack: Blockage of coronary artery
2. leading to characteristic chest pain
3. radiation to neck/left arm/jaw
4. muscle damage.

Question 4

What are the key principles to CPR (5)

Answer 4

1. Concentrate on chest compressions
2. Initiation of CPR ASAP – speed of initiation important to survival chance
3. Use defibrillator where available
4. Simplify BLS to allow lay persons/bystanders to resuscitate
5. Key interventions of CPR and automated external defibrillators (AEDs) can be delivered by untrained members of the public

Question 5

What is the chain of survival (4)

Answer 5

1. Early recognition and call for help - to prevent cardiac arrest
2. Early CPR - to buy time
3. Early defibrillation - to restart the heart
4. Post resuscitation care - to restore quality of life

Question 6

What are causes of cardio-respiratory arrests (6)

Answer 6

1. In adults, this is most commonly a cardiac cause (i.e. MI or arrhythmia)

Other potential causes:

1. Respiratory obstruction
2. Electrocution
3. Drowning
4. Hypovolaemia
5. Poisoning

Question 7

What are the first steps to attending a casualty in public (4)

Answer 7

S - Shout for help

A - Approach with caution

F - Free from danger

E - Evaluate responsiveness

Question 8

What to do if the person is responsive (4)

Answer 8

1. Leave the person in the position in which you find them, provided there is no further danger.
2. Check for injuries
3. Reassess regularly
4. Get help

Question 9

What to do if the person is unresponsive (3)

Answer 9

1. Shout for help
2. Turn patient onto back
3. Open airway and assess breathing

Question 10

How do you open the airway (2)

Answer 10

1. Tilt head and lift chin
2. Jaw thrust in cervical spinal injury

Question 11

How do you assess breathing (5)

Answer 11

1. Look for chest movement
2. Listen for breath sounds
3. Feel for expired air
4. Assess for 10 seconds before deciding breathing is absent
5. If you have doubts about whether breathing is normal, act as if it is NOT normal.

Question 12

What to do when breathing is present (4)

Answer 12

1. If safe, and able to do so then put patient in recovery position
2. Call an ambulance, or send for help
3. Continue to monitor breathing and check pulse
4. Provide reassurance, person may be aware of surroundings even if unresponsive

Question 13

What to do is breathing is absent (4)

Answer 13

1. Call an ambulance
2. Ask someone to call for an ambulance if possible, or if you are on your own do this yourself.
3. Ensure ambulance operator aware that this is a cardiac arrest
4. Start chest compressions

Question 14

How do you do chest compressions (11)

Answer 14

1. Place heel of one hand in centre of victim’s chest, place heel of other hand on top of first hand
2. Interlock fingers , ensure pressure is not applied over victim’s ribs.
3. Do not press over upper abdomen or bottom end of sternum.
4. Positioned vertically above victim’s chest and with straight arms.
5. Press down on the sternum 4-5cm
6. After each compression, release pressure on chest without losing contact between hands and sternum.
7. Repeat at a rate of 100/min (just under 2 compressions per second)
8. If chest compressions only are given, these should be continuous at a rate of 100/minute
9. Swap rescuer every 2 minutes to avoid tiredness where possible.
10. Minimise time where there is no compressions taking place.
11. Stop to re –check victim only if he starts breathing normally: otherwise do not interrupt resuscitation.

Question 15

What are reasons to stop CPR (4)

Answer 15

1. To allow a shock to be delivered by an AED in line with instructions
2. Because a paramedic arrives and takes over
3. The person shows signs of life
4. Because you are alone, and too exhausted to continue

Question 16

How are AEDs used (6)

Answer 16

1. Not all arrhythmias can be shocked.
2. Arrhythmias are classed as “shockable” or “non-shockable”
3. Automated electric defibrillators (AEDs) can analyse the heart rhythm, determine whether a shock is required and then deliver a shock.
4. If AED available locally, then send someone to collect it
5. Open AED, attach adhesive pads to chest (directly to skin) and follow verbal instructions
6. Ambulance operators may also talk rescuers through the process of using an AED

Question 17

What are rescue breaths (5)

Answer 17

1. If trained and willing, can give rescue breaths
2. Recommended to give in a 30:2ratio (i.e. 30 compressions to 2 rescue breaths)
3. If two rescuers, one should do compressions and the other rescue breaths, then swap approximately every 2 minutes
4. Pinch nose and lift chin. After taking a deep breath, seal mouth over victims mouth and blow steadily for 1 second.
5. Watch for chest rise, then remove mouth and repeat.