C-A-B. Compressions: Push hard and fast on the center of. Airway: Tilt the victim s head back and lift the chin to

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1 Center fr Prfessinal Practice f Nursing CPR Guidelines fr Health-Care Prviders C-A-B Cmpressins: Push hard and fast n the center f the victim s chest Airway: Tilt the victim s head back and lift the chin t pen the airway Breathing: Give muth-t-muth rescue breaths

2 Center fr Prfessinal Practice f Nursing CPR Guidelines fr Health-Care Prviders CPR GUIDELINES FOR ADULTS ASSESS Unrespnsive: N breathing r n nrmal breathing (nly gasping) Activate the EMS (call 911). Get the AED if available and return t the victim If secnd rescuer is available send them t get help and the AED Check Pulse: Check the victim's pulse at the cartid artery fr n mre than 10 secnds DELIVER HIGH QUALITY CPR Start cmpressins within 10 secnds f identifying cardiac arrest Cmpress chest at least 2 inches, 30 times n the lwer half f the breastbne Cmpress 2-handed, with ne hand n tp f the ther Cmpress at a rate f at least 100 cmpressins per minute Each set f 30 cmpressins shuld take 18 secnds r less Allw cmplete chest recil after each cmpressin Minimize interruptins in chest cmpressins t less than 10 secnds CPR rati is 30 cmpressins t 2 breaths Rati stays the same fr ne-persn & tw-persn CPR In tw-persn CPR the rescuers shuld change psitins after every 2 minutes

3 GUIDELINES FOR ADULTS Center fr Prfessinal Practice f Nursing CPR Guidelines fr Health-Care Prviders PROVIDE EFFECTIVE BREATHS Open the victim s airway. Use the apprpriate technique t pen the airway Head Tilt-Chin Lift: tilt the head back and lift the chin Jaw Thrust: If a head r neck injury is suspected Deliver each rescue breath ver 1 secnd The victim s chest shuld rise with each breath Avid excessive ventilatin Use bag-valve mask r barrier device if available Once an advanced airway is placed, cntinuus cmpressins are prefrmed withut pause fr ventilatin. Ventilatins are delivered at a rate f 1 breath every 6-8 secnds If there is a pulse and the victim is nt breathing: Prvide rescue breathing: 1 breath every 5-6 secnds (10-12 breaths/minute) CONTINUE HIGH QUALITY CPR Cntinue cycles f cmpressins and ventilatin at a rati f 30:2 Healthcare Prviders shuld rtate cmpressrs every 2 minutes Attach and use AED as sn as available Minimize interruptins in chest cmpressins Limit t less than 10 secnds Health care prviders cntinue effective chest cmpressins/cpr until return f spntaneus circulatin (ROSC) r terminatin f resuscitative effrts

4 Center fr Prfessinal Practice f Nursing CPR Guidelines fr Health-Care Prviders CPR GUIDELINES FOR CHILDREN (Age: 1 year t Puberty) ASSESS Unrespnsive: N breathing r n nrmal breathing (nly gasping) Send secnd rescuer t activate the EMS (call 911) and get the AED If alne, remain with victim and prvide 2 minutes f CPR befre activating the EMS Check Pulse: Check the victim's pulse at the cartid artery fr n mre than 10 secnds If the victim s heart rate is less than 60 beats per minute with signs f pr perfusin, start CPR DELIVER HIGH QUALITY CPR Cmpress chest at least 1/3 the depth f the chest (abut 2 inches), 30 times just belw the nipple line Yu may use either 1 r 2 hands fr chest cmpressins Cmpress at a rate f at least 100 cmpressins per minute Each set f 30 cmpressins shuld take 18 secnds r less Allw cmplete chest recil between each cmpressin Minimize interruptins in chest cmpressins t less than 10 secnds CPR rati fr ne-persn CPR is 30 cmpressins t 2 breaths CPR rati fr tw-persn CPR is 15 cmpressins t 2 breaths Each set f 15 cmpressins shuld take 9 secnds r less In tw-persn CPR the rescuers shuld change psitins after every 2 minutes After 2 minutes, activate the EMS (call 911) if nt already dne and get the AED

5 Center fr Prfessinal Practice f Nursing CPR Guidelines fr Health-Care Prviders CPR GUIDELINES FOR CHILDREN (Age: 1 year t Puberty) PROVIDE EFFECTIVE BREATHS Open the victim s airway. Use the apprpriate technique t pen the airway Head Tilt-Chin Lift: tilt the head back and lift the chin Jaw Thrust: If a head r neck injury is suspected Deliver each rescue breath ver 1 secnd The victim s chest shuld rise with each breath Avid excessive ventilatin Use bag-valve mask r barrier device if available Once an advanced airway is placed, cntinuus cmpressins are prefrmed withut pause fr ventilatin. Ventilatins are delivered at a rate f 1 breath every 6-8 secnds If there is a pulse >60 per minute and inadequate breathing: Prvide rescue breathing: 1 breath every 3-5 secnds (12-20 breaths/minute) CONTINUE HIGH QUALITY CPR Cntinue cycles f cmpressins and ventilatin at a rati f 30:2 fr ne-rescuer and rati f 15:2 fr tw-rescuers Healthcare Prviders shuld rtate cmpressrs every 2 minute Attach and use AED as sn as available Minimize interruptins in chest cmpressins limit t less than 10 secnds

6 Center fr Prfessinal Practice f Nursing CPR Guidelines fr Health-Care Prviders CPR GUIDELINES FOR INFANTS (Age: Birth t 1 year) ASSESS Unrespnsive: N breathing r n nrmal breathing (nly gasping) Send secnd rescuer t activate the EMS (call 911) and get the AED If alne, remain with victim and prvide 2 minutes f CPR befre activating the EMS Check Pulse: Check the victim's pulse at the brachial artery fr n mre than 10 secnds If the victim s heart rate is less than 60 beats per minute with signs f pr perfusin, start CPR DELIVER HIGH QUALITY CPR Cmpress chest at least 1/3 the depth f the chest (abut 1 ½ inches), 30 times just belw the nipple line Cmpress with the Tw-Finger cmpressin technique fr infants Cmpress at a rate f at least 100 cmpressins per minute Each set f 30 cmpressins shuld take 18 secnds r less Allw cmplete chest recil between each cmpressin Minimize interruptins in chest cmpressins t less than 10 secnds CPR rati fr ne-persn CPR is 30 cmpressins t 2 breaths CPR rati fr tw-persn CPR is 15 cmpressins t 2 breaths Each set f 15 cmpressins shuld take 9 secnds r less Use the Tw-Thumb Encircling Technique fr cmpressins In tw-persn CPR the rescuers shuld change psitins after every 2 minutes After 2 minutes, activate the EMS (call 911) if nt already dne and get the AED

7 Center fr Prfessinal Practice f Nursing CPR Guidelines fr Health-Care Prviders CPR GUIDELINES FOR INFANTS (Age: Birth t 1 year) PROVIDE EFFECTIVE BREATHS Open the victim s airway. Use the apprpriate technique t pen the airway Head Tilt-Chin Lift: tilt the head back and lift the chin Deliver each rescue breath ver 1 secnd The victim s chest shuld rise with each breath Avid excessive ventilatin Use bag-valve mask r barrier device if available Once an advanced airway is placed, cntinuus cmpressins are prefrmed withut pause fr ventilatin. Ventilatins are delivered at a rate f 1 breath every 6-8 secnds If there is a pulse >60 per minute and inadequate breathing: Prvide rescue breathing: 1 breath every 3-5 secnds (12-20 breaths/minute) CONTINUE HIGH QUALITY CPR Cntinue cycles f cmpressins and ventilatin at a rati f 30:2 fr ne rescuer and rati f 15:2 fr tw rescuers Healthcare Prviders shuld rtate cmpressrs every 2 minute Attach and use AED as sn as available Minimize interruptins in chest cmpressins limit t less than 10 secnds

8 AED GUIDELINES Center fr Prfessinal Practice f Nursing CPR Guidelines fr Health-Care Prviders Early defibrillatin is critical fr victims f sudden cardiac arrest. The earlier defibrillatin ccurs, the higher the survival rate. Fr VF victims, survival rates are highest when immediate bystander CPR is prvided and defibrillatin ccurs within 3 t 5 minutes f cllapse. Attach and use the AED as sn as it is available. Minimize interruptins in chest cmpressins befre and after each shck. AED use in children and infants: Fr children frm 1 t 8 years ld, an AED with a pediatric dseattenuatr system shuld be used if available. If an AED with a dse attenuatr is nt available, a standard AED may be used (including adult pads) Fr infants <1 year f age, a manual defibrillatr is preferred. If a manual defibrillatr is nt available, an AED with a pediatric dseattenuatr is desirable. If neither is available, a standard AED may be used (including adult pads) COMMON STEPS TO OPERATE ALL AEDS 1. Pwer ON the AED: this activates vice prmpts fr guidance in all steps 2. Attach electrde pads t victim s bare chest Chse crrect pads (adult vs child) D Nt use child pads fr victims 8 years and lder (Adults) Plug in the electrde pad cnnectr 3. Clear the victim and the AED will analyze the rhythm Be sure n ne is tuching the victim The AED then tells yu if a shck is needed 4. If the AED advises a shck Make sure n ne is in cntact with the victim Press the shck buttn 5. As sn as the AED gives the shck, immediately resume CPR, starting with chest cmpressins

9 Center fr Prfessinal Practice f Nursing CPR Guidelines fr Health-Care Prviders AED GUIDELINES SPECIAL SITUATIONS WHEN USING AN AED Hairy Chest: The AED pads may stick t the hair and nt stick t the chest. Make sure t press firmly n each pad. If they d nt stick t the chest, shave the area with the razr in the AED carrying case and put n a new set f pads. Water: D nt use an AED in water. If the victim is in water, pull the victim ut f the water. If the victim s chest is cvered with water, wipe the chest befre attaching the pads. Pacemaker: Yu can identify pacemakers because they create a hard lump beneath the skin f the upper chest. Place the AED pad at least 1 inch t the side f the pacemaker. Medicinal Patches: D nt place AED pads n tp f a medicatin patch. Remve the patch and wipe the area clean befre attaching the AED pads. Make sure nt t tuch the medicine with bare hands. Flammable Items: Make sure the scene is safe and the victim is nt near flammable items. If yu find a victim in a garage with flammable items (e.g., gasline, paint thinner, etc.) remve the victim frm the area befre attaching and using the AED.

10 Center fr Prfessinal Practice f Nursing CPR Guidelines fr Health-Care Prviders GUIDELINES FOR THE CHOKING ADULT/CHILD CAN THE PERSON SPEAK, COUGH OR BREATHE Are they using the universal chking sign? Ask the questin are yu chking? PERFORM ABDOMINAL THRUSTS (Fr Children and Adults) Standing r kneeling behind the victim, wrap yur arms arund the victim s waist With ne hand, make a fist and place the thumb side (flat side) f yur fist against the victim s abdmen, belw the breastbne and slightly abve the navel Grasp yur fist with yur ther hand and press the victim s abdmen with quick upward thrusts. D nt squeeze the rib cage; cnfine the frce f the thrust t yur hands Repeat until bject is expelled r victim ges uncnscius If the victim is pregnant r bese, perfrm chest thrusts FOR THE UNCONSCIOUS VICTIM Activate the EMS (call 911) and get the AED if available, and return t the victim Open the airway and remve the bject if yu see it D nt d a blind finger sweep Begin CPR Every time yu pen the airway t give a breath, lk fr the bject If yu see the bject, remve it If yu d nt see the bject, attempt 2 breaths, and cntinue CPR

11 Center fr Prfessinal Practice f Nursing CPR Guidelines fr Health-Care Prviders GUIDELINES FOR THE CHOKING INFANT (Age: Birth - 1 year) SIGNS OF CHOKING: Infant cannt cry, cugh r breathe PERFORM BACK BLOWS AND CHEST THRUSTS D Nt perfrm abdminal thrusts Hld infant face dwn. Keep head lwer than the infant s trunk. Supprt jaw and neck with yur hand and straddle the infant s bdy ver yur frearm. Rest yur frearm n yur lap r thigh t supprt the infant Give 5 back blws between the shulder blades with the heel f yur hand Turn the infant ver and give 5 chest thrusts in the same lcatin as chest cmpressins Repeat back blws and chest thrust until bject is expelled r victim becmes uncnscius If the victim becmes uncnscius, stp back blws and chest thrust and start CPR FOR THE UNCONSCIOUS VICTIM Activate the EMS (call 911) and get the AED if available, and return t the victim Open the airway and remve the bject if yu see it D nt d a blind finger sweep Begin CPR Every time yu pen the airway t give a breath, lk fr the bject If yu see the bject, remve it If yu d nt see the bject, attempt 2 breaths, and cntinue CPR

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