Chapter 1: Introduction to Cardiac Arrest and CPR Overview of Heart Disease It is the leading cause of death globally CPR and Emergency Response Notes

Cardiac Arrest Overview

  • Location: 75-80% of out-of-hospital cardiac arrests occur at home.

  • Importance of CPR: Training in CPR can save lives in emergencies involving loved ones.

    • Cardiac arrest can happen to anyone, irrespective of age or health.

CPR for Infants vs Adults

  • Similar Principles: The basic principles of CPR for infants (under one year) mirror those for adults, with notable differences.

  • Key Differences:

    • Pulse Check: Use brachial pulse for infants.

    • Compression Method: Use either two-finger technique or two-thumb encircling hands technique.

  • Compression Depth: At least one third the depth of the chest (~1.5 inches or 4 cm).

  • Compression Rate: 100-120 compressions per minute.

Infant CPR Steps

  1. Check Responsiveness & Breathing:

    • If unresponsive and not breathing (or only gasping), activate emergency services.

    • If alone and no phone, take the infant with you to call for help.

    • For unwitnessed collapse: check the brachial pulse.

  2. If No Pulse Detected:

    • Start CPR (30 compressions and 2 breaths).

  3. Breaths for Non-Breathing Infant:

    • Deliver one rescue breath every 2-3 seconds (20-30 breaths per minute).

Checking Brachial Pulse

  • Locate the pulse with 2-3 fingers on the upper inside arm, pressing gently for 5-10 seconds.

  • If no pulse or <60 bpm with poor perfusion, begin CPR.

Compressions Technique for Infants

  • Two-Finger Technique:

    • Position fingers on the sternum, just below the nipple line.

  • Two-Thumb Encircling Technique:

    • Thumbs placed on the lower half of the breastbone with fingers encircling.

  • Key Points:

    • Compressions must be hard and fast, allowing full chest recoil after each.

Performing Rescue Breaths with a Bag Mask Device

  • Use a correctly-sized mask for the infant.

  • Position yourself above the infant's head using the EC clamp technique, ensuring the airway is not occluded by tilting the head into a neutral position (sniffing position).

  • Deliver just enough breath to see the chest rise (~1 second).

Two Rescuer Infant CPR

  • Differences:

    • Always use the two-thumb technique for compressions.

    • Compression to ventilation ratio is 15:2 instead of 30:2.

  • Maintain 100-120 compressions/minute.

Use of AED for Infants

  • Pediatric vs Adult Shock Doses:

    • Use appropriate pads/body size for children. Ensure that pads do not touch or overlap.

    • If using adult pads on infants, ensure one pad on the chest and one on the back.

  • Manual Defibrillators: Preferable if available but requires special training.

Choking in Infants

  • Signs of Severity: Inability to cough, speak, or breathe; possible cyanosis.

  • Infant Choking Relief Steps:

    1. Hold infant face down on forearm with head slightly lower.

    2. Administer up to five forceful back slaps between shoulder blades.

    3. Turn infant over, and perform up to five quick downward chest thrusts (just below nipple line).

General Reminders for All CPR Techniques

  • Always ensure scene safety before helping.

  • Check responsiveness: If unresponsive, call for help.

  • Check for pulse and breathing for 5-10 seconds using the flat part of your finger.

  • If no pulse/breathing, administer CPR immediately.

Conclusion of Training Session

  • Importance of practice and familiarity with CPR techniques and AED equipment.

  • Understanding differences between adult, child, and infant CPR procedures is crucial.

    • Focus on effective communication and teamwork during CPR.

  • Successful application of skills during tests allows for thorough refresher on essential techniques.