CIRCULATION

EMERGENCIES &
Cardiopulmonary
Resuscitation- C.P.R.
 TERMINOLOGY
 CAUSES OF CARDIAC ARREST
 C.P.R. FOR THE ADULT, CHILD & BABY
 STROKE & STROKE MANAGEMENT
 CARDIOVASCULAR
EMERGENCIES
Occur when circulation of blood to various parts
of the body is impaired. Remember the main
function of blood is to TRANSPORT OXYGEN
through the body. Without Oxygen- cells die=
tissue hypoxia
Common causes- Heart Attack, Angina, Stroke,
Shock, Deadly Bleeding
 CARDIOPULMONARY
RESUSCITATION
 CPR is an emergency procedure used to
maintain life in a victim who is breathless and
has no signs of circulation until they recover or
until advanced life support is available.
 CPR combines ventilations and chest
compressions for a casualty who is V.S.A.
 Definitions: Angina (Pectoris), Cardiovascular
(Heart) disease, Myocardial Infarct, Heart
Attack, Cardiac Arrest.
 COMMON CAUSES OF CARDIAC
ARREST
 Cardiovascular Disease
 Drowning and near drowning
 Suffocation
 Electrocution
 Poisoning
 Respiratory Arrest
 Severe Blood loss (Hypovolemic Shock)
CARDIOVASCULAR DISEASE
 RISK FACTORS FOR
CARDIOVASCULAR DISEASE
 Factors that you cannot change
 Heredity
 Sex
 Age
 Menopause
 Risk factors you can control/change…
 Smoking
 High Blood Pressure/Cholesterol
 Stress
 Diabetes
 Obesity/Physical Activity
 CARDIOPULMONARY
RESUSCITATION
 RELUCTANCY IN PERFORMING CPR
 Liability
 Disease
 Fear in general and fear of making a mistake
 Good Samaritan Laws – Laws that protect
bystanders acting in good faith when giving
first aid to ill or injured casualties of an
emergency.
 DISEASE TRANSMISSION
 Some people hesitate to act because they
fear the risk of disease transmission.
 This risk (although small) encompasses a
wide range of infectious diseases
 Different routes of transmission include
 Direct Contact
 Indirect Contact
 Airborne Transmission
 Vector Transmission
PROTECTION FROM DISEASE
TRANSMISSION
 WARNING SIGNS OF A HEART
ATTACK

 There are a number of

different warning signs of
a possible heart attack
including;
 Denial
 Chest Pain

 Profuse sweating

 A feeling of indigestion

 ‘Soft signs’ are minor and

frequently overlooked.
Signs and symptoms of an
Angina attack are often
similar but are resolved
with rest and medication
HEART ATTACK
Kehr’s Sign – Referred Pain

• Phrenic Nerve irritation

• Pressure on Pericardium From the
Diaphragm.
 Heart Attack

 A complete blockage of one or more

of the coronary arteries
 Prevents a part of the cardiac muscle
from receiving blood- heart can not
contract and relax properly
 Causes heart to go into fibrillation
 Victim needs advanced medical help
ANGINA
A medical condition the
victim is diagnosed with
-often has medication to
help in an acute attack:
nitroglycerine or ASA
-unless it is the first attack
victim knows they have
the condition
-S/S similar to heart attack,
except that they improve
with rest and Medication
-if not improving- treat as a
Heart Attack
Aspirin or Nitroglycerine?
How to decide
 CARDIOPULMONARY
RESUSCITATION
 Once the patient’s vital signs have been taken and it
has been determined that they are breathless (10
second evaluation and two breaths given), and there
are no signs of circulation, CPR can then be initiated.
 Steps;
 Landmarking for Compressions- on the mid to lower 1/3rd of
the sternum
 30 Compressions pushing hard and pushing fast
 Ventilations – 2 breaths (puff for a baby)
 Repeat cycle 5 times- then re-assess breathing and
Circulation
 Apply and follow steps for AED if available after the first 2
minutes of care
LANDMARKING
THE HEART
 COMPRESSIONS
 Compressions are
performed with two hands
(adult) one hand (child) or
two fingers (infant).

 The depth of compression

will differ according to the
victim- Adult- 4-5 cm; Child
and Baby- ½ to 1/3rd depth
of chest

 Compressions should be
performed in a straight up
and down movement taking
care that the up and down
strokes are equal.
 VENTILATIONS
 Ventilations are done
by mouth to mouth
or by using a mask.
 They should last 1
second in length
 Should not be too
forceful as this can
cause gastric
distention- watch
chest and stomach
CPR TECHNIQUE
 SPECIAL SITUATIONS

PREGNANCY AND CARDIAC ARREST

When cardiac arrest occurs in a pregnant woman, activate EMS/911, then start CPR as soon
as possible.
Put a pillow or some other wedge-shaped object under the right side of the
woman’s abdomen to shift the uterus to the left side. This will help blood return to the
heart.
SPECIAL SITUATIONS

Mouth-To-Stoma Breathing
 AUTOMATED EXTERNAL
DEVICE
 When someone collapses from (A.E.D.)
sudden cardiac arrest, often the heart
does not completely stop but goes into ventricular fibrillation.
 A pulse may not be felt and a shock from an AED can reverse this
condition if delivered within the first few minutes after a collapse.
 An AED is safe to use on adults and children
 It should only be used on unconscious victims
 Slight variations between makes/models may exist, but they device is
quite self-explanatory and increases chances of survival significantly
 Look for medical patches, pace-maker scars, amount of water person is
lying in
 If indicated by machine prompt, will

alternate between delivering shock to

person and performing regular CPR for
2 minutes.
AUTOMATED EXTERNAL
DEVICE
 STROKE
(CEREROVASCULAR ACCIDENT)

 A stroke is any disease process that impairs circulation to the brain.

 A stroke can be caused by a blood clot lodging in the arteries of the
brain, an artery which ruptures (aneurysm), a head injury or a tumor.
 STROKE/TIA

 A victim may
experience a T.I.A.
(Transient Ischemic
Attack) or mini stroke.
 Like a stroke, a T.I.A.
can reduce blood flow to
the brain but is usually
reversible.
 A stroke will however
cause bleeding in the
brain.
 SIGNS AND SYMPTOMS
 The signs and symptoms will vary depending on
what section(s) of the brain are effected.
 MANAGEMENT
 As with any situation, think Check, Call Care.
 If there are no A, B, C complications:
 Place the victim in recovery position with the effected side
up.
 Do Secondary Survey and treat for Shock
 Think F. A. S. T.
F acial numbness/weakness
A rm numbness/weakness
S peech problems.slurring
T ime is essential due to the ‘Anticlotting medication’ which
is most effective if used immediately- person needs
advanced madical care