Definition

• Cardiopulmonary resuscitation (CPR) is defined as artificial breathing and closed chest heart compressions.
  • Cardio stands for heart, and pulmonary stands for lungs.
  • Rescue breathing is CPR without the chest compressions.

Indications

• Start rescue breathing if victim is not breathing but has a pulse.
• Start CPR if victim is not breathing and does not have a pulse.

Causes of Respiratory Arrest (Not Breathing)

• Airway obstruction (choking)
• Brain injury
• Chest injury or paralysis
• Cardiac arrest
• This is only a partial list.

Causes of Cardiac Arrest

• Heart attack (sudden death)
  • Most heart attacks send the heart into ventricular fibrillation.
    • This is when the heart quivers rather than pumps.
    • This condition is serious, but paramedics can treat it effectively.
• Severe shock (e.g. loss of blood)
• Trauma (emotional or physical)
• Drugs
• Respiratory arrest
  • This is often the cause in children.
• Again, this is only a partial list.

Good Samaritan Laws

• Good Samaritan Laws are designed to encourage people to help without fear of being sued.
• Good Samaritan Laws state that a person cannot be held liable for damage if they were acting to the best of their abilities and were not negligent.
  • Negligence is essentially doing something that is blatantly wrong, or not doing something that is blatantly right.
• Good Samaritan Laws are not in effect in every state, so be sure to find out what the law is in your area.

Ways to tell if CPR is working

• Properly performed CPR only produces 25% of the normal blood flow, so it is important to monitor the effectiveness of CPR.
• If CPR is being performed correctly, the color will often return to the victim.
• Proper chest compressions should produce a pulse that can be felt in the carotid arteries in the neck.
• Proper ventilations should slightly raise the chest.

Reasons to stop CPR

• You don't have to start CPR (unless you work for an agency required to by law, for example an ambulance service), but once you start, there are only certain reasons you can stop without risking charges of abandonment.
• CPR may be stopped if the victim's pulse and respirations return.
• You may stop if someone else takes over.
• You may stop if you are too exhausted to continue.
• You may stop if you are alone and must leave to get help. In this case, you must return to the victim.

Hazards of CPR

• Broken ribs (this is almost certain to happen)
• Injuries to internal organs
• Gastric distention (the stomach fills with air)
• Lacerated liver, spleen, kidneys, etc.
• These injuries may occur even when CPR is being performed correctly.

Protection from Infection

• It is possible that the rescuer can become infected by a victim.
• To help eliminate this possibility, it is suggested that barrier devices (masks) be used when ventilating the patient. These help stop the transfer of fluids, etc. from victim to rescuer, and vice-versa.
• It is also suggested that you wear a pair of latex gloves to keep bodily fluids off your hands.

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