First Aid: Definition And Procedure Of CPR

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Introduction and definition:

It is very essential to be aware of rules of first aids as they are the chief succor or help that can be done at place of accident to injured person. They are usually done prior to ambulance access. They must be applied rapidly and judiciously [1]. Cardiopulmonary resuscitation (CPR) is one of first aids which considered as lifesaving method for patient of abrupt cardiac arrest. CPR can be done at any place as it may be chest compression only when applied (manually) out hospital or chest compression supported with ventilation (in hospital) [2]. There are passerby resuscitation attempts as AED (automatic external defibrillator) and CPR can protect patient of cardiac arrest. If AED is not obtainable for not more than ten minutes demise of brain cells may occur [3]. Cardiopulmonary resuscitation includes a collection of chest compressions intermittent with or transversed by ventilation [4]. CPR supply patient of cardiac arrest with circulation and oxygenation. CPR extends patient with artificial or synthetic ventilation and circulation. When CPR is applied out the hospital it comprises chest compression intermittent with rescue breathing to stimulate regular oxygenation and indigenous cardiac output [3]. The procedure of CPR comprises three process described in letters A, B, C which are known as airway, breathing and chest compression [5].

When it is critical to apply CPR? It is crucial to apply CPR if patient is non-reactive or no response, no respiration and only wheezing or gasping. CPR provide five cycles of chest compression and rescue breathing taking two minutes. If no respiration it is advisable to begin with chest compression. To save patient with cardiac arrest energizing essencial medical devices, CPR application and defibrillation must be done. Retardation or stoping CpR to introduce shock to patient with ventricular fibrillation is very important [5].

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Actually CPR is considered as emergency technique which is applied to rescue life of person with cardiac arrest as no respiration and heart collapses and losses the ability to pump blood to all body organs so CPR act as artificial pump of blood by applying chest compression [6].

Procedure of CPR:

Before CPR application you need to confirm if patient is conscious or unconscious. To make this you should shake or jerk victim softly and call him. If there is any response ask him if there is neck soreness, tingling sensation or if he is able to move or shift his arms or legs. If victim shows no response so emergency medical services must be done. If two savers or supporters are present one of them starts emergency medical services and the other call the emergency or ambulance. Before starting chest compression check and stablish victim position to be in sluggish or supine position. Dangle victim on a stable or firm surface where his head is beneath thoracic plane or level. To allow opening of air way of victim kneel or prostrate next to them and place them in recovery position. Recovery position (figure 1) is to lay patient on his side to keep his airway open and clear [8]. It is very important to confirm that the airway of victim is pure and obvious not blocked by chocking [9]. Head Tilt/Chin Lift Maneuvers is done to suspended person (unconscious) if no problem with his neck or head. Head Tilt/Chin Lift Maneuvers (figure 2) is done by using one hand to render head aback and other hand to make chin upward. Don’t press under chin firmly as it may lead to airway obstruction. Lifting the chin id done using two or three fingers without using thumb. If victim uses a dental plate don’t strip it as it may assist to keep mouth shape and support or aid rescue breathing.

If spine or cervical injury is supposed replace head tilt chin lift with jaw Thrust to open airway. Jaw thrust maneuver is done by grasping mandible using both hands one hand on the right side and other hands on left side, withdraw it forward and leaning head aback. jaw thrust maneuver is beneficial for victim with spine injury as it doesn’t involve expansion or stretching neck.

Mandibular Displacement and Triple Airway Maneuver are not recommended or approved.

Breathing:

after confirming airway opening breathing must be checked. Breathing examination is done by applying three steps Looking, and see if chest of victim lifts and downs then hear for presence of any sound and try to sense expired air. If no response and signs not present apply CPR. Also rescue breathing must be done incase of retrogression of respiration or in case of wheezing and gasping.

Rescue breathing (mouth-to-mouth breathing) is done by blocking or plugging nostrils by using the hand you had used to render head backward in head tilt maneuver and the other hand to lift chin. Recommended number of rescue breathing varies from ten to twelve rescue breathing per minute and two seconds between each rescue breathing and the other. Rescue breathing can applied by sealing lips of both rescuer and patient then rescuer plumps air into mouth of patient. Mouth to nose breathing is substitutional to mouth-to-mouth breathing. Mouth to mouth breathing can be done using some apparatus or instruments as Mouth to barrier device, Mouth to mask and Mouth to tracheostomy tube. Mouth to stoma breathing is specific to victims with tracheostomy.

Recording pulse and maintaining circulation: it is important to preserve circulation to ensure functional perfusion or aspiration to pivotal organs. To ensure good circulation pulse must be recorded through femoral or carotid artery. If pulse is existed but no respiration so beginning ventilation is very important in average 12 per sixty seconds. If pulse is nihilistic (no pulse) this means occurrence of cardiac arrest and chest compression must be applied. Chest compression shouldn’t take more than ten seconds.

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