Cardio Pulmonary Resuscitation (CPR)

(Adult One rescuer CPR)

Tips: DR- ABC 

D = Danger

R = Response

A = Airway

B = Breathing

C = Circulation

Step1: DANGER

1)      Take Control / Take Charge – Ensure your safety and that of others first

2)      Make sure the environment is safe

Step2: RESPONSE

1)      Establish unresponsiveness

-               Tap and shake the victim’s shoulder gently and ask “Hello ! Hello! Are you Ok?”

2)      Activate Emergency Medical System by calling 999

-               Shout for help if you are alone

-               If there are bystanders around, ask him/her to call for Ambulance 999

-               If you are alone and the phone is hereby, you should activate the EMS yourself immediately

-               However if the phone is very far away, you should commence CPR for 1 minute (approximately 4 cycles of external chest compressions) before proceeding to call ambulance 999

3)      Position the victim in a supine position

-               CPR is only effective if performed on a flat and firm surface

-               If the victim is lying face down, gently turn/roll him over as a unit onto his back, supporting the head and neck while turning him.

Step3: AIRWAY

1)      Check Airway

-               Perform tongue jaw lift to check the mount for any foreign body (e.g solid food particles, liquid vomits)

-               Solid material can be extracted by using a finger of one hand to perform a finger-sweep while the other hand maintains the tongue-jaw lift. Liquid/semi liquid materials can be removed by turning the victims head to the side and sweeping out using gloved fingers or a piece of clothe.

2)      Open the airway by performing head-tilt-chin-lift.

-               Place one hand on the victim forehead and apply firm backward pressure to tilt the head backwards while two fingers of others hand will be placed under the body part f the chin to lift the chin backwards.

Step4: BREATHING

1)      Check breathing (for not more than 10 seconds)

2)      The head-tilt-chin-lift should be maintained while we look, listen and feel for breathing.

3)      Look – for the rise and fall of the victims chest

4)      Listen – for breath sounds

5)      Feel – for warm moist air during exhalation

6)      If there is no breathing, proceed to deliver 2 initial ventilation (2 seconds per breaths)

7)      Take a deep breath, pinch the victims nose and make a tight seal around the victims mouth when giving ventilation

8)      You are to observe for chest rise during ventilation. Release the pinch on the nostrils after ventilation and allow the chest to fall before proceeding to give the second ventilation

Step5: CIRCULATION

1)      Check for circulation (for not more than 10 seconds)

2)      Place two fingers at the Adam’s Apple and slide down to the groove at the side nearer to you. Apply a slight pressure and check for carotid pulse.

3)      Do not rely on pulse check alone. Check for signs of circulation (eg. Normal breathing, coughing or movement)

4)      If the pulse is present, commence rescue breathing

5)      1 breath every 5 seconds for 1 minutes or 12 cycles.

6)      You should check for breathing while counting “ 2 a thousand, 3 a thousand, 4 a thousand, 5 a thousand”

Compression

7)      If no pulse or unsure, begin the first cycle of external chest compressions

8)      Locate for chest compressions site on the lower half of sternum (breastbone)

9)      Compress using your body weight in a downward direction for a depth of 4-5cm. You should lock your elbows during compressions and count to establish rhythm : 1 and 2, and 3 and 4 and 5, and 1 and 2 and 3 and 4 and 10 and 1 and 2 and 3 and 4 and 15, and 1 and 2 and 3 and 4 and 20, and 1 and 2 and 3 and 4 and 25, and 1 and 2 and 3 and 4 and 30.

10)  1 cycle : 30 chest compressions followed by 2 ventilation

11)  Check for signs of circulation after the end of 5 cycles.

12)  Deliver 2 ventilation after 30 chest compressions.

13)  Check pulse

14)  Resume CPR, starting with chest compressions if there is still no pulse after 5 cycles.

Rescue Breathing

1)      Perform rescue breathing if pulse is present but breathing is absent

2)      Perform rescue breathing for 1 minute, (12 cycles). Rescue breathing consists of giving one rescue breathing every 5 seconds. You are advised to count “2a thousand, 3 a thousand, 4 a thousand, 5 a thousand” after administering each ventilation and check for breathing while counting.

3)      If breathing is still absent after the first minute of rescue breathing, you are to check for pulse as the heart might have stopped while rescue breathing was being administered.

4)      Start the chest compressions again if pulse is absent. Only begin a second minute of rescue breathing if pulse is present.

Recovery Position

1)      Place victim in recovery position once breathing and circulation are restored.

2)      Monitor the victim until professional help arrives.

Summary of Cardio Pulmonary Resuscitation (CPR)

Tips: DR-ABC
D = Danger
R = Respond
A = Airway
B = Breathing
C = Circulation

1) Assess & Approach
2) Ascertain & Call 999
3) Head Till Chin Lift (hold and move slowly victim forehead)
4) Check Tongue Jaws(remove foreign body)
5) Check Breathing (Look+Listen+Feel)(rise/fall of chest + breath sounds + warm moist air)
6) Give 2 Blow (deep slow blow).
7) Check Pulse (two finger at Adam Apple and slide down to the groove at side you).
    Look for signs of circulation (conscious, movement, breathing or coughing)
     - No Pulse, Start CPR
8) Compress 4-5cm deep
     - Say,
       And1,And2,And3,And4,And5,
       And1,And2,And3,And4,And10,
       And1,And2,And3,And4,And15,

       And1,And2,And3,And4,And20,
       And1,And2,And3,And4,And25,
       And1,And2,And3,And4,And30
9) Give 2 blow (pinch nose and release after each blow ventilation).
10) Continue Step 8 & 9
      (5 cycles).
11) After 5 cycles

* each cycle consist of 30 compression & 2 blow (30:2 = 1 cycle)
Condition (a):
      - Check Pulse - if Yes
      - No Breathing
>Give 12 Blow each 5 seconds
     - Say,
        2a Thousand, 3a Thousand, 4a Thousand, 5a Thousand, Blow
>repeat until 12 times.

Condition (b):
     - Check pulse - Yes
     - Check breathing - Yes
> then put in Recover Position

Emergency Numbers:

999 Police / Ambulance / Fire Brigade
112 From any mobile phone