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FACULTY OF MEDICAL SCIENCE

DEPARTMENT OF PUBLIC HEALTH

GROUP Assignment

Course title: Surgery I

Course code: SURG-3242

Assignment topic: CPR

Submitted by:

NAME ID.NO

1. Dereje Tadesse UU89386R

Submitted to: Dr Tomas (Med General surgeon)

Submitted on April 11, 2024

Addis Ababa, Ethiopia

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 Contents
7.1 OBJECTIVES ............................................................................................................................2
7.2 ASSESSING A VICTIM FOR CPR/ RECOVERYPOSITION ............................................2
Purpose ..........................................................................................................................................2
Articles required ..........................................................................................................................2
Procedure ......................................................................................................................................2
1.3 CARDIOPULMONARYRESUSCITATION (CPR) ..............................................................4
1.3.1 Concept and Purpose ......................................................................................................4
1.3.2 Procedure .........................................................................................................................5
1.3.3 Safety and Precautions....................................................................................................8
1.6 REFERENCES ...........................................................................................................................9

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 INTRODUCTION
Uniform International Guidelines in reviviscence of the body were first
developed after the first World Science Conference (2000) for cardiopulmonary
resuscitation and emergency cardiovascular care. In medical practice CPR is the "gold
standard" which can be divided into 2 stages:
1. Basic CPR (Basic Life Support) which can be rendered by rescuers,
firefighters, trained non-medical and medical workers and others.
Basic CPR establishes an adequate Airway, artificial respiration (Breathing)
and external cardiac massage (Circulation) - ABC technique. This is the initial stage
of recovery when the rescuer is one-to-one with the injured and must render
resuscitation only with his bare hands.
2. Specialized cardiopulmonary resuscitation (Advanced
Cardiovascular Life Support) are performed by medical staff (emergency services,
doctors of the intensive care unit), trained and provided with appropriate medical
equipment and medicines.

1.1 OBJECTIVES
● assess a victim for recovery position and CPR;
● acquire skills in performing CPR; and
● demonstrate skills by placing a victim in recovery position.

1.2 ASSESSING A VICTIM FOR CPR/ RECOVERYPOSITION

Before approaching a victim you have to ensure that the environment is safe for you and the
victim.. After this the most important thing is to assess whether the victim needs to be placed in
recovery position or he/she needs CPR. In this section, I will tell the skills for this assessment and
for performing CPR or placing the victim in Recovery Position.
Purpose
The main purpose of assessing the victim is to conduct assessment and find out which procedure
must be started to resuscitate the victim in emergency.
Articles required
For this activity you need to have a volunteer. However, he/she should be explained that they
would have to be placed in a specific position by changing the posture. You can also take a manikin
instead.
Procedure
Step 1 Ask the volunteer to act as victim. Ask him/her to lie down on their back.

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 Skills: The volunteer should lie down comfortably on his back with his hand on the
side of his/her body and both the feet straight.

Step 2 Conduct assessment as per the flow-diagram given below:

Step 3 Tap the person on one of his shoulders and speak loudly,
“Hello, Are you Okay?”

Skills : Tapping of shoulder and speaking, “ Hello, Are you Okay?” should be done
simultaneously. This is done to check response. If the victim is an infant( age
0-1 year), you should tap on any one of the heels of his/her foot.
Step 4 If the person does not respond, check for pulse and breathing.
Skills : Check pulse by observing carotid or radial pulse. The
breathing should be checked by observing the chest rise with
each effort of breathing in. Gasping should be considered as
absence of breathing.
Step 5 If the person does not respond but is breathing and has pulse, place him/her in Recovery
Position.

Step 6 If a victim is not responding and not breathing with no pulse, CPR should be started
immediately.
Step 7 Continue the procedure till victim is revived.

Thus, by assessing a victim for responsiveness and breathing you can decide what first aid care is
to be provided to save his/her life.

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1.3 CARDIOPULMONARYRESUSCITATION (CPR)

In the previous section we see how to assess the victim in emergency and decide the next step of
action i.e. whether to give CPR or place the person in recovery position. In this section, we will
see about CPR and procedure of giving CPR. So, let’s begin.
1.3.1 Concept and Purpose

Concept

Cardiopulmonary Resuscitation (CPR) simply means:

Cardio – heart

Pulmonary- related to lungs

Resuscitation- revival

It is the process of revival of the functions of heart and lungs once they have stopped. This is
done by an alternating process of compressing the chest of the person and giving him/her
artificial breathing in a cycle of 30 chest compressions and 2 artificial rescue breaths. This is an
emergency procedure which is repeated till the functions of heart and lungs are restored (Fig
1.1).

Fig. 1.1: Giving CPR

Purpose of CPR

CPR is performed in sudden cardiac arrest, a dangerous situation where our heart can not pump
out the blood to our body. Sudden cardiac arrest can occur in various situations like electric shock,
heart disease, severe blood loss, overdose of some drugs, allergic reaction, drowning and in
poisonous snake bites. The lack of blood and oxygen to brain makes the person unconscious,
breathing stops and death can occur within minutes.

In CPR we provide chest compressions alternating with rescue breaths in a ratio of 30 chest
compression to 2 rescue breaths. This provides blood as well as oxygen to our brain to sustain life
for some time. During this time we alert and call the emergency response system/emergency

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medical services to provide advanced care. But it may not be immediately available and CPR buys
time for victim to sustain blood circulation and breathing till AED or help or ambulance arrives.

1.3.2 Procedure

When giving CPR the procedure is as follows:

Articles required

The following articles/equipments are required for learning various skills in performing effective
CPR

1. An adult CPR manikin

2. An infant CPR manikin

Steps of Procedure for giving CPR

Step 1 As the scenario is such that the person is not responding and
not breathing,
You will activate Emergency Medical Services (ambulance) and also ask for AED.
Meanwhile you will start CPR.
Skills : Emergency Medical Services are different in each country. In our country, it is
calling an Ambulance or any hospital staff from the nearby hospital. Also the
phone no of ambulance varies from state to state in Ethiopia.
Step 2 Sit on your knees on the side of the manikin.

Step 3 Place the heel of your dominant hand on the lower half of the breast bone (Fig. 1.2)
pointatthejunctionof
collarbone
Point to give
compressionson breastbone
lowerhalfside

pointwhereribsmeets

ribs
Fig. 1.2: Location for giving Chest Compressions

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 Skills :
For finding out where to place the hands on the chest while giving compressions,
you can make out the center of chest and place your hands below this center
point to give chest compressions. This roughly comes in the center point of line
drawn between two nipples on the lower side of breast bone.

Step 4 Place your other hand over this hand and lock the fingers
(Fig. 1.3).

Fig. 1.3: Locking the fingers over the location

Step 5 Give 30 compressions fast and deep using the pressure of your body from your shoulders
at the rate of 100-120 per minute(Fig. 1.4). Push at about 2 inches in adults and children
(1- 8 years) and at least 1.5 inches in infants( 0-1yr). So, Push hard and Push Fast.

Fig. 1.4: Giving Chest Compression

Skills: The compression technique is similar in children
(1-8 years of age). You can use one or both hands depending upon the age
and built of the child. For infants (New born and upto one year of age) you
should place index and middle fingers on the breast bone just below the
nipple line
Step 6 Verify the correctness of your compressions by the “ click” sound during each
Compression.
Step 7 After 30 chest compressions, open the mouth of the manikin and observe for any
foreign body in the nose or mouth. If you find anything, carefully take it out but
avoid blind sweep

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Step 8 Open the airways by “Head tilt and Chin lift technique
Skills: Apply firm, backward pressure on the forehead ( head tilt)
while lifting the chin upward (Chin lift). This will tilt the
head back and move the jaw forward.

Step 9 Place the back of one hand on the forehead of the victim and block
the nose by pinching it with your thumb and index finger.

Skills: Avoid pressing the soft tissues with your fingers as it can obstruct
the airways.

Step 13 Encircle the mouth of the victim by your mouth, making a tight
seal

Step 15 If you can not see the chest rise, again position victim’s head by jaw thrust or head
tilt and chin lift technique discussed earlier and make a good seal between the mouth
of victim and your mouth. Blow the air again into the mouth of the victim and keep
observing the rise of chest
Step 16 Repeat the continuous cycles of 30 chest compressions and 2 rescue breaths.
Skills: When other trained person is available, one can give chest
compression and the other person can give rescue breaths.
Both the persons should switch their roles after every 2
minutes (or 5 cycles) (Fig. 1.5). For children below 8 years
and infants, with 2 rescuers the ratio of compression and
breaths is 15:2.

Fig. 1.5: Two rescuer CPR

Step 17 If an AED becomes available, turn it on and follow the AED’s
voice instructions.
Step 18 If AED is not available, continue the cycles of 30 chest compressions and 2 rescue
breaths.
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 Remember:
CPR has to be continued till:

● the victim starts responding and/or breathing

● specialized medical help arrives ● Someone (a trained personnel) relieves you ●
AED becomes available.

Step 19 Transport as soon as medical help arrives. Record and Report thereafter as required.

1.3.3 Safety and Precautions

The safety precautions to be followed are as follows:

1. Chest compressions:
● Follow the recommended position of hands. It will prevent fracture of ribs and provide
desired effective chest compressions.
● There should not be any movement of your wrists when giving compressions.
● Elbows should be straight.
● The contact with chest wall should not be lost at any time.
● Allow complete chest recoil (coming of chest in its original position) after each
compression.
● The rate should be at least 100-120/minute.
● You should keep on counting from 1…. 30 to make the compressions synchronous.
● Minimize any interruptions between the compressions.
2. Rescue breaths :
● If chest rise is not visible, rescue breaths are not effective.
It means that either the mouth to mouth seal is not proper or rescue breaths are not
enough or forceful or the airway is not patent.
● Avoid pressing the soft tissues of nose with your fingers as it can obstruct the airways.
● Take a deep breath before giving rescue breaths. Never blow twice – one after the another
without taking a deep breath in between as the oxygen concentration will be less.

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 1.6 REFERENCES

1. http://www.redcross.org/images/MEDIA_CustomProductCatalog/ m55540601_FA-CPR-
AED-Part-Manual.pdf

2. http://cpr.heart.org/AHAECC/CPRAndECC/ResuscitationScience/
Guidelines/UCM_473201_Guidelines.jsp

3. https://physicalsportsfirstaid.files.wordpress.com/2014/09/recoveryposition-instructions.jpg
4. https://www.healthnavigator.org.nz/healthy-living/first-aid/recovery-position/

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