0:08 I'm now going to take you through the process of cardiopulmonary resuscitation CPR if somebody experiences a cardiac arrest the heart will stop pumping blood around the body I mean in our vital organs are deprived of the oxygen that we desperately need so here I'm going to be treating an adult an adult is defined as someone that is 18 years and over so I'm going to carry out my primary survey shortly and I'm going to find that they are unresponsive and not breathing normally which means I need to start doing the hearts job for it and pumping the blood around the body so it reaches those vital organs that it needs so the process of CPR consists of 30 compressions where we are pumping on the chest and two rescue breaths in order to keep the
0:55 lungs oxygenated so the blood that we're pumping around the body has oxygen in it also when we're doing the compressions we want to try and achieve a depth of five to six centimeters we're going to use the heel of our hand and we're going to place it on the center of the chest so I'm just going to unzip the jacket here so that you can see my hand placement a little bit easier so with the heel of my hand I'm going to place that on the center of the chest so right on the breastbone now if you're not sure exactly where to put your hand on the mannequins here it is in between the nipples but what I'm going to do is use my middle finger work my way from the armpit to the center of the chest I'm going to place my other hand and interlock my fingers
1:40 I'm going to get my knees nice and close to the casualty and I'm going to bring my shoulders above so they're in line with my hands and I'm going to keep my arms nice and straight I'm now going to apply some pressure to achieve the depth of five to six centimeters okay so that's my 30 compressions and as you could hear there was a clicker that was telling me that I was achieving the right depth so where I would go for my 30 compressions is to do my two rescue
2:27 breaths now you don't have to give rescue breaths although that is the best treatment for the casualty but if the casualty had any bodily fluids so blood or vomit then you may not want to do this perhaps you could incorporate the breasts a little bit later on when a pocket mask is brought to you with a first aid kit or an AED okay so I'm going to do the two rescue breaths now we're going to do a head tilt chin lift to open the airway I'm going to pinch the nose to get a good seal and I'm going to put my mouth around their mouth again to make sure I get a good seal so as you could see I did one breath I
3:13 turned to the side took a breath myself allowed the chest to go down and then immediately put another breath in we don't want to spend too long here and if for any reason I thought that perhaps my breath wasn't successful I just need to make sure that I've got a good seal on the nose around the mouth and that I've got a good head tilt chin lift on the casualty still doesn't work I don't keep trying to achieve those two breaths I go back to the compressions and then we'll attempt it again another time so I'm going to go back to my 30 compressions
4:03 and two breaths speed of the compressions we're aiming to achieve 100 to 120 compressions per minute which is about two per second I'm now going to show you all of that from the beginning from the start of your primary survey okay so I'm going to check for danger everything seems okay for me to approach I'm going to check for response hello can you hear me can you open your eyes there's no response is anyone there to help I'm just going to check the airway I'm going to open the airway and I'm going to check for breathing
4:56 my help has now arrived I need an ambulance and a decade I've got a adult Casualty that is not breathing come back as soon as you can I'm going to start CPR I'm going to continue 30 compressions to two breaths
5:49 all right foreign okay so I would still continue to do 30 compressions to two breaths now hopefully somebody will come back with an AED and I can start to apply that and use it otherwise I'm going to continue CPR and I would only stop if I was completely exhausted and could no longer continue if a medical professional told me to stop or if the casualty shows definite Signs of Life some additional information that you'll need to be aware of is if you choose not to do rescue breaths then you would do continuous chest compressions so you
6:35 wouldn't stop at 30 you would just keep going some other problems that might arise during CPR is perhaps breaking a rib or you may think that you've broken a rib because of the noise you can hear from the popping and cracking of cartilage from putting that pressure on the chest now if we have broken a rib that is going to be down the list of our priorities because we will always treat breathing first then bleeding bones and burns and any other medical condition so we will continue with the chest compressions at the same depth and the same speed we just need to make sure that we haven't wandered off onto another area of the chest which perhaps have an impact on the ribs something else that might happen is that your casualty May regurgitate if this happens you need to
7:20 act quite quickly so as the vomit does not block the airway so what I can do in this situation is I can roll the casualty away from me protect them across the chest to make sure that they don't fall on their front and allow them to be sick once they're finished I can check the mouth and I can clear any any vomit that's left there once they're finished I'm going to roll them back down and I'm going to see if there's any signs of life and if they're breathing if your casualty is still not breathing you can continue with chest compressions and rescue breaths if you have a pocket mask as they have now been sick
8:07 and if they are breathing but unresponsive you would place them in the recovery position in this demonstration I had help so I had somebody to go and call an ambulance and get me an AED if you didn't have help with an adult casualty as soon as I'd established that they weren't breathing normally I'd have had to leave them go and call 999 and get an AED if there was one available I would then come back as quickly as I could and start CPR and if I did have an AED I would use it I'm going to show you how to use a pocket mask so as I mentioned especially if somebody had bodily fluids vomit blood around their mouth you would want to use one but if you've got a pocket mask I would advise that you would always use it or as soon as one becomes available so there are several different types of
8:54 pocket masks this is just one of them it comes with a one-way valve the pocket mask itself needs to be made ready to go by pushing this out it can be quite stiff I need to put that on my valve in place and then this thinner part will go on the nose so I'm going to place that over the casualties face now I need to make sure I still get a good seal because any breath that I put in I don't want to escape around the edges of the pocket mask so I'm going to place my hands around the pocket mask like this I'm going to lift the chin and I'm going to push the head back on the forehead
9:39 here so I'm still achieving a head tilt and Chin lift and then I'm just going to apply a normal breath like I did before foreign so two breaths and then back to your chest compressions I'm going to take you through the process of what we call the China survival now this is four links that we put into place to ensure the casualty has the best chance of surviving especially in the case of a cardiac arrest so those four links are early recognition and call for help so we need to be understand that they're not breathing normally and not mistake agonal gasps as normal breathing or any movement from the casualty as signs of life we must go through our primary
10:24 survey and establish normal breathing so early recognition and call for help the second link is early CPR so if the casualty is not breathing normally we need to get somebody to start CPR as quickly as possible the next Link in our China survival is early AED so your automated external defibrillator if we can get that to the casualty in the first few minutes of their collapse that is going to increase their chance of survival anywhere up to around 70 percent every minute that that defib is delayed that could decrease their chance of survival of anywhere between three to five percent The Last Link in your chain of survival is early post resuscitation care this is getting them to hospitals as quickly as possible to get the Advanced Medical Care that they require
11:10 okay so your chain of survival only recognition and call for help early CPR early dfib and early price resuscitation care I'm going to take you through child CPR a child is defined as somebody from the age of one until the age of 18. you're going to start by checking that there's no danger if there is any danger then you may need to eliminate this first get some help or perhaps it's too dangerous for you to approach so you would just have to call Emergency Services in this case it is safe for me to approach I'm now going to check for response hello can you hear me can you open your eyes there's no response I'm going to shout for some help can I have some help
11:55 I'm going to check the airway by opening the mouth if there is anything in the mouth I'm going to turn the casualty away from me and make sure that is removed so it might be vomit that's sitting in the mouth I'm going to bring them back down and I'm now going to open the airway using the head tilt chin lift but I'm going to make sure I don't till the head all the way back on a child because this will block the airway so about half of its capability I'm now going to check for breathing when checking for breathing I'm listening for breath I'm feeling for the breath on my cheek which is why I get nice and close to the casualty and I'm looking for the natural rise and fall of
12:41 the chest as I've for now established the casualty is not breathing normally if I have help at this point I'm going to ask them to go and call for an ambulance get me an AED and tell them that I've got a child that is not breathing normally and I'm going to start CPR with a child it's a lot less likely to be a problem with the heart and more to do of a respiratory issue so we need to start with five initial rescue breaths so I'm going to open the airway I'm going to pinch the nose and I'm going to attempt five rescue breaths
13:26 okay so those five were successful if I felt that they hadn't been successful I wouldn't keep trying until I'd achieved five successful rescue breaths there may be a blockage or some other reason why I can't get those breasts in and I need to start compressions compressions on a child I want the heel of my hand in the center of the chest right on the breastbone I'm going to use one hand for this child because it's quite small if you've got an older child reaching towards 18 you may have to introduce a second hand if you can't achieve the depth the depth that you're trying to achieve on a child casualty is around four to five centimeters you're going to get your knees nice and close to your casualty you're going to bring your shoulders in line with your hand and keep your arm nice and straight
14:29 after your 30 compressions you're going to do two breaths and then back to your 30 compressions you will continue those cycles of 30 compressions to two rescue breaths until either a medical professional tells you to stop the casualty shows definite Signs of Life or you're completely exhausted unlike an adult casualty who was likely to be suffering cardiac arrest so would have had oxygen in their lungs for us to pump around a child casualty probably hasn't been able to achieve getting any oxygen into their lungs for some period of time so if they have had a severe Airway blockage so choking if they had been underwater for a period of time
15:16 accidental suffocation then no oxygen has been getting in so it's imperative that we give those rescue breaths to children and babies to give them the best chance of survival I'm going to take you through baby CPR a baby is defined as anyone under the age of one so you're going to start with your primary survey you're going to check for any danger you're going to check for response we could blow in the casualties face see if there's a response clap beside both ears we may give a little squeeze and a tickle to the hands and feet and see if there's any response there's no response from the casualty so I'm going to ask for some help can I have some help and I'm going to check the airway make sure there's no obstructions
16:02 the airway is clear so I'm going to open the airway to open a baby's Airway I'm going to put the head in a neutral position I don't want to tilt the head too far back or allow it to be too far forward because that will close off the airway I'm now going to check for breathing for a maximum of 10 seconds and I'm going to look for the rise and fall of the chest I'm going to listen for breath and I'm going to try and feel for any breath on my cheek okay my casualty is not breathing can I have an ambulance and a d-fib and come back as quickly as you can I'm going to start CPR with a baby you're going to start with five initial rescue breaths because the problem is more likely to be
16:48 a respiratory one they probably haven't been asked to get any Oxygen in their lungs for a period of time so we need to give them some so we're going to give them five rescue breaths and we're going to cover the mouth and the nose because the features are very small a little path for there oh after those five initial rescue breaths we're gonna then go on to 30 compressions when you're doing the compressions for a baby you're just going to use two fingers in the center of the chest and support the baby's head we're trying to achieve a depth of about three to four
17:33 centimeters after your 30 compressions we're going to do two more breaths and then 30 compressions
18:23 and then you will continue those cycles of two rescue breaths and 30 compressions until a medical professional arrives and tells you to stop if you become completely exhausted or if the baby wakes up and shows definite Signs of Life
