CARDIO PULMONARY RESUSCITATION

Cardio pulmonary resuscitation ( CPR ) is a technique of basic life support for the purpose of oxygenating the brain and heart until appropriate, definitive medical treatment can restore
normal heart and ventillatory action. Respiratory arrest has been associated with a better survival than cardiac arrest. Once cardiac arrest occur, the outcome of resuscitative effort is poor.Complete apnea signals need rapid and vigorus action to prevent cardiac arrest. In such situations, nurse must be prepared to initiate action immediately.Neurologically intact survival has occured only in those patients who received immediate resuscitation and respond promptly.Cardio pulmonary resuscitation is an emergency procedure that consists of artificial respiration and external cardiac massage, instituted after cardiopulmonary arrest.

The basic principles of life support center on the ABC of CPR :
1.Airway
2.Breathing
3.Circulation

Cardinal symptoms of cardiact arrest are the following :
1. Sudden loss of consciousness
2.Absence of carotid / femoral pulses
3.Absence of audible heart sounds
4.Convulsions
5.Dilation of pupil with gray or ash color


FAST FACT
For effective cardio pulmonary resuscitation victim is placed on the back i.e, in the supine position on a firm, flat, hard surface, supporting head and neck. With loss of consciousness the tounge wich is attached to the lower jaw, relaxes and falls back, obstructing the air way.To open the air way head is positioned with either head tilt/ chin-lift or jaw thrust maneuver.

When achild requires CPR,consider the size, not just the age. For example,youg children who can be palced on the rescue's thigh should receive infant CPR. Since many older children with severe chronic ilness or disability remain small in size. So pediatric CPR may be appropriate.After the initial two breaths, the pulse is pulpated to determine the presence of heart beat. The carotid is the most central and accessible artery in children over 1 year of age.However the very short and often fat neck of the infant renders the carotid pulse difficult to palpate. Therefore it is preferable to use the brachial pulse in the infant, located on the inner side of the upper arm.Absence of a carotid or brachial pulse is considered sufficient indication to begin external cardiac massage.

External chest compressions consist of serial, rhythmic compressions of the chest to maintain circulation to vital organs untill the child achieves spontaneous vital signs or ALS can be provided.Chest compressions are always interspersed with ventilation of the lungs. The volume of air in an infant's lung is small, and the air passages are considerably smaller,with resistance to flow. Therefore smlal puffs of air are delivered.It is essential to prevent over-extension of the head of small infants, since this tends to close the flexible trachea.

The patient who has been resuscitated is at risk for another episode of cardiac arrest.If the victim is breathing or resumes effective breathing after emergency interventions,placed in the recovery position .but if rescue breathing or RPR required victim should not be placed in the recovery position.