Course Content
Advanced Cardiopulmonary Resuscitation (CPR)
Course Overview: The Advanced CPR course provides in-depth training in cardiopulmonary resuscitation (CPR) techniques beyond basic life support. It equips participants with the skills to respond effectively to cardiac and respiratory emergencies, emphasizing advanced procedures, decision-making under pressure, and the use of medical devices such as automated external defibrillators (AEDs). Designed for healthcare professionals, first responders, and individuals in high-stakes environments, this course ensures that participants gain the confidence and expertise to perform lifesaving techniques with precision. *LEARNING OBJECTIVES* • Understand the fundamental differences in CPR techniques for adults, children, and infants. • Comprehend the physiology behind cardiac arrest and respiratory emergencies. • Develop expertise in advanced chest compression, ventilation, and airway maintenance techniques. • Identify the key factors affecting CPR success rates. *CPR TECHNIQUES FOR ADULTS , CHILDREN , AND INFANTS* Adult CPR Techniques For adults, CPR is performed using a combination of chest compressions and, when possible, rescue breaths to keep oxygenated blood circulating to the brain and other vital organs until professional help arrives. Techniques include: *Chest Compressions*: Delivered at a depth of at least 2 inches at 100–120 compressions per minute. *Hand Positioning* Two hands are placed one over the other in the center of the chest, aligned with the sternum. *Rescue Breaths (if trained)* Rescue breaths follow every 30 compressions. The rescuer pinches the nose, tilts the head, and delivers two breaths into the person’s mouth, ensuring a visible chest rise. *CHILD CPR TECHNIQUES* CPR for children requires modifications to account for their smaller body size and fragility: Compression Depth: Compress the chest to about one-third the depth of the chest, or roughly 2 inches. *Hand Positioning* For younger children, use one hand to compress the chest; for older children, two hands may be used. Compression Rate: Maintain a rate of 100–120 compressions per minute. *Rescue Breaths*: Give two breaths after every 30 compressions. *INFANT CPR TECHNIQUES* Infants under one year of age require highly gentle and controlled CPR methods: *Compression Depth* Approximately 1.5 inches, or one-third of the chest depth. Finger Positioning: Use two fingers at the center of the chest, just below the nipple line. *Compression Rate* Maintain 100–120 compressions per minute. *Rescue Breaths* Administer two gentle breaths after every 30 compressions, ensuring only a slight chest rise.
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OXYGEN DELIVERY IN VENTILATION
When oxygen supply is available, it can be attached to the BVM or other devices: *Oxygen Concentration* Supplemental oxygen can deliver nearly 100% oxygen to the patient, improving outcomes in respiratory emergencies. *Oxygen Flow Rate*: Set the oxygen flow rate to 10-15 liters per minute depending on the device and patient's needs. *ADDRESSING AIRWAY OBSTRUCTIONRECOGNIZING AND CLEARING AIRWAY OBSTRUCTION* Airway obstructions can quickly become life-threatening, making prompt action essential: *Types of Obstructions*: Common obstructions include foreign objects, fluids (vomit, blood), and soft tissue (tongue). *Abdominal Thrusts (Heimlich Maneuver)* For conscious adults and children with a foreign body obstruction, abdominal thrusts are performed by standing behind the patient, wrapping your arms around their waist, and thrusting inward and upward. *Back Blows and Chest Thrusts (Infants)* To remove obstructions in infants under one year old, alternate between back blows and chest thrusts. Using Suction Devices Suctioning can be necessary when obstructions like vomit or blood block the airway. Key techniques include: *Manual vs. Mechanical Suction* Mechanical suction devices provide more vigorous and more sustained suction than manual devices, typically used in field settings. *Suction Technique* Insert the suction catheter carefully to avoid stimulating the gag reflex, then suction for no more than 10 seconds in adults (5 seconds in children and infants) to avoid hypoxia. *MASTERY IN VENTILATION SUPPORT DURING EMERGENCY* *Combining Chest Compressions with Ventilation* Effective CPR requires the coordination of chest compressions with ventilation: *Compression-Ventilation Ratios* For adult single-rescuer CPR, the ratio is 30:2 (30 compressions to 2 breaths). Continuous compressions are delivered in a two-rescuer scenario with an advanced airway in place, with one breath every 6 seconds. *Avoiding Hyperventilation* Excessive ventilation can decrease blood flow during CPR. Ensuring controlled ventilation avoids compromising cardiac output. *VENTILATION IN SPECIAL CIRCUMSTANCES* Advanced airway support in specific scenarios requires adjustments: *Drowning Victims* Prioritize ventilation in drowning cases, as hypoxia is the primary cause of cardiac arrest in such situations. Initiate rescue breaths before compressions. *Overdoses* In cases of suspected opioid overdose, naloxone can reverse respiratory depression, facilitating more effective ventilation.
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EFFECTIVE COMMUNICATION IN CPR TEAM
Closed-Loop Communication: Closed-loop communication is a vital technique for ensuring that commands and information are clearly understood: *Command Issuance* The team leader addresses instructions directly by addressing a team member (e.g., “John, start chest compressions”). Acknowledgement: The designated team member acknowledges the command (e.g., “Starting chest compressions”). *Feedback*: The team leader confirms the action has been completed correctly, closing the communication loop. *Standardized Language and Clear Communication* Using simple, standardized language helps prevent miscommunication. Critical terms and phrases, such as “clear” before defibrillation, “rotate compressors,” or “check pulse,” should be universally understood among all team members. Effective communication ensures a smoother, more organized approach in a high-pressure environment. *Verbal Updates and Monitoring* Regular patient condition updates allow the team to adjust strategies as needed. For example, the airway manager may report changes in the patient's respiratory status, prompting adjustments to ventilation or compression techniques.
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Advanced Cardiopulmonary Resuscitation (CPR)
About Lesson

Simulated Team Scenarios:

Practical, hands-on simulations are essential for reinforcing team-based CPR skills. Common scenarios include:

 

*Standard Cardiac Arrest Scenario:* This scenario simulates a sudden cardiac arrest, where team members practice role delegation, communication, and AED operation. This exercise allows each member to rotate roles, gaining comprehensive experience.

 

*Complicated Resuscitation Scenario* This complex scenario, with obstacles such as airway obstruction or AED malfunctions, requires real-time problem-solving and team adaptability.

 

*Two-Rescuer Scenarios*: In cases where only two rescuers are available, participants practice switching between chest compressions and ventilation while one person operates the AED. This builds versatility and efficiency in low-resource situations.

 

*COORDINATION DRILLS*

 

Coordination drills, including timed practice for compressor switches and AED setup, help streamline the team’s response. These drills improve overall speed and effectiveness in real-life emergencies.

 

*Feedback and Reflection*

 

After each simulation, team members should review their performance and discuss areas for improvement. Reflecting on communication, role execution, and teamwork allows learning and growth, ensuring greater preparedness for emergencies.