Monday , March 18 2019
CPR Chest compression



To provide oxygen to the brain, heart and vital organs until appropriate definitive medical treatment (advanced cardiac life support) can restore normal heart and ventilator function.


Patient who are in Cardiac arrest and Respiratory arrest.


  • Basic Life Support (BLS) is that particular phase of emergency cardiac care that either –
  • Prevent circulatory or respiratory arrest or insufficiency through prompt recognition and intervention.
  • Externally supports the circulation and ventilation of a victim of cardiac or respiratory arrest through Cardio Pulmonary Resuscitation (CPR).

Applicable Areas

All Departments.


Staff Nurses, ANM, Head Nurse, ICU Registrar, Intensivist and Housekeeping.

Requirements / Equipments

Crash Cart, Defibrillator, Jelly (to prevent burns), Emergency Drugs, Intubation Trolley things necessary for I.V. access such as Veinflow with extension, Disinfectant.

  • CAB’s of CPR are –
  • Circulation
  • Airway
  • Breathing
  • Good Outcome if –
  • It is witnessed arrest.
  • Ventricular Fibrillation >Asystole (Better Prognosis)
  • Early defibrillation in case of a ventricular fibrillation.
  • CPR started early.
  • Protocols followed.
  • Illness is treatable.


  • Basic CPR Procedure –
  • Establish Unresponsiveness.
  • Call for help.
  • CAB (Circulation, Airway and Breathing).
  • If circulation absent, start CPR.
  • If breathing and circulation present, put in recovery position.
  • If breathing absent, start Ambu and Face Mask Ventilation.
  • Circulation –
  • Start external cardiac massage.
  • The heel of one hand with the other on top is placed on the lower half of the sternum and cardiac massage is started with the interlocking elbow.
  • Sternum should be depressed 2” (In adults).
  • Compressions are delivered at a rate of at least 100/min.
  • Ventilations are delivered at 2 breath after every 30 compressions.
  • Once you begin, do not interrupt CPR for more than 10 seconds.
  • Airway –
  • Chin lift, Head tilt (for a special case of head injury) and Jaw Thrust.
  • Put Oropharyngeal Airway.
  • Breathing –
  • Start controlled ventilation, using a resuscitator bag and mask.
  • Ensure that chest is moving.
  • Rate should be 10/min.
  • Advanced CPR –
  • Attach ECG Monitor and establish venous access.
  • Establish Rhythm causing arrest.
  • Ventricular Fibrillation or pulseless V.T.
  • Asystole
  • Electromechanical dissociation or pulseless electrical activity.
  • Airway Management.
  • Assist for endotracheal intubation.
  • IN VF or Pulseless V.T. –
  • DC Shock, start with 200J. If not reverted 300J and then 360J.
  • If not reverted, establish venous access and intubate.
  • CPR 30:2
  • Use of appropriate drug as per condition of the patient as instructed by the Doctor.
  • Again D.C. shock and then give drugs.
  • Asystole
  • Use of appropriate drug as per condition of the patient as instructed by the Doctor.
  • Continue CPR, assess patient’s general condition and carry out Doctors’ orders.
  • CPR is stopped after 45 minutes, if patient is not resuscitated.


  • ICU Flow Sheet
  • Nurses Observation Sheet.