CPR Refresher

Based on ALS PCS & AHA BLS Guidelines

Quick Reference — Adult
Ratio (no airway)30:2 (regardless of officer numbers)
Rate100–120 /min
DepthAt least 5 cm (1/3 chest depth)
CPR Indication ≤< 40 BPM
Procedure Details
Compression:Ventilation (no airway)30:2 (regardless of officer numbers)
With advanced airwayContinuous compressions — 6–10 breaths/min
Compression rate100–120 /min
Compression depthAt least 5 cm (1/3 chest depth)
Hand placement2 hands — heel on lower half of sternum
Chest recoilAllow full recoil; do not lean on chest
Compressor rotationRotate every 2 minutes
Technique
Two-hand technique — heel of one hand on lower sternum, other hand on top
Advanced Airway
With ETT or SAD: continuous compressions, time ventilations with release phase
Rhythm Check
After 2 min CPR or earlier if signs of responsiveness — check rhythm; pulse check only if organized rhythm
Indications
No signs of life
Unresponsive
Inadequate respiration
Pulse cannot be confidently palpated/auscultated within 10 seconds
Signs of inadequate perfusion
Unresponsive
Pallor or central cyanosis
Pulse < 60 BPM (newborn/infant)
Pulse < 40 BPM (paediatric 1–12 yr / adult)
General Principles
1
Provide good quality compressions
2
Minimise interruptions to chest compressions
3
Oxygenate the lungs
4
Avoid excessive ventilation
CPR Notes
Rate: 100–120 compressions/min; allow full chest recoil
Switch compressor every 2 minutes — focus on high quality CPR
Minimize interruptions to chest compressions at all times
Give ventilations over 1 second just to point of seeing chest rise
Limit interruptions to < 10 seconds — CCF goal > 80%
Adult — Additional Notes
Compression rate >120/min has no additional benefit
Use CPR feedback device (ZOLL X Series) for patients ≥ 8 years
No PEEP during cardiac arrest in adults
Minimize interruptions — CCF goal > 80%
Intubation attempts must not interrupt chest compressions
Contraindications

Nil in this setting

Complications

Pulse as sole arrest indicator is unreliable

Rib/chest injury possible

CPR Refresher

Compression : Ventilation

30:2

Regardless of officer numbers

Rate100–120 /min
Depth≥ 5 cm
Hand placement2 hands — lower sternum
CPR if pulse< 40 BPM
Advanced airway6–10 breaths/min (continuous compressions)

ALS Medications

Epinephrine1 mg IV/IO q3–5 min
Amiodarone300 mg IV/IO (refractory VF/VT)
Lidocaine1–1.5 mg/kg IV/IO (alt)
Magnesium1–2 g IV (torsades)
Sodium Bicarb1 mEq/kg IV (hyperK/TCA)
Peds GuideALS PCS v5.4
kg

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