First Responder EMS Curriculum for Training Centers in Eurasia

1. Demonstrate the proper technique of chest compressions on an adult.2. Demonstrate the proper technique of chest compressions on a child.3. Demonstrate the proper technique of chest compressions on an infant.4. Demonstrate the steps of one-rescuer adult CPR.5. Demonstrate the steps of two-rescuer adult CPR.6. Demonstrate child CPR.7. Demonstrate infant CPR.2. IntroductionIn the United States, more than 600,000 people die each year from cardiovascular diseases.Half of these deaths occur outside the hospital, with sudden death (collapse) being the firstsign of cardiac disease in 50% of the cases. Early CPR, which will be covered in thislesson, is the major determinant of survival in cardiac arrest. In this lesson, we will reviewthe anatomy and physiology of the circulatory system and learn the techniques of CPR in astep-by-step manner.3. Review of the Circulatory SystemThe circulatory system functions to deliver oxygen and essential nutrients to the tissues ofthe body. It also functions to remove carbon dioxide and other waste products from thetissues of the body. It is a highly efficient system composed of the heart and blood vessels(arteries, veins, capillaries).a. AnatomyThe heart is a muscle with specialized intrinsic conduction fibers. This highly efficientmuscle pumps blood throughout the entire body, supplying all of our organs with thevital oxygen and nutrients they need. It is composed of four chambers, two atria and twoventricles. The right atrium receives deoxygenated blood returning through the veins ofthe body. Blood then travels through the tricuspid valve into the right ventricle. Theright ventricle then pumps blood to the lungs through the pulmonic valve. Oxygenatedblood from the lungs returns to the left atrium. Blood flows through the mitral valve intothe left ventricle. The left ventricle then pumps the oxygenated blood through the aorticvalve to the rest of the body. The valves act to prevent backflow of blood into therespective heart chambers.Arteries are muscular tubes that carry oxygenated blood away from the heart to the restof the body. It is important to remember four major arteries because their pulsations canbe palpated at the level of the skin. Palpating these arteries at their appropriatelandmarks provides vital information when evaluating the circulatory system of anypatient. The carotid arteries supply the head and brain and can be palpated on either sideof the neck, just lateral to the trachea. The femoral arteries supply the lower extremitiesand can be palpated on either side in the groin, just below the inguinal ligament. Theradial arteries supply the forearms and wrists and can be palpated on the palm aspect,thumb side of either wrist. The brachial arteries supply the upper arms and can bepalpated on the inner aspect of the arm between the elbow and shoulder.Capillaries connect the arteries to the veins at the tissues. These thin-walled, tiny bloodvessels allow exchange of oxygen and carbon dioxide, and nutrients and waste products,at the tissues throughout the body.104 First Responder EMS Curriculum/AIHA, July 2002