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Procedure - CPR

Section: Human Resource Procedures 
Procedure Owner: Ignition633 Ministries Human Resources   
Procedure Name: CPR Procedure 
Origination Date: October 2024  

CPR Procedure
The ministry will provide basic life support, including CPR, to a resident who requires such emergency care before the arrival of emergency medical services, consistent with the doctor’s orders. 
 
Purpose:
The CPR Procedure, including AED use, aims to provide immediate life-saving intervention for cardiac arrest or respiratory failure victims. It maintains vital organ blood flow through chest compressions and rescue breaths, while AEDs allow for heart rhythm analysis and potential defibrillation, increasing survival chances. 
 
Scope: 
This procedure outlines steps, supplies, and AED usage for effective CPR in emergencies. It covers scene assessment, responsiveness checks, emergency activation, compression-breath techniques, and AED operation. By following these guidelines and maintaining necessary supplies, responders can deliver timely, potentially life-saving care during cardiac emergencies.

Supplies:

  • Backboard 

  • Face mask or Resuscitator Bag 

  • Automated External Defibrillator (AED) 

  • Crash Cart 

  • Basic airway equipment 

  • Oxygen masks, tubing, cannulas, etc. 

  • Suction Machine and equipment 

Procedure: 

  • The employee will verify the safety of the scene/environment. 

  • Check for the victim’s response: Tap or shake the victim's shoulder, asking, “Are you okay?”  

  • Simultaneously assess the victim for breathing and pulse for 10 seconds.  

  • If necessary, open the airway: 

  • Head-tilt/chin-lift technique 

  • If a head, neck, or spinal injury is suspected, utilize the modified jaw-thrust maneuver 

  • Shout for help or use the phone provided to call for help. Quickly get the AED and emergency equipment. If you see the collapse and are alone, activate the emergency response system or immediately call the doctor and get the AED (unless someone else can get it) before starting CPR. 

  • Advance directives: Check for advance directives. Advance directives could include: 

  • POLST: Physician Orders for Life-Sustaining Treatment Form that indicates that resuscitation is not desired 

  • MOLST: MOLST forms are medical orders signed by a healthcare provider that translate ‘patients' preferences for life-sustaining treatment, including CPR, into actionable medical orders.  

  • DNR: Do Not Resuscitate.   

Follow the trained procedures. If directives say DNR or DNAR (Do Not Attempt Resuscitation), do not perform CPR. 

  • If no DNR order or advance directive exists or if the advance directive does not indicate “Do Not Resuscitate,” begin resuscitation efforts. 

  • If the victim does not exhibit normal breathing and has a pulse, begin rescue breathing, 1 breath every 5-6 seconds (10-12 per minute) using a face mask or Resuscitator Bag.  

  • If they are presenting with agonal breaths, continue as if the resident is not breathing. 

  • Agonal breathing is when someone who is not getting enough oxygen is gasping for air. It is usually due to cardiac arrest or stroke. It's not true breathing. It's a natural reflex when your brain is not getting the oxygen it needs to survive.  

  • Check pulse approximately every 2 minutes.  

  • If there is no pulse, begin CPR (Please note: if AED is immediately available, use the defibrillator as soon as possible when the device is ready for use): 

  • Place the backboard under the victim in bed or assist the victim to a firm, flat surface if possible 

  • Compress chest compressions at a rate of 100-200 per minute (place 2 hands on the lower half of the sternum) 

  • Compress to a depth of at least 2” (inches) 

  • Ensure full recoil following each compression 

  • Minimize any pauses in compressions 

  • Ventilate 2 breaths after 30 compressions, each breath delivered over 1 second, causing the chest to rise (30:2 Ratio for both 1 or 2 rescuers). Use a face mask or resuscitator bag.  

Automated External Defibrillator (AED):
Follow the manufacturer’s recommendations and training procedure. Check rhythm.  

  • If AED indicates yes, shockable, give 1 shock. Resume CPR immediately for approximately 2 minutes until the AED prompts a rhythm check. Continue resuscitation efforts until one of the following occurs: 

  • If the victim has a heartbeat and is breathing on their own, transfer care to emergency responders for advanced support. 

  • If the rescuer is unable to continue due to exhaustion or dangerous conditions or if resuscitation efforts pose risks to others. 

  • If reliable signs of irreversible death are present, if obvious signs of death are identified, or if resuscitation criteria are met. 

  • If AED indicates no, non-shockable, Resume CPR immediately for approximately 2 minutes until the AED prompts a rhythm check. Continue resuscitation efforts until one of the following occurs: 

  • If the resident has a heartbeat and is breathing on their own, let emergency responders take over for advanced support. 

  • If the rescuer can't continue due to exhaustion, danger, or risks to others. 

  • If clear signs of irreversible or obvious death are present or if resuscitation criteria are met. 

  • Turn CPR over to emergency personnel upon arrival. 

  • Perform hand hygiene. 

  • Notify the doctor of the victim’s status and obtain further orders. 

  • Notify the family of the incident. 

  • Prepare for transfer, including documentation information to be sent with the doctor/emergency responders to the hospital. 

  • Document all appropriate information, including the transfer, in the medical record. 

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This procedure will be reviewed annually and is subject to change. Any changes will be communicated to all employees promptly.   

For any questions or further assistance regarding this procedure, employees should contact the HR department at hr@ignition633.org.   

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