CPR Cheat Sheet
Reflecting 2015 AHA Standards and Maryland Medical Protocols
ADULT / CHILD / INFANT / NEWBORN/NEONATEAGE / Puberty and Older / 1 year to Puberty / Birth – 1 year / Birth – 1 month
COMPRESSION DEPTH / 2 inches OR
1/3 Diameter of the Chest / 2 inches OR
1/3 Diameter of the Chest / 1 ½ inches OR
1/3 Diameter of the Chest / 1/3 Diameter of the Chest
COMPRESSION RATE / 100-120/min / 100-120/min / 100-120/min / 120/min
COMPRESSION TO VENTILATION RATIO / > 8 1 Ventilation every 5-6 seconds OR every 10th compression.
Respiratory Arrest Only
- Open Airway
- Insert Adjunct
- BVM for 30 seconds and Reassess for Breathing and Pulse. No Pulse, start CPR.
1 Rescuer- 30:2
2 Rescuer- 15:2
> 8 1 Ventilation every 5-6 seconds OR every 10th compression. / 1 Rescuer- 30:2
2 Rescue- 15:2 / Inverted Pyramid
- Dry, Warm, Suction, Stimulate
- Vigorously Rub Baby’s Back to Encourage Breathing.
- If Inadequate Breathing, BVM at 40-60 a minute (every 2 seconds)
- Reassess Every 30 seconds
- HR < 100 but > 60 bpm, Ventilate for 30 seconds and reassess.
- HR < 60 do CPR at 3:1 for 30 seconds and reassess.
HAND/FINGER PLACEMENT / Palms (Hand Over Hand) Center of the Chest / 1 Hand with Palm Center of Chest (If Tired, Acceptable to Use 2) / 1 Rescuer- 2 fingers center of chest
2 Rescuer- 2 Thumbs encircling the chest. / 1 Rescuer- 2 fingers center of chest
2 Rescuer- 2 Thumbs encircling the chest.
AED PAD PLACEMENT / Right Clavicle
Left Lateral Lower Ribs / Anterior Medical Chest
Posterior Medial Chest / Anterior Medical Chest
Posterior Medial Chest / Anterior Medical Chest
Posterior Medial Chest
WHEN TO CALL 911 / Before Beginning CPR UNLESS submersion, injury or overdose. / After 2 minutes of CPR / After 2 minutes of CPR / After 2 minutes of CPR
MD Termination of Resuscitation Protocol / MD Pronouncement of Death Protocol
You CANNOT Terminate Resuscitation If:
-Secondary to hypothermia or submersion.
-Patient is pregnant
-Patient not yet 18 years of age. / INDICATIONS
You May Pronounce Death in the Field When One or More the Following Criteria Have Been Met:
-Decapitation
-Rigor Mortis
-Decomposition
-Dependent Lividity
-Pulseless, apneic patient in a Multi-Casualty Incident
-Pulseless, apneic patient with an injury not compatible with life.
-Via Termination of Resuscitation Protocol
You CAN Terminate Resuscitation WITHOUT Consult If:
-NOT witnessed by EMS AND
-AED advises “No Shock Advised” AND
-No Return of Spontaneous Circulation (ROSC) has occurred at ANY time AND
-15 minutes of CPR has been conducted
For all others, you must consult.
DNR/MOLST Notes
Acceptable Forms
-A copy of a Maryland EMS DNR Order Form CAN be accepted.
-A Maryland MOLST form can be accepted in lieu of a Maryland DNR Form.
-MOLST Form has now replaced the DNR Form, but DNR Form can still be accepted. / Types
-Option A – MOLST A1 – Maximal (Restorative) care (with intubation) before arrest, then DNR
-Option A – MOLST A2 – Comprehensive efforts to prevent arrest but do not intubate, then DNR.
-Option B – MOLST B – Limited (Palliative) care only before arrest, then DNR. / Oral Orders
-Can accept from physician, physician asst., or nurse practitioner ON SITE. NONE OVER THE PHONE.
-Can accept an order online via EMS Communications.
Reciprocity
-Forms from other states are acceptable. Treat as Option B / Revocation of DNR Acceptable By:
-Physical cancellation or destruction of DNR
-Oral statement by the PATIENT made directly to EMS
-An authorized decision maker CANNOT revoke orally.
Acceptable Orders
-Original DNR Form
-Copy of DNR/MOLST Form
-Out of State DNR
-Maryland DNR Bracelet Insert
-Medic Alter DNR Bracelet or Necklace
-Oral DNR Order from Medical Consult / Acceptable Orders (cont.)
-Oral DNR Order from on-site physician
-Maryland MOLST Form
-Maryland MOLST Bracelet / Unacceptable Orders
-Advance directives without DNR Order
-Facility specific DNR
-Notes in medical records
-Prescription pad orders
-DNR stickers
-An oral request from someone other than a physician or NP / Unacceptable Orders (cont.)
-An oral order from a physician or NP not on site.