Cardiopulmonary resuscitation (CPR) is a lifesaving
technique useful in many emergencies, including heart attack or near drowning,
in which someone's breathing or heartbeat has stopped.
Ideally, CPR involves two elements: chest
compressions combined with mouth-to-mouth rescue
breathing. (A complete description of how to do both follows
farther down in this article.)
However, what you as a bystander actually should do in an
emergency situation really depends on your knowledge and comfort level.
The bottom line is that it's far
better to do something than to do nothing at all if you're
fearful that your knowledge or abilities aren't 100 percent complete. Remember,
the difference between your doing something and doing nothing could be
someone's life.
Untrained: If you're not trained in CPR, then
provide hands-only CPR. That means uninterrupted chest presses of about two per
second until paramedics arrive (described in more detail below). You don't need
to try rescue breathing.
Trained, and ready to go: If you're well trained, and confident
in your ability, then you can opt for one of two approaches: 1. Alternate
between 30 seconds of chest compressions and two rescue breaths, or 2. Just do
chest compressions. (Details described below.)
Trained, but rusty: If you've previously received CPR
training, but you're not confident in your abilities, then it's fine to do just
chest compressions.
The above advice applies only to adults needing CPR, not
to children.
CPR can keep oxygenated blood flowing to the brain and
other vital organs until more definitive medical treatment can restore a normal
heart rhythm.
When the heart stops, the absence of oxygenated blood can
cause irreparable brain damage in only a few minutes. Death will occur within
eight to 10 minutes. Time is critical when you're helping an unconscious person
who isn't breathing.
To learn CPR properly, take an accredited first-aid
training course, including CPR and how to use an automatic external
defibrillator (AED).
Before you begin
Assess the situation before starting CPR:
- Is the person conscious or unconscious?
- If the person appears unconscious, tap or shake his or her shoulder and ask loudly, "Are you OK?"
- If the person doesn't respond and two people are available, one should call the local emergency number and one should begin CPR. If you are alone and have immediate access to a telephone, call before beginning CPR — unless you think the person has become unresponsive because of suffocation (such as from drowning).
If an AED is immediately available,
deliver one shock if advised by the device, then begin CPR.
Remember the ABCs
Think ABC — Airway, Breathing and Circulation — to remember the steps explained below. Move quickly through Airway and Breathing to begin chest compressions to restore circulation.
AIRWAY: Clear the airway
1. Put the person on his or her back on a
firm surface.
2. Kneel next to the person's neck and
shoulders.
3. Open the person's airway using the
head-tilt, chin-lift maneuver. Put your palm on the person's forehead and
gently tilt the head back. Then with the other hand, gently lift the chin
forward to open the airway.
4. Check for normal breathing, taking no
more than five or 10 seconds: Look for chest motion, listen for breath sounds,
and feel for the person's breath on your cheek and ear. Gasping is not
considered to be normal breathing. If the person isn't breathing normally and
you are trained in CPR, begin mouth-to-mouth breathing. If you believe the
person is unconscious from a heart attack and you haven't been trained in
emergency procedures, skip mouth-to-mouth rescue breathing and proceed directly
to chest compressions to restore circulation.
BREATHING: Breathe for the person
Rescue breathing can be mouth-to-mouth breathing or mouth-to-nose breathing if the mouth is seriously injured or can't be opened.
1. With the airway open (using the
head-tilt, chin-lift maneuver) pinch the nostrils shut for mouth-to-mouth
breathing and cover the person's mouth with yours, making a seal.
2. Prepare to give two rescue breaths.
Give the first rescue breath — lasting one second — and watch to see if the chest
rises. If it does rise, give the second breath. If the chest doesn't rise,
repeat the head-tilt, chin-lift maneuver and then give the second breath.
3. Begin chest compressions to restore
circulation.
CIRCULATION: Restore blood circulation
with chest compressions
1. Place the heel of one hand over the
center of the person's chest, between the nipples. Place your other hand on top
of the first hand. Keep your elbows straight and position your shoulders
directly above your hands.
2. Use your upper body weight (not just
your arms) as you push straight down on (compress) the chest 2 inches
(approximately 5 centimeters). Push hard and push fast — give two compressions
per second, or about 120 compressions per minute.
3. After 30 compressions, tilt the head
back and lift the chin up to open the airway. Prepare to give two rescue
breaths. Pinch the nose shut and breathe into the mouth for one second. If the
chest rises, give a second rescue breath. If the chest doesn't rise, repeat the
head-tilt, chin-lift maneuver and then give the second rescue breath. That's
one cycle. If someone else is available, ask that person to give two breaths
after you do 30 compressions.
4. If the person has not begun moving
after five cycles (about two minutes) and an automatic external defibrillator
(AED) is available, apply it and follow the prompts. The American Heart
Association recommends administering one shock, then resuming CPR — starting
with chest compressions — for two more minutes before administering a second
shock. Trained staff at many public places are also able to provide
and use an AED. Use pediatric pads, if available, for children ages 1 to 8. Do
not use an AED for infants younger than age 1. If an AED isn't available, go to
No. 5 below.
5. Continue CPR until there are signs of
movement or until emergency medical personnel take over.
To perform CPR on a child
The procedure for giving CPR to a child age 1 through 8 is essentially the same as that for an adult. The differences are as follows:
If you're alone, perform five cycles of
compressions and breaths on the child — this should take about two minutes —
before calling your local emergency number or using an AED.
Use only one hand to perform heart
compressions.
Breathe more gently.
Use the same compression-breath rate as
is used for adults: 30 compressions followed by two breaths. This is one cycle.
Following the two breaths, immediately begin the next cycle of compressions and
breaths.
After five cycles (about two minutes)
of CPR, if there is no response and an AED is available, apply it and follow
the prompts. Use pediatric pads if available. If pediatric pads aren't
available, use adult pads.
Continue until the child moves or help arrives.
To perform CPR on a baby
Most cardiac arrests in infants occur from lack of oxygen, such as from drowning or choking. If you know the infant has an airway obstruction, perform first aid for choking. If you don't know why the infant isn't breathing, perform CPR. To begin, assess the situation. Stroke the baby and watch for a response, such as movement, but don't shake the child. If there's no response, follow the ABC procedures below and time the call for help as follows:
If you're the only rescuer and CPR is
needed, do CPR for two minutes — about five cycles — before calling your
local emergency number.
If another person is available, have
that person call for help immediately while you attend to the baby.
AIRWAY: Clear the airway
1. Place the baby on his or her back on a
firm, flat surface, such as a table. The floor or ground also will do.
2. Gently tip the head back by lifting the
chin with one hand and pushing down on the forehead with the other hand.
3. In no more than 10 seconds, put your
ear near the baby's mouth and check for breathing: Look for chest motion,
listen for breath sounds, and feel for breath on your cheek and ear.
If the infant isn't breathing, begin mouth-to-mouth
breathing immediately.
BREATHING: Breathe for the infant
1. Cover the baby's mouth and nose with
your mouth.
2. Prepare to give two rescue breaths. Use
the strength of your cheeks to deliver gentle puffs of air (instead of deep
breaths from your lungs) to slowly breathe into the baby's mouth one time,
taking one second for the breath. Watch to see if the baby's chest rises. If it
does, give a second rescue breath. If the chest does not rise, repeat the
head-tilt, chin-lift maneuver and then give the second breath.
3. If the chest still doesn't rise,
examine the mouth to make sure no foreign material is inside. If the object is
seen, sweep it out with your finger. If the airway seems blocked, perform first
aid for a choking infant.
4. Begin chest compressions to restore
circulation.
CIRCULATION: Restore blood circulation
1. Imagine a horizontal line drawn between
the baby's nipples. Place two fingers of one hand just below this line, in the
center of the chest.
2. Gently compress the chest to about
one-third to one-half the depth of the chest.
3. Count aloud as you pump in a fairly
rapid rhythm. You should pump at a rate of about 100 to 120 pumps a minute.
4. Give two breaths after every 30 chest
compressions.
5. Perform CPR for about two minutes
before calling for help unless someone else can make the call while you attend to
the baby.
6. Continue CPR until you see signs of
life or until a professional relieves you.
CPR ANIMATED DEMONSTRATION HERE
Quote Of the Day:
"When Something Bad happens, you have 3 choices
1. You can either let it define you.
2. Or let it destroy you.
3. Or you can let it strengthen you. "
Word of the Day:
acuity (noun) = "Sharpness of the mind or the senses" from the latin acuere: to sharpen
e.g. The oratory of Barrack Obama's Speeches reflects his intellectual acuity.
"When Something Bad happens, you have 3 choices
1. You can either let it define you.
2. Or let it destroy you.
3. Or you can let it strengthen you. "
Word of the Day:
acuity (noun) = "Sharpness of the mind or the senses" from the latin acuere: to sharpen
e.g. The oratory of Barrack Obama's Speeches reflects his intellectual acuity.
