Cardiopulmonary resuscitation, or CPR, is one of many resuscitation techniques that need to be used when someone has a cardiac arrest. Cardiac arrest is a medical condition that occurs when the heart stops pumping blood to the brain and other vital organs. Once this happens, unconsciousness occurs, and little to no pulse can be felt.
If you encounter a situation where a person collapses, stops breathing, and can’t feel a pulse, the first thing to do is call 911. After that, immediately start performing CPR. This technique requires you to start chest compressions to help the heart pump blood back to the vital organs. This gives you precious time until emergency response units arrive at the scene.
Knowing the Signs
Many people that don’t have any medical background can’t distinguish between a cardiac arrest and a heart attack. A heart attack occurs when blood stops getting to the heart, which can make the heart muscle stop and die. Cardiac arrest happens when the electrical system of the heart stops, and blood isn’t pumping to the vital organs.
Knowing the difference is key because someone that is having a heart attack can still be conscious, have a pulse, and be responsive, while cardiac arrest victims collapse and stop breathing. Performing CPR on a heart attack victim isn’t necessary if you manage to keep the person calm and conscious until medical help arrives. If they do go unconscious, starting chest compressions instantly can double their chances of survival.
If you happen to come across a person that has collapsed, doesn’t show any signs of life, isn’t breathing, isn’t responsive, and doesn’t have a pulse, you should instantly begin performing CPR. With continuous chest compressions, you are sending blood to vital organs and increasing the chances of the person not having brain damage or death.
You should stop performing CPR at the arrival of EMTs, who will either continue CPR or use an AED; or when the person gains consciousness and responds to some basic questions. This is when you start talking and try to keep them calm until help arrives.
Basic Life Support Training
While many people have heard about CPR and may know that it involves chest compressions, a basic life support training course can teach you the ins and outs of the technique. There are also other resuscitation techniques that can be learned, including rescue breathing, previously known as mouth-to-mouth resuscitation, AED use, and getting out foreign bodies in the case of airway obstruction (choking).
Performing chest compressions and rescue breathing at the same time isn’t necessary in all cases. Rescue breathing can be performed on a cardiac arrest victim when they are unconscious but still have a pulse. When the pulse disappears, CPR needs to start. Also, rescue breathing may be used when someone is choking, has almost drowned, is experiencing a drug overdose, or has a severe asthma attack.
Using an AED can be of massive help when someone is experiencing cardiac arrest. This small device delivers an electric shock called defibrillation to the chest and heart, helping it start pumping blood once again. This device gives extra time for EMTs to arrive at the scene and provide proper care.
In the US, AEDs have become available in most public places, including shopping malls, schools, offices, stores, gyms, and airports. While there are special training courses for the use of AEDs, the general public can use them. When you start the device, there will be an audible voice that will guide you through the process. When the device is placed on a person, it will tell the user when a shock is or isn’t needed.
If there are more people present at the scene it is easy to call for help, look for an AED device and start performing CPR immediately. If you are alone it is best to call medical professionals first. However, there are certain cases, such as drug overdose or drowning, when it is recommended to start performing CPR first for about 2 minutes before leaving the patient to call for assistance.
If you haven’t attended any CPR classes or training or have never seen it being performed, here is a step-by-step guide on the basics of CPR.
- Place your hands one over the other, with the heel of one of your hands on the middle of the person’s chest
- Keep your arms straight and start pushing down hard and fast, about 2 inches
- The compression rate should be from 100 to 120 per minute
- Make sure the chest comes back to its natural position after every compression
- After about 30 chest compressions, apply rescue breathing (2 breaths)
- Continue the cycle of 30 compressions and 2 breaths until the person shows signs of life or medical professionals arrive
You should not delay CPR in cases involving an infant or a child. If you are alone, administer CPR treatment for about 2 minutes before stopping to call for help.
In pediatric cardiac or breathing emergencies, it is important to know the difference between adult CPR and child or infant CPR. While chest compressions need to be at the same rate per minute, 100 to 120, there are some differences. For example, if you are dealing with a baby up to 12 months of age, instead of placing the heel of one hand on the chest and the other hand on top, you need to place both of your thumbs side by side on the center of the baby’s chest.
Your other fingers will be supporting the body of the baby, and at the same time, push down hard with your thumbs about one-and-a-half inches. The rate per minute stays the same, 100 to 120, and let the chest come back to normal after you push down. The compression rate can be remembered better if you know the beat to the famous song by the Bee Gees, ‘Stayin’ Alive.’
After about 30 chest compressions:
- Give the infant 2 rescue breaths.
- Close its nose, and blow for about a second into the mouth.
- Make sure the chest rises and comes back to normal after each breath.
- Continue this cycle until you see some sort of signs of life, a trained professional arrives, an AED is brought to the scene, or medical assistance arrives at the scene.
In children older than 1 year, up until the signs of puberty or up to 121 pounds of weight you should use one hand to perform chest compressions and keep the 30:2 ratio. You should be extremely careful about the position of the head and the volume of breaths as a child’s airway is much more delicate than in adults.
- Place the heel of the hand on the lower part of the chest bone
- Apply one and a half or two inch deep compressions depending on the size and weight of the child
- After 30 compressions provide 2 breaths
- If you are alone at the scene repeat the cycle for 2 minutes then call emergency services
- Continue with CPR until the child starts breathing on their own or until paramedics arrive.
Avoid the risks
While many people won’t even hesitate to help out, there are occasions when the scene or setting is too dangerous to assist, so it’s crucial to know when to perform CPR in an emergency situation. Whether there has been a car accident on a busy road or highway, or a power line has electrocuted someone, it is a huge risk that you may get hurt yourself from trying to get to the person. The best thing to do in these types of situations is to call 911 and wait for experts to arrive.
On the other hand, if the scene and setting are safe, check for any signs of life before starting CPR. If the person is still breathing, has a pulse, and is responsive, simply call 911 and continue monitoring their condition until medical assistance arrives.
CPR can buy you some time before an AED or medical professional arrives at the scene. While those chest compressions will get some blood flowing, defibrillation is needed to get the heart pumping again. Like any other type of emergency, for example, breathing emergencies, stroke emergencies, trauma injuries, etc., you always have to assess the scene and the condition that the person is in before administering any form of medical help.There are clear-cut signs that someone is experiencing a cardiac arrest, and as soon as you spot them, the greater the chances they have of surviving. Check for any signs of life, including movement, breathing, and regular pulse. If none of that is present, start chest compressions, and rescue breathing, until an AED is on the scene and shock management can be applied or until medical professionals are at the scene.