CPR (Cardiopulmonary Resuscitation) is among the paramount emergency measures that the people of the world consider essential to establish blood circulation in the two chambers of the heart that support breathing function. A heart that has stopped will no longer pump blood effectively into the brain and other vital organs. The brain will, therefore, be denied oxygen, leading to irreversible damage in a matter of minutes.
Providing CPR thus becomes crucial in order to keep that oxygen going to those vital organs until professional help arrives. CPR’s timing also greatly influences the survival rate. CPR is more than just a skill; it’s a lifesaving skill. In this blog, we will discuss how to actually administer CPR with an understanding of its significance.
CPR Time Duration: The Magic Window
The time limit for CPR is very low. Cardiopulmonary Resuscitation can reverse cardiac arrest, but if not done within the tight time frame, the brain cells will die without oxygen after a couple of minutes.
After approximately 4-6 minutes without oxygen, brain damage becomes increasingly likely, and beyond 10 minutes, the chances of survival with full recovery are severely diminished.
As such, it is of utmost importance to start CPR as early as possible. The goal of CPR is to attempt to maintain circulation to keep oxygen flowing to the brain and vital organs until medical help can take charge.
When is CPR Needed?
CPR is needed in the following states:
Signs that CPR is Needed
Signs include:
Unresponsiveness: The individual does not respond to touch or loud speech. Attempt to wake the person by tapping them firmly on the shoulder and asking them if they are okay.
Absence of Breathing: Look for normal breathing. The person may not be breathing at all or maybe gasping, which is a sign of abnormal breathing.
No Pulse: Check for a pulse. If a pulse is not detected within 10 seconds, proceed with CPR.
Heart Attack: Chest pain, shortness of breath, and other symptoms may indicate a heart attack, which can lead to cardiac arrest.
Cardiac Arrest Due to Underlying Heart Condition: Individuals with known heart conditions are at higher risk.
Drowning, Choking, or Severe Trauma: These situations may result in the loss of consciousness and cessation of breathing.
Confirm Safety: Be sure to ensure the safety of both yourself and the person needing help before approaching the individual. Remove any immediate hazards, such as traffic, fire, or unsafe structures.
Balance Work Between the Emergency and the Person: The most important action is activating the emergency response system. Provide the dispatcher with the location of the emergency, the condition of the person, and other important information.
Use an AED if Available: As soon as you happen to lay your hands on the AED, someone should be told to go get it.
CPR Procedure: Key Components of High-Quality CPR
These are some basic steps following the guidelines of CPR. Just bear in mind that the key to success is continuous and unbroken chest compressions.
Step 1: Assess the Situation
Following are the steps to assess the situation:
Check for Responsiveness: Approach the person and tap them firmly on the shoulder while shouting, “Are you okay?” This establishes whether the person is conscious.
Look for Breathing: Observe for normal breathing. If the person is gasping, not breathing, or breathing abnormally, proceed to the next step, chest compressions.
Call Emergency Services: If the person is unresponsive and not breathing or only gasping, immediately call emergency services or instruct someone else to do so.
Delegate: If others are present, delegate tasks. Have someone call for help, retrieve an AED, or provide other assistance.
Step 2: Chest Compressions
Following are the steps for chest compressions:
Positioning: Lay the person on a firm, flat surface (e.g., the floor). Ensure the surface is stable to allow for effective compressions.
CPR Hand Placement: Kneel beside the person’s chest. Locate the centre of the chest, on the sternum (breastbone). Place the heel of one hand on the centre of the chest.
Second-Hand Placement: Place your other hand on top of the first hand, interlocking your fingers. Do not let your fingers touch the chest.
Compression Technique:
Keep your arms straight and your shoulders directly over your hands.
Press down hard and fast on the chest, compressing it at least 2 inches (5 cm) deep for adults.
Compressions should be delivered at a rate of 100-120 compressions per minute. Think of the rhythm of the song “Staying Alive” by the Bee Gees to maintain the correct pace.
Chest Recoil: Allow the chest to fully recoil between compressions. This allows the heart to refill with blood, which is important for effective circulation. Do not lean on the chest during the period the chest is recoiling.
Step Three: Rescue Breaths
Following are the steps for rescue breaths process:
Opening the Airway: After every 30 chest compressions, open the person’s airway by tilting the head back and lifting the chin. Place one hand on the person’s forehead and gently tilt the head back. Place your fingers under the chin and lift it upward.
Breathing: Pinch the person’s nose shut with your thumb and index finger.
Deliver Breaths: Give two slow, full breaths. Seal your mouth completely over the person’s mouth.
Observe Chest Rise: As you deliver each breath, watch for the chest to rise. If the chest does not rise, re-tilt the head and ensure a good seal. If that doesn’t work, it is possible the person is choking.
Continue: Continue with a cycle of 30 chest compressions followed by two rescue breaths. Continue this cycle until the person begins to breathe normally or until help arrives and takes over.
Step 4: Continue CPR Until Help Arrives
Following are the steps to continue CPR until help arrives:
Maintain CPR: Continue the cycle of 30 compressions and two breaths (if trained and willing) without interruption until one of the following occurs:
The person starts breathing normally and shows other signs of life (movement, coughing).
Emergency medical services (EMS) personnel arrive and take over.
You are physically unable to continue.
An AED is available, set up, and ready to use.
Use an AED: If an AED is available, use it as soon as possible. Follow the AED’s voice prompts, which guide you through the process. Continue CPR while the AED is being prepared, and if the AED advises a shock, give the shock and then immediately resume CPR.
Types of CPR and Special Considerations
CPR techniques vary depending on the age and condition of the person.
Hands-Only CPR
Hands only CPR includes:
Purpose: Primarily used for those whose heart suddenly stops beating normally.
Technique: Narrowly chest compressions in the absence of mouth-to-mouth breathing.
Effectiveness: This method might be a good means to sustain blood flow under effective depth and rates.
Benefits: It simplifies the process and allows any good Samaritans to intervene even in the absence of CPR training.
Conventional CPR: With Rescue Breaths
Conventional CPR includes:
Purpose: It is used for infants, children, drowning victims, and choking cases.
Ratio: Follows the 30 compressions to 2 breaths ratio.
Importance: This method ensures that oxygen is delivered along with maintaining blood circulation, which is particularly important in scenarios where oxygen depletion is the primary problem.
For Choking Victims: If the person is choking, attempt to remove the obstruction before providing rescue breaths.
Neonatal CPR (For Newborns)
Neonatal CPT includes:
Age Range: For infants under 28 days old.
Compression Technique: A different compression technique is used, with two fingers instead of two hands.
Hand Placement: Use two fingers of one hand to compress the chest on the lower sternum, just below an imaginary line between the nipples.
Compression Depth: Compress the chest about 1.5 inches (4 cm).
Ratio: Follows three compressions to 1 breath ratio.
Difference: Neonatal CPR requires a softer touch as well as some extra interventions, such as giving oxygen or clearing the airway with suction.
CPR in Pregnancy
CPR in pregnancy includes:
Specific Considerations: Standard CPR is altered to suit the anatomy and physiology of the pregnant woman.
Positioning: Tilt the woman slightly to her left side to relieve pressure on the major blood vessels (vena cava and aorta). This improves blood flow to the heart.
Compression Technique: The technique used to provide chest compressions is the same as that used for adults, although the chest may be compressed slightly higher to accommodate the fetus.
Medical Intervention: Rapid medical intervention is required, which may include an emergency C-section within minutes to save both the mother and the baby.
Breathing: Ensure you’re giving full, effective breaths to ensure oxygenation.
CPR Ratio and Key Guidelines: Keeping the Rhythm
Guidelines are as follows:
Adults: 30 compressions: 2 breaths (if trained and willing to provide breaths)
Children: 30 compressions: 2 breaths (if trained and willing to provide breaths)
Neonates: 3 compressions: 1 breath
Hands-Only CPR: Continuous chest compressions with no rescue breaths.
Recovery Position After CPR
If the person regains consciousness but remains unresponsive:
Place in the Recovery Position: Roll them onto their side to prevent choking on fluids (vomit, blood, etc.).
Airway Maintenance: Ensure their airway remains open.
Monitor Breathing: Continuously monitor their breathing until emergency services arrive.
Common Complications of CPR: Be Aware, But Don’t Hesitate
While CPR is a life-saving intervention, there are potential complications:
Rib Fractures: Due to the force of compressions.
Lung Injuries: If compressions are too deep or forceful.
Vomiting or Aspiration: Requiring immediate airway clearing.
Bruising and Soreness: In the chest area after successful resuscitation.
These risks are far outweighed by the need to provide life-saving CPR.
The ability to perform CPR, which is a skill that can ultimately save lives, is something that everyone should learn. Preparation is the key when it comes to neonatal CPR and adult CPR so that when emergencies occur, one can react efficiently and confidently. An opportunity to save a life.
Atrius Cardiac Care for a Healthy Heart
Atrius Cardiac Care is a group of leading experts in cardiology and emergency medical care. Schedule a consultation now to learn CPR techniques, heart health, or advanced life-saving interventions. Get the preparation you need to confidently be able to respond to cardiac emergencies.
