Definition of CPR

CPR stands for cardiopulmonary resuscitation. It is an emergency procedure that serves as a life saving method. Artificial respiration is performed to keep oxygen flowing through the blood. Intermittent external chest compressions massage the heart and stimulate it to resume pumping the artificially oxygenated blood to the brain. Without this procedure, permanent brain damage or death can occur within minutes. When the heart stops, the brain is deprived of the oxygen it needs to continue functioning and keep the body alive.

CPR is the first treatment for someone who has passed out, has no pulse, and is also not breathing. If the victim still has a pulse, only artificial resuscitation is necessary. Continue CPR or artificial breathing alone until the victim’s breathing and pulse resume on their own or until medical professionals arrive to take over.

Make Sure the Scene is Safe

Before you begin performing CPR, there are certain steps you must take to be sure that more harm will not come to the victim and that no harm will come to you. It is imperative that you check the locale for safety hazards and attend to them promptly so that more victims are not created while you are helping the first one.

• Do not hesitate to tell others what to do. If everyone waits for someone else to take the lead, nothing will get done. Time is of the essence in an emergency situation where someone is not breathing and has no pulse. Courtesy is not.
• Have someone else call 911. If you know how to perform CPR, you should not waste time on the phone if someone else can do it. If you are the only person around and have a phone available to you, call but continue preparations.
• Avoid safety hazards in the environment of the victim, like fire or a downed power line. If you can fix any of the immediate issues or have someone else do it, then secure these things before continuing to perform CPR. If you can get to the victim safely, do so. If you injure yourself, no one is helped and another victim is created.
• If the victim needs to be moved because of some imminent danger, move them – carefully and quickly. Try to keep their neck as immobile as possible but when you have to choose between a possible spinal injury and death, take the chance and move that victim to a safer place to perform CPR.

When To Use CPR

Once the area is secure and no harm is immediately recognizable, it is necessary to figure out what injuries the victim has suffered, which are the most serious, and deal with them in order of most importance.

• Check to see if the victim is conscious. If so, ask them what hurts and what their name is as you check for injuries. If they are conscious, do not perform CPR.
• If they are unconscious, make sure that their airway is open and that they are breathing. If they are not breathing, perform artificial breathing. If they are breathing, do not perform CPR.
• Check their pulse. If there is no pulse, perform CPR. If there is a pulse, but the victim is not breathing, perform artificial resuscitation only.
• Even if the victim is bleeding heavily, deal with breathing and pulse problems first. Heartbeat and oxygen are the most important things to focus on.
• This may seem like an obvious pointer, but absolutely DO NOT perform CPR if the victim has a pulse and/ or is breathing. Sometimes people get carried away in an emergency and do what they know – whether or not it is necessary.
• Be sure to hold the victim’s head motionless while checking the airway, breathing, and pulse. If possible, have someone else do it for you so that you can focus on CPR as necessary.
• If at all possible, try to record what happens. Whether it’s a scrap of paper that you scribble on out in the woods or you have someone else do it, any information you have will help medical personnel when they arrive. You don’t want to forget life saving details in the heat of the moment.

ABC

ABC is an acronym to help you remember the important first steps before performing CPR: airway, breathing, and circulation. Open the airway, check the victim’s breathing, and pulse (i.e. circulation).

• To open the victim’s airway, lift the chin carefully. This will move the jaw forward and tilt the head backward, allowing a path for air to travel to the lungs from the mouth and nose.
• Remember – don’t push the forehead back in an effort to open the airway. If the victim has a neck or spinal injury, this will only make it worse.
• To check for breathing, watch the victim’s chest. If you can see it rise and fall even slightly, then they are breathing.
• Whether or not you can see the chest rise and fall, listen with your ear to the mouth and nose. You are listening for breathing sounds.
• If you can’t hear the victim breathing, but can feel their breath on your ear, then they are breathing. Use as many senses as possible and your best judgment.
• To check circulation, feel for a pulse. Press two fingers gently on the victim’s neck between the Adam’s apple and the muscle and the side of the neck. Don’t use your thumb, because your thumb has a pulse of its own.
• To check an infant’s circulation, press two fingers between the armpit and elbow on the inside of the baby’s arm.

Remember, if your search for breathing and circulation yield nothing, have someone call 911 or call them yourself if you are the only conscious person in the room, and immediately begin compressions and artificial breathing.

Check the Results of Artificial Breathing

We’ve discussed how to open the airway and check for breathing. If there is no breathing, you will need to begin breathing for the victim immediately.

• Keep the airway open and pinch the victim’s nose shut hard enough to be sure that no air will escape.
• Seal their mouth with yours and give two long breaths, slowly.
• If the breaths don’t make the victim’s chest rise, then re-tilt the victim’s head. Seal their mouth with yours again, pinch the victim’s nose, and offer two long breaths again, watching out of the corner of your eyes to see if their chest rises.
• If the chest still doesn’t rise, the airway might be blocked.

If Artificial Breathing Doesn’t Work

If the breaths you are giving the victim are not making the chest rise, you are sure that you have pinched the nose completely closed, sealed their mouth with yours, and offered the breaths strongly enough, then you must check the airway to see if it is obstructed.

• Put your index finger underneath the victim’s chin and your thumb inside their mouth on top of their tongue.
• Squeeze your index finger and thumb and pull the lower jaw (and tongue) down toward the victim’s chest. The goal of this step is to push the tongue down as far as possible so that you can clearly see down the victim’s throat.
• If you have a pen light or small flashlight, use it to look for the object obstructing the victim’s airway.
• If you can see it, use the index finger of the hand that is not holding the jaw and tongue down to sweep the object out of the throat. This should unblock the airway.
• Begin artificial breathing again by pinching the nose, sealing the mouth with your own, and breathing twice, slowly, watching out of the corner of your eye to see that the chest moves.
• Continue offering breaths to adult victims once every 5 seconds until the victim begins breathing autonomously, medical help arrives, or you can continue no longer.
• For infants, follow the above steps but place your mouth over the baby’s mouth and nose, instead of pinching the nose and sealing the mouth.
• All of the above steps apply to infants and children up to 8 years old, except the breath cycles. Offer a breath every 3 seconds until help arrives or the child begins breathing on its own.
• Be sure that you don’t breathe too hard for infants and children. Breathe just hard enough that their chest rises gently.

No Pulse and No Breath?

Then it’s time to perform CPR.

• Find the lowest tip of the breastbone. Position the heel of your hand two finger widths toward the head.
• Place your other hand on top of the first hand and interlace your fingers.
• Sit up and lean over so that your shoulders are directly above your hands.
• Using your shoulders and upper body, push down on the chest (a compression) 15 times in 10 seconds.
• Stop compressions and give two slow breaths.
• Give adults 15 more compressions in 10 seconds followed by two slow breaths, repeating this 4 times. Check for pulse and breathing.
• For children up to age 8, give 5 compression in 3 seconds followed by one slow breath, repeating 12 times before checking for pulse and breathing. NOTE: Do not offer as much force during compressions for children as for an adult.
• Continue this until the victim’s pulse and breath return or medical personnel arrive on the scene.

Infants

The only difference between adult and child CPR is the number of compressions and breaths per cycle and the amount of force used during compressions. Infants have a few more differences.

• Place your index, middle, and ring fingers directly between and just below the infant’s nipples. The pads of your fingers should be facing you.
• Lift your index finger, but keep your middle and ring fingers in place and offer the same number of compressions and breaths as for children: 5 compressions in 3 seconds followed by one slow breath in cycles of 12.
• Between cycles, check for breathing and pulse.
• Continue until professional help arrives or the infant begins breathing or regains a heartbeat.

If a child has been struck by lightning or was drowning when you found him or her, properly performed CPR has an excellent chance of helping the child regain a heartbeat and breathing. Don’t give up! And don’t forget to offer less force during compressions for children and infants. You don’t want to crack a rib!

Tips

• If the victim has a mouth or lip injury, then close the mouth and seal it shut with your hand while offering breaths through the nose.
• Watch out of the corner of your eye while delivering breaths to be sure that the chest is rising gently. This will show you that the breaths are making it to the lungs and that the airway is not obstructed.
• Try to use your upper body weight when giving compressions so that you don’t tire as quickly.
• If there is someone else present who also knows CPR, trade off while you wait for emergency personnel. It will help keep you from getting tired too quickly.
• If the victim vomits, turn them on their side. When they are finished, clean their mouth and roll their onto their back so that you can continue artificial breathing.
• Diseases are transmitted through body fluids and the air. Be as safe as possible and wear safety gear like latex gloves, plastic goggles, or a surgical mask if you have them available. Keep everything that touches the victim as sanitary as possible.
• Do not let this article be your only guide. Contact your local American Red Cross chapter for a schedule of CPR classes in your area.

Disclaimers

If you do not understand any of the above information, contact a doctor or medical professional to answer any questions you may have. This article is not meant to replace proper medical care and treatment. Should your heart or breathing stop for any reason, we recommend immediate emergency medical treatment. If symptoms continue, see your doctor as soon as possible.