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Jai Ganesh

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CPR (Cardiopulmonary Resuscitation)

Cardiopulmonary Resuscitation (CPR)

Gist

Cardiopulmonary Resuscitation (CPR) is an emergency procedure for someone who is unresponsive and not breathing normally. It involves 30 chest compressions (100-120 per minute) followed by 2 rescue breaths (or continuous "hands-only" compressions) to keep blood flowing to vital organs until professional help arrives.

The 7 steps of CPR (Cardiopulmonary Resuscitation) involve ensuring scene safety, checking responsiveness, calling emergency services, opening the airway, checking for breathing, performing 30 chest compressions, and delivering 2 rescue breaths. These steps are repeated until medical help arrives or the patient wakes up.

Summary

Cardiopulmonary resuscitation (CPR) is an emergency procedure used during cardiac or respiratory arrest that involves chest compressions, often combined with artificial ventilation, to preserve brain function and maintain circulation until spontaneous breathing and heartbeat can be restored. It is recommended for those who are unresponsive with no breathing or abnormal breathing, for example, agonal respirations.

CPR involves chest compressions for adults between 5 cm (2.0 in) and 6 cm (2.4 in) deep and at a rate of at least 100 to 120 per minute. The rescuer may also provide artificial ventilation by either exhaling air into the subject's mouth or nose (mouth-to-mouth resuscitation) or using a device that pushes air into the subject's lungs (mechanical ventilation). Current recommendations emphasize early and high-quality chest compressions over artificial ventilation; a simplified CPR method involving only chest compressions is recommended for untrained rescuers. With children, however, 2015 American Heart Association guidelines indicate that doing only compressions may result in worse outcomes, because such problems in children normally arise from respiratory issues rather than from cardiac ones, given their young age. Chest compression to breathing ratios are set at 30 to 2 in adults.

CPR alone is unlikely to restart the heart. Its main purpose is to restore the partial flow of oxygenated blood to the brain and heart. The objective is to delay tissue death and to extend the brief window of opportunity for a successful resuscitation without permanent brain damage. Administration of an electric shock to the subject's heart, termed defibrillation, is usually needed to restore a viable, or "perfusing", heart rhythm. Defibrillation is effective only for certain heart rhythms, namely ventricular fibrillation or pulseless ventricular tachycardia, rather than asystole or pulseless electrical activity, which usually requires the treatment of underlying conditions to restore cardiac function. Early shock, when appropriate, is recommended. CPR may succeed in inducing a heart rhythm that may be shockable. In general, CPR is continued until the person has a return of spontaneous circulation (ROSC) or is declared dead.

Medical uses

CPR is indicated for any person unresponsive with no breathing or breathing only in occasional agonal gasps, as it is most likely that they are in cardiac arrest.  If a person still has a pulse but is not breathing (respiratory arrest), artificial ventilations may be more appropriate, but due to the difficulty people have in accurately assessing the presence or absence of a pulse, CPR guidelines recommend that lay persons should not be instructed to check the pulse while giving healthcare professionals the option to check a pulse. In those with cardiac arrest due to trauma, CPR is considered futile but still recommended. Correcting the underlying cause such as a tension pneumothorax or pericardial tamponade may help.

Details

CPR (cardiopulmonary resuscitation) is an emergency procedure for someone who’s in cardiac arrest. CPR with breaths and hands-only CPR are the two types. Even if you’re not CPR-certified, you can do hands-only CPR. This involves doing 100 to 120 chest compressions per minute. Start CPR immediately to give the person the best chance of survival.

What Is CPR?

CPR stands for cardiopulmonary resuscitation. It’s an emergency procedure that can save your life if you’re in cardiac arrest. This means your heart stops beating and can’t pump blood out to your body. The key part of CPR is chest compressions (pushing hard and fast in the center of the chest). This keeps some blood flowing to vital organs. CPR may also involve mouth-to-mouth breaths, which give you oxygen.

Healthcare providers, like doctors, nurses and paramedics, routinely perform CPR both in and out of hospitals. Others, called lay rescuers, can also perform CPR wherever it’s needed, like at homes, gyms and shopping malls.

If you’re reading this and aren’t a healthcare provider, you have the opportunity to be a lay rescuer. This means you can save someone’s life, no matter who you are. Lay rescuers include people with CPR certification (you take classes and get an official certificate), as well as those without it. You’ll do the type of CPR that reflects your training and comfort level.

Types of CPR

There are two main types of CPR:

* CPR with breaths (conventional CPR): You use chest compressions and mouth-to-mouth breaths. You need CPR certification to do this type.
* Hands-only CPR: You only use chest compressions (no breaths). You don’t need CPR certification to do this type. You can learn on your own.

Both types are effective and can be lifesaving within the first few minutes of cardiac arrest in adults. However, CPR with breaths is more helpful in situations where CPR must go on for longer than a few minutes. This is because the person’s blood needs more oxygen at that point to prevent damage to vital organs like the brain.

How to recognize when someone needs CPR

A person needs CPR if they’re unconscious and have absent or abnormal breathing. Here’s what that means:

* Unconscious: This is also called being “unresponsive.” It means the person doesn’t respond if you shout, say their name or tap them on the shoulder.
* Absent or abnormal breathing: This means the person either isn’t breathing, or they’re breathing in ways that don’t sound normal. It may sound like they’re gasping for air.

These are signs that the person is in cardiac arrest.

What not to do

When someone’s in cardiac arrest, do NOT delay CPR in order to:

* Check for a pulse: The latest guidelines say that lay rescuers should NOT check for a pulse (this is true even if you’re CPR certified). This can waste valuable time. If the person is unresponsive and not breathing right, start CPR right away.
* Check their airways for an object that’s stuck: The guidelines do NOT recommend routine inspection of the mouth or throat when a person is in cardiac arrest. Also, never do a “blind finger sweep,” looking for an object. This can push any object deeper into the airway.

The only time to check the airways for a lodged object is if you witness someone collapse while choking. In that case, quickly look in their mouth. Don’t feel around for an object. But if you can clearly see an object and it’s easily removed, you can remove it. Otherwise, start CPR right away.

Procedure Details

Before starting CPR, quickly ask someone to:

* Call your local emergency services number): Ideally, someone nearby can make the call so you can immediately start CPR. But if you’re alone, call for emergency help and put the phone on speaker while you get started.
8 Get an automated external defibrillator (AED): An AED is a device that can restart the heart. AEDs are available in many public places. You can use them even if you don’t have training. The device will give you instructions aloud.

It may take some minutes for emergency services to arrive and for someone to find an AED. Don’t wait. Start CPR immediately.

CPR steps for adults and teens

1. Make sure the person is on a firm, flat surface. They should be lying on their back. Gently position the person as needed.
2. Kneel down. You should be next to the person, with your knees about shoulder width apart.
3. Place your hands on their chest. Put the heel of one hand in the middle of their chest, with your fingers lifted upward and spread out. Put your other hand on top and interlace your fingers. Your fingers should be slightly lifted up off their chest, with the lower heel pressing down.
4. Position your body. Your shoulders should be directly over your hands. Your arms should extend straight downward, with your elbows locked (not bent). This helps you use your body weight to push down forcefully enough.
5. Start chest compressions. Push down on the middle of the person’s chest with hard, fast movements. Their chest should go down by at least 2 inches (5 centimeters) each time, but not more than 2.4 inches (6 centimeters). Their chest should rise up before you push again.
6. Keep a steady pace. Do chest compressions at a rate of 100 to 120 per minute. This follows the beat of “Stayin’ Alive,” by the Bee Gees, and “Crazy in Love,” by Beyoncé and Jay-Z. Make sure you allow the person’s chest to come all the way back up between compressions.
7. Give breaths (IF TRAINED). For hands-only CPR, simply continue doing chest compressions. But if you’re CPR certified and willing to give breaths, you should do so. Follow the guidance you learned in your training. You should generally give two breaths after every 30 compressions.

Continue doing CPR until any of the following happen:

* The person starts breathing normally again.
* First responders arrive and take over the care.
* An AED is available to use (if this happens, stop CPR and start using the AED right away).

If at any point, you feel too tired to continue, let someone else who’s ready step in. Make the switch as quickly as possible so there aren’t long breaks in between compressions. Generally, it’s advised to switch personnel every two minutes.

CPR steps for children and babies

There are some key differences when you’re doing CPR for anyone 12 or younger. Here’s what to know:

* CPR with breaths is best for children and babies. This means, ideally, someone who’s CPR certified will step in. But if no one with training is available, it’s OK to do hands-only CPR.
* For infants, don’t use both hands for chest compressions. Instead, use modified techniques that are more appropriate for an infant’s small size. These are described farther below. The infant’s chest should go down by about 1.5 inches (4 centimeters).
* For children, use either one or two hands for chest compressions. It depends on the size of the child. For children 1 to 8 years old, using one hand may be OK as long as you can keep the proper form. The child’s chest should go down by about 2 inches (5 centimeters).

When performing CPR on an infant (1 to 12 months old), use one of the following techniques for chest compressions:

* The “two thumb-encircling hands” technique: You wrap both hands around the infant’s upper body. Your thumbs should meet at the center of their chest, forming an upside-down V. Push down with both thumbs. This is better than doing two-finger compressions (an older method).
* The “heel-of-one-hand” technique: If you can’t wrap both hands around the infant, then use the heel of one hand (not both) to do chest compressions.

What are the potential benefits and risks of CPR?

CPR can save your life if you receive it right after going into cardiac arrest. CPR keeps blood moving through your body. This may prevent organ damage, like cerebral hypoxia.

Some people with certain preexisting health conditions might not experience the same benefits from CPR. It depends on how sick you are before you go into cardiac arrest. Consider speaking with a healthcare provider you trust about what your recovery or outlook might look like if you needed CPR.

Possible risks of CPR include broken ribs and injury to organs in your chest. This is because chest compressions must be forceful to keep blood circulating and keep you alive.

Recovery and Outlook:

What happens immediately after CPR?

If you’re a lay rescuer, you’ll step back when first responders arrive. They’ll take over and begin providing medical care. They’ll transport the person to a hospital as soon as possible. If the person survives, healthcare providers will check for any organ damage from a lack of oxygen. They’ll also determine the cause of cardiac arrest and provide any needed treatment.

If a cardiac arrest occurs at home and an individual wakes up after CPR from a non-trained family member, they should be evaluated immediately by a healthcare team. This is true even if they look well.

Additional Information

CPR stands for cardiopulmonary resuscitation. It can help save a life during cardiac arrest, when the heart stops beating or beats too ineffectively to circulate blood to the brain and other vital organs.

What Is the Purpose of CPR?

With a half-million cardiac arrests each year, CPR increases the likelihood of surviving cardiac arrest, when the heart stops beating or beats too ineffectively to circulate blood to the brain and other vital organs. It’s not just for healthcare workers and emergency responders. CPR can double or triple the chance of survival when bystanders take action. The Red Cross helps train you safely, effectively and confidently so you’re prepared for the moments that matter.

Why is CPR Important?

CPR should be used when you see someone who is unresponsive and is not breathing or only gasping. Having more bystanders trained in this simple skill can help save lives by putting more cardiac arrest victims within a few steps of lifesaving assistance.

What Are the Types of CPR?

* Hands-Only CPR: Hands-only CPR is an easy-to-learn skill that could save a life. It involves calling 9-1-1, sending someone for the AED if available and then giving continuous chest compressions. It only takes minutes to learn.

* Full CPR With Rescue Breaths: While Hands-only CPR can be lifesaving, learning full CPR is still very important. Getting trained in full CPR – combinations of chest compressions and rescue breaths – will increase your confidence and may enable you to help in other types of emergencies. Full CPR is ideal for all ages, and especially for people who are more likely to experience respiratory emergencies such as children and infants.

Why Learn CPR?

Learning how to perform CPR properly takes just a few short hours, but it can change a life forever. Red Cross CPR training classes give you the information and the skills you need to help adults, children and infants during cardiac emergencies. Whether you choose 100% in-person or blended learning CPR classes, our world-class instructors deliver the most up-to-date information that's engaging and effective, preparing you for the moments that matter.

Benefits to Being CPR Certified

* An Emergency Can Happen When You Least Expect It.  No one ever expects emergencies to occur as they go about their day, which is why it is important to learn CPR ahead of time. Cardiac arrest can happen at home, at school, at the gym, on an airplane, in the workplace or anywhere in the community. CPR is a critical skill that can help save a life when a person's breathing or heart stops.
* Every Second Counts. You may be wondering, "why learn CPR when I can just call 9-1-1?" While you should always call 9-1-1 first in the event of an emergency, it still takes rescuers some time to arrive at the scene. For every minute without intervention, the chance of survival drops for a person experiencing sudden cardiac arrest. CPR can significantly improve someone’s chance of surviving when bystanders take prompt action.
* CPR Also Prevents Brain Death. Even if someone survives cardiac arrest, they may suffer permanent brain damage when they don't receive enough blood flow and oxygen to the brain. CPR certification can help prevent brain damage and death by keeping oxygenated blood moving throughout the body.
* Anyone Can Learn It. Another benefit of CPR is that this lifesaving training is for everyone. It only takes a few hours, and it can give you the skills and confidence to act in an emergency and help save a life. You'll find classes that are designed for the way you live and learn, with options available on weekdays and weekends in a variety of formats.
* You'll Have the Confidence to Act when Needed. CPR instruction will give you the skills and confidence to perform this life-saving procedure when it's needed the most. Plus, to keep your skills fresh, online refresher materials are available that can help you retain the knowledge you've gained. In addition, you'll also have access to a printable list of the basic steps for performing CPR. This way, you can keep the information you need right at your fingertips.

Cardiac Arrest Chain of Survival

Cardiac arrest can happen anytime and anywhere. In these emergencies, the heart stops beating or beats too ineffectively to circulate blood to the brain and other vital organs. The cardiac arrest out-of-hospital chain of survival shows the steps necessary to take in order to improve chances of survival from cardiac arrest.

The 6 links in the adult out-of-hospital Chain of Survival are:

* Recognition of cardiac arrest and activation of the emergency response system (such as calling 9-1-1)
* Early CPR with an emphasis on chest compressions
* Rapid defibrillation
* Advanced resuscitation by Emergency Medical Services (EMS) and other healthcare providers
* Post-cardiac arrest care in the hospital
* Recovery (such as additional treatment, rehabilitation, and psychological support)

CPR/AED Classes

At the Red Cross, you can choose the type of class for your schedule – and the way you learn best. For those who want to become certified in CPR/AED, you can choose from three types of courses:

* In-person: Designed for those who learn best in a traditional classroom setting, our in-person courses combine lecture with hands-on skills sessions. This way, you can not only learn what CPR is, but you will be able to practice your skills with a certified instructor. If the course is completed with a passing grade, you'll receive a two-year certification.

* Online: Perfect for those who want the freedom to take self-paced courses, our online classes can help you learn what CPR is and how to perform the different types of CPR. However, online safety training courses do not allow you to demonstrate your skill proficiency to a certified instructor, and therefore your certification may not meet the requirements for workplace safety.

* Blended Learning: Our blended learning programs combine self-paced, interactive instruction and in-person skills sessions. That way, you can learn what CPR is, why CPR is important and how to perform it in theory and in practice. Additionally, because this option allows you to demonstrate your skills to a certified instructor, you can receive full certification with a passing score.

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