Cardiopulmonary Resuscitation (CPR) is a lifesaving technique that everyone should know. It is a combination of rescue breathing and chest compressions that will restore breathing and a heartbeat (circulation) to someone who has been injured, nearly drowned, suffered a heart attack or stroke, lost a great deal of blood, suffocated, or had a drug overdose, carbon monoxide poisoning or electric shock. It may buy enough time until emergency services arrive to save their life.

The American Red Cross, the American Heart Association and other organizations can teach CPR, using aids such as videos, printed material, demonstrations and guided assistance with mannequins of different sizes. The instruction you are currently reading here in no way replaces the valuable hands-on education that is given by trained professionals, but it can refresh your memory if you have already learned CPR. It is recommended that you take a refresher course occasionally to learn any new techniques and tips. If you have not yet taken a class I urge you to find one in your area, perhaps at a local hospital or fire station, because it can truly make the difference between life and death to someone.

When a person’s heart stops beating, or he or she stop breathing, they may have as few as 4 to 6 minutes before brain damage occurs, because oxygen is not getting to the brain. When you have determined that the person is truly unconscious and/or unable to breathe get started immediately. Of course, it is helpful if there is another person nearby who can make the phone call to 911 and then assist you – administering CPR can be exhausting – but chances are you will be entirely responsible for the situation.

The first thing to do in the case of an unconscious adult is call the emergency medical assistance number (911), but in the case of a child or baby administer aid for 1 minute, then call the emergency number. There is a little difference in the ways you perform CPR on adults compared to how it is performed on babies and children (discussed later), but basically the ABC’s are the same regardless of size/age.

A is for airway,

B is for breathing, and

C is for circulation

In order for the breath you are going to provide to enter the person’s body, their airway must be clear. Gently roll the person onto their back. If you can see something in their mouth remove it. Place one of your hands on their forehead and several fingers of the other hand under their chin. Tilt the head and lift the chin – this will clear the airway if their tongue has relaxed and fallen back against the throat. If it is possible that there has been a neck injury, limit the amount of chin lifting you do in order to avoid tilting the head too much and causing further damage.

Check for breathing by placing your face near the victim’s nose/mouth. Look towards their chest. Listen for their breath while you are watching their chest to see if it moves up and down. Be alert to the feel of their breath on your cheek. It is up to you to get oxygenated air into their lungs. If there has been no indication of breathing, pinch their nose closed so none of your breath will escape, and then administer 2 full breaths into their mouth. (Take a very deep breath and completely cover their mouth with your own - it is necessary for you make a tight seal, although you don’t actually have to be pressing down too hard, and exhale deliberately yet evenly). Each breath should last about 1-1/2 seconds. Between the breaths move your mouth away and inhale. It takes quite a bit of exertion, but if your breath will not go in try moving their head a little and try again. You will see their chest rise as your breath enters their body. If you are still unsuccessful it will be necessary to perform the Heimlich maneuver – place your fists, which are clenched together, on their abdomen and thrust quickly to try to dislodge whatever might be stuck in the airway.

After completing 2 breaths, check to see if circulation has been restored. If so, you will feel their pulse on the carotid artery (on either side of the Adam’s apple). It may be weak and either slow or rapid. At this point, if you are alone try to get to a telephone to make the call to 911. If the phone is not nearby continue CPR for a full minute. (Breathe once every 5 seconds – 12 times a minute – until the victim begins to breathe on his own or until medical help arrives).

Circulation will have to be induced artificially by you if the person has no pulse yet. The method is as follows: locate the sternum by finding the spot where the ribs meet the breastbone. Place your hands face down on top of each other just above the person’s sternum. Rise up on your knees and lock your elbows, which will allow you to use your body weight to perform the procedure. To avoid damaging their ribs, do not let your fingers bear any of your weight - use only the heel of your hand. In order to get their blood moving, it is necessary to depress the chest 1-1/2 – 2 inches. Do this action 15 times, holding the “down” position for half a second and then “relaxing” for half a second. When the 15 compressions are done, give 2 breaths as described above (rate is 80 - 100 per minute). Check for a pulse every minute.

When doing CPR on a child or baby you should be aware of a few changes. For instance, at the beginning of rescue breathing continue for 1 full minute instead of just 2 breaths. Rather than 15 compressions per 2 breaths, perform 5 compressions per 1 breath. On a child between the ages of 1 and 8, compression of the chest should be done with the heel of one hand to a depth of 1”. For babies age 1 and younger, chest compression should be done with 2 or 3 fingers placed on the sternum to a depth of ½”.

Hopefully, you will never be called on to administer CPR to anyone, but if/when the need arises having the technique memorized is essential – you just can’t count on being able to find written instructions on a moment’s notice. It would be so sad to be confronted with a situation where CPR would be a lifesaver, but no one in the vicinity can remember how to do it! I hope that if I’m ever in need of CPR there will be someone nearby who can keep me alive until the EMS gets there!

Endnotes

http://kidshealth.org/PageManager.jsp?dn=KidsHealth&lic=1&ps=107&cat_id=149&article_set=21645

http://cpmcnet.columbia.edu/texts/guide/hmg13_0001.html#13.1

http://my.webmd.com/content/healthwise/255/86362.htm

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