What is CPR?
Definition: An emergency procedure consisting of external cardiac massage and artificial respiration; the first treatment for a person who has collapsed and has no pulse and has stopped breathing; attempts to restore circulation of the blood and prevent death or brain damage due to lack of oxygen
CPR (Cardio Pulmonary Resuscitation) is a life saving emergency response technique. Performing CPR pumps oxygen-rich blood into the heart and brain. It can prevent brain damage and may save a life.
Few road users however know this technique and have only seen this administered, often incorrectly on television and the movies.
How can I learn to perform lifesaving CPR?
The best way to learn CPR is to attend a CPR class presented by an accredited medical institution or emergency response provider. CPR is a skill both to be learnt, practiced and regularly updated.
What are the Basic Steps of CPR?
The Basic Steps are easy to remember - When you get to a scene, and you find an emergency situation, follow these 3 basic steps: CHECK , CALL , CARE
Step 1: Check
First, you should check the scene, for safety and then later on you'll check the victim.
When you check the scene you want to make sure that it's safe for both you and the victim. Do not put your own life in danger and become a victim yourself!
What do you need to check for?
When you are assessing the scene, also make a note of the following:
- Possible safety risks
- Check for the number of victims. How many victims do you have?
- Check for clues as to what could have happened or bystanders able to provide more information or to render assistance in stopping traffic.
Now you can check the victim. Find out if they are unconscious. The best way to find out if the victim is conscious is to talk to them. Tap them on their shoulder and shout and see if they respond to you.
Step 2: Call
If they are unconscious or under any other life threatening conditions, you should automatically call one of the Emergency response numbers
Step 3: Care
It is most important to remember the ABC of Care
A is for airway
B is for breathing
C is for circulation.
Step 4: A for Airway
To open the airway, tilt the head back, lift the chin and look, listen, and feel for up to ten seconds. This way you can tell if a person is breathing.
Step 5: B for Breathing
If there is no breathing, go to the "B" step, which involves administering two rescue breaths into the person's mouth. Tilt the head back, pinch the nose, lift the chin and give two breaths ensuring that a tight seal in made around their mouth with yours. Those breaths are about 1 second long.
If the breaths go in, look towards the victim’s chest while administering the rescue breaths, you will notice the chest rise, that tells you that there is no blockage. Look over the victim's body and see if there's any bleeding, and if so you need to put pressure on the site so as to stop the bleed. If there is a second rescuer or bystander, get them to hold a sturdy amount of pressure on the wound. Then, begin CPR.
If the breaths did not go in try again, you may not have maintained a good seal the first time, if the breaths still do not go in, the victim's airway is obstructed. Follow the steps for Unconscious Choking.
Step 6: Check Pulse
Pulse check is no longer done for adults. However, one should check the pulse of children and infants. For children, check the pulse on the side of the neck. For infants, check the pulse on the middle of the inside of the arm, between the elbow and the shoulder.
Step 7: C For Circulation
Check the pulse and breathing, and act accordingly. If there is a pulse and breathing, place them on their side in the recovery position.
Step 8: Rescue Breathing
If there is a pulse but no breathing, breathe for the victim. They do not require compressions - only breaths. So do what is called "rescue breathing".
Give one breath every 5 seconds, and give 24 breaths in about 2 minutes. At the end of two minutes, stop to re-check the pulse and breathing again, and decide how to proceed.
Step 9: CPR
If the victim had no pulse / no breathing, perform CPR.
CPR is a combination of compressions and breaths and it serves to let oxygenated blood throughout the entire body. It keeps the brain and other vital organs alive, until advanced emergency personnel can take over.
When we do CPR, we're going to do 30 compressions and 2 breaths and we're going to do them five times every 2 minutes.
For CPR for a child, you can use two hands, but if you're dealing with a very small child, you probably want to do a one-handed technique. The one-handed technique involves putting one hand on the center of the chest and the other on the forehead. Keep that airway open and put your shoulders directly over the victim's chest and keeping your arms straight. Compress down one to one and a half inches as you do your compressions. Count out loud while doing the compressions: one and two and three and four… Ensuring that you compress the victims chest at least 2/3 of the width of the chest.
Remember to keep your hands placed on the victims chest on the breastbone at the level of the nipples.
Step 10: Stopping CPR
Once you begin CPR, do not stop to recheck. Continue without stopping, until you see signs of life, another trained person takes over, a defibrillator is ready to be used, the scene becomes unsafe, or you are too exhausted to continue.
Step 11: Recovery
If the victim shows signs of life, recheck their airway and breathing, and if they are breathing, place them in the recovery position with the stomach to the ground and the head to the side, resting on their arm.
Contact the ER24 Training Academy on 0861 084 124.
New Guidelines from the American Heart Association
In recent years, CPR training classes have been revised to put more emphasis on chest pushes for sudden cardiac arrest. In 2008, the heart group said untrained bystanders or those unwilling to do rescue breaths could do hands-only CPR until paramedics arrive or a defibrillator is used to restore a normal heart beat. Now, the group says everyone from professionals to bystanders who use standard CPR should begin with chest compressions instead of opening the victim's airway and breathing into their mouth first.
The change ditches the old ABC training – airway-breathing-compressions. That called for rescuers to give two breaths first, then alternate with 30 presses. Sayre said that approach took time and delayed chest presses, which keep the blood circulating. "When the rescuer pushes hard and fast on the victim's chest, they're really acting like an artificial heart. That blood carries oxygen that helps keep the organs alive till help arrives," said Sayre, an emergency doctor at Ohio State University Medical Center. "Put one hand on top of the other and push really hard," he said. Sudden cardiac arrest – when the heart suddenly stops beating – can occur after a heart attack or as a result of electrocution or near-drowning. The person collapses, stops breathing normally and is unresponsive. Survival rates from cardiac arrest outside the hospital vary across the country – from 3 percent to 15 percent, according to Sayre.
Under the revised guidelines, rescuers using traditional CPR, or cardiopulmonary resuscitation, should start chest compressions immediately – 30 chest presses, then two breaths. The change applies to adults and children, but not newborns. One CPR researcher, though, expressed disappointment with the new guidelines. Dr. Gordon Ewy of the University of Arizona Sarver Heart Center thinks everyone should be doing hands-only CPR for sudden cardiac arrest, and skipping mouth-to-mouth. He said the guidelines could note the cases where breaths should still be given, like near-drownings and drug overdoses, when breathing problems likely led to the cardiac arrest. Ewy is one of the authors of a recently published U.S. study that showed more people survived cardiac arrest when a bystander gave them hands-only CPR, compared to CPR with breaths.
The guidelines issued also say that rescuers should be pushing deeper, at least 2 inches in adults. Rescuers should pump the chest of the victim at a rate of at least 100 compressions a minute – some say a good guide is the beat of the old disco song "Stayin' Alive." Dr. Ahamed Idris, of the University of Texas Southwestern in Dallas, said people are sometimes afraid that they'll hurt the patient. Others have a hard time judging how hard they are pressing, he said. "We want to make sure people understand they're not going to hurt the person they're doing CPR on by pressing as hard as they can," he said. Idris, who directs the Dallas-Fort Worth Center for Resuscitation Research, said that for the last two years, they've been advising local paramedics to start with chest compressions and keep them up with minimal interruptions. That, along with intensive training, has helped improve survival rates, he said.
He said they found paramedics hadn't been starting compressions until the patient was in the ambulance and lost time getting airway equipment together."The best chance was to start chest compressions in the house, immediately," he said.
To Summarize NEW Guidelines
Now as you are approaching a patient who is unconscious, and you cannot rouse them, you immediately check for a pulse and begin with chest compressions if you don't feel one or it is weak and thready. 30 compressions and then you go to Airway, followed by Breathing and then Circulation.