Cardiopulmonary Resuscitation (C.P.R)

In this blog you will get the information related to the first aid to be provided in case of cardiac arrest.

Cardiopulmonary resuscitation(CPR)

 Is an emergency procedure that combines chest compressions often with in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person who is in cardiac arrest. It is recommended in those who are unresponsive with no breathing or abnormal breathing.

CPR involves artificial ventilation chest compressions for adults between 5cm (2.0in) and 6cm (2.4in) 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 or using a device that pushes air into the subject's lungs. Current recommendations place emphasis on early and high-quality chest compressions over artificial ventilation; a simplified CPR method involving chest compressions only is recommended for untrained rescuers. In children, however, only doing compressions may result in worse outcomes.

CPR alone is unlikely to restart the heart. Its main purpose is to restore partial flow of oxygenated blood to the brain and heart, he objective is to delay 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 in order to restore a viable or "perfusing" heart rhythm. Defibrillation is effective only for certain heart rhythms, namely venticular fibrillation or pulseless venticular tachycardia rather than asystole pulseless electric activity. CPR may succeed in inducing a heart rhythm that may be shockable. In general, CPR is continued until the person has a reture of spontaneous circulation(ROSC) or is declared dead.

Compressions: Restore blood circulation

1. Put the person on his or her back on a firm surface.
2. Kneel next to the person's neck and shoulders.
3. Place the heel of one hand over the center of the person's chest, between the nipples. Place your other hand on top of the first hand. Keep your elbows straight and position your shoulders directly above your hands.
4. Use your upper body weight (not just your arms) as you push straight down on (compress) the chest at least 2 inches (approximately 5 centimeters) but not greater than 2.4 inches (approximately 6 centimeters). Push hard at a rate of 100 to 120 compressions a minute.
5. If you haven't been trained in CPR, continue chest compressions until there are signs of movement or until emergency medical personnel take over. If you have been trained in CPR, go on to opening the airway and rescue breathing.

Recommending that chest compressions be the first step for lay and professional rescuers to revive victims of sudden cardiac arrest, the association said the A-B-Cs (Airway-Breathing-Compressions) of CPR should now be changed to C-A-B (Compressions-Airway-Breathing).

CPR for Adults

Adult Basic Life Support Algorithm for Healthcare Providers

In the algorithm for adult basic life support, emphasis is placed upon immediate recognition of cardiac arrest and the implementation of efficient compressions and early defibrillation. To immediately recognize cardiac arrest, the healthcare provider is trained to assess for unresponsiveness and/or an absence of breathing or presence of abnormal breath sounds. Laypersons should be instructed to use hands-only CPR. This approach calls for continuous compressions at a rate of 100-120 per minute.

CPR should be continued by a healthcare provider until return of spontaneous circulation (ROSC) or until termination of efforts. High quality CPR emphasizes adequate depth and number of chest compressions.

The pulse check has been deemphasized, and the guidelines recommend a pulse check for no less than 5 seconds and no more than 10 seconds. An integrated team approach includes simultaneous compressions and rescue breathing. Rhythm detection should take place as soon as an AED or defibrillator is available, with subsequent shock, as indicated, as the survival rate from ventricular fibrillation and pulseless ventricular tachycardia ranges from 5% to 50%, and decreases with an increase in the length of time to the first shock.

When a victim is unresponsive to a tap on the chest (ask “Are you ok ?”), then the healthcare provider should observe the victim for breathing for 5 to 10 seconds. If respirations are present, the victim should be attached to a cardiac monitor. Otherwise, the healthcare provider (HCP) should activate EMS and retrieve the AED by himself or by sending a second rescuer.

The pulse check is the third step in the algorithm. The pulse should be checked for no less than 5 seconds and no more than 10 seconds. If there is a definite pulse, then rescue breathing should be done for one second every six seconds with a recheck every 2 minutes.

If the victim does not have a pulse, or there is a question as to whether it is present, then compressions should be initiated at the rate of 30:2, with 2 breaths every 30 compressions. Compressions should be provided at a rate of 100-120/min. When the AED or defibrillator is available, then the HCP should check the victim’s rhythm. If it is shockable, then 1 shock should be given with immediate CPR instituted for 2 minutes, beginning rapidly (within seconds) of the shock.

If the rhythm is not shockable, then the HCP should administer CPR for 2 minutes and recheck the rhythm every 2 minutes. 
continue CPR until ALS is available.

• High quality chest compressions:
• Position patient on hard surface in supine position
• Minimal interruptions for ventilation
• 18 seconds per cycle
• Adequate speed of compressions: >100/minute
• Adequate depth of compressions: 2-2.4” (5-6cm)
• Allow complete recoil of chest
• Do not over ventilate

CPR For Children

Phone 911 or send someone to call

Compression: Do 30 chest compressions at a rate of 100 per minute using only one hand.

Airway: If trained in CPR, open the airway by tilting head back.

Breathing: Attempt two breaths if trained in CPR, repeat steps C, A and B until victim starts breathing or until emergency help arrives.

CPR For Infant

Phone 911 or send someone to call

Compression: Do 30 chest compressions at a rate of 100 per minute using only one hand.

Airway: If trained in CPR, open the airway using a by tilt lifting of chin.

Breathing: Attempt two gentle puffs of breath if trained in CPR, repeat steps C, A and B until victim starts breathing or until emergency help arrives.




From the above information you can be a life saver.