Cardiopulmonary resuscitation, or CPR, must be initiated immediately when a patient experiences cardiac arrest. The American Heart Association reports that almost 80 percent of cardiac arrests happen at home. Effective bystander CPR improves the chance of survival. Good CPR restores oxygenation to the heart and brain, helping to protect neurologic function. The steps in giving CPR are different for infants, children, adults and trauma patients. Learning the method of giving non-traumatic adult CPR allows you to easily adapt to the other methods.
Determine Responsiveness
The first step in performing CPR is to determine whether a patient needs it or not. To do this, find out if the person is responsive. Shake his shoulder and shout "hey hey, are you OK?" If the person does not respond to verbal or tactile (touch) stimulation, call for help.
Activate EMS
The American Heart Association advises that if you are by yourself, quickly call 9-1-1. If there is someone else there with you, instruct her to call 9-1-1. Report that there is an unresponsive adult, male or female, and give your location; answer any questions the dispatcher has. If you have a cell phone or a land line near the victim, you may be able to stay in communication with the EMS dispatcher while you wait for the ambulance. If you had to leave the victim to call, explain this to the dispatcher, and quickly return to the victim.
Breathing
Take no more than 10 seconds to assess for breathing. First, make sure the victim has a patent airway. If you gently tilt the head back by pressing down on the forehead with one hand and tilt the chin up with the other, you can help open the victim's airway. Lean your ear next to his mouth and listen and feel for breathing. At the same time, look to see if there is any rise and fall of the chest. If the victim is not breathing, give her two breaths, for one second each.
Check Pulse
Only check for a pulse if you are a health-care provider; otherwise, begin chest compressions immediately. To check for a pulse, place two fingers over the carotid artery on the side of the neck closest to you. Press gently and check for no more than 10 seconds. If you do not feel a pulse, or if you are not sure if you feel one, begin chest compressions.
Chest Compressions
Place your hands in the center of the chest, between the nipples. Put the heel of one hand on the chest, and the other on top of it and interlock your fingers; keep your arms straight and push down hard and fast on the chest. Compress the chest about 1 1/2 to 2 inches for 100 times per minute. Give two breaths after every 30 compressions. The Society of Critical Care Medicine advises that you do not interrupt CPR for anything but rescue breathing or defibrillation. Continue with compressions and breathing until help arrives.
References
- American Heart Association: "Family and Friends CPR Anytime FAQS"
- "Advanced Cardiovascular Life Support"; American Heart Association; 2006
- "Fundamental Critical Care Support (4th ed.); Society of Critical Care Medicine; 2007
