Cardio Pulmonary Resuscitation (CPR)
CPR (Cardio-Pulmonary Resuscitation)
CPR is an emergency combination akin to making available an artificial heart and lungs to a person so desperately in need of them that he or she may lose life for want of it. CPR comprises of techniques designed to be carried out by a person without any healthcare background as you never know when you may be called upon to save a life.
To give you an idea of how important CPR can be, here is a list of few situations where it might be life saving:
- Accidental injuries
- Heart conditions
- Lung diseases
The aim of CPR is to prevent irreversible damage to brain as a result of stoppage of blood pumping action from the heart. Just imagine, how useful this simple knowledge can be as accidents and situations like those listed above are everyday occurrences and one might come across a situation of this nature during the course of life.
CPR is a life-saver procedure. It is of paramount importance to ensure that the person providing CPR and the victim are safe from any damage or harm at the scene of accident or emergency. So make sure that you are not in the middle of road or under a collapsing building before you begin to provide CPR.
Your readiness to provide CPR can be of two types. Either you are well trained and confident or you are not. In case you are confident that you can handle the emergency, and then follow the steps listed as under:
For a trained CPR Provider
Start with 30 chest compressions and also give rescue breathing. (Details follow in the next section)
For an untrained CPR Provider
Provide continuous chest compressions at a rate of about 100 per minute but without providing rescue breathing.
The following description is suitable for CPR performed on an adult.
- First of all, make sure that the person receiving CPR is conscious. To check the status, tap the shoulder of the victim and ask loudly as to how he or she is doing (not recommended if choking is suspected especially in children) and look for a response.
- If there is a response, proceed with CPR.
If there is no response, and you are not alone, then ask your companion to arrange for assistance from emergency services like hospital, police, or fire services. Their numbers should be on your tips. If you are alone, then inform the emergency services first and proceed on to CPR. Automated External Defibrillator (AED) is standard equipment for basic life support.
CPR comprises of three steps that can be memorized as CAB
C stands for Circulation (or Chest Compression)
A stands for Airway, and
B stands for Breathing
Chest compression work in the same way as an artificial heart for a critical person. To proceed with chest compression, first of all position the person on a flat surface, stand close to the side of the subject’s neck and bend down, place one palm over the centre of the person’s chest (the middle of chest where you feel a slightly depressed surface), keep your arms straight without bending at the elbows and push the chest downwards by at least 5 centimeters using your own weight. Continue chest compression at a rate of about 100 times a minute. Provide 30 chest compression followed by rescue breathing.
The second step is clearing the airway to allow for exchange of air by lungs. Clear the airway after giving about 30 compression. This is done by tilting head of the person backwards followed by lowering the chin. If the person has had a head injury, then the head should not be tilted back and also one should not force open the jaws to clear the airway. Check whether the person is breathing by placing your fingers under the person’s nostrils and feeling for the movement of air, or by noting breath sounds. Please note that gasping is not considered to be normal breathing. If the subject is not breathing, provide mouth to mouth breathing. Please note that rescue breathing can either be given mouth to mouth, or mouth to nose (if mouth cannot be opened due to injury or any other reason). If you do not know the technique for mouth to mouth breathing, then this step may be skipped while chest compression are continued till help arrives.
Breathing is given in cycles wherein each cycle comprises of 30 chest compressions followed by two rescue breaths.
The first cycle should begin immediately after ensuring patency of the airway. For mouth to mouth breathing, pinch the nostrils (to prevent air from escaping), put your lips on the lips of the person to seal the opening, and blow into mouth of the subject. Watch to see whether the chest rises or not. If the chest rises, give another breath. If the chest does not rise, again ensure the patency of airway; give a second breath followed by 30 chest compressions. You should keep one hand on the chest when you release the pressure of the palm (otherwise you have to locate the right placement position every time you compress the chest). Provide further chest compressions and breath cycles till at least five cycles have been given. It takes about two minutes to complete five cycles. Continue the process till the person is revived or until the help arrives.
CPR for children of 1-8 years
The procedure for giving CPR to children aged one to eight years is same as that for adults except following differences.
- If you have no one to help you, then first give 5 cycles of compressions and breaths and then inform emergency services.
- Use single hand for chest compressions.
- Preferably use pediatric pads or otherwise use adult pads for compressions if using AED.
CPR for babies (under one year of age)
First of all ensure that the airway is not choked. If it is choked, then give first aid for choking, otherwise proceed to CPR. All other steps of CPR are the same as for older children. Remember that a baby should not be shaken physically as this may lead to further choking.
Remember following facts about CPR
- Anybody can give CPR. You can give chest compressions even if you are not trained in full CPR.
- To be better able to locate the chest bone feel your own and get familiar with its location and feel as a slightly depressed flat surface in the centre of chest.
- The telephone numbers of emergency services should always be on your finger tips. If it is not possible to memorize them, then please store them in your mobile phone or pocket diary. Never hesitate to seek help, whatever the situation may be.
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Dr Vinay Kumar
Senior Consultant Dermatologist
+91-93 199 299 00
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