Cardio Pulmonary Resuscitation
Cardiopulmonary resuscitation (CPR) is a lifesaving technique useful in many emergencies, including cardiac arrest or near drowning, in which someone’s breathing and heartbeat has stopped. Ideally, CPR involves two elements: chest compressions combined with mouth-to-mouth rescue breathing.
Basic life support comprises the “A-B-C” steps which concern the airway, breathing, and circulation respectively. Basic life support is indicated for:
- Airway obstruction
- Breathing (respiratory) arrest
- Circulatory or cardiac arrest.
Any inadequacy or absence of breathing or circulation must be determined immediately.Assessment of breathing
- Tilt the head firmly backwards with one hand while lifting the neck with the other hand to relieve obstructed breathing.
- Pull the tongue forward.
- Suck or swab out excess secretions.
- Clean any vomit from the mouth and back of the throat. Remove any loose dentures.
- Listen and feel for any movement of air, because the chest and abdomen may move in the presence of an obstructed airway, without moving air. The rescuer’s face should be placed close to the casualty’s nose and mouth so that any exhaled air may be felt against the cheek. Also the rise and fall of the chest can be observed and the exhaled breath heard.
- Look, listen and feel for five seconds before deciding that breathing is absent.
Assessment of heart functionCheck for a pulse. The best pulse to feel in an emergency is the carotid. Feel for five seconds before deciding it is absent. If it cannot be felt or is feeble, there is insufficient circulation.
Airway: Clear the airwayPut the person on his or her back on a firm surface.Kneel next to the person's neck and shoulders.Open the person's airway using the head-tilt, chin-lift maneuver. Put your palm on the person's forehead and gently tilt the head back. Then with the other hand, gently lift the chin forward to open the airway.Check for normal breathing, taking no less than 5 and no more than 10 seconds while looking for signs of life. Look for chest motion, listen for normal breath sounds, and feel for the person's breath on your cheek and ear. Gasping is not considered to be normal breathing. If the person isn't breathing normally and you are trained in CPR, begin CPR, chest compressions first. Remember, only unconscious, not breathing people get CPR.
Circulation: Restore blood circulation with chest compressionsPlace 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.Use your upper body weight (not just your arms) as you push straight down on (compress) the chest 2-2.4 inches (approximately 5 centimeters). Push hard at a rate of 100-120 compressions a minute.After 30 compressions, tilt the head back and lift the chin up to open the airway. Prepare to give two rescue breaths. Pinch the nose shut and breathe into the mouth for one second. If the chest rises, give a second rescue breath. If the chest doesn't rise, repeat the head-tilt, chin-lift maneuver and then give the second rescue breath. That's one cycle.Continue CPR until there are signs of movement or until emergency medical personnel take over. Attempt to change the compressor at least every 2 minutes. As the compressor tires the compressions are not as fast or deep and therefore not as effective.Attempt to change the compressor at least every 2 minutes. As the compressor tires the compressions are not as fast or deep and therefore not as effective.
Breathing: Breathe for the person COMPRESSIONS FIRST. THIS COMES AFTER 30 CHEST COMPRESSIONS.Rescue breathing can be mouth-to-mouth breathing or mouth-to-nose breathing if the mouth is seriously injured or can't be opened.With the airway open, pinch the nostrils shut for mouth-to-mouth breathing and cover the person's mouth with yours, making a seal.Prepare to give two rescue breaths. Give the first rescue breath lasting one to 1 to 1-1/2 seconds and watch to see if the chest rises. If it does rise, give the second breath. If the chest doesn't rise, repeat the head-tilt, chin-lift maneuver and then give the second breath.Continue with 30 compressions to 2 breaths for 5 cycles or approximately 2 minutes. Reassess breathing. If the patient is breathing and has no potential injury to the head, neck or spine log roll the patient onto his or her side, resting the head on the upper arm. If still no breathing continue CPR.
The following media explains about the Cardiopulmonary Resuscitation:Technique for heart compressionCompression of the breast bone produces some artificial ventilation, but not enough for adequate oxygenation of the blood. For this reason, artificial respiration is always required whenever heart compression is used.
Effective heart compression requires sufficient pressure to depress the casualty's lower breast bone about 4 to 5 cm (in an adult). For heart compression to be effective, the casualty must be on a firm surface. If he is in bed, a board or improvised support should be placed under his back. However, chest compression must not be delayed to look for a firmer support.
Kneel close to the side of the casualty and place only the heel of one hand over the lower half of the breast bone. Avoid placing the hand over the tip of the breast bone which extends down over the upper abdomen. Pressure on the tip may tear the liver and lead to severe internal bleeding.Feel the tip of the breast bone and place the heel of the hand about 4 cm towards the head of the casualty. Your fingers must never rest on the casualty's ribs during compression. This increases the possibility of rib fractures.
Place the heel of the other hand on top of the first one.Rock forward so that your shoulders are almost directly above the casualty's chest.Keep your arms straight and exert adequate pressure almost directly downward to depress an adult's lower sternum 4 to 5 cm.
Depress the sternum 80 to 100 times per minute for an adult (when two rescuers are used). This is usually rapid enough to maintain blood flow, and slow enough to allow the heart to fill with blood. The compression should be regular, smooth, and uninterrupted, with compression and relaxion being of equal duration. Under no circumstances should compression be interrupted for more than 5 seconds.
The following media explains Chest Compression.
Rescue BreathingRescue breathing is the process of breathing air into the lungs of a casualty who has stopped breathing (respiratory arrest). This process is also called artificial respiration. The common causes are air-way obstruction, drowning, electric shock, drug overdose, and chest or lung (trauma) injury.
Never give rescue breathing to a person who is breathing normally. Other important steps to be followed are:Check unresponsiveness Call for Help, if there is no response from casualty.Open airway (Head-tilt/Chin lift or Jaw thrust) Place your hand on the casualty's forehead. Place the fingers of your other hand under the bony part of the chin. Avoid putting pressure under the chin, it may cause an obstruction of the airway. Tilt the head and lift the jaw, avoid closing the casualty's mouth. Place your ear over the casualty's mouth and nose. Look at the chest, listen, and feel for breathing, for 5-10 seconds while looking for signs of life.If the patient is breathing and there is no apparent injury to the head, neck or spine Position the casualty Kneel down on the casualty's side, midway between his or her hips and shoulders facing the casualty. Straighten legs and move arm closest to you above casualty's head. Place your hand on the casualty's shoulder and one on the hip. Roll casualty toward you as a unit, move your hand from the shoulder to support the back of the head and neck. Place the casualty's upper arm closest to you under the casualty's head. If the patient is not breathing, begin CPR.
SummaryRestore circulation through compressionPlace heel of your palm on patient's chestPlace your other hand above firstKeep elbows straightPush down using upper body weight (compress)Push hard and fastAfter 30 compressions, clear airwayGive two rescue breaths Continue in ratio of 2:30 (2 no.Breathing:30 no.Chest Compression)This is one cycleGive 100 compressions /minuteThat means 3-4 cycles/minuteContinue CPR till medical help arrives
