The leading cause of death in the US according to the Center for Disease Control (CDC.gov) is Cardiovascular disease. CPRGlobalAcademy.com is committed to teaching useful techniques for saving lives. It is important to remember that Cardiopulmonary resuscitation (CPR) can be applied in many ways. If a person has drowned, had a heart attack, had a stroke, went into cardiac arrest or is choking proper training could be the difference between life and death of the patient. If the patient isn’t breathing, is unconscious or has no pulse CPR should be applied immediately. Always remember proper CPR begins with chest compressions.
It is important to note that death is most likely to occur after 10 minutes of loss of oxygen to the brain. From 6 to 10 minutes brain damage is expected. From 4 to 6 minutes brain damage is very possible and from 0 to 4 minutes brain damage is virtually non-existent.
Understanding CPR
When the heart stops beating blood stops flowing throughout the body. Cardiopulmonary resuscitation (CPR) is when one person performs chest compressions and breathing into a patient who does not have pulse or who isn’t breathing. Chest compressions combined with breathing into the patient will carry the now oxygenated blood throughout the body and into the brain. CPR acts like an artificial heart moving the blood rich in oxygen into the brain.
If CPR is performed on the patient the chances of survival increases and continues to increase if the AED is applied and if medical help arrives within ten minutes.
Any persons who assist those who are injured, ill or in peril are protected by the Good Samaritan Law. As long as they’re acting voluntary, without expectation of reimbursement or compensation while performing such aid, on site-they’ll have legal protection. Remember, when performing CPR every second counts so, unless required otherwise, don’t hesitate to call 911, perform CPR or external chest compressions immediately.
Before you attempt CPR upon a patient there are several things you must do. Make sure you and/or the patient aren’t in any danger-if possible, resolve the danger and if not, move the victim out of harms way. If unable to, for whatever reason, immediately call 911.
Check the patient and see if he/she is conscious or not. Do not check for a pulse because time is of the essence and finding a pulse can take too much time. Call out to the patient asking, “Are you okay?” Repeat if necessary, and if the patient doesn’t respond, immediately call 911 and then perform CPR-initiating Circulation, Airway and Breathing Tasks (the C-A-B’s) and not the A-B-C’s. Also, if possible have someone else call 911 and begin CPR, immediately.
It’s important to note: that the latest 2010 AHA guidelines recommends in-confident performers should, at least, perform chest compressions upon the patient, since studies show chest compressions can be as effective as the combination of CPR.
C is for Circulation – Adult Compressions
Circulation – chest compressions circulate the blood within the patient. It’s important to place your hands correctly upon the patient’s chest. To do so, find the point where both halves of the patient’s ribs meet, interlock your fingers and with the palm of your hand, you’ll compress. It’s important to kneel beside the patient while doing so, for maximum compression. Once in position, lock your elbows and use your body’s weight to compress 2 inches upon the patient’s chest. Compress again, once the chest inflates back into position. A ratio of 30 compressions to 2 breaths (30:2) is the recommended amount while compressing 100 times a minute. Remember, you should administer CPR until help arrives.
A is for Airway – Clear the airway
Airway – Make sure the patient is on a solid surface (on the backside). Next, kneel next to the patient’s neck and shoulders. Open the patient’s airway by tilting the head back with the palm of one hand while gently lifting the chin with the other hand. For no more than 10 seconds, check for life: listen for any sounds, put your cheek next to the patient’s mouth to feel any breaths while also looking for any motion. If the patient is assumed lifeless begin Mouth-to-Mouth.
B is for Breathing – Mouth-to-Mouth
Rescue Breathing is widely known to be performed mouth-to-mouth-it can also be performed mouth-to-nose but in rare cases.
While still performing the Airway technique pinch the patient’s nose shut.
With a complete seal over the patient’s mouth, with your mouth, breathe until you see the chest inflate. If the chest does not inflate repeat the Airway technique.
Once the chest inflates, breathe into the patient a second time (30:2). When performing the breathing technique make sure to give a breath for each one-second.
Once the breathing technique is applied you will continue the C-A-B’s.
Review – Adult
Check to see if the patient is conscious by shouting “Are you okay?” Several times. If the patient doesn’t respond, immediately call 911. Then, perform the C-A-B’s.
Circulation – use 2 hands for chest compressions at a ratio of 100 per minute-30 compressions then mouth-to-mouth (30:2).
Airway – tilt the head back and listen for breathing while also looking for any motion.
Breathing – mouth-to-mouth – pinch the nose shut, sealing the patient’s mouth with yours and breathe once checking for the patient’s chest to inflate. If the chest doesn’t inflate, perform the airway technique until the chest inflates. 2 breaths every 30 chest compressions-each breath, 1 second.
Child CPR ages 1-8
Perform all the same actions mentioned for the Adult: check for safety, consciousness and ask the child “Are you okay?” Several times.
In a child’s case you must administer 5 reps of CPR before calling 911. Unless you can shout for someone else to call 911.
Check the child’s pulse by placing 2 fingers on the carotid artery (press your index and 3 finger on the side of the neck, against the windpipe). If there isn’t a pulse begin compressions.
C is for Circulation – Child Compressions
Make sure the child is resting upon a solid-firm surface.
Before you begin compressions determine if 1 hand could be used instead of 2, depending on the size of the child.
Its important to note that when performing chest compressions on a child do not exceed 1/2 the depth of the child’s circumference. It should be between 1/3 and 1/2.
Make sure your hands are placed correctly upon the child’s chest.
Follow the same steps when performing CPR on an adult. 30 compressions and 2 breaths equaling 5 reps. Do NOT forget to call 911. Repeat process.
Check again for a pulse.
A is for Airway – Clear the Airway
Kneel beside the child the same way you would kneel beside an adult.
Perform the 3 steps as you would with an adult-Tilt-chin and open mouth while listening and feeling for any breathing for 10 seconds.
Make sure nothing is blocking the airway.
If the child isn’t showing any signs of life proceed to the Breathing technique.
B is for Breathing – Mouth-to-Mouth
Make sure to perform the same Breathing task upon the child as you would upon the adult. Children’s lungs are much smaller than adults so make sure to give a lesser breath when performing this task upon a child.
After tilting the head and chin, squeeze the nose shut.
Seal your mouth over the child’s mouth and perform the Breathing task.
Remember, give one breath into the child’s lungs while making sure the child’s chest inflates. If the child’s chest doesn’t inflate, repeat the Airway technique. Once, the chest inflates, perform the 5 reps.
Review – Child
AHA guidelines for children are from ages 1-8. The same process is performed with the child as you would with an adult besides a few differences.
Make sure to perform CPR, before calling 911
The ratio of chest compressions to breathing is 30:2
Look, Listen and feel for breathing.
Make sure nothing is blocking the airway
Squeeze the nose shut and perform the Breathing task.
Remember the order of the tasks being: Circulation, Airway, Breathing – C-A-B.
Infant CPR ages 12 months or younger
Before attempting CPR on an infant make sure to check for safety and consciousness. For infants, make sure to administer CPR before calling 911. Never leave the infant alone. Make sure to perform 5 reps of CPR with the same ratio of 30:2 compressions over breathing.
C is for Circulation – Infant Compressions
Before attempting any chest compressions check the infant for a pulse. You can find the pulse just under the upper arm. If a pulse isn’t felt begin chest compressions. To perform chest compressions upon an infant you’ll have to use EXTREME caution.
Just below the infant’s nipples, in the center of the chest, just below the middle-horizontal line, place 2 fingers for compression.
Remember, 100 compressions a minute while maintaining the same ratio 30:2 Compression to Breathing.
Perform 5 reps of Compressions and Breathing, or about 2 minutes, and then call 911. Continue CPR until help arrives or until the infant breathes again.
Compressions will be pressed at about 1/3 of chest circumference.
A is for Airway – Clear the Airway
As you would with an adult or child, make sure to lay the infant on a solid-firm surface on its back.
Make sure to kneel beside the infant’s shoulder while placing 1 hand on the infant’s forehead as the other hand gently lifts the chin.
Once again, you’ll check for any signs of life while performing the Airway technique.
Look, listen and feel for any breathing for 10 seconds. Remember, place your cheek just in front of the infant’s mouth while checking for pulse under the upper arm.
If the infant isn’t showing any signs of life, begin the Breathing technique.
B is for Breathing – Mouth-to-Mouth
Breathing into an infant is different than breathing into an adult or child.
Place your entire mouth over the infant’s mouth and nose when you breathe into the infant. Make sure to perform this task with less breath than you would with a child.
If the chest rises complete the second breath, each for 1 second.
If the chest doesn’t rise make sure to check for anything blocking the Airway of the infant and repeat the process.
Make sure to feel for a pulse and if there isn’t one continue performing CPR.
Review – Infant
AHA guidelines for infants are under the age of 12 months. The same C-A-B process is performed with the infant as with adults and children besides a few important differences.
Make sure to perform CPR before calling 911, unless someone else can call.
Make sure to place 2 fingers just under the nipples and below the middle of the chest for compressions.
Unlike a children and adults you’ll place your mouth over the infant’s mouth and nose.
The same ration of C-A-B’s are used 30:2 at 100 compressions a minute, with 1 second breaths. And remember, the order of the tasks being: Circulation, Airway, Breathing C-A-B
Automated External Defibrillator (AED) Guidelines
When should an AED be used?
CPR is a very important action for saving a patient’s life. However, an AED is crucial towards regaining the natural rhythm of the heartbeat as well as restarting the patient’s heart. CPR should be performed if the patient is non-responsive and not breathing and an AED should be applied after performing CPR. If the AED does not bring the patient back to consciousness CPR should be re-administered. It’s crucial to call 911 or any Emergency Medical Service (EMS) before performing CPR or applying an AED.
How to use an AED
Turn on the AED – Usually there will be an “On” button but in some cases there might be a lever.
Make sure to remove all clothing from the arms, chest and abdomen whether male or female.
Attach pads to bare skin on the chest. Make sure to use the appropriate system for the child or adult (an AED should not be used on an infant). Place the left pad under the left armpit to the left of the nipple. Place the right pad under the collarbone on the right side of the chest. Make sure to place the pads at least one inch away from any implanted devices. Next, connect the wiring.
Analyze the patient’s heart rhythm. Make sure you DO NOT touch the patient during the defibrillator process. If the AED does not begin analyzing automatically make sure to press the analyze button.
If a shock is advised then push the shock button. Make sure your patient is cleared of any debris such as: metal, large amounts of water, etc…
Newer AED’s only shock once; however, some models do shock up to 3 times. If the patient is shocked but doesn’t regain a pulse immediately perform CPR for 2 minutes.
If a shock is not advised continue CPR.
Make sure to stay clear of any large amounts of water or any metals.
Make sure to shave the patient, if needed, when using an AED.
Make sure to place the pads at least one inch away from any implanted devices or Transdermal medication patches (or remove patch).
Note: Before using an AED physical training is recommended.
Infant – Review
AHA guidelines for infants are under the age of 12 months. The same C-A-B process is performed with the infant as with children and adults besides a few important differences.
Make sure to perform CPR (5 reps) before calling 911; unless someone else can call.
Make sure to place 2 fingers just under the nipples and below the middle of the chest.
Unlike a children and adults you will place your mouth over the infant’s mouth and nose.
The same ration of C-A-B’s are used 30:2 at 100 compressions a minute with 1 second breaths. Remember, the order of the tasks being: Circulation, Airway, Breathing C-A-B
Child Review
AHA guidelines for children are from ages 1-8. The same process is performed with the child as you would with an adult besides a few important differences.
Make sure to perform CPR (5 reps) before calling 911; unless someone else can call.
The ratio of chest compressions to breathing is 30:2
Look, Listen and feel for breathing.
Make sure nothing is blocking the airway
Squeeze the nose shut and perform the Breathing task.
Remember the order of the tasks being: Circulation, Airway, Breathing – C-A-B
Adult Review
Check to see if the patient is conscious by shouting “Are you okay?” Several times. If the patient doesn’t respond, immediately call 911 then, perform the C-A-B’s.
Circulation – use 2 hands for chest compressions at a ratio of 100 per minute-30 compressions then mouth-to-mouth.
Airway – tilt the head back and listen for breathing and then look for any response.
Breathing – Mouth-to-mouth – pinch nose shut sealing the patient’s mouth with yours and breathe once checking for the patient’s chest to inflate. If not, perform the airway technique until chest inflates. 2 breaths every 30 chest compression (30:2)-each breath, 1 second.
When using an AED
Make sure to remove the patient’s clothing from the intended area.
Place the pads on bare skin.
Place the pads away from any implanted devices or medicated patches.
Connect the wires and check the patient’s heart rhythm.
Shock the patient if advised to do so. If not, perform CPR for an additional 2 minutes and re-check the patient’s hearth rhythm.
