Cardiopulmonary resuscitation (CPR) is an essential lifesaving procedure that combines chest compressions and artificial ventilation. People who work in healthcare and service industries should have knowledge of basic life support to assist any member of the public during a cardiac emergency, heart attack, or near-drowning. Emergency situations occur daily, and having the knowledge and confidence to perform CPR is crucial for saving lives.
Importance of CPR
Cardiac arrest leads to permanent brain damage and death within eight minutes if CPR is not administered, as the major organs do not receive oxygen-rich blood when the heart stops. Performing CPR immediately after cardiac arrest triples the victim’s chances of survival.
Even those without formal first aid training save lives by following CPR steps. This urgency highlights the importance of performing CPR to maintain a person's life during a cardiac arrest. CPR manually pumps blood, ensuring it continues to carry oxygen to the organs until emergency medical professionals arrive. Bystander CPR saves lives in the critical minutes following cardiac arrest, where taking action directly impacts the victim's chances of survival.
How to perform CPR for Adult and Child
Before beginning adult and child CPR, there are guidelines or emergency procedure that must be followed. The American Heart Association is a world leader in first aid and CPR and develops science-based guidelines for performing CPR. The recommendations below are based on the 2020 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.
1. Assess if the environment is safe. If the setting is unsafe, the person who is performing CPR should move the victim to a more secure environment whenever it’s possible to do so.
2. Check to see if the victim is responsive. Do this by tapping their shoulder and asking loudly, “Are you ok?” Next, check their neck or wrist to detect a pulse. If the victim has a pulse, do not perform chest compressions and proceed directly to rescue breathing. If there is no response and the victim does not have a pulse, begin CPR.
3. Call 911. If you are alone, call 911 and place the call on speakerphone, so you have your hands free to perform CPR. If there’s another person on the scene, ask them to call 911.
4. Open the Airway. Check their mouth and throat are clear. Remove any blockages in the mouth or nose, such as vomit, blood, and food, then gently tilt their head back and lift their chin.
5. Check the Breathing. Check if the person is breathing abnormally or not breathing at all after 10 seconds. If they breathe normally, place them in the recovery position and stay with them.
6. CPR. If the cardiac arrest victim is still not breathing normally, start CPR. Chest compressions are the most crucial part of CPR. Adult chest compressions rate is 100-120 compressions per minute.
7. Automated External Defibrillator. If an AED is available, turn it on and attach pads to the victim’s chest. An AED will analyze heart rhythm every 2 minutes, and it will give a shock if needed. Continue to provide CPR in between each analysis cycle.
Carry out chest compressions
To do chest compressions, use your fingers to locate the end of the victim’s breastbone, where the ribs come together. First, place two fingers at the tip of the breastbone. Next, place the heel of your other hand above your fingers, on the side closest to the victim’s face. Then put the heel of your other hand on top of the first hand, so your hands are stacked.
Push hard and fast in the center of the chest until emergency medical help arrives. Use the weight of your body to add strength to your pushes. It’s important to push, giving 100 to 120 compressions per minute. For adults, the recommended compression depth is at least 2 inches deep. Chest compression depth for child is at least ⅓ the depth of the chest size, or 2 inches deep.
Mouth to Mouth Breathing (Rescue Breathing)
Only CPR-trained bystanders are allowed to give mouth-to-mouth breathing. If you are trained, use the fingers of your one hand to pinch the victim’s nose shut to prevent air from escaping through their nose. For adults and older children, cover the mouth with yours, forming a proper seal so that air doesn’t escape. For smaller children, form a complete seal around the mouth and nose. If it’s hard to form a good seal this way, try a mouth-to-nose or mouth-to-mouth resuscitation instead.
Give mouth-to-mouth resuscitation by gently breathing into the victim’s mouth, and should last about 1 second. Check for chest movement as you give the first rescue breath. If you don’t see the chest rise on the initial rescue breathing, open the airway again and give additional rescue breaths.
Continue giving 30 chest compressions and 2 rescue breaths until emergency medical services arrive or advanced emergency care becomes available or until you see signs of life or normal breathing. If they start moving, coughing, or talking, put the victim in a recovery position. Doing CPR is exhausting so if possible, with minimal interruption, swap between doing mouth-to-mouth and compressions so keep going with effective compressions.
Read- CPR vs Rescue Breathing: The Basic Difference
What are the types of CPR?
The American Heart Association (AHA) outlines two types of CPR – Hands-only CPR and Conventional CPR.
Both types are effective, and it’s important to remember that any attempt at CPR is better than not performing it at all. If an individual has not received formal training in CPR, the American Heart Association recommends that they use hands-only CPR. If they are, it is recommended to use CPR combined with rescue breathing.
The American Heart Association suggests that individuals who are performing CPR follow the acronym CAB. It is similar to the process outlined above. However, there are several significant changes to note. If an individual is alone, they should perform five cycles of chest compressions and rescue breathing before pausing to call 911.
If alone, perform CPR at the 30:2 compressions to breaths ratio, but if there are two rescuing individuals, they should use a 15:2 ratio. As children are smaller than adults, rescuers should remember to compress as deep as 1/3 of the depth of the chest, or approximately 1.5 inches or less for younger children.
Other Important Things to Know About CPR
In addition to the steps above, there are several points to know about the CPR technique. Most importantly, it’s critical to remember that CPR facilitates blood pumping to the organs after cardiac arrest, but it does not restart the heart. The only way to restart the heart after it has stopped is to use an AED or for medical professionals to restart it in a hospital or under professional emergency care.
Many people are concerned about causing further harm to the victim, but this will likely not be the case. There is a chance of cracking or breaking the victim’s ribs when performing CPR, more likely with female victims. However, it’s important to note that this occurs when CPR is done in the hospital. Rescuers should not concern themselves with hurting the victim when they should focus on saving their life.
Remember that performing bystander CPR of any kind, whether hands-only or CPR combined with rescue breathing, is always better than not stepping in.
What are the Benefits of CPR Certification?
Knowing how to perform CPR is an important life skill for anyone and is especially relevant for professionals who serve the greater public. CPR certification provides an individual with all the tools they need to comply with American Heart Association, Emergency Cardiovascular Care (ECC), and Occupational Safety and Health Administration (OSHA) guidelines. The steps described above demonstrate the many nuances of the CPR technique, providing further reason for individuals to master CPR through formal certification. perform CPR in an emergency
CPR Certification lets others know that a person has more than just general knowledge about CPR, allowing individuals to become leaders within their organization who teaches this valuable skill to their colleagues. Having CPR certification puts people at an advantage when seeking work in the service sector because their lifesaving skill set is in high demand among health and safety-conscious employers.
How to Become CPR Certified?
It’s easy for anyone to learn CPR and become certified. An individual has several options for obtaining certification. First, training occurs in person at a workshop or hands-on class. Typically, hospitals, community centers, and other health organizations offer this course on evenings and weekends. The other way to obtain CPR certification is through an online course. Online CPR training classes are ideal for people with busy schedules or those who live in areas where they don’t have regular access to CPR courses.
Are there significant differences in survival rates between hands-only CPR and conventional CPR for children?
Yes, there are significant differences in survival rates between hands-only CPR and conventional CPR for children. Conventional CPR, which includes both chest compressions and rescue breaths, is generally more effective for children, as their cardiac arrests are often caused by respiratory issues. Studies published in the Journal of the American Medical Association (JAMA) have shown that conventional CPR leads to better survival rates and neurological outcomes in pediatric cases compared to hands-only CPR.
Can rib fractures during CPR be prevented without compromising the effectiveness of chest compressions?
No, rib fractures during CPR cannot be entirely prevented without compromising the effectiveness of chest compressions. Rib fractures are a known risk due to the force required to compress the chest adequately, especially in older adults or those with brittle bones. The priority in CPR is to maintain blood circulation, even if it results in rib fractures. The American Heart Association advises that the effectiveness of compressions should not be compromised to avoid fractures, as proper compressions are crucial for patient survival.
Does the effectiveness of CPR vary significantly between using manual methods and using an AED?
Yes, the effectiveness of CPR varies between using manual methods and using an AED. An AED (Automated External Defibrillator) significantly enhances the effectiveness of CPR by providing electrical shocks to restore a normal heart rhythm. Research in the New England Journal of Medicine indicates that survival rates improve substantially when an AED is used in conjunction with manual CPR, particularly in cases of sudden cardiac arrest due to ventricular fibrillation.
Are there specific contraindications for performing CPR on certain age groups or health conditions?
No, there are no specific contraindications for performing CPR based on age groups or health conditions. CPR should be administered to any individual in cardiac arrest, regardless of age or health status. However, certain conditions, such as severe osteoporosis in elderly patients or specific congenital heart conditions, requires modifications in the technique. CPR training programs emphasize the importance of adjusting the method of CPR to suit the patient's age and physical condition while ensuring that life-saving measures are effectively applied.
It’s evident that there’s a need for CPR training for professionals, especially those who work in the service industry who encounter increased possibilities for acting in emergencies. Earning a CPR certification is the best way to ensure that an individual has the skills and knowledge to use CPR to increase the cardiac arrest victim’s chance of survival, and save a life when required.
Online CPR certification gives professionals of all types the training and confidence they need to perform CPR in a comfortable and convenient format that is completed anytime.
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