Cardiopulmonary Resuscitation: Understanding the Basics of CPR

Many of you may have heard the letters C-P-R, but what exactly is CPR? What does it stand for, and what does it mean? In this article, we will delve into the meaning of CPR, its significance, essential terminology, and the fundamental techniques involved. Understanding CPR is crucial for being prepared to respond effectively in emergency situations.

What Does CPR Stand For?

CPR is short for Cardio Pulmonary Resuscitation. It is an emergency procedure performed on individuals experiencing cardiac arrest or sudden cardiac failure, where the heart has stopped beating effectively. The CPR procedure involves a combination of chest compressions and rescue breaths, aiming to manually pump oxygenated blood to vital organs, particularly the brain, and maintain minimal blood flow until emergency medical care is available. Let's break this down further to understand CPR better.

C in CPR: Cardio

The word "cardio" basically means the heart. Our heart is one of the most critical organs in our bodies. The heart is a powerful muscle found in the chest, which expands and contracts more than 60 times every minute and pumps blood, which is rich in oxygen, from the lungs to the rest of the organs in the body. If the heart stops pumping that all-important oxygen-rich blood to the rest of the body, tissue begins to die because its vital organs are deprived of the oxygen it needs to survive. This can lead to organ malfunction, brain damage, or, in the worst case, death.

P in CPR: Pulmonary

The word "pulmonary" means the lungs. The lungs are as important as the heart because when you take a breath (which you do up to 25 times a minute!), you fill your lungs with much-needed oxygen, and that oxygen combines with sugar to fuel your body and its vital organs. Since the tissues in our body do not store much oxygen, they must remain constantly oxygenated.

R in CPR: Resuscitation

The "R" in CPR is the most crucial letter, meaning "resuscitation." It means bringing someone who is apparently "dead" back to life. The human body only has a short supply of oxygen once the heart stops and the lungs no longer receive adequate oxygen. Once it runs out of oxygen, it may lead to permanent brain damage and even death. When resuscitating a victim, it is important to remember that without oxygen, cell and tissue death begins between four and six minutes after being deprived of oxygen.

Importance of CPR

Cardiopulmonary Resuscitation can be lifesaving. It helps keep the blood circulating and delivers oxygen to the body until treatment from a medical professional is available. There is usually sufficient oxygen in the blood to keep the victim's brain and other vital organs alive, supported for a few minutes. Still, it is not circulating until someone accomplishes CPR.

Although there is no guarantee that a cardiac arrest victim will survive CPR, it gives the victim a chance. According to the American Heart Association (AHA), cardiopulmonary resuscitation can double or triple the chances of survival after cardiac arrest. Without CPR, it will only take a few minutes for the victim's brain to become injured due to a lack of oxygen.

What is the Goal of CPR?

The primary goal of Cardiopulmonary Resuscitation (CPR) is to restore spontaneous circulation until professional medical help arrives. By initiating CPR promptly, bystanders can significantly increase the chances of survival for the affected individual by buying crucial time until the arrival of professional medical personnel who can administer advanced life support interventions.

Things To Know About CPR:

CPR Saves Lives: About 9 in 10 people who have experienced cardiac arrest outside the hospital die. But did you know that CPR can help improve those odds? If CPR is performed immediately and correctly, it can double or triple the chance of survival.

Cardiac arrests often happen at home: According to studies, approximately 350,000 cardiac arrests happen outside hospitals each year. About 7 in 10 of those cases occur at home. Unfortunately, almost half of the victims don't get the help they need from relatives and bystanders due to a lack of knowledge of CPR. Often, they wait until the ambulance arrives because they fear the harm or complications of CPR.

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When do you give CPR to someone?

In general, if you encounter someone unresponsive and not breathing normally, it is important to begin CPR immediately while waiting for professional medical help. Prompt action can significantly improve a person's chances of survival. Remember to call emergency medical services (EMS) or the local emergency response number immediately. Here are the common situations where CPR should be given to someone:

• Cardiac arrest: When a person's heart has stopped or is not functioning effectively, leading to the absence of a pulse and no normal breathing.
• Drowning: CPR should be initiated if someone is found unresponsive after being submerged in water.
• Electric shock: CPR should be started when a person experiences an electric shock and becomes unresponsive.
• Unresponsiveness and not breathing normally: If someone is unresponsive, not breathing normally, and there is no pulse, CPR should be performed.

What are the 2 Types of CPR?

The two main types of CPR are Standard CPR and Hands-only CPR (Compressions only CPR). Both standard CPR and hands-only CPR can be life-saving techniques when performed promptly and correctly. The choice between the two methods depends on the rescuer's level of training, comfort, and the specific circumstances of the medical emergency.

Standard CPR with rescue breaths

Standard CPR involves chest compressions with rescue breaths. Healthcare providers and individuals with CPR training can only do it. Studies have shown that CPR with rescue breaths is most effective, especially for children and infants who experience cardiac arrest due to hypoxia or severe lack of oxygen. In addition, other underlying causes of cardiac arrests, such as drowning, trauma, drug overdose, and other noncardiac causes, will benefit from rescue breaths and compressions. 

Hands-only CPR

Also known as compressions-only CPR, hands-only CPR involves calling for help and doing continuous and uninterrupted chest compressions in a rapid motion. Hands-only CPR can be performed by the general public or bystanders who witness an out-of-hospital cardiac arrest. It can prevent a delay in getting the blood moving through the body.

The Basics of CPR

CPR, or cardiopulmonary resuscitation, involves four essential components: chest compressions, airway, breathing, and the use of an automated external defibrillator (AED). Let's take a closer look at each of these basics:

Chest Compressions

Chest compressions are a critical part of CPR. The rescuer places the heel of their hand on the center of the person's chest and interlaces their fingers. With straight arms, the rescuer pushes hard and fast, aiming for a depth of about 2 inches (5 centimeters), depending on the age and size of the victim. The goal is to compress the chest to help circulate oxygenated blood to vital organs, such as the brain.

Airway

Maintaining an open airway is crucial during CPR. The rescuer tilts the person's head back gently while lifting their chin. This maneuver helps ensure the airway is clear and allows for effective breaths to be delivered.

Breathing

After performing chest compressions, the rescuer provides rescue breaths or mouth to mouth resuscitation. Pinching the person's nose shut, the rescuer creates an airtight seal with their mouth over the person's mouth and delivers two full breaths. Each breath should last about one second and should visibly make the person's chest rise.

AED

An AED is a device used to deliver an electric shock to the heart in certain cases of cardiac arrest. It is often used in conjunction with CPR. These portable devices have voice prompts and visual instructions to guide the rescuer. If an AED is available, it should be used as soon as possible. The rescuer attaches the AED pads to the person's chest and follows the device's instructions for delivering a shock if advised.

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What happens during CPR?

During the CPR procedure, a person initiates a series of steps to help the victim's blood continue circulating and maintain oxygen levels in the victim's body. The procedure includes rescue breathing into the victim's lungs and compressing the victim's chest. Cardiopulmonary Resuscitation works on the principle of 30 chest compressions and two ventilation breaths, known as 30:2

How to Perform CPR?

Many people outside the medical field do not know the steps of CPR. According to the British Heart Foundation, nearly 10,000 out-of-hospital cardiac arrest victims die each year due to a lack of knowledge about what to do if someone is found unconscious. That's why learning how to do CPR is essential in the community to increase the survival rate. Here are the proper steps that should be followed when performing CPR:

CPR Procedures for Adults

1. Check responsiveness by tapping the shoulder and shouting, "Are you ok?"

2. Call 911 and get an AED if the adult victim is unresponsive.

3. Check pulse and breathing for no more than 10 seconds.  If the victim has a pulse but not breathing, perform rescue breathing only.

4. If the victim doesn't have a pulse and not breathing, give 30 compressions, followed by 2 rescue breaths.

5. Using 2 hands, compress the chest at 2-2.4 inches deep, at a rate of 100-120 compressions per minute. Allow the chest to return to its normal position after each compression.

6. When performing rescue breathing, open the airway using the head-tilt/chin-lift technique. Ensure each rescue breath lasts about 1 second and makes the chest rise.

7. Use an Automated External Defibrillator once available.

CPR Procedure for Children 1 year old and above

1. Check responsiveness by tapping the shoulder and shouting, "Are you ok?"

2. Check pulse and breathing for no more than 10 seconds.

3. If the collapse is witnessed, call 911 and get an AED immediately. If the collapse is unwitnessed, perform 2 minutes of CPR, call 911, get an AED, and return to the victim to continue CPR.

4. If the child doesn't have a pulse and not breathing, give 30 compressions, followed by 2 rescue breaths. For 2 or more rescuers, the CPR ratio is 15:2 (switch every 2 minutes)

5. Using 1 or 2 hands, compress the chest at 2 inches deep at a rate of 100-120 compressions per minute. Allow the chest to return to its normal position after each compression.

5. To give rescue breaths, open the airway to a slightly past-neutral position using the head tilt/chin-lift. Ensure each rescue breath lasts about 1 second and makes the chest rise.

CPR Procedures for Infants (1-year-old below)

1. Check responsiveness by tapping the bottom of the baby's foot.

2. Check pulse and breathing for no more than 10 seconds.

3. Perform 2 minutes of CPR, call 911, get an AED, and return to the victim to continue CPR.

4. To perform chest compressions, place both thumbs (side-by-side) on the center of the baby's chest, just below the nipple line. Compress the chest at 1 ½ inches deep at a rate of 100-120 times per minute. Allow the chest to return to its normal position after each compression.

5. For 2 or more rescuers, the CPR ratio is 15:2 (switch every 2 minutes)

6. Open the airway to a neutral position using the head-tilt/chin-lift to give rescue breaths. Ensure each rescue breath lasts about 1 second and makes the chest rise.

CPR for Pets

CPR for pets, also known as animal CPR, is a life-saving technique performed on animals in emergency situations. While the principles are similar to human CPR, there are some key differences to consider. 

CPR Procedure for Dogs and Cats

1. Check to see if the pet is breathing and check for a heartbeat.

2. Place the heel of one hand over the pet's chest and the other hand over the first hand and perform chest compressions at a rate of 100-120 per minute. Compression depth is 1/3 to 1/2 the width of your pet's chest.

3. Close the pet's mouth and extend the neck to open the airway.

4. Give rescue breath through the pet's nose until you see the chest rise.

5. Briefly check for breathing and a heartbeat every 2 minutes.

6. Continue CPR until veterinary care is available.

Safety Precautions in CPR

While performing CPR, it's important to prioritize the safety of both the rescuer and the person receiving CPR. Here are some safety precautions to consider:

Protect the person's airway

• Ensure the person is lying on a firm, flat surface.
• Tilt their head back gently and lift the chin to open the airway. Provide appropriate breaths per minute for CPR
• Be cautious not to exert excessive force while tilting the head or lifting the chin, especially in cases of potential neck or spinal injury.

Minimize interruptions during chest compressions

• Aim for uninterrupted chest compressions to maintain blood circulation.
• Coordinate with other rescuers to ensure smooth transitions during CPR, especially when switching between compressions and breaths.
• If using an AED, resume CPR immediately after delivering a shock as directed by the device.

Protect yourself

• If available, use protective gloves and a face mask to minimize the risk of infection or transmission of diseases.
• If there are concerns about the person's safety or the environment (e.g., fire, hazardous substances), ensure your own safety first and wait for professional help.

Follow correct hand placement for chest compressions

• Place the heel of one hand on the center of the person's chest, interlace your fingers, and keep your arms straight.
• Avoid pressing on the person's ribs or lower part of the sternum (breastbone) to prevent fractures.

Adapt CPR for specific age groups

• Modify the technique for infants, children, and adults based on age and size. Adjust the depth and of compressions accordingly.

Communicate with emergency medical services (EMS)

• Call EMS or activate the local emergency response system as soon as possible.
• Provide clear and concise information about the situation and follow their instructions.

Remember, if you are uncertain or not trained in CPR, call for professional medical help immediately. Following safety precautions while performing CPR ensures the best possible care for the person in need while minimizing risks to both the rescuer and the patient.

Why Should Everyone Get CPR Certification?

CPR certification equips individuals with the skills and knowledge to save lives in emergencies. The ability to perform CPR can significantly affect the outcome of someone experiencing cardiac arrest or other life-threatening conditions.

By getting CPR certified, you gain the confidence and readiness to respond effectively and provide immediate assistance when it matters most. CPR certification ensures that you understand the correct techniques for chest compressions, rescue breaths, and automated external defibrillators (AEDs). It also provides valuable training on recognizing signs of cardiac arrest, performing CPR on infants, children, and adults, and implementing safety measures during resuscitation efforts.

Beyond the potential to save lives, CPR certification promotes empowerment, enabling individuals to take decisive action in emergencies. Having CPR certification means being prepared to respond appropriately and make a lifesaving difference, whether at home, in the workplace, or public settings.

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