Introduction to CPR
The body requires a constant circulation of oxygen from the lungs to the organs to live. The heart is responsible for pumping oxygen carrying blood throughout the body. When the heart fails to pump the blood, and the organs do not receive oxygen, a downward path of damage begins, leading to the victim’s death. The heart may stop beating for different reasons, including injury and disease. If a rescuer is present at the onset of sudden cardiac arrest, CPR may be initiated to save the victim's life.
Good Samaritan Laws
Good Samaritan Laws exist in many states to protect volunteers offering aid to an injured person. Under the law, a person giving assistance to an injured person is free from civil liability under the following conditions: The person giving assistance must be acting voluntarily, without the expectation of reimbursement or compensation in any form, and the aid must be given at the scene of the emergency.
Good Samaritan Laws do not apply to persons providing advice and aid through the course of their regular employment, such as doctors, nurses, and other health care professionals. It may also fail to protect a person acting in a reckless or wanton manner. A person will not be protected under the Good Samaritan Law if they are the cause of the emergency.
Chain of Survival
The Chain of Survival is a treatment method designed by the American Heart Association to treat victims with sudden cardiac arrest (SCA). In this condition, the victim’s heart twitches irregularly, stopping the flow of blood and oxygen throughout the body. SCA is fatal unless medical intervention is provided in a timely manner. The chain of Survival’s structure gives rescuers a protocol to follow, increasing the victim’s chance for survival. Each minute that passes between the onset of symptoms and intervention increases the victim’s chance of death by up to 10%. There are five steps in the chain:
- Immediate recognition of cardiac arrest, call 911
- CPR with emphasis on chest compressions. Continue CPR until medics arrive
- Rapid defibrillation with an AED (this is necessary to restore a normal heartbeat) within minutes of the onset of symptoms
- Advanced life support, administered by trained medics
- Post-cardiac arrest care, administered in a hospital setting
Cardiopulmonary Resuscitation (CPR) Adult/Child/Infant
The procedures used when administering CPR depend on a few variables. The victim's age and the number rescuers are the most important. Infant CPR is used with victims under the age of one. Child CPR is used with victims between the ages of 1 and puberty. Adult CPR is used on victims who have entered puberty and older.
The protocol for CPR assumes that two rescuers are present: one to administer CPR and one to retrieve the AED.
Protocol for Two Rescuers
- Victim becomes unresponsive, not breathing, or only gasping for air
- Assess that the victim is truly unresponsive by yelling or tapping on the victim's shoulders.
- Call 911
- Rescuer A begins CPR (compressions and ventilations) while rescuer B retrieves an AED
- Use the AED to check the victim as soon as possible, repeat every two minutes
- Push hard and fast while administering CPR
In many situations, a team of rescuers will be present, allowing for further delegation of tasks. Rescuer A can call 911 while Rescuer B begins compressions and Rescuer C prepares to administer ventilations. Simultaneously, Rescuer D is retrieving the AED and preparing for its use. Working as a team allows the victim to receive higher quality CPR in a timelier manner.
At the same time, a rescuer may find himself alone when dealing with an emergency. If the rescuer is alone, he should call 911 before beginning CPR unless the victim suffered an injury or drowning. In those cases, one minute of CPR should be administered before pausing to call 911. If an infant or child is found unconscious, deliver two minutes of CPR before pausing to call 911.
Administering CPR to a child or adult
- Ask the victim, "are you ok?" to check for consciousness. Try tapping on the shoulders to stimulate the victim. If the victim is truly not breathing and requires CPR, continue with the sequence.
- Position the victim laying flat on his back. Open or remove the victim's shirt to provide access to the chest. Kneel next to the victim and position the hands on the victim's chest.
- The heel of one palm should be placed on the center of the chest, in line with the victim's nipples. Place the heel of the other hand on top of the first and interlock fingers.
- The fingers should point towards the victim's nipples, with the long axis of the hand parallel to the ribs. This reduces the chance of rib fractures.
- Compressions are delivered with the heel of the palm. Fingers should not make contact with the chest during compressions. It may be necessary to extend or curl the fingers under to achieve this position.
- The rescuer should keep his elbows straight, shoulders over the hands, and lean over the victim. This creates a posture that allows hard and fast compressions to be delivered.
- Begin with 30 chest compressions at a rate of at least 100 compressions per minute. Allow the chest to completely recoil between compressions. Press on the center of the chest. It may be helpful to count the compressions out loud as they are administered to keep track of progress.
- For adult victims, the compressions should be two inches deep.
- For child victims, the compressions should be 1/3 the chest diameter, or about two inches deep.