By Chris Woolston
CPR -- cardiopulmonary resuscitation -- is a potentially life-saving procedure that can restart a person's heartbeat and breathing. CPR is often used to revive victims of electric shock, near-drowning, and heart attack. According to the National Institutes of Health, quick CPR can triple a victim's chances for survival. The best way to learn the technique is to take a certified training class. (See http://www.americanheart.org to find a class near you.) The following tips offer a quick introduction to CPR, but they can't take the place of training.
When to use CPR
Before performing CPR, check to see if the victim is responsive. Ask him if he's okay and touch him on the shoulder. If he responds or is breathing, CPR isn't necessary. If he doesn't respond, you need to get emergency help right away. Call 911 or have someone call for you. If you're alone, you may have to leave the victim for a few moments to call for emergency help. CPR is intended to keep a victim alive until medical help arrives.
Note: If you are alone, there are times when it is more important to start CPR immediately than to take the time to call 911 first.
In April 2008, the American Heart Association (AHA) announced a new lifesaving option for bystanders who witness an adult collapse due to cardiac arrest. After calling 9-1-1, people who are not trained in conventional CPR or aren't confident in their ability to give chest compressions and mouth-to-mouth breaths should use a simple technique called Hands-Only CPR. "This involves providing high-quality chest compressions by pushing hard and fast in the middle of the victim's chest, without stopping until emergency medical services responders arrive," said Michael Sayre, M.D., chair of the AHA statement writing committee. To learn more about Hands-Only CPR, go to http://www.americanheart.org/handsonlycpr.
The committee found that Hands-Only CPR was on par with conventional CPR when used for an adult who has suddenly collapsed due to cardiac arrest. Hands-Only CPR should not be used for infants, children, and adults whose cardiac arrest was a result of drug overdose or near-drowning. It also should not be used for an unwitnessed cardiac arrest. In these cases, conventional CPR with chest compression and breaths would benefit the patient most.
Although Hands-Only CPR can save lives, conventional CPR is still an important skill to learn. In November 2005, the American Heart Association standardized the following CPR instructions for all ages except newborns.
CPR on an infant
When performing CPR on an infant, tilt the baby's head back to open the airway, cover both the nose and mouth with your mouth, and give two gentle breaths. Each breath should be one second long. Then position your third and fourth fingers in the center of the baby's chest, about half an inch below the nipples. Give 30 quick, gentle compressions, pressing down about one third to one half the depth of the chest. The compression rate should be the same as for adults -- about 100 per minute, or faster than one per second. Repeat a cycle of two breaths and 30 compressions for about two minutes before calling 911. Continue the cycle of breathing and compressions until the baby starts breathing or help arrives.
Keep in mind:
Protecting yourself from bodily fluids during CPR
The American Red Cross recommends the use of protective breathing barriers during CPR to protect the rescuer from bodily fluids such as blood, vomit, and saliva. Called "pocket masks," these barriers are either reusable or disposable, and have one-way valves that allow air into the victim but prevent the rescuer from having contact with the victim's fluids. The chances of disease transmission during direct mouth-to-mouth rescue are very low, but if you're worried about bloodborne viruses such as HIV or Hepatitis C, keep a pocket mask at the ready in your first aid kit. Contact your local Red Cross chapter for purchasing information.
Further ResourcesYou can find illustrated guides on performing CPR on the University of Washington School of Medicine's Web site: http://depts.washington.edu/learncpr/
University of Washington School of Medicine. Learn CPR: You can do it!
National Institutes of Health. Medical Encyclopedia: CPR --Adult. May 2004.
Harvard Medical School Family Health Guide. CPR on a child 8 years or older or on an adult.
Cardiopulmonary Resuscitation (CPR) American Heart Association. P.1http://www.americanheart.org/presenter.jhtml?identifier=4479
Cardiopulmonary Resuscitation (CPR). Mayo Clinic. http://www.mayoclinic.com/invoke.cfm?id=FA00061
Emergency Cardiovascular Care (ECC) Revisions for the Lay Rescuer. American Red Cross. http://www.redcross.org/services/hss/resources/ecclay.doc
Interview with Mickey Eisenberg, MD, emergency medicine specialist, University of Washington Medical Center.
American Heart Association announced updated emergency care guidelines. November 28, 2005 http://www.americanheart.org/downloadable/heart/1132687904678FINALnewsrelease112105.pdf
2005 American Heart Association Guidelines For Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Comparison chart of key changes http://www.americanheart.org/downloadable/heart/1132781451610Comparison%20Chart%202005%20guidelines%20FINAL.pdf
American Heart Association 2005 Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Part 3: Overview of CPR. Circulation. 2005;112:IV-12-IV-17. http://circ.ahajournals.org/rapidaccess.shtml
Rosen P. et al. The use of the Heimlich maneuver in near drowning: Institute of Medicine report. Journal of Emergency Medicine. 13(3):397-405. May-June 1995. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=7673638&query_hl=4&itool=pubmed_docsum
American Heart Association. 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: Part 10.3: Drowning. November 2005. http://circ.ahajournals.org/cgi/content/full/112/24_suppl/IV-133
American Heart Association. April 1, 2008. News release: Hands-Only CPR Simplifies Saving Lives For Bystanders. http://americanheart.mediaroom.com/index.php?s=43&item=377
Last Updated: March 11, 2013
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