What is CPR? – Guides, Steps and First Aid

CPR or cardiopulmonary Resuscitation is a lifesaving measures or technique which is performed during emergencies when a person’s heart stops beating (cardiac arrest) or if they stop breathing. It is also performed in near drowning & chocking situations too. The critical care and emergency department at Cardiology in Aadicura Superspeciality Hospital is well equipped to deal with any such emergency and trauma situation. The American heart association recommends this technique to both untrained bystanders and first responders as a life saving measure till the medical aid is available.

CPR is performed immediately during emergency situations, double or triple the chances of survival after cardiac arrest. This will help to keep a person alive until the emergency services arrive. CPR helps to keep a person’s blood flowing towards the brain & prevent brain damage. People without first aid training can still save a life by using CPR steps. AHA(American Heart Association) are giving such training since last many years. Recently in India also such training started by IRC(Indian Resuscitation Council)

Guides:

It is ideal for everyone to get CPR training. If you are not, it is still better to do something instead of nothing at all because it may potentially save someone’s life.

What is cardiac arrest?

It’s a sudden cessation of either mechanical, electrical or both activities of the heart.

Clinically characterized by:

1. Unresponsiveness
2. Absence of pulse
3. Absence of breathing

If you are trained:

1. Approach safely at scene
2. Check the response & breathing
3. Call for help/AED or 108(emergency services)
4. Check for neck (carotid) pulse
5. If there is no pulse start chest compressions at the rate of 100-120 per minute.
6. Compression: rescue breathing ratio should be 30:2, means after each 30 compression you should have to give two rescue breathes
7. After 5 cycles of 30:2 compression & breathing (almost 2 min) again check for neck pulse & response
8. Repeat the cycle until the person starts breathing or until medical assistance arrives

If you are untrained or are unsure about your abilities:

It’s advisable to give hands-only CPR or COLS (compression only life support) it involves uninterrupted chest compressions of 100 to 120 per minute.

1. Ensure safety
2. Check response
3. If no any response start 30 chest compression at the rate of at least 120/min, You need not to give rescue breaths with this technique
4. Continue 5 cycles of 30 chest compression for 2 min
5. After 2 min again check for response, if not then continue CPR
6. You should not stop giving CPR until you find some response or until medical help arrives.

Before performing CPR, follow these steps:

1. Make sure you are in a safe surrounding – A middle of the road, fire or other dangers are considered unsafe to perform CPR. Find a safe, isolated spot before starting.
2. Try to wake the person & see for breathing, tap the person’s shoulder firmly and ask loudly “Are You Okay?”. Try to wake the person up and move over to the next steps.
3. Call an ambulance – It is important to call an ambulance immediately even if you’re performing CPR as there is a possibility the person might require additional medical help.
4. Put the person on their back on hard surface – If the person does not have spine injury, try moving the person on their back carefully.
5. Check for breathing – Tilt the patient’s head back to access the airway and determine if they are breathing. If the patient is not breathing, start CPR within 10 seconds.

Steps of doing CPR:

CPR techniques vary slightly depending whether the person is an adult, toddler or an infant.

For adults:

1. Place both your hands on the person’s chest- Imagine a line between the nipples and put the heel of one hand on that line and in the centre of the chest. Place your other hand on top of that hand. Centre your weight on top of both your hands.
2. Perform chest compressions- Push your hands with the force to a depth of least 2 inches (5 cm) (but no deeper than 2.4 inches) and fast—about twice per second until the person responds. Your hands shouldn’t bounce, but you should lift your entire body weight off the patient in between each compression.
3. Give rescue breaths- Tilt the person’s head gently and lift the chin up with 2 fingers. Pinch the person’s nose. Seal your mouth over their mouth and blow steadily and firmly into their mouth for about 1 second.
4. Repeat- Repeat cycles in the CPR ratio of 30:2 (chest compressions and breaths)

For children:

This procedure is used in children between the years 1- 8.

1. Place your hands on the child’s chest- Place both your hands (or one hand if the child is very small)
2. Perform chest compressions- Push hard but not more than 2.4 inches, twice per second.
3. Give rescue breaths- Tilt the person’s head gently and lift the chin up with 2 fingers. Pinch the person’s nose. Seal your mouth over their mouth and blow steadily and firmly into their mouth for about 1 second.
4. Repeat- Repeat cycles of 30 chest compressions and two breaths until medical assistance arrives or the child wakes up.

For infants-

Shake the bottom of the foot to get a response.

Place two fingers of one hand in the centre of the chest.

Give chest compressions by gently pressing your fingers about 1.5 inches deep.

Keep compression breathing ratio 15:2 if you are single rescuer. Perform rescue breathing.

What is the importance of each step?

Every step of CPR serves an important purpose-

1. Asking the person if they are OK- There is a possibility that the person may wake up when you shake them gently and try to talk to them. Which is why it is important to not start CPR right away. But do seek medical help immediately, especially if they seem confused or unable to speak.
2. Calling an ambulance- if CPR does not help in reviving the person, an ambulance can have essential medical equipment like an automated external defibrillator (AED).
3. Chest compressions- compressing the chest moves blood through the brain, keeps it working until the heart can restart.
4. Rescue breathing- Also called as mouth-to-mouth resuscitation, rescue breathing is used to fill the person’s lungs with air and restore their ability to breathe.

First Aid: –

First aid refers to the immediate care which is provided when a person is injured until full medical treatment is made available. First aid is the application of basic medical techniques in an emergency situation. It can range from treating minor wounds and bruises to taking care of more serious conditions before professional assistance can be administered. Knowing basic first aid techniques and maintaining a dedicated kit for first aid at home is critical, especially when there are young children and senior adults around the house. First aid helps to treat the ABC’s (Airway, Breathing and Circulation)

Common items found in a first aid kit are:

1. Bandages
2. Surgical tape
3. Gauze
4. Antiseptic wipes and swabs
5. Antibiotic cream
6. Burn ointment

Advanced first aid kids may also contain:

1. Oropharyngeal airway
2. Nasopharyngeal airway
3. Bag valve mask
4. Manual aspirator or suction unit
5. Sphygmomanometer
6. Stethoscope

First aid covers a variety of procedures that you might require in an emergency situation. The most basic of these is first aid to treat common wounds such as grazes or cuts. Follow this 3 step basic first aid routine for wound care:

• The first step toward optimal healing is a clean and sterile wound. Run your wound under cool water to remove any dirt, bacteria, or visible particles.
• The second step is to protect your wound from dirt and bacteria so that it can heal undisturbed. Do this by applying a plaster to cover up the wound.
• The third step is to assist your wound in healing safely and quickly. Change the wound plaster on a daily basis to ensure that the wound is well protected and heals as quickly as possible.

Always make sure to cover your wound up with a plaster to reduce the risk of infection. Keeping these basic first aid tips in mind is all you need to lead a safe and healthy life.

We at Aadicura Superspeciality Hospital, Vadodara are available with a well-equipped critical care unit with experts and specially trained staff of healthcare providers.