Cardiopulmonary resuscitation (CPR) is an emergency procedure consisting of chest compressions often combined with artificial ventilation in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person who is in cardiac arrest.
- CPR involves chest compressions for adults between 5 cm (2.0 in) and 6 cm (2.4 in) deep and at a rate of at least 100 to 120 per minute.
- The rescuer may also provide artificial ventilation by either exhaling air into the subject’s mouth or nose (mouth-to-mouth resuscitation) or using a device that pushes air into the subject’s lungs (mechanical ventilation). Current recommendations place emphasis on early and high-quality chest compressions over artificial ventilation; a simplified CPR method involving only chest compressions is recommended for untrained rescuers.
- With children, however, 2015 American Heart Association guidelines indicate that doing only compressions may actually result in worse outcomes, because such problems in children normally arise from respiratory issues rather than from cardiac ones, given their young age.
CPR alone is unlikely to restart the heart. Its main purpose is to restore partial flow of oxygenated blood to the brain and heart. The objective is to delay tissue death and to extend the brief window of opportunity for a successful resuscitation without permanent brain damage. Administration of an electric shock to the subject’s heart, termed defibrillation, is usually needed in order to restore a viable, or “perfusing”, heart rhythm. Defibrillation is effective only for certain heart rhythms, namely ventricular fibrillation or pulseless ventricular tachycardia, rather than asystole or pulseless electrical activity, which usually require the treatment of underlying conditions to restore cardiac function. Early shock, when appropriate, is recommended. CPR may succeed in inducing a heart rhythm that may be shockable. In general, CPR is continued until the person has a return of spontaneous circulation (ROSC) or is declared dead.
Cardiopulmonary resuscitation (CPR) is a lifesaving technique that’s useful in many emergencies, such as a heart attack or near drowning, in which someone’s breathing or heartbeat has stopped. The American Heart Association recommends starting CPR with hard and fast chest compressions.
CPR steps: Quick reference
Use CPR when an adult is not breathing or when they are only gasping occasionally, and when they are not responding to questions or taps on the shoulder.
In children and infants, use CPR when they are not breathing normally and not responding.
Check that the area is safe, then perform the following basic CPR steps:
Call 911 or ask someone else to.
Lay the person on their back and open their airway.
Check for breathing. If they are not breathing, start CPR.
Perform 30 chest compressions.
Perform two rescue breaths.
Repeat until an ambulance or automated external defibrillator (AED) arrives.
Read on for more detailed descriptions of how to perform CPR in adults, children, and infants.
There are two main stages to CPR: the preparation stage and the CPR stage.
Before performing CPR on an adult, use the following preparation steps:
Step 1. Call 911
First, check the scene for factors that could put you in danger, such as traffic, fire, or falling masonry. Next, check the person. Do they need help? Tap their shoulder and shout, “Are you OK?”
If they are not responding, call 911 or ask a bystander to call 911 before performing CPR. If possible, ask a bystander to go and search for an AED machine. People can find these in offices and many other public buildings.
Step 2. Place the person on their back and open their airway
Place the person carefully on their back and kneel beside their chest. Tilt their head back slightly by lifting their chin.
Open their mouth and check for any obstruction, such as food or vomit. Remove any obstruction if it is loose. If it is not loose, trying to grasp it may push it farther into the airway.
Step 3. Check for breathing
Place your ear next the person’s mouth and listen for no more than 10 seconds. If you do not hear breathing, or you only hear occasional gasps, begin CPR.
If someone is unconscious but still breathing, do not perform CPR. Instead, if they do not seem to have a spinal injury, place them in the recovery position. Keep monitoring their breathing and perform CPR if they stop breathing.
Use the following steps to perform CPR:
Step 4. Perform 30 chest compressions
Place one of your hands on top of the other and clasp them together. With the heel of the hands and straight elbows, push hard and fast in the center of the chest, slightly below the nipples.
Push at least 2 inches deep. Compress their chest at a rate of least 100 times per minute. Let the chest rise fully between compressions.
Step 5. Perform two rescue breaths
Making sure their mouth is clear, tilt their head back slightly and lift their chin. Pinch their nose shut, place your mouth fully over theirs, and blow to make their chest rise.
If their chest does not rise with the first breath, retilt their head. If their chest still does not rise with a second breath, the person might be choking.
Step 6. Repeat
Repeat the cycle of 30 chest compressions and two rescue breaths until the person starts breathing or help arrives. If an AED arrives, carry on performing CPR until the machine is set up and ready to use.
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