CARDIOPULMONARY RESUSCITATION (CPR) delivered at a rate of at least 100

WHAT IS CPR? compressions per minute

 CPR stands for Cardiopulmonary 6. Deliver Rescue Breaths
Resuscitation, an emergency procedure that  With the person’s head tilted back slightly
is a combination of chest compressions and and the chin lifted, pinch the nose shut
artificial ventilation (breathing) used to save a and place your mouth over the person’s
person’s life when a person’s heart stops mouth to make a complete seal
beating or breathing ceases.  Blow into the person’s mouth to make the
 When performed right away, CPR can increase chest rise
a person’s chances  Deliver two rescue breaths, then continue
What Are the 7 Steps of CPR In Order? compressions
Note:
 If the chest does not rise with the initial
rescue breath, re-tilt the head before
delivering the second breath.
 If the chest doesn’t rise with the second
breath, the person may be choking. After each
subsequent set of 30 chest compressions, and
before attempting breaths, look for an object
(inner mouth) and, if seen, remove it.
Note: Rescue breaths are recommended by the
The American Red Cross guidelines for American Red Cross. The American Heart Association
performing CPR are as follows: recommends calling 911 and delivering chest
Before Giving CPR: compressions only.
1. Check the scene and the person: 7. Continue CPR steps
 Make sure the setting is safe Continue with cycles of chest compressions
 Tap the person on the shoulder and shout, and breathing until:
“Are you OK?” to make sure the person needs  The person exhibits signs of life, such as
help breathing.
2. Call 911 for assistance  An AED becomes available, once it is applied
 If it’s not clear help is needed, call 911 (or ask continue CPR if the patient is still
a bystander to call) unresponsive EMS or a trained medical
 Send someone to get an AED if one is responder arrives on the scene and takes over
available Note: End the cycles if the scene becomes unsafe or
 If there is no AED available or there is no you are unable to continue performing CPR due to
bystander to access it, stay with the victim, exhaustion
call 911, and prepare to give assistance
3. Open the airway CARDIOPULMONARY RESUSCITATION (ADULT)
 With the person lying on his or her back, tilt Cardiopulmonary Resuscitation (Adult) CPR – or
the head back slightly to lift the chin Cardiopulmonary Resuscitation
4. Check for breathing  an emergency lifesaving procedure performed
 Listen carefully for sounds of breathing, for no when the heart stops beating.
more than 10 seconds (occasional gasping  Immediate CPR can double or triple the
sounds are not the same as breathing) chances of survival after cardiac arrest.
 If there is no breathing, begin CPR  High-quality CPR should be performed by
5. Begin chest compressions anyone - including bystanders.
 Position hands one on top of the other in the  There are five critical components:
middle of the chest a. Minimize interruptions in chest compressions
 Push hard, push fast b. Provide compressions of adequate rate and
 Use your body weight to help administer depth
compressions at least 2 inches deep and c. Avoid leaning on the victim between
compressions
 d. Ensure proper hand placement e. Keep arms straight.
e. Avoid excessive ventilation f. Lock elbows.

CPR PROCEDURE:
Before starting CPR:
 Check for signs of life/breathing: Look for
normal Breathing (less than 10 secs)
 If the person doesn't respond and another
person who can help, have one person call
911 or the local emergency number and get
the Automated External Defibrillator (AED), if
available. Have the other person begin CPR.
 Remember to spell C-A-B. Use the letters C-A-
B to help remember the order to perform the
steps of CPR.
 C: Compression
Performing CPR Compressions:
 A: Airway
 Put the person on his or her back on a firm
 B: Breathing
surface.
 Kneel next to the person's neck and
shoulders.
 Locate the compression site

Locating the Compression Site

a. Push fingers along the lower edge of the rib cage
toward the center of his chest until the notch is
located. The notch is the location where the ribs meet
the sternum, and where the xiphoid process begins.
b. Place the tip of the middle finger in the notch and
against the bottom of the sternum.
A. Compressions: Restore blood flow c. Place index finger next to the middle finger and
over the sternum. The index finger is now above the
 Compressions will be delivered by using the
hands to push down hard and fast correctly xiphoid process.
on the person's chest.
Performing CPR Compressions
Perform 30 Chest Compressions
 Compression consists of a thrust that
compresses the heart and a release that
allows the heart to refill with blood.
 These compressions are delivered at a rate of
approximately 100 per minute.
 Allow the chest to spring back (recoil) after
each push.
 Establish a definite rhythm when performing
external chest compressions.
Steps to ensure correct compressions:  Use a system to keep the compressions
a. Place the heel of one hand in the center of the regular, smooth, and uninterrupted:
chest on the breastbone.  (a) Count out loud, "One and two and three
b. Place the heel of the other hand directly on and four and five and six and seven and eight
top of the first. and nine and ten and eleven and twelve and
c. Lift or interlace fingers. thirteen and fourteen and fifteen and...."
d. Position shoulders directly over the hands.  (b) Push down on the sternum when saying a
number.
  (c) Release the pressure when saying "and."  Assess consciousness by speaking, and
tapping the infant’s heel gently to obtain a
B. Breathing: response. Don't shake the baby.
Breathe for the person  Carefully turn the child on his back.
 Rescue breathing can be mouth-to-mouth  Open the airway by tilting the head and lifting
breathing or mouth-to-nose breathing if the the chin.
mouth is seriously injured or can't be opened. Attempt to clear airway.
 Current recommendations suggest performing  Remove any visible obstruction from the
rescue breathing using a bag-mask device client’s mouth.
with a high-efficiency particulate air (HEPA)  Support head and neck with one hand, and
filter. cradle the infant face down, head lower than
Administer Two Breaths the trunk over forearm (support forearm on
 Immediately after giving the thirtieth the thigh).
chest compression, move hands to the  Using the heel of hand, deliver four firm back
casualty's head, open his airway (head blows between the shoulder blades.
tilt/chin lift or jaw thrust maneuver) and  Turn the infant over and re-inspect mouth.
administer two breaths  Use bulb syringe or suction to remove
 Immediately after giving the 30th chest obstruction if possible.
compression, move hands to the  Repeat procedure if necessary.
casualty's head, open his airway and  Place the infant stomach-down across your
administer two breaths. forearm and give 5 quick, forceful blows on
 Each breath should take about 1 second the infant’s back with heel of your hand.
to administer.  Check if the infant does not breathe after the
 Observe the casualty's chest out of the airway is opened through clearing.
corner of your eye to make sure that the  Initiate CPR if the infant does not breathe.
chest rises when a breath is into the  Locate the sternum, in the middle of the
casualty's mouth (or nose). The procedure infant’s chest or between the nipples.
should be completed within 3 to 5  Place two fingers of one hand and gently
seconds. compress the chest about 1.5 inches (about 4
 Perform four (4) more cycles of centimeters).
cardiopulmonary resuscitation. Each cycle  Deliver 30 chest compressions at the sternum.
consists of administering 30 chest (Deliver 100 to 120 compressions per minute).
compressions followed by administering Count aloud while pushing in a fairly rapid
two breaths. rhythm.
 Check for pulse and breathing. After two  After 30 compressions, gently tip the head
full breaths of the fifth CPR cycle has been back by lifting the chin with one hand and
administered, check the carotid pulse pushing down on the forehead with the other
again to confirm if the heart has resumed hand.
beating on its own.  Place lips around the newborn's nose and
 If there is pulse but no breathing, initiate mouth, making an airtight seal.
rescue breathing at 10 to 12 times a  Give 2 gentle, rescue breaths (1 second for
minute. each breath) into the newborn.
 At the same time, check for signs that  Watch to see if the baby's chest rises. If it
spontaneous breathing has resumed. The does, give a second rescue breath.
check should take about 5 seconds.  If the baby's chest still doesn't rise, continue
 If no pulse, continue CPR. CPR should not chest compressions.
be stopped for more than 10 seconds.  Check if the infant begins to normally breathe
by himself.
CARDIOPULMONARY RESUSCITATION (INFANT)
 Turn the child on his side into the recovery
Before performing CPR:
position.
 Ensure that the area is safe.
AUTOMATED EXTERNAL DEFIBRILLATOR (AED) chance of surviving drops by seven to 10
 An AED, or automated external defibrillator, is percent for every minute a normal heartbeat
used to help those experiencing sudden isn’t restored.
cardiac arrest. It’s a sophisticated, yet easy-to-
use. Why are AEDs important?
 Its medical device that can analyze the heart  AEDs make it possible for more people to
rhythm and, if necessary. respond to a medical emergency where
 Use to deliver an electrical shock, or defibrillation is required.
defibrillation, to help the heart re-establish an  Because AEDs are portable, they can be used
effective rhythm. by nonmedical people (lay rescuers). They can
be made part of emergency response
programs that also include rapid use of 9-1-1
and prompt delivery of cardiopulmonary
resuscitation (CPR).
 All three of these activities are vital to
improving survival from SCA.
 The computer calculates whether
defibrillation is needed. If it is, a recorded
voice prompts the rescuer to press the shock
What is an AED and how does it work? button on the AED.
 An AED is a type of computerized defibrillator  This shock momentarily stuns the heart and
that automatically analyzes the heart rhythm stops all activity. It gives the heart the chance
in people who are experiencing cardiac arrest. to resume beating effectively. Audible
When appropriate, it delivers an electrical prompts guide the user through the process.
shock to the heart to restore its normal  AEDs advise a shock only for ventricular
rhythm. fibrillation or another life-threatening
condition called pulseless ventricular
tachycardia.

Who can use an AED?

 Non-medical personnel such as police, fire
service personnel, flight attendants, security
guards and other lay rescuers who have been
trained in CPR can use AEDs. Although formal
training in the use of an AED is not required, it
is recommended to help the rescuer increase
What is an AUTOMATED EXTERNAL DEFIBRILLATOR? their comfort and level of confidence.
 An automated external defibrillator (AED) is a  However, AEDs are intended for use by the
lightweight, portable device that delivers an general public. Most AEDs use audible voice
electric shock through the chest to the heart. prompts to guide the user through the
The shock can potentially stop an irregular process. Are AEDs safe to use? AEDs are safe
heartbeat (arrhythmia) and allow a normal to use by anyone. Some studies have shown
rhythm to resume following sudden cardiac that 90% of the time AEDs are able to detect a
arrest (SCA). rhythm that should be defibrillated. This data
 SCA occurs when the heart malfunctions and suggests that AEDs are highly effective in
stops beating unexpectedly. If not treated detecting when (or when not) to deliver a
within minutes, it quickly leads to death. Most shock.
SCAs result from ventricular fibrillation (VF). Where AEDs should be placed?
 VF is a rapid and unsynchronized heart  All first-response vehicles, including
rhythm that originates in the heart’s lower ambulances, law enforcement vehicles and
chambers (the ventricles). The heart must be many fire engines should have an AED. AEDs
“defibrillated” quickly because a victim’s also should be placed in public areas such as
 sports venues, shopping malls, airports,
airplanes, businesses, convention centers,
hotels, schools, and doctors’ offices.
 They should also be in any other public or
private place where large numbers of people
gather or where people at high risk for heart
attacks live. They should be placed near
elevators, cafeterias, main reception areas,
and on walls in main corridors.