Life-support techniques such as CPR can buy a person struggling to survive in a medical emergency enough time until health professionals can take over. In many cases, the seconds bought by CPR can make the difference between life and disability or death.
Permanent brain damage can set in on a person if they do not get oxygen to their brain after just 3 or 4 minutes. Ideally, learning CPR is best done through a formal course which allows you to practice on a mannequin (do NOT practice on a conscious, healthy person—it can be extremely dangerous). Contact your local American Red Cross or the American Heart Association at (AHA) 800-242-8721 to find out where you can sign up for CPR classes.
The AHA offers the following CPR instructions that can be applied to an adult in need of resuscitation. Children under the age of eight will have somewhat different CPR instructions simply due to their size.
CPR Basics: The ABCs of CPR
Airway. Position the person's head properly to make certain their airway is open. Accomplish this by tilting back their head and moving forward the chin.
Breathing. Cardiac arrest and death come quickly when the person stops breathing. The fastest way to get oxygen into the person’s lungs is using mouth-to-mouth rescue breathing, which should be performed until breathing resumes, or until medical help arrives.
Circulation. If the victim’s heart has stopped beating, perform rescue breathing plus chest compressions, which can help to maintain some amount of blood flow to crucial areas: the lungs, brain, coronary arteries, and other major organs.
Performing CPR
1. Assessment. Determine if a person who has collapsed is unconscious and may need CPR: check responsiveness by tapping or softly shaking their shoulder. Try shouting, "Are you OK!?" (However, do not attempt mouth-to-mouth resuscitation on a person who has merely fainted and is continuing to breathe on their own.)
2. Call 911. If the person does not respond, call 911 or your local emergency number or ask another person present to do so, before you start CPR.
3. Position victim. Turn the victim on his back so you can open his airway and support his head and neck. To tilt back his head, lift up his chin gently with one hand and push downward on his forehead with the other.
4. Check for breath. Look at his chest for any movement, listen for sounds that he is breathing, lean your cheek near his mouth to feel any breath. If the victim is breathing, use his arm and leg and roll him gently onto his side into what is called the recovery position.
The recovery position is the position a victim should be moved into if he has collapsed but continues to breathe on his own. Also, put him into the recovery position if he begins to breathe after CPR.
5. If the victim is not breathing, pinch his nostrils shut and make a tight seal around his mouth using your own. Begin by giving two slow breaths lasting 1 1/2 to 2 seconds per breath. Watch his chest to see it rise. Wait for his lungs to deflate between breaths.
Performing mouth-to-mouth breathing: pinch shut his nose using your thumb and forefinger. Maintain an air-tight seal with your mouth over the mouth of the victim, and immediately give two full breaths.
6. Is there a pulse? Put two to three fingers on the victim’s voice box then slide them between the voice box and muscle. If there is a pulse, perform rescue breathing and provide around twelve breaths per minute, or around one breath every five seconds.
If there is no pulse, combine rescue breathing with chest compressions, which are explained below.
Chest Compressions: Kneel next to the victim’s chest. Using the middle and index fingers of your hand which is closest to the victim’s legs, find the notch where the bottom rims of the two halves of the rib cage meet, in the middle of the chest.
Performing chest compressions: Locate the notch where the bottom rims of the two halves of the rib cages meet in the middle of the chest. Put the heel of one hand on the sternum (breastbone) next to the fingers that found the notch. Put your free hand on top of that hand.
Next, put the heel of one hand on the victim’s breastbone, next to the fingers that found the notch. Put your other hand on top of that hand. Be certain to keep your fingers up off the chest wall (you can try interlocking your fingers). Line up your shoulders directly over the victim's sternum and press down, keeping your arms straight. With adults, you will depress their sternum about 1 1/2 to 2 inches.
Chest compressions: Depress the sternum about 1 1/2 inches to 2 inches, and then completely allow the chest to return to its normal position.
Next, relax your pressure on the sternum. Do not remove your hands. Between each compression, allow their chest to rise into its normal position. Compression and Relaxation together should require an equal amount of time, at a rate of between 80 and 100 compressions every minute. To help yourself establish a rhythm, count out loud: "One and- Two and- Three and- Four and-"
Until Help Arrives: Following each 15 chest compressions, provide two slow rescue breaths. Check their pulse after 4 cycles of compressions/breaths. If you do not find a pulse, continue CPR beginning with chest compressions. If you do find a pulse but no breathing, provide 1 rescue breath every 5 seconds. If the victim begins to breathe and he or she regains a pulse during or following resuscitation, place him in the recovery position.
CPR Basics End Notes: The Breathless Approach
The chief features of CPR are two primary steps: chest compression and mouth-to-mouth ventilation. However, some research hints that doing chest compressions alone may be enough to save a life.
The study pitted telephone dispatchers instructing bystanders in CPR methods at the scene of a heart attack. Results suggest that instructions for chest compression alone proved quicker to give to bystanders, and that survival to hospital discharge for patients was better as well. Also, bystanders getting instructions on two-step CPR were twice as likely either to hang up, or to object that the instructions were too difficult, compared to the people who were instructed through giving chest compressions.
