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Cardiopulmonary Resuscitation
By Matt Unangst, 31 Jan 19:32
We’ve all seen it in movies, so we know the basics, but what do you really have to know in order to administer CPR? CPR is an extremely useful skill to have in any number of emergencies. If someone has stopped breathing or had his/her heart stop beating, CPR is the method used to restore these bodily functions. By using chest compression and mouth-to-mouth breathing, the brain and other vital organs can be supplied with oxygenated blood until bigger measures can be taken.
This article will give you some basic tips for administering CPR in an emergency situation, but to actually learn CPR, you should take an accredited course in administering CPR and automatic external defibrillation (AED).
If your heart stops due to a severe problem like a heart attack or near drowning, your brain will be cut off from the oxygen it needs to function. It takes just a few minutes without oxygen for the brain to be irreparably damaged and just 8 to 10 minutes for death to occur, so time is of the essence when dealing with someone who has stopped breathing.
When preparing to administer CPR, first check if the person who is not breathing is conscious. If he/she appears to be unconscious, tap them on the shoulder and ask whether or not he/she is OK. You should call 911 before beginning CPR. The faster the paramedics arrive, the better the chance for the person to avoid any lasting damage. If the person has become unconscious from suffocation (such as by drowning), you should administer CPR for one minute before calling 911. Of course, if there is no telephone readily available, administer CPR before searching for one. If you have an AED device available, administer one shock if advised to do so by the device’s instructions before beginning CPR.
An easy guide to CPR is the simple ABC system – Airway, Breathing, and Circulation. These three things are the essential parts of CPR and this simple anagram will help you to remember what you must do.
Airway
You must ensure that the person has a clear path between his/her mouth and his/her lungs. Begin by laying the person on his/her back on a solid surface and kneeling next to his/her neck and shoulders. Put your palm on the person’s forehead and gently tilt his/her head back. Use your other hand to lift the chin forward. This opens up the airway. Next, check to see if the person has begun to breathe normally. Do not wait more than five or ten seconds for normal breathing to begin. Look for chest motion, listen for breath sounds, and feel for breath with your cheek and ear. Gasping breathing should not be considered normal. If the person does not resume normal breathing and you have been trained in CPR, begin mouth-to-mouth breathing. If you have not been trained in CPR, you should also begin with mouth-to-mouth breathing unless you believe that the person has suffered a heart attack, in which case you should skip immediately to chest compression.
Breathing
If a person has stopped breathing, you must breathe for them as part of CPR. Mouth-to-mouth breathing is the most common method, but you may have to perform mouth-to-nose breathing if the person has suffered a serious mouth injury or if the mouth cannot be opened. In order to provide mouth-to-mouth breathing, you must keep the person’s head tilted and pinch his/her nostrils shut, keeping the airway open and preventing any air from escaping through the nostrils. Place your mouth over the person’s mouth, making sure to cover it completely in order to form a seal. Give a breath lasting one second and watch to see if the person’s chest rises. If it rises, give a second breath. If it does not rise, tilt the head again using the method described above before giving the second breath. Following two rescue breaths, begin chest compression.
Circulation
In order to restore blood circulation, you must compress the chest. Begin by placing the heel of one of your hands in the center of the person’s chest between the nipples. Place your other hand over this hand. Straighten out your elbows and lift your body until your shoulders are directly above your hands. Push straight down on the person’s chest two inches using the weight of your entire upper body, not just your arm strength. You must push hard in order to properly compress the chest. The compressions must also be fast – two per second, if they are to restore circulation. Continue compressing the chest for 15 seconds – 30 compressions. After you are through with these, re-open the airway by tilting the head back and the chin back again. Seal the person’s airway with your hand and mouth and give one rescue breath. If the person’s chest does not rise with this breath, try again to open the airway. Then give a second rescue breath. 30 chest compressions and two breaths comprise one cycle of CPR.
If there is an AED available and the person is still not moving after you have completed five cycles of CPR, administer the AED. According to the American Heart Association, you should administer one shock from the AED, then continue with chest compressions. If the person does not respond after another two minutes of CPR, administer the AED once again. 911 operators can often help you with the use of an AED if you do not know how one works. There are also trained staff members at many public locations who have access to and know how to use an AED.
You should not use an AED on a child under one year of age. For children aged one to eight, you should use pediatric pads with the AED if they are available.
If no AED is available, continue CPR until the person starts moving or until the arrival of trained medical personnel.
If someone else is with you while performing CPR, one of you should do the rescue breathing; the other should do the chest compressions.
CPR procedures for children aged one to eight differ from adults in some minor respects. You should use only one hand to perform chest compressions on a child and breath more gently than you would with an adult. One cycle of CPR is the same with a child as with an adult: 30 compressions and two breaths. AEDs can be used on children who are over one year old, but should be used with pediatric pads if they are available. If you are alone with a child who needs CPR, perform five cycles before calling 911 or using an AED. As with an adult, you should continue CPR until the child moves or medical personnel arrives.
Infants require far different medical care from children, much less adults. This holds true for CPR as well. Babies often choke on small objects – if you know that the infant in question is choking, perform first aid for choking instead of CPR. Only begin CPR if the problem is not choking and the baby does not respond to stimuli.
The ABC rules of thumb apply to infants, as well. Place the baby on its back on a flat, solid surface before beginning. This can be a table, but it can also be the ground. Use the same procedure of pushing down on the forehead and lifting the chin as you would with an adult. Check for breathing. A baby will exhibit the same signs of breathing as an adult. If there are no signs of breathing within ten seconds, begin mouth-to-mouth breathing.
With a baby, you should be able to cover both the mouth and the nose with your mouth, making holding the nose unnecessary. Use your cheeks instead of your lungs to deliver the breath. This will force the air into the baby’s lungs more softly, avoiding injury. If the infant’s chest does not rise with the first breath, repeat the head-tilting measure to clear its airway. Look inside the baby’s mouth for any objects that may be blocking the airway. Clear any objects you see out of the mouth with your finger. If the airway seems to be blocked by something you cannot remove, begin first aid for choking. Then deliver another breath to the infant.
After the second breath, you should begin chest compression. Place two fingers from one hand in the middle of the infant’s chest just below the nipples. Press down gently on the chest until it reaches a level one half to two thirds of its normal depth. You should compress the chest 100 to 120 times per minute. Count aloud as you are doing so. Give another two breaths after you pump 30 times.
After two minutes of CPR, you should call for help. If another person is available, have him/her call for help while you administer CPR. Continue CPR until the baby starts moving or professional help arrives.
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