How To Perform CPR?

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How To Perform CPR?

Cardiology | by Dr. Ashok B Malpani


CPR or cardiopulmonary resuscitation is a lifesaving technique which is performed when the heart stops beating. You may have seen in a movie, a person giving mouth-to-mouth to an individual who loses consciousness. While you may have wondered how people know when to perform CPR or how it is performed, this blog can provide you with step-by-step information to help you familiarise yourself with how CPR works. 

Anyone including children can perform CPR if the proper technique is known. If you are wondering about the need to know CPR, it becomes crucial if anyone around you suffers from a cardiac arrest, even at home. Please note that this blog is only for informational purposes and does not replace the significance of a doctor’s consultation

What is CPR?

CPR or cardiopulmonary resuscitation refers to the emergency procedure which can be done to save a person’s life if their breathing stops. There are several reasons which can result in sudden malfunction in the heart and thus, may require immediate resuscitation. Such individuals if do not receive help from the bystanders before the ambulance arrives, can lead to serious health hazards. 

CPR keeps the blood flow active, even partially until medical help arrives. A timely CPR can increase the chances of survival in many patients. There are two commonly known versions of CPR - Conventional CPR for trained healthcare professionals and Compression-only CPR for anyone who witnesses an individual sudden collapsing. 

How To Perform CPR?

The primary aim of CPR is to resuscitate the victim or maintain the blood flow until the emergency medical team arrives. Before beginning CPR, it is important to call an ambulance as soon as possible. 

CPR procedure is done in different methods depending on whether the individual is a bystander or a trained professional. You don’t need formal training or special certification to perform CPR. 

Compression-only CPR or Hands-only CPR is done without mouth-to-mouth breaths. You must push hard and fast in the centre of the chest at a rate of 100 to 120 pushes a minute. If that confuses you, some heart associations recommend timing the pushes to the beat of the song “Stayin’ Alive by Bee Gees”. 

Conventional CPR can be performed using chest compressions and mouth-to-mouth at a ratio of 30:2 compressions-to-breath. In the case of adult victims, medical professionals usually perform chest compressions at a ratio of 100 to 120/min to a depth of at least 5cm. In case there is an AED (Automated External Defibrillator) available, the machine can provide an electrical shock to the heart and cause it to begin beating again. However, it should be done by trained medical personnel. 

What Are The 7 Steps of the CPR procedure?

Before you begin CPR, there are certain things that you must keep in mind. CPR is only done if the individual is unconscious or does not respond. A high-quality CPR procedure includes five critical components listed below - 

  • Ensuring proper hand placement
  • Restricting excessive ventilation
  • Minimising the interruptions during chest compressions
  • Providing adequate compressions of rate and depth
  • Avoiding leaning on the victim between compressions

A simple concept which can help you remember the basic steps during the CPR procedure is called C-A-B. 

  • C stands for Compression
  • A stands for Airway
  • B stands for Breathing 

Compression is done using your hands to push down hard in a specific area of the chest. This is one of the most crucial steps during CPR. Here are the 7 steps for performing compressions during the CPR procedure - 

  1. Put the individual on their back on a flat surface and kneel next to their neck and shoulders.
  2. Place the lower palm of your hand over the centre of the individual’s chest.
  3. Place the other hand on top of the first hand while keeping your elbows straight.
  4. Position your shoulders directly above your hands to ensure effective compressions.
  5. Push straight down on the chest at least 5 cm using your entire body weight when doing compressions.
  6. Avoid pushing down on the chest more than 6 cm. Push hard at a rate of 100 to 120 compressions a minute and allow the chest to recoil after each push.
  7. In case you do not know the proper technique of CPR, continue chest compressions until there are signs of movement or until emergency medical care arrives. If you know the proper technique of CPR, then go on to open the airway and rescue breathing.

Airway is the passage from where you can provide mouth-to-mouth if you are trained in CPR procedures. After completing 30 chest compressions, you can open the person’s airway using the head-tilt, chin-lift manoeuvre.

Put your palm on the individual’s forehead and gently tilt the head backwards. Using the other hand, lift the chin gently to open the airways to proceed with the mouth-to-mouth manoeuvre.

Breathing can be mouth-to-mouth or mouth-to-nose in case the mouth is seriously injured. The CPR procedure for children is very similar and the C-A-B technique can be used. In the case of 4-week-old babies or older, cardiac arrest may be due to a lack of oxygen. Check for any blockage in the airway and perform first aid for choking. If you do not figure out the reason why the child is not breathing, perform CPR. Here are some steps to follow during rescue breathing - 

  1. Pinch the nostrils shut for mouth-to-mouth breathing after opening the airway using the head-tilt, chin-lift manoeuvre.
  2. Cover the individual’s mouth with yours and make a seal.
  3. Provide simultaneous rescue breaths. The first rescue breath lasts one second. Wait to see if the chest rises. If the chest rises, give a second breath.
  4. In case the chest does not rise, repeat the head-tilt, and chin-lift manoeuvre and again give a second breath. 
  5. Remember to give thirty chest compressions followed by two rescue breaths (considered one cycle). Avoid too many breaths or breathing with too much force. Resume chest compressions to restore blood flow.
  6. In case an automated external defibrillator (AED) is available, apply it to give one shock, then resume chest compressions for around 90 seconds before giving another shock. Do not use the AED if you are not trained. 
  7. Continue CPR until there are signs of movement or emergency medical personnel take over.

Conclusion:

Immediate CPR can double or even triple the chances of survival if the heart stops beating. Every year millions of people die because of cardiac arrest which can be prevented by taking adequate steps on time. People who are aware of the technique of CPR can prevent the chances of fatalities. 

A recent study has shown the potential of children performing hands-only CPR. With proper training and hand-only CPR, the majority of children can help save lives and reduce fatalities at home. In the end, it is all about the bystanders’ quick decision and awareness, the CPR procedure can be effective.