Cardiopulmonary Resuscitation (CPR)
Cardiopulmonary Resuscitation (CPR) is a
first aid technique which should be administered as soon as possible to a
person who has suffered a cardiac arrest (their heart has stopped beating). A
heart attack is the commonest cause of cardiac arrest.
The first few minutes after a cardiac
arrest are vital: if the pumping activity of the heart is not restored within a
couple of minutes the brain suffers irreversible damage. CPR involves a
combination of mouth-to-mouth rescue breathing and chest compressions to keep
oxygenated blood flowing to the brain and other organs.
New guidelines concerning the best method
for carrying out CPR were published by the American Heart Association in
November 2005, and have been adopted by the Irish Heart Foundation since July
2006. This means the following guidelines may differ from advice you have
previously received. If you feel more confident using older techniques that you
may be familiar with, you can continue to do so; they are still effective and
valid.
CPR technique
Adults (including children above the age of
puberty)
- Check the person for a response and for any
sign of normal breathing.
- If they are unresponsive and are not breathing
normally, ring for an ambulance immediately on 999 (or 112) – or if possible,
get some else to ring for you.
- Begin CPR as follows.
First give 30 chest compressions:
- Place the heel of one hand in the centre of
the person’s chest (between the nipples) and place your other hand on top of
the first. Keep your elbows straight and position your shoulders directly above
your hands.
- Press down on the chest 4-5cm, pushing hard
and fast. Repeat this 30 times, at a rate of 100 compressions/minute (faster
than once per second).
Give 2 rescue breaths:
- Pinch the person’s nose and seal the patient’s
mouth with your own. Blow steadily into the person’s mouth for one second,
checking to see whether the person’s chest rises with each breath.
- Continue with cycles of 30 chest
compressions followed by 2 rescue breaths until help arrives, or the person
begins to breathe normally.
Babies and children
There are some differences to the procedure
if you need to give CPR to a child or a baby (under one year of age). The key
differences are:
- If you are on your own, give one minute of
CPR BEFORE calling an ambulance (ideally, have someone else call an ambulance
while you begin CPR)
- Babies and children should be given 5
initial rescue breaths BEFORE commencing chest compressions.
- Check the airway for any obvious
obstructions before giving rescue breaths by placing one hand on the forehead,
gently tilting the head back and lifting the chin.
- For babies, you will need to place your
mouth over the infant’s mouth and nose to give rescue breaths.
- Use only two fingers for chest compressions
for babies, placed just below the nipple line; for children above the age of 1,
use one or two hands.
- After the 5 initial rescue breaths, the
same adult procedure can be followed (i.e., 30 chest compressions followed by 2
breaths).
Recovery position
- If breathing is restored and signs of
circulation are present, roll the patient over onto their side into what is
commonly known as the 'recovery position' until an ambulance arrives.
- The patient may still be unconscious at
this point, but placing them on their side means that mucus or vomit which may
have accumulated as a result of the trauma they have experienced will be able
to get out of the mouth and will not obstruct the airways.
- Also, the 'recovery position' prevents the
tongue from falling back into the mouth and blocking the air passages.
Note: CPR is best learned at a first aid
course where hands-on experience of the technique is acquired. Training is
usually performed on a special mannequin, which has been constructed to
simulate the signs of cardiac arrest. The above instructions should not be
regarded as adequate instruction in CPR.
