How do I perform CPR?

Joshua Ferdinand

Director
Staff member
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I would like to know how to best perform CPR.

Where is it done best in the world, and at what ages should I change the style of CPR I am giving to the person, child or newborn baby? When I change what should these styles be?
 
Solution
CPR, or cardiopulmonary resuscitation, is a life-saving technique that's useful in many emergencies, such as a heart attack or near drowning, where someone's breathing or heartbeat has stopped. Here's a general guide on how to perform CPR:

1. Check the environment and the person: Ensure the scene is safe, then tap the person on the shoulder and shout "Are you OK?" to ensure that the person needs help.

2. Call for help: Dial 999 or ask someone else to do so.

3. Open the airway: With the person lying on their back, tilt the head back slightly to lift the chin.

4. Check for breathing: Listen carefully, for no more than 10 seconds, for sounds of breathing. If there is no breathing begin CPR.

5. Push hard...
CPR, or cardiopulmonary resuscitation, is a life-saving technique that's useful in many emergencies, such as a heart attack or near drowning, where someone's breathing or heartbeat has stopped. Here's a general guide on how to perform CPR:

1. Check the environment and the person: Ensure the scene is safe, then tap the person on the shoulder and shout "Are you OK?" to ensure that the person needs help.

2. Call for help: Dial 999 or ask someone else to do so.

3. Open the airway: With the person lying on their back, tilt the head back slightly to lift the chin.

4. Check for breathing: Listen carefully, for no more than 10 seconds, for sounds of breathing. If there is no breathing begin CPR.

5. Push hard, push fast: Place your hands, one on top of the other, in the middle of the chest. Use your body weight to help you administer compressions that are at least 2 inches deep and delivered at a rate of at least 100 compressions per minute.

6. Deliver rescue breaths: With the person's head tilted back slightly and the chin lifted, pinch the nose shut and place your mouth over the person's mouth to make a complete seal. Blow into the person's mouth to make the chest rise. Deliver two rescue breaths, then continue compressions.

7. Continue CPR steps: Keep performing cycles of chest compressions and breathing until the person exhibits signs of life, such as breathing, an AED becomes available, or EMS or a trained medical responder can take over.

The best place to perform CPR is on a firm, flat surface. This allows for the most effective chest compressions.

As for the age groups, the style of CPR does change:

- Adults: Use the method described above.

- Children aged 1 to puberty: Use one or two hands, as needed, to achieve proper chest compression depth. The rate of compression and breaths remains the same.

- Infants (up to 1 year old, excluding newborns): Use two fingers to give compressions in the centre of the chest. Compressions should be about 1.5 inches deep at a rate of 100-120 per minute. Give one breath every 3-5 seconds.

- Newborns: Newborn resuscitation is complex and should be performed by trained healthcare providers. It involves measures to clear the airways, provide warmth, and stimulate breathing.

Remember, any attempt at CPR is better than no attempt. CPR can keep oxygenated blood flowing to the brain and other vital organs until more definitive medical treatment can restore a normal heart rhythm.

As for where it's done best in the world, it's hard to say definitively as it depends on many factors including the training of the individual, the availability of medical equipment, and the immediate response of medical services. However, countries with advanced healthcare systems and widespread CPR training, such as the UK, the US, Canada, Australia, and many countries in Europe, tend to have higher survival rates from cardiac arrest.
 
Solution
What age is puberty this is rather ambiguous to detect in a child. Please tell me the specific ratios, i.e. 15:2 or 3:1
Apologies for the confusion. The age of puberty can indeed vary, but for the purposes of CPR, a child is typically considered anyone between the age of 1 and the onset of puberty, which can be around 12-14 years old. However, the most important factor is the size of the child, not necessarily the age. If the child is the size of a typical adult, perform adult CPR.

As for the specific ratios:

- Adults: Perform 30 chest compressions followed by 2 rescue breaths. This is a 30:2 ratio.

- Children aged 1 to puberty: If you're alone, perform 30 chest compressions followed by 2 rescue breaths (30:2 ratio). If there are two rescuers, one should perform chest compressions while the other keeps the airway open and performs rescue breaths at a ratio of 15:2.

- Infants (up to 1 year old, excluding newborns): If you're alone, perform 30 chest compressions followed by 2 rescue breaths (30:2 ratio). If there are two rescuers, one should perform chest compressions while the other keeps the airway open and performs rescue breaths at a ratio of 15:2.

Remember, the most important thing is to start CPR as soon as possible and not to stop until professional medical help arrives.
 
Shouldn't I provide rescue breaths before commencing CPR?
The sequence of actions in CPR has been the subject of much debate and research. The current guidelines from the Resuscitation Council (UK) and the American Heart Association recommend starting with chest compressions rather than rescue breaths, which is often referred to as C-A-B (Compressions, Airway, Breathing) rather than the old A-B-C (Airway, Breathing, Compressions).

The rationale behind this change is that starting with chest compressions can help circulate any remaining oxygen in the bloodstream. In the first few minutes after cardiac arrest, there is still oxygen in the blood, so starting with compressions can make use of this.

After 30 chest compressions, the airway is opened and 2 rescue breaths are given. This cycle is repeated until professional help arrives or the person starts to show signs of regaining consciousness.

However, if you've been trained in the A-B-C method and feel more comfortable with it, it's better to do that than do nothing. The most important thing is to act quickly and call for professional medical help.
 
Even for children and newborn?
For children and infants (up to age 1, excluding newborns), if you're alone and witnessed the collapse, start with compressions (C-A-B sequence). However, if you didn't witness the collapse, start with 5 rescue breaths before moving onto compressions (A-B-C sequence). This is because cardiac arrest in children and infants is often due to lack of oxygen (respiratory arrest) rather than a cardiac problem.

For newborns, the situation is different. Newborn resuscitation is a complex process that should ideally be performed by trained healthcare providers. It involves measures to clear the airways, provide warmth, and stimulate breathing. If you find yourself in a situation where a newborn needs resuscitation and no healthcare providers are present, call emergency services immediately and follow their instructions.
 

 
Remember DR ABC

Danger
Response
Airways
Breathing
Circulation

If you have followed this, this is usually a good indication of when to start CPR.
It's great that you're familiar with the DR ABC approach, which stands for Danger, Response, Airways, Breathing, and Circulation. This mnemonic is a helpful way to remember the essential steps in assessing a person's condition and determining when CPR may be necessary.

By following DR ABC, you can quickly assess the situation, check for responsiveness, ensure the airway is clear, look for breathing, and assess circulation. If you find no signs of life during this assessment, it's crucial to start CPR promptly.

Prompt initiation of CPR can significantly improve the chances of survival for someone experiencing cardiac arrest. Remember, even if you're unsure, it's better to err on the side of caution and start CPR if you suspect someone may need it. Early intervention can make a lifesaving difference in such emergencies.
 
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