CARDIOPULMONARY RESUSCITATION

How To Perform A CPR - CPR Procedure

Cardiopulmonary Resuscitation or CPR  Procedure
Cardiopulmonary resuscitation procedure, otherwise known as CPR, is a medical life-saving process to prevent brain death of a person who has suffered a cardiac arrest, until medical help arrives. CPR is usually given when a person shows signs of no or abnormal breathing. When a person suffers a cardiac arrest or a heart attack, flow of oxygenated blood to the brain and rest of the body is restricted. If CPR is not performed on time, the person can become brain dead within 5-10 minutes. Cardiopulmonary resuscitation is performed to restore partial oxygen and blood flow to the brain.

Many cardiac arrests happen outside the hospital and formal training and knowledge of cardiopulmonary resuscitation in India is necessary to save a person’s life. Cardiopulmonary resuscitation includes mouth to mouth resuscitation and chest compressions. A combination of the two helps revive the oxygen and blood flow to the organs.

Cardiopulmonary Resuscitation Procedure 
There are different cardiopulmonary resuscitation procedures for adults, children and new born babies. It is important to follow the stabilization technique according to the set CPR standards. Before starting CPR, check if the person has any signs of not breathing or irregular breathing, unconscious or unresponsive. The acronym CAB (Compression, Airway and Breathing) is used to easily remember the cardiopulmonary resuscitation procedure.

Hands-only CPR for Adults
This cardiopulmonary resuscitation procedure is followed for adults and children who have attained puberty. Hands-only CPR should not be performed on a person who has had the cardiac arrest due to near-drowning, drug overdose or an unwitnessed cardiac arrest. In such cases, chest compressions and mouth to mouth resuscitation should be performed in combination BY TRAINED PERSONS ONLY.

Check the responsiveness of the person
Your first step will have to be to check the responsiveness of the person.

• You must gently shake the person or tap their shoulder and shout “Are you okay?”
• In case there is no normal breathing, call the emergency helpline.

Chest Compressions- To be done by trained and certified persons only
The next step will be to do chest compressions.

• You will need to place the heel of your hand on the centre of the person’s chest or the lower half of the breastbone.
• Next you will have to interlock your fingers by placing your other hand, over the first one.
• Your arms should be straight and your shoulders should be directly above your hands.
• Press down smooth, strong and consistently, compressing the chest to either 1/3th the depth or 2 inches.
• You will have to wait for the chest to rise before you compress again.
• There should be about 100 compressions a minute.

You must only stop if the person resumes breathing, help arrives or you are too tired to continue. Try to arrange for an ambulance with trained personnel to use an Automated External Defibrillator (AED) as soon as possible.

Mouth to Mouth Resuscitation
If you are trained in CPR, you will have to give 30 compressions and 2 rescue breaths (mouth to mouth resuscitation). If the person is not breathing normally, you have to ensure that they are lying on their back.

• Tilt the head back, lift the chin and open the airway.
• Use your finger and thumb to close their nostrils.
• Blow into their mouth by placing your mouth over theirs.
• 2 full breaths (rescue breathing) should be given to person. It is necessary to ensure that there is no air leak and there is rising and falling of the chest. If the chest does not rise and fall, check if the nostrils are pinched correctly and their mouth is sealed completely by yours. Also check for any obstruction in the airway.

For children below the age of eight, follow the above cardiopulmonary resuscitation procedure of chest compressions, but use only one hand.

In case of infants, neonatal resuscitation is performed. Neonatal resuscitation needs to be performed delicately and with utmost care by persons trained in handling neonatal resuscitation. Use only 2 fingers for chest compressions. Place the infant on their back and use mouth to mouth resuscitation (the head need not be tilted). Make sure there are only small breaths.