CONDITIONS

CPR

What Is CPR

CPR stands for Cardiopulmonary resuscitation, a lifesaving technique used when someone’s heart has stopped beating or they’re not breathing (for example, they’ve had a heart attack, or nearly drowned). While it’s best to be trained in CPR before attempting to perform it on someone, it’s better to try something than do nothing if you see a person in a life-or-death situation.

 

Why is knowing how to perform CPR important?

 If a person has stopped breathing or her heart is no longer beating, he can sustain brain damage in as little as several minutes, and die in as few as 8 to 10 minutes. CPR may help head off these dire consequences. It can keep oxygen-rich blood flowing to the person’s brain and other vital organs until medical professionals can help him to recover a normal heart rhythm.

What should you do before you perform CPR?

  1. If the person seems to be unconscious, shake her shoulder or tap her, and loudly ask if she’s all right.
  2. If she doesn’t reply, ask someone to call 911 or a local emergency number while you begin CPR, or call for help yourself, if there’s no one else in sight and you have a phone handy. (One exception: If you’re alone and think the person has suffocated due to an accident such as drowning, perform CPR for one minute before calling for help.)
  3. If an automatic defibrillating device (or AED)—a device that can deliver an electrical shock to the chest, possibly restarting the heart—is right at hand, deliver one shock if the device’s instructions indicate it, and begin CPR after that.

How to perform CPR on an adult

How is CPR performed? Your best course of action depends on your skill level, and the age of the victim. The directions below are for an adult.


To perform CPR on an adult:

  • If you’ve never received CPR training, or once had training but aren’t sure you remember how to do it, perform chest compressions on the person at a rate of roughly 100 per minute until help arrives.
    • To perform chest compressions:
      • Lay the person on his back on a flat, firm surface.
      • Kneeling beside his neck and shoulders, put the heel of one of your hands on the middle of his chest (the place midway between his nipples). Cover that hand with your other hand, keeping your elbows straight and your shoulders directly above your hands’ location.
      • Push straight down on the chest, using your upper body weight. Compress the chest by at least two inches. Keep pushing hard at a rate of roughly 100 compressions per minute until medical help arrives, or the person begins to move.
  • If you have received CPR training and are confident in your ability to perform CPR:
    • Give the person 30 chest compressions.
    • Open the person’s airway. To do this:
      • Put your palm on his forehead and tilt his head back gently. With your other hand, lift his chin forward gently.
      • Take 5 to 10 seconds to check to see if he’s breathing normally. Is his chest rising and falling? Is he making normal breath sounds? (Gasping isn’t normal.) Can you feel his breath on your ear and cheek?
      • If he isn’t breathing, and you don’t believe he’s had a heart attack, begin doing mouth-to-mouth breathing. If you think he’s had a heart attack and you have not received training for such an emergency, continue with the chest compressions instead.
        • To perform mouth-to-mouth breathing:
          • After opening the person’s airway (hyperlink to “Open the person’s airway” section), pinch his nostrils shut and put your mouth over his, forming a complete seal around it.
          • Breathe into his mouth for one second, watching to see if his chest rises—this is called a ‘rescue breath’. When the chest rises, you know that the person is receiving air. If his chest rises, perform a second rescue breath. If his chest doesn’t rise, try to open the airway again. (Hyperlink to “Open the person’s airway” section.) Thirty chest compressions, followed by two rescue breaths, is what’s called ‘a cycle.’
          • If, after 5 cycles (this should take roughly two minutes), the person hasn’t started moving, see if an Automatic External Defibrillator (AED) is available—this device can restart a stopped heart by delivering an electrical charge to the victim’s chest. If no AED is on hand, continue CPR until help arrives or the person starts moving. If you can locate an AED, however, follow the directions to administer one shock. You may also ask a 911 operator for AED guidance.
          • After administering the AED shock, resume performing CPR, starting with chest compressions. After two minutes, use the AED to deliver a second shock. If someone is with you, you should rotate doing CPR every two minutes.

How to perform CPR on a child

How is CPR performed? Your best course of action depends on your skill level, and the age of the victim. The directions below are for a child between the ages of 1 and 8.


To perform CPR on a child between 1 and 8 years of age:

  • Have another person on the scene call for help while you begin CPR. If no one else is around, perform five cycles of chest compressions and breaths [hyperlink to “To perform chest compressions”] before pausing to call 911 on your local emergency number, or using an AED.
  • To perform chest compressions:
    • Lay the child on his back on a flat, firm surface.
    • Kneeling beside his neck and shoulders, put the heel of one of your hands on the middle of his chest (the place midway between his nipples), keeping your elbows straight and your shoulders directly above your hands’ location.
    • Push straight down on the child’s chest, using your upper body weight. Press down on the child’s chest so that it compresses about 1/3 to 1/2 the depth of the chest. Keep doing this at a rate of roughly 100 compressions per minute.
  • After you’ve done 30 chest compressions, attempt to open the child’s airway:
    • Put your palm on his forehead and tilt his head back gently. With your other hand, lift his chin forward gently.
    • Take 5 to 10 seconds to check to see if he’s breathing normally. Is his chest rising and falling? Is he making breath sounds? (Gasping is not normal.) Can you feel his breath on your ear and cheek?
    • If he isn’t breathing, begin doing mouth-to-mouth breathing. With these steps:
      • After opening the child’s airway (hyperlink to “Open the person’s airway” section), pinch his nostrils shut and put your mouth over his, forming a complete seal around it.
  • Breathe into his mouth (don’t do this too hard – his lung capacity is less than an adult’s) for one second, watching to see if his chest rises—this is called a ‘rescue breath’. If his chest rises, perform a second rescue breath. If his chest doesn’t rise, try to open the airway again. (Hyperlink to “Open the person’s airway” section.) Perform thirty chest compressions, followed by two rescue breaths—this is called ‘a cycle.’
  • If, after 5 cycles (about 2 minutes), the child hasn’t started moving, see if an Automatic External Defibrillator (AED) is available—this device can restart a stopped heart by delivering an electrical charge to the victim’s chest. (Note: AED’s should not be used in children less than 1 year old.) If no AED is on hand, continue CPR until help arrives. If you can locate an AED, however, follow the directions to administer one shock. Use pediatric pads if you can; if not, use the adult pads. You may also ask a 911 operator for AED guidance.
  • After administering the AED shock, resume performing CPR, starting with chest compressions. After two minutes, use the AED to deliver a second shock. Continue until help arrives or the child moves on his own.

Prognosis

How is CPR performed? Your best course of action depends on your skill level, and the age of the victim. The directions below are for an infant.


To perform CPR on an infant:

If you know the baby is choking on something, perform first aid for choking. Otherwise, stroke the baby and see if he moves (do not shake the baby).

If someone else is on the scene, have her call 911 or a local emergency number for help. Meanwhile, take these steps:

  • First, perform chest compressions:
    • Place the baby on her back on a surface that’s flat and firm.
    • Take two fingers of one of your hands and place them just below the center point between the baby’s nipples.
    • Gently compress the baby’s chest about 1.5 inches.
    • Continue to press at a rate of about 100 times a minute, while counting aloud.
  • After performing 30 compressions, clear the baby’s airway if you can:
    • Gently lift his chin with one hand while pushing down on his forehead with your other hand.
    • Put your ear near his mouth and listen for breath sounds (take no more than 10 seconds to do this). Also look to see if his chest is moving, and assess whether you feel his breath on your ear and cheek.
  • If the baby isn’t breathing on his own, you will need to breathe for him:
    • Use your mouth to cover both his mouth and nose.
    • Next, give him two rescue breaths. Using the strength of your cheek muscles (not the full power of your lungs), breathe gentle air puffs into the baby’s mouth for one second. Watch to see if his chest rises, and if it does, perform a second gentle breath. If his chest doesn’t rise, clear his airways again before attempting the second breath.
    • If, after the second breath, the baby’s chest still does not rise, check his mouth to see if there’s a foreign object lodged in it. If there is, sweep it out using your finger. If you can’t free it, perform first aid for a choking baby.
    • Resume chest compressions, giving two rescue breaths after each 30 compressions.
    • Keep performing CPR for two minutes before calling for help, if you’re the only one present on the scene.
    • Continue CPR until the baby shows signs of life, or medical assistance arrives.