What is CPR?
Cardiopulmonary Resuscitation (CPR) is a vital emergency procedure designed to sustain life when an individual's heart ceases to beat or their breathing
becomes critically abnormal. This life-saving intervention artfully combines rhythmic chest compressions with rescue breaths. Its primary aim is to manually circulate oxygen-rich blood throughout the body, particularly to essential organs like the brain, until professional medical assistance can take over. Without prompt CPR, the brain can begin to suffer irreversible damage within a mere 3 to 4 minutes due to oxygen deprivation, and the chances of survival diminish by a significant 7-10% for every minute CPR is delayed. It’s crucial to note that even individuals without formal CPR training can make a profound difference by performing 'hands-only' CPR, which involves continuous chest compressions. Studies indicate this can dramatically increase survival rates, often doubling or even tripling them, in cases of out-of-hospital cardiac arrest.
When to Act
Initiating CPR is critical when you encounter a person who is unresponsive, clearly unconscious, and not breathing normally – perhaps only gasping. Before commencing CPR, your immediate priority is to ensure the safety of the environment for yourself and the casualty. Gently tap their shoulder and call out loudly to assess responsiveness. Simultaneously, observe their breathing for a period of 5 to 10 seconds to confirm it is not normal. If the situation warrants CPR, the next crucial step is to summon emergency medical services immediately. In India, this would be calling 108, or your local emergency number elsewhere. If others are present, delegate this task. If you are alone, place your phone on speaker mode so you can communicate with emergency responders while you begin CPR. If an Automated External Defibrillator (AED) is accessible, dispatch someone to retrieve it, as this device can analyze the heart's rhythm and administer life-saving electrical shocks if necessary.
Adult CPR Procedure
For adult CPR, begin by positioning the individual on a solid, level surface. Kneel beside their chest to gain a stable position. Place the heel of one hand directly in the center of the chest, on the lower half of the sternum, which is typically between the nipples. Position your other hand on top of the first, interlacing your fingers for better leverage. Ensure your arms are straight and your shoulders are positioned directly over your hands. The core of CPR involves pushing hard and fast: compress the chest to a depth of 5 to 6 cm (2 to 2.4 inches) at a rate of 100 to 120 compressions per minute. Aim to match the tempo of well-known songs like 'Stayin' Alive'. It's vital to allow the chest to fully recoil between each compression, enabling the heart to refill with blood. Perform a cycle of 30 compressions, which should take approximately 18 to 24 seconds.
Rescue Breaths Explained
Rescue breaths are an optional but beneficial part of CPR, particularly for those who have received training. To administer them, gently tilt the person's head back slightly while lifting their chin to open the airway. Pinch their nose shut firmly. Create a seal by placing your mouth over theirs and deliver two breaths, each lasting about one second. Observe for the chest to rise visibly with each breath, indicating air has entered the lungs. It's important to avoid over-inflating the lungs, as this can lead to stomach distension. Each breath should be just enough to make the chest rise. Continue alternating cycles of 30 compressions and 2 rescue breaths until emergency medical professionals arrive, an AED becomes available, or the person shows signs of response.
Child CPR Steps
Performing CPR on a child involves similar principles but with slight modifications. For chest compressions, you might use one hand, or two hands for larger children, placing the heel of your hand on the center of the chest, just below the nipple line. The compression depth should be about 5 cm (2 inches), which is roughly one-third of the child's chest depth. Maintain the compression rate of 100 to 120 beats per minute, delivering approximately 30 compressions. When administering rescue breaths to a child, seal your mouth over their mouth and nose, delivering smaller, gentler puffs of air to prevent over-inflation of their stomach. Continue the cycle of 30 compressions and 2 breaths. If you are alone and have not yet called emergency services, perform 2 minutes of CPR before making the call to ensure immediate intervention.
Infant CPR Techniques
For infants under one year old, the approach to CPR is gentler. Use the index and middle fingers of one hand to perform chest compressions. Place these fingers on the breastbone, just below the nipple line. The compression depth should be approximately 4 cm (1.5 inches), about one-third of the infant's chest depth. Deliver 30 compressions at the standard rate of 100 to 120 per minute. Rescue breaths for infants require a very gentle puff of air, delivered by covering the infant's mouth and nose with your mouth. Ensure you support the infant's head and neck throughout the process. Continue with the 30:2 compression-to-breath ratio until help arrives.
Hands-Only CPR
If you are untrained in CPR or feel hesitant about providing rescue breaths, rest assured that 'hands-only' CPR is a highly effective alternative, especially for adults. This method focuses solely on delivering continuous chest compressions at the recommended rate of 100 to 120 beats per minute, without any rescue breaths. This approach has been proven to significantly improve survival chances in cases of out-of-hospital cardiac arrest. The consistent circulation of blood achieved through these compressions is paramount in keeping vital organs oxygenated until professional medical help can take over. This simplified approach empowers more individuals to intervene confidently in emergencies.
Common Mistakes to Sidestep
When performing CPR, certain common errors can diminish its effectiveness. Compressions that are too shallow or too slow are frequent issues; it’s important to use your body weight, not just arm strength, to achieve the correct depth and speed. Be mindful not to lean on the chest after compressions, as allowing full chest recoil is essential for the heart to refill with blood properly. Overly vigorous or excessive ventilation can lead to stomach inflation, which is counterproductive. Another critical point is not stopping CPR prematurely; continue until relieved by professional rescuers or the person shows signs of recovery. If fatigue sets in, switch rescuers every 2 minutes to maintain effectiveness. It's vital to remember that the risk of causing injury, like broken ribs, is far less severe than the certainty of death without CPR intervention.
