Cardiopulmonary Resuscitation (CPR)
Cardiopulmonary resuscitation (CPR) is a basic life-support technique that is used when a person is not breathing and the heart may have stopped. CPR allows you to manually perform the functions of the heart and lungs, which send blood and oxygen to all parts of the body.
All the bodyís cells, especially the brain cells, need a steady supply of oxygen. CPR opens and clears the personís airway and restores breathing and blood circulation through mouth-to-mouth breathing and repeated pressure on the chest.
Adults and Children Age 8 and Older
Check for consciousness. Gently shake the person and shout, ďAre you OK?Ē If there is no response or the individual is not breathing, shout for help and ask someone to call the doctor immediately. The order of action to take in an emergency can be remembered as the ABCsóAirway, Breathing, and Circulation.
Airway: Open the Airway (Head Tilt/Chin Lift)
Tilt the personís head back if no neck/spinal injuries are suspected.
Place one hand on the forehead and apply firm, backward pressure to tilt the head back.
Push down on the forehead and lift the personís chin.
Place two fingers of your other hand on the bony part of the personís chin. Pull the personís chin forward and support the jaw, helping to tilt the head back.
Breathing: Check Breathing/Perform Rescue Breathing
Place your ear over the personís mouth and nose while keeping up an open airway. Look for the chest to rise and fall; listen for air escaping during exhalation; and feel for the flow of air. Watch for 5 seconds. If there is no sign of breathing, perform rescue breathing as follows:
Keep the airway open by using the head tilt / chin lift maneuver described above. Gently pinch the personís nose shut using the thumb and index finger of the hand on the forehead.
Take a deep breath and seal your lips tightly around the personís mouth.
Give two full breaths one-and-half to 2 seconds per breath, 10 to 12 breaths per minute. Take a breath for yourself after each two breaths for the other person. Watch for his or her chest to rise with each breath. Let the personís chest fall between breaths.
If the personís chest doesnít rise during rescue breathing, the airway is blocked. Retilt the personís head and try again. If the airway is still blocked, perform the following action :
Kneel and straddle the person, placing the heel of your fist on his or her stomach above the navel and below the ribs.
Place your other hand over your fist. Keeping your elbows straight, give four quick, downward thrusts toward the chest.
Open the personís mouth by grasping both the tongue and lower jaw between the thumb and fingers and lift. This will draw the tongue away from the back of the throat and away from any object that might be lodged there. Look to see if an object is visible in the back of the throat.
Next, perform the finger-sweep as follows:
Insert the index finger of the other hand down along the inside of the cheek and deeply into the throat to the base of the tongue. Use a hooking action to dislodge the object and move it into the mouth so that it can be removed.
Attempt rescue breathing again. If you are still unable to breathe air into the personís lungs, reposition the head and try again. Repeat the sequence of Heimlich maneuver, finger sweep, and rescue breathing. Perform this cycle until the object is dislodged, and you are able to continue rescue breathing.
Circulation: Check for Pulse
By keeping the personís head tilted back, move two fingers from the Adamís apple to the side of the neck between the windpipe and the neck muscles. Press down gently and gradually for 5 to 10 seconds. A pulse shows that the heart is beating.
If the person has a pulse but is not breathing, continue rescue breathing at a rate of 10 to 12 times per minute, or once every 5 or 6 seconds. If the person has no pulse and is not breathing, begin chest compressions.
Find the notch where the individualís ribs meet the breastbone in the center of the chest. Place the heel of your flattened hand 2 finger- widths up toward the chest from the notch. Place your other hand on top of this hand, interlocking your fingers.
Lean forward until your shoulders are directly over your hands. Your body weight falling forward provides the force to depress the breastbone.
Do 15 chest compressions (at a rate of 80 to 100 per minute), continuing to lean over the person so your shoulders are over your hands.
Donít rock back and forth or pause between compressions. Lock your arms straight and press hard on the breastbone to 1-and-1/2 to 2 inches or one-third of the chest depth.
Count out loud ďone and, two and, three and, four and,Ē as you push straight down. Allow the chest to return to its normal position after each compression. Do not lift your hands from the chest or change position, or correct hand position may be lost.
Open the airway again using the head tilt/chin lift and give two slow rescue breaths. Watch for the chest to rise. Repeat this sequence of 15 compressions and two breaths for four cycles. Recheck for pulse.
When the person is breathing and has a pulse, stop performing CPR. If the person has a pulse but is not breathing, continue rescue breathing. Recheck the pulse every 60 seconds. Start chest compressions again if pulse stops. If the person has no pulse and is not breathing, repeat sequence of 15 compressions and two breaths, checking for pulse every four cycles, Continue until the person revives or help arrives.