Sharon has 21+ years of experience as a qualified Emergency Care Nurse registered with the Australian Health Practitioner Regulation Agency (APHRA) and 12+ years as a First Aid Trainer.
She takes pride in FirstAidPro making first aid training available, comprehensive and affordable to everybody.
Cardiopulmonary Resuscitation (CPR) stands as a cornerstone of emergency medical care, serving as a bridge between life and death in critical situations. It is a lifesaving technique designed to sustain vital functions when the heart stops beating or when breathing abnormally.
In this comprehensive exploration, we delve deeply into the intricacies of CPR, shedding light on its significance, its relationship with first aid principles, the various types of CPR, and the protocols that guide its administration.
Understanding the Significance of CPR
The significance of CPR cannot be overstated, as it serves as a bridge between the onset of a cardiac event and professional medical help. Understanding the importance of CPR can empower individuals to act decisively in critical moments, potentially saving lives.
One of the primary reasons CPR is so vital is its ability to maintain blood circulation and oxygenation to vital organs when the heart has stopped beating. The heart serves as the body’s pump, circulating oxygen-rich blood to all tissues and organs. In cases of cardiac arrest, where the heart abruptly stops beating, immediate intervention is required to sustain blood flow and prevent irreversible damage to the brain and other vital organs.
Performing CPR involves chest compressions and rescue breaths, both designed to mimic the natural circulation of blood and oxygen in the body. Chest compressions help pump blood through the heart and into the vital organs, while rescue breaths deliver oxygen to the lungs, replenishing the oxygen supply to the bloodstream. This combination aims to maintain a sufficient supply of oxygen to the brain and other organs until advanced medical assistance can be administered.
Time is of the essence with heart attacks or cardiac emergencies, and CPR buys precious minutes. The chances of survival decrease significantly with each passing moment after cardiac arrest. Immediately giving CPR can double or triple the likelihood of survival, making it a critical link in the chain of survival. The sooner CPR is started, the better the chances of restoring normal heart function and preventing permanent damage.
CPR is not solely for cardiac events; it is also crucial in situations where breathing has stopped. Respiratory failure, caused by drowning, choking, or other respiratory emergencies, can quickly lead to a lack of oxygen in the body. Performing CPR compressions and giving rescue breaths can help sustain oxygen levels until professional medical assistance arrives, preventing brain damage and increasing the chances of a positive outcome.
Furthermore, the significance of CPR extends beyond the immediate impact on the individual receiving aid. Bystander CPR can create a ripple effect in the community by promoting a culture of preparedness and response. Training more people in CPR increases the likelihood that someone nearby will step in during an emergency, further reinforcing the chain of survival. Public awareness and education on the importance of CPR contribute to creating a safer environment for everyone.
What is ABC and CPR in First Aid?
In first aid, the terms “ABC” and “CPR” are fundamental concepts that guide the initial assessment and response to a medical emergency, particularly those involving cardiac or respiratory issues. These principles are crucial in providing timely and effective assistance to individuals in distress.
ABC
A stands for Airway: The first step in assessing any emergency is to ensure that the person’s airway is clear and open. If an individual is unconscious, their tongue may fall back and obstruct the airway, preventing normal breathing. First aid responders should gently tilt the person’s head backward and gently lift the chin to open the airway. This allows for the passage of air into the lungs.
B stands for Breathing: After ensuring an open airway, the next step is to check for breathing. This involves looking, listening, and feeling for signs of normal breathing. If the person is not breathing or is having difficulty breathing, immediate intervention is required.
C stands for Circulation: Once airway and breathing are addressed, the next focus is on circulation, specifically the person’s pulse. Assessing circulation involves checking for a pulse at a major artery, typically the carotid artery in the neck. If a pulse is absent, it indicates a lack of circulation and may necessitate cardiopulmonary resuscitation (CPR).
CPR (Cardiopulmonary Resuscitation)
CPR is an emergency lifesaving technique that involves performing chest compressions and rescue breaths when an individual is unresponsive, not breathing or not breathing normally.
Chest Compressions: The rescuer places the heel of their hand on the centre of the person’s chest and delivers rhythmic compressions. The goal is to push down at least 2 inches deep for adult victims and at a rate of 100-120 compressions per minute. Performing CPR compressions helps circulate blood to the vital organs.
Rescue Breaths: After every 30 compressions (in the traditional CPR method), the rescuer gives two rescue breaths to provide oxygen to the lungs. For hands-only CPR, where rescue breaths are not performed, chest compressions alone can still be effective in maintaining circulation.
The ABC and CPR sequence is a systematic approach to prioritizing and addressing the critical elements of a medical emergency. It ensures that immediate attention is given to maintaining an open airway, facilitating breathing, and supporting circulation. Both ABC and CPR are essential components of first aid training, equipping individuals with the skills to respond effectively to situations that require prompt and decisive action.
Is CPR and AED the Same as CPR and First Aid?
CPR and AED (Automated External Defibrillator) are closely intertwined components within the broader context of first aid.
While CPR focuses on manually sustaining circulation through chest compressions and, optionally, rescue breaths, an AED (Automated External Defibrillator)is a specialised device used to deliver electrical shocks to restore normal heart rhythm during cardiac arrest. CPR and AED training often go hand in hand in first aid programs, emphasizing the complementary nature of these interventions in saving lives.
Is CPR the Same as First Aid?
CPR represents a vital subset of first aid but does not encapsulate the entirety of first aid principles and techniques. First aid encompasses a wide spectrum of skills, ranging from wound care and fracture management to basic life support interventions like CPR. While CPR specifically targets circulatory emergencies, first aid encompasses a broader array of medical interventions aimed at stabilizing individuals in various emergencies.
How Long Can You Do CPR?
The duration for which CPR should be performed depends on various factors, including the cause of cardiac arrest, the responder’s stamina and professional medical help.
CPR should be continued until one of the following situations occurs:
- Professional Medical Help Arrives: Ideally, CPR should happen until an ambulance arrives at the scene and takes over the resuscitation efforts. Once EMS arrives, they can provide advanced life support, including the use of defibrillation and medications, which may improve the chances of restoring the person’s heartbeat and breathing.
- The Person Revives: In some cases, CPR may result in the restoration of spontaneous circulation, leading to the person regaining consciousness and breathing on their own. If the person starts breathing normally and shows signs of consciousness, CPR can be discontinued.
- Rescuer Fatigue: CPR can be physically demanding, especially if performed for an extended period. Rescuers may become fatigued, which can affect the quality of chest compressions and compromise the effectiveness of CPR. In such cases, it may be necessary to rotate rescuers or take breaks until paramedics arrive.
It’s important to note that the effectiveness of CPR diminishes over time and the chances of successful resuscitation decrease with each passing minute after cardiac arrest. For this reason, initiating CPR as soon as possible is crucial for improving the person’s chances of survival.
Current guidelines recommend uninterrupted chest compressions with minimal interruptions to maximise blood flow to vital organs during CPR. The American Heart Association (AHA) suggests that interruptions in chest compressions should be minimised, with an emphasis placed on providing high-quality compressions at a rate of 100-120 compressions per minute.
Why is it Called CPR?
The acronym CPR holds a profound significance, embodying a life-saving skill that addresses the intricacies of cardiac and respiratory emergencies or when the person stops breathing.
At its core, “Cardio” in CPR directs attention to the heart, which is responsible for pumping life-sustaining blood throughout the body. In instances of cardiac arrest, the heart’s rhythmic pumping ceases abruptly, resulting in a halt in blood circulation.
The primary objective of the “Cardio” component of CPR is to reignite this cardiac activity. Chest compressions, a central element of CPR, are administered to mimic the heart’s pumping action. The forceful compressions, when applied correctly, promote blood flow to vital organs, particularly the brain, preventing irreversible damage during the critical moments before professional medical help arrives.
The second component, “Pulmonary,” emphasises the importance of the lungs and the respiratory system. This aspect recognises that effective resuscitation involves not only addressing the heart but also ensuring a continuous supply of oxygen to the body’s tissues. “Pulmonary” in CPR is manifested through rescue breaths. These artificial respirations, delivered through mouth-to-mouth breathing or a person’s mouth-to-mask ventilation, sustain oxygenation of the blood. By providing this vital element, CPR aims to prevent organ failure and enhance the chances of a positive outcome.
The term “Resuscitation” completes the CPR acronym, encapsulating the overarching goal of the technique. “Resuscitation” embodies the act of reviving or restoring an individual from an unconscious or lifeless state. In CPR, this revival involves not only restarting the heart but also maintaining a balance between chest compressions and rescue breaths. The holistic approach of CPR acknowledges the interdependence of cardiac and pulmonary functions and underscores the need for a comprehensive strategy in the face of emergencies.
The significance of the name “CPR” lies in its ability to succinctly capture the essence of the life-saving technique. Beyond being an acronym, CPR represents a dynamic and integrated approach to emergency response. It symbolises the coordinated effort required to navigate the complexities of cardiac and respiratory emergencies successfully.
How Do You Know Someone Needs CPR?
Recognising when someone needs CPR (Cardiopulmonary Resuscitation) is crucial for providing timely and effective assistance during a medical emergency. Several signs and symptoms indicate the need for CPR:
Unconsciousness
If an individual is unresponsive and does not react to stimuli such as touch, sound or gentle shaking, it could be a sign that they require CPR.
Absence of Breathing
Check for signs of breathing by observing the person’s chest for rise and fall movements, listening for breath sounds, and feeling for breath on your cheek. If the person is not breathing or is only gasping irregularly, CPR may be necessary.
No Pulse
Assess the person’s pulse by checking for signs of circulation at a major artery, typically the carotid artery in the neck. If a pulse is absent or difficult to detect, it may indicate cardiac arrest and the need for immediate CPR.
Unresponsiveness and Abnormal Breathing
In some cases, the person may be unresponsive but still exhibit abnormal breathing patterns, such as gasping, agonal breaths or shallow breathing. These signs suggest a compromised airway or impending cardiac arrest, warranting the start of CPR.
Sudden Collapse
If an individual suddenly collapses and shows no signs of consciousness or normal breathing, it could be indicative of a cardiac event or respiratory failure, necessitating immediate CPR intervention.
Witnessed Cardiac Arrest
In situations where cardiac arrest is witnessed, start CPR even if the person appears unresponsive or not breathing normally.
It’s important to note that in cases of suspected cardiac arrest, every minute counts. Early initiation of CPR can significantly improve the person’s chances of survival and minimize the risk of irreversible brain damage.
When Should You Not Start CPR?
While CPR is a critical intervention in many emergency scenarios, there are instances where initiating CPR may not be appropriate or feasible.
Two primary scenarios guide the decision-making process regarding the initiation of CPR: 1. the presence of obvious signs of irreversible death and 2. the existence of valid Do Not Attempt Resuscitation (DNAR or DNR) orders.
Firstly, where there are apparent signs of irreversible death, starting CPR would be futile and ethically inappropriate. Signs such as rigour mortis, decomposition, dependent lividity or decapitation indicate that the individual has passed beyond the threshold where resuscitative efforts can be effective. Attempting CPR in these circumstances not only disregards medical futility but also fails to respect the dignity and integrity of the deceased individual. Therefore, healthcare providers and first responders must be trained to recognise these unmistakable indicators of irreversible death and refrain from initiating CPR to avoid unnecessary distress to the individual’s loved ones and to uphold professional standards of care.
Secondly, the presence of valid DNAR orders signifies the individual’s autonomous decision to decline resuscitative measures in the event of cardiac arrest or respiratory failure. DNAR orders are legal documents that articulate the individual’s preferences regarding end-of-life care, including the withholding of CPR. It is imperative for healthcare professionals and emergency responders to honour these directives and respect the individual’s right to make informed decisions about their medical treatment.
What Are the Five Steps of CPR?
The five essential steps of CPR are as follows:
Assess the Scene
Before starting CPR, ensure that the scene is safe for both the rescuer and the victim. Check for any potential hazards or dangers that could pose a risk during the rescue process. Assessing the scene helps prevent additional injuries and ensures a secure environment for assisting.
Check Responsiveness
Approach the victim and assess their level of responsiveness by tapping their shoulders and asking loudly, “Are you okay?” If there is no response, gently shake the victim and check for any signs of consciousness. Look for normal breathing and movement responses. If the victim is unresponsive, proceed to the next step.
Call for Help
If the victim is unresponsive and not breathing normally, immediately call for emergency medical assistance or instruct someone nearby to do so. Activate the local emergency response system and provide clear and concise information about the situation, including the victim’s condition and location. Promptly calling for help ensures that professional medical assistance is on the way while CPR is being administered.
Perform CPR – Chest Compressions
With the victim lying in their recovery position, put yourself beside them. Place the heel of one hand in the centre of the victim’s chest, between the nipples. Interlock your fingers and position your shoulders directly over your hands. Begin performing chest compressions by pressing down firmly and quickly at a rate of 100 to 120 compressions per minute. Allow the chest to rise completely between compressions to facilitate blood flow.
Deliver Rescue Breaths
After 30 chest compressions, provide two rescue breaths to the victim to help oxygenate their lungs and bloodstream. Ensure that the victim’s airway is open by tilting their head back and lifting their chin. Pinch the victim’s nose shut, create a tight seal over their mouth with your mouth, and deliver a second rescue breath lasting about one second each. Observe for chest rise and fall to confirm adequate ventilation. Resume chest compressions immediately after delivering rescue breath.
After 30 compressions, open the person’s airway using the head-tilt chin-lift maneuver, and give two rescue breaths. Watch for chest rise with each breath. Continue cycles of 30 compressions and 2 breaths until professional medical help arrives or until the person shows signs of responsiveness and normal breathing.
These five CPR steps form the foundation and are crucial for initiating immediate and effective assistance to individuals experiencing cardiac arrest or respiratory failure. Proper CPR training, first aid courses and practice in CPR techniques can help improve confidence and readiness to respond to medical emergencies.
What Are the Two Types of CPR?
There are two primary types of CPR (Cardiopulmonary Resuscitation): conventional CPR and hands-only CPR.
Conventional CPR
Also known as traditional CPR, conventional CPR involves a combination of chest compressions and rescue breath. It is typically administered in a ratio of 30 chest compressions to 2 rescue breaths. The rescuer begins by delivering chest compressions to help circulate oxygenated blood to important organs of the body. Following the chest compressions, the rescuer provides two rescue breaths to deliver oxygen to the person’s lungs. Conventional CPR is recommended for individuals of all ages, including adults, children and infants, who are in cardiac arrest or experiencing respiratory failure.
Hands-Only CPR
Hands-only CPR, also referred to as compression-only CPR, involves performing uninterrupted chest compressions without rescue breaths. This simplified form of CPR is particularly advocated for bystanders who may be hesitant or uncomfortable with mouth-to-mouth ventilation. Hands-only CPR focuses solely on maintaining blood circulation through rhythmic chest compressions at a rate of 100-120 compressions per minute. It is primarily recommended for adults and adolescents who suddenly collapse because of cardiac arrest in out-of-hospital settings. Hands-only CPR is equally effective as conventional CPR in cases of witnessed cardiac arrest in adults.
Both conventional CPR and hands-only CPR aim to sustain vital organ perfusion and maximise the chances of survival until professional medical assistance arrives. The choice between the two types of resuscitation depends on factors such as the rescuer’s level of CPR training, the circumstances of the emergency, and the preferences of the individual assisting. Regardless of the type performed, prompt initiation of CPR is essential for improving outcomes in cases of cardiac arrest and respiratory distress.
How to Perform CPR — Children Over 1 year
To perform CPR on a child over 1-year-old, start by ensuring the scene is safe, then check the child’s responsiveness and call for help. Open the child’s airway by tilting their head back and lifting the chin. Check for breathing and, if the child is not breathing normally, begin chest compressions. Place the heel of one hand on the centre of the child’s chest and compress about one-third of the depth of the chest at a rate of 100-120 compressions per minute.
If trained, provide rescue breaths after every 30 compressions by pinching the child’s nose closed and giving two mouth-to-mouth breathing. Continue cycles of compressions and breaths on the child’s mouth until help arrives or the child recovers. Remember to stay calm and focused, as prompt CPR can make a critical difference in the child’s survival.
How to Perform CPR — Babies Under 1 year
Performing CPR on babies under 1-year-old involves several steps to ensure their safety and well-being. Start by assessing the scene and checking the baby’s responsiveness. If the baby is unresponsive, call emergency services immediately. To perform CPR, gently tilt the baby’s head back to open the airway and check for breathing. Administer chest compressions using two fingers in the centre of the baby’s chest, followed by gentle rescue breaths if trained. Alternate between compressions and breaths until help arrives or signs of life appear. Remember, quick action and proper technique can significantly improve the baby’s chances of survival during a medical emergency.
Conclusion
CPR stands as a cornerstone of first aid, playing a pivotal role in preserving life and minimising the impact of medical emergencies. By understanding the principles of CPR, recognising the indications for its use, and adhering to established protocols, individuals can become empowered to intervene effectively in critical situations. Through education, CPR training and public awareness initiatives, we can ensure that CPR remains a vital link in the chain of survival, empowering communities to respond decisively to emergencies and save someone’s life.
