The single most important skill in first aid.
Recap on CPR
CPR is a critical life-saving technique that can be used to restore circulation and breathing in someone whose heart has stopped.
It involves rescue breaths and chest compressions, which are performed at a rate of 100-120 per minute.
The importance of CPR cannot be overstated; it can mean the difference between life and death for those who experience cardiac arrest.
Knowing how to perform CPR correctly is essential for anyone who wants to help save lives in an emergency situation.
Before You Start: Ensure Your Own Safety
Before you start providing help, it is important to ensure your own safety. If the situation is dangerous or hazardous, such as a car accident or fire, do not enter the area until emergency services arrive and have assessed the risk.
Make sure that you are wearing protective clothing such as gloves and masks if necessary. Additionally, be aware of any sharp objects in the vicinity that could cause injury while performing CPR.
Finally, make sure that someone else has called 911 so medical assistance can arrive quickly and provide further care when needed.
Checking For Signs of Life
Before beginning chest compressions, it is important to check for signs of life.
To do this, you should assess the person’s level of consciousness by gently shaking their shoulder and asking if they can hear you.
If there is no response, then proceed to checking for a pulse. Place two fingers on the side of the neck or wrist and feel for any movement that indicates a heartbeat.
If there is still no sign of life, then check for signs of breathing. Place your ear to a person’s mouth and look towards their chest. Look for the rise of the chest, listen for their breath and try to feel any air on your cheek coming out of their mouth or nose.
Be aware of agonal breathing, which can be described as ‘barely there’, heavy, noisy, or gasping. It is present in up to 40% of cardiac arrests. It is also a sign of cardiac arrest!
If there is still no sign of life, begin chest compressions and rescue breaths.
It’s also important to remember that these steps must be done carefully, as CPR can be harmful if done unnecessarily. Check for signs of life for about 10 seconds.
Starting Chest Compressions
Starting chest compressions is the next step in performing CPR. It is important to ensure that you are pressing on the correct area of the chest and with enough force.
Place your hands, one on top of the other, in the centre of their chest between their nipples. Push down firmly at a rate of 100-120 compressions per minute.
Make sure each compression goes about 2 inches deep into their chest before releasing pressure. For children under 8 years old, it is important that the compressions are slightly shallower. Depending on the age and size of the child, the compressions should be about a third of the diamater of their chest.
Keep track by counting out loud or using a metronome to maintain an even rhythm throughout all cycles until help arrives or they regain consciousness.
Delivering Rescue Breaths
Rescue breaths are an essential part of CPR, as they provide oxygen to the lungs, which is necessary for survival.
However, it’s important to remember that if you feel uncomfortable or unable to perform rescue breaths due to lack of experience or fear of infection, it’s still possible to perform effective CPR by focusing on providing quality chest compressions only until help arrives or they regain consciousness.
The American Heart Association recommends delivering two rescue breaths after every 30 chest compressions in adults and children over 8 years old.
To deliver a rescue breath effectively, tilt the head back slightly while pinching the nose shut before breathing into their mouth twice slowly.
Make sure you can see their chest rise with each breath as this indicates that air is entering their lungs correctly.
Keeping a Steady Rhythm
When performing CPR, it is important to maintain a steady rhythm of chest compressions and rescue breaths.
To ensure this, count out loud, sing or hum in your head, or use a metronome to keep track of the rate at which you are pressing down on the chest.
For adults and children over 8 years old, press down firmly at a rate of 100-120 times per minute; for infants under 1 year old use two fingers instead and press at a rate of 30-50 times per minute.
A commonly chosen song to keep in your mind for rhythm keeping is “Stayin’ Alive” by Bee Gees. Other examples can be found online.
Remember about timing the rescue breaths in relation to chest compressions – two rescue breaths after every 30 chest compressions in adults and children over 8 years old.
If you feel uncomfortable or unable to perform rescue breaths due to lack of experience or fear of infection, focus on providing quality chest compressions until help arrives.
Troubleshooting Problems
If you find yourself getting tired, it is important to switch with someone else to ensure that your compressions remain consistent and effective. Communicate clearly and count them in to ensure a smooth transition and minimal interruption to the delivery of effective chest compressions.
It is essential that as soon as cardiac arrest is recognised, professional help is called for – try to get somebody who is not delivering CPR arrange that.
If you lose count, don’t worry – finish as close to 30 chest compressions as you can and continue with the cycle. In a stressful emergency situation this is not unusual.
Stopping CPR
When to stop CPR is an important decision that must be made carefully. Ideally, CPR should be continued until the person revives, but there are circumstances when CPR needs to be stopped.
If the person regains consciousness, opens their eyes, makes a sound or starts breathing, you should stop CPR. However, if the person became unresponsive again with no signs of life, CPR should be restarted.
If you become too exhausted to continue providing quality chest compressions and rescue breaths and there is nobody else on the scene who can switch with you, it may be necessary to pause CPR.
Once professional medical help arrives on scene, do not stop CPR unless clearly instructed to do so – generally, the professionals will take over, but this will need to be done in a controlled fashion.
Finally, if it becomes too dangerous to the rescuer to provide CPR – e.g. due to a fire, traffic in a road traffic accident or other circumstances, they will need to stop.
Using an AED
An automated external defibrillator (AED) is a device used to deliver an electric shock to the heart in order to restore normal rhythm. It can be used when someone has gone into cardiac arrest due to a cardiac rhythm abnormality.
They are commonly available in public places, such as airports or train stations and knowing how to use one may save someone’s life. Using an AED requires following specific steps, which should be done as quickly as possible.
First, turn on the AED and follow the instructions given by its voice prompts. Remove clothing and place adhesive pads on the person’s chest according to their size and position indicated by the machine. Do not forget to plug the pad connector cable into the AED.
Allow the AED to analyse the person’s heart rhythm – make sure no one is touching the person at this time. If the AED advises a shock, again make sure nobody is touching the person by saying ‘CLEAR’ in a loud commanding voice.
Once all of these preparations have been made, press the “shock” button if instructed by the machine or medical personnel present at the scene.
The shock will cause a brief interruption of electrical activity in order for it to reset itself back into a normal rhythm. Once the AED delivers the shock, or if no shock is advised, immediately restart CPR.
Refreshing Your Skills
It is important to stay up-to-date with your CPR knowledge and skills. Regularly refreshing your understanding of the technique can help you remain confident in providing life-saving assistance when needed.
Consider taking a refresher course or attending an online seminar to review the basics, as well as any new developments in CPR techniques.
Additionally, practice on mannequins or other training aids so that you are familiar with how it feels to perform chest compressions and rescue breaths correctly.
It is also beneficial to watch instructional videos or read articles online for further information.
By staying informed and prepared through regular practice sessions and refresher courses, you will be able to provide quality care when someone needs it most.
