Cardiopulmonary Resuscitation for Adults
(Lay Rescuer CPR for Adults)
Definition
Cardiopulmonary resuscitation (CPR) is a series of steps to help a person who has stopped breathing and has no heartbeat. CPR manually delivers oxygen to the lungs and temporarily restores the heartbeat.
Reasons for Procedure
Lay CPR is given to an unresponsive victim who is not breathing. Reasons for this may include:
- Sudden cardiac arrest
- Cerebrovascular accident (eg, stroke )
- Trauma
- Choking
- Drowning
- Electrical shocks and lightning strikes
- Severe infection
- Severe allergic reaction
- Drug overdose
- Excessive bleeding
- Hypothermia
The outcome will depend on the initial cause and how soon effective CPR was initiated. Many victims are unable to regain a normal heartbeat after it has stopped.
Possible Complications
The goal of the CPR is to provide blood flow to a victim’s heart, brain, and other vital organs until proper medical care can be given. The victim is likely to die if CPR is not started immediately. Complications may include fracture of the ribs, broken teeth, infections, and puncture of the lung.
People with weakened bones have a higher risk of bone fractures from CPR. However, there is far greater risk of death if CPR is delayed or not done correctly.
What to Do
Prior to Procedure
When you see someone suddenly collapse or find someone unconscious on the ground, immediately check to see if he or she is responsive. Tap the victim and ask: “Are you OK?” If the victim is unresponsive, follow these three steps.
Step 1: Call 911 immediately and check for breathing
- If someone is with you, have them make the call.
- If you are alone, call for help before starting CPR.
- If an automatic external defibrillator (AED) is available, have it brought to the scene. If you are alone, retrieve the AED when you call for help.
- Check for breathing. If the victim is not breathing, begin CPR.
Step 2: Give mouth-to-mouth resuscitation
- Position the adult so that he or she is lying on his back.
- Open the airway by placing one hand on the forehead and lifting the chin with your other hand.
- Gently tilting the head backward, pinch the victim's nose and cover his or her mouth with yours.
- Breathe twice into his or her mouth until you see the chest rise. Breaths should be about one second each.
Step 3: Do chest compressions
- Place the heel of one hand palm down on the chest, with the other hand on top.
- Straighten your arms and lock your elbows. Begin pressing down in a straight motion. The compressions should be about two inches deep.
- Push hard. Push fast. Push at a rate of 100 compressions/minute.
- Allow the chest to rise completely between compressions.
- Minimize interruption between compressions.
- After 30 compressions, give two rescue breaths.
Use AED as soon as it is available.
- Turn the AED on.
- Attached the pads.
- Follow the prompts. If advised, deliver the shock. If the shock is not advised, the AED will tell you to resume CPR.
Continue cycle of 30 compressions and 2 breaths until one of the following occurs:
- Medical help arrives
- It becomes unsafe to continue
- The victim regains consciousness and is able to breathe
Chest Cavity and Air Pathway
Hands-Only CPR
In 2008, the American Heart Association began recommending a simplified version of CPR. This version was created to encourage previously reluctant by-standers to help. The hands-only method is certainly better than doing nothing at all.
In hands-only CPR, there are just two steps:
- Call 911.
- Push hard and fast in the center of the chest.
How Long Will It Take?
The length of time for CPR depends on the underlying causes and response time of the emergency medical team.
Will It Hurt the Victim?
The patient is unconscious when CPR is given. The procedure does not hurt. Some patients may complain of soreness in the chest after regaining consciousness.
Post-procedure Care
The patient should be taken to the hospital. They should go even if they have recovered. Emergency personnel will take over care when they arrive.
RESOURCES:
American Heart Association
http://www.americanheart.org/
American Red Cross
http://www.redcross.org/
CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca/
Public Health Agency of Canada
http://www.phac-aspc.gc.ca/
References:
American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=1200000.
American Heart Association. Heartsaver First Aid with CPR and AED. Dallas, TX: American Heart Association; 2006
American Red Cross website. Available at: http://www.redcross.org.
Cardiopulmonary resuscitation (CPR). Am Fam Physician . 2000;62(7). Available at http://www.aafp.org/afp/20001001/1564ph.html. Accessed February 27, 2007.
Cayley WE. Practice guidelines 2005 AHA guidelines for CPR and emergency cardiac care. Am Fam Physician . 2006;73(9). Available at http://www.aafp.org/afp/20060501/practice.html. Accessed February 27, 2007.
Neumar RW, Nolan JP, Adrie C, et al. Post-cardiac arrest syndrome: epidemiology, pathophysiology, treatment, and prognostication. A consensus statement from the International Liaison Committee on Resuscitation. Circulation. 2008 Dec 2;118(23):2452-83. Epub 2008 Oct 23. No abstract available.
Last reviewed October 2009 by Marcin Chwistek, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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