Cardiopulmonary Resuscitation for Teens and Adults
Definition
Cardiopulmonary resuscitation (CPR) is a series of steps to help a person who is not responding and has stopped breathing. CPR helps deliver oxygen rich blood to the body tissue when the body is not able to do this on its own.
Reasons for Procedure
Lay CPR is given to an unresponsive victim who is not breathing and and is not responsive. 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 is responsive. Tap the victim and ask: “Are you OK?†If the victim is unresponsive, follow these steps.
- If you are alone, call 911 and, if available, get the automatic external defibrillator (AED). An AED is a device that delivers electric shocks to the victim's heart. If someone is with you, have that person call 911 and get the AED.
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If the person is not breathing or only gasping, begin CPR by doing 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 at least two inches deep.
- Push hard and fast at a rate of 100 compressions per minute.
- Allow the chest to rise completely between compressions.
- Minimize interruption between compressions.
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If you are trained in CPR, give two rescue breaths after 30 compressions. To give rescue breaths:
- 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 mouth with yours.
- Breathe twice into his mouth until you see the chest rise. Breaths should be about one second each.
- After giving two rescue breaths, do 30 compressions. Continue the cycle of two breaths and 30 compressions.
- If you are not trained in CPR, continue doing the chest compressions without giving rescue breaths.
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Give CPR until the AED is brought to the scene or until:
- Medical help arrives.
- It becomes unsafe to continue.
- The victim regains consciousness and is able to breathe.
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To use the AED:
- Turn the AED on.
- Attach the pads.
- Follow the prompts. If advised, deliver the shock. If the shock is not advised, the AED will tell you to resume CPR.
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. He should go even if he has recovered. Emergency personnel will take over care when they arrive.
Resources:
American Heart Association
American Red Cross
Canadian Resources:
Health Canada
Public Health Agency of Canada
References:
American Heart Association. 2010 American Heart Association Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care science: part 1 executive summary. American Heart Association website. Available at: http://circ.ahajournals.org/cgi/content/full/.../18_suppl_3/S640. Published October 2010. Accessed October 25, 2010.
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.
Bardy GH. A critic's assessment of our approach to cardiac arrest. NEJM. 2011;364(4);374-375.
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 December 2011 by Ganson Purcell Jr., MD, FACOG, FACPE
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.