Cardiac Resuscitation (CPR)

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Last Medical Review: March 28, 2020
Medically Reviewed by Dr. David Costa Navarro
Cardiopulmonary resuscitation (CPR) (March 28, 2020)
What is CPR? (March 28, 2020)

Cardiac resuscitation, which is usually abbreviated CPR, is a first aid treatment given to get the cardiac activity and breathing going on for someone who has had cardiac arrest. The earlier chest compressions and breaths are started, the greater the chance of surviving a cardiac arrest.

That’s how it goes

Before you start giving cardiovascular rescue, check if the person is conscious and if breathing is normal.

Check if the person is conscious

Talk and try to shake your shoulders lightly to see if the person is responding. If the person does not wake, check the breathing.

Check if the person is breathing

Open the airway by placing a hand on the forehead. Bend your head back and raise your chin with your other hand’s forefinger and middle finger placed on the chin tip.

Place your ear near the person’s nose and mouth. Listen and feel for breath, while watching the chest rise. Abnormal breathing with sparse, deep, sighing breaths can occur in cardiac arrest, but it is not normal breathing.

When should I give cardiac resuscitation?

If the person is unconscious and does not breathe normally, assume that it is a cardiac arrest. Then you should start with cardiac resuscitation.

When should I not give cardiopulmonary resuscitation?

However, you should not start with cardio-respiratory rescue if the person is unconscious but breathing normally. Then place the person in stable lateral position and bend your head back so that the airways are open. Then call 112 for an ambulance and stay with the unconscious person until help arrives. While you wait for the ambulance to arrive, you need to check that the person is still breathing normally. The condition can change.

Start by calling 911

Before you start cardiopulmonary resuscitation, you must get help by calling 911. Then you should immediately start cardiopulmonary resuscitation as the possibility of the person surviving increases if treatment is started immediately.

It goes faster if someone else can call 911 while you start your cardio-pulmonary rescue. It is good to know that the alarm operator can provide continued counseling on the phone, for example on how cardio-pulmonary rescue should be performed. Use the speaker feature on your phone.

Cardiopulmonary rescue

When you provide cardiac resuscitation, you begin with chest compressions. It means using your hands and pressing the unconscious person’s chest to get blood flowing. At regular intervals you make short breaks and switch to breathing air through the other’s mouth with mouth to mouth method to supply oxygen to the blood.

The chest compressions temporarily replace the work of the heart and the breaths replace the breathing.

Here’s how cardiovascular rescue goes to:

  • Make sure the person is lying on their back, preferably on a hard surface, such as the floor or the ground.
  • Place your one hand on the middle of the sternum between the nipples, place your other hand on top. Press down the chest at least 5 but not more than 6 cm. Keep a rate of 100-120 pressure/min. Press 30 times, hard and fast.
  • Then switch to making mouth-to-mouth breaths. First open the airway by lifting the hook tip with two fingers and bend the unconscious person’s head back with the help of a forehead. At the same time, squeeze the nose with your thumb and forefinger.
  • Then take a regular breath and let your own mouth cover the unconscious person’s mouth. Breathe in slowly and gently until the chest is raised. You should always do two breaths in a row.
  • Switch between giving 30 chest compressions and two breaths of air. Keep doing this until healthcare professionals come to your aid.

If you find it uncomfortable to give mouth to mouth breath, you can put a thinner piece of textile, such as a handkerchief or a t-shirt, over your mouth. If you can’t give mouth-to-mouth breathing, it’s better to just do chest compressions than not do anything at all while waiting for an ambulance.

How serious is the situation?

If you are going to take care of a person who seems to be faint or unconscious, you must first make sure that the place is safe and not dangerous to yourself. Then decide how serious the situation is. Check if the person is conscious and breathing is normal.

Awake?

First you can try to talk to the person and try to shake your shoulders lightly to see if you get an answer. A person who is drunk or asleep usually responds to this. If you do not get any reaction, assume that the person is unconscious.

Breathe?

In the next step, open the airway of the unconscious by bending one’s head back with one hand on the forehead while lifting the chin upwards with the other hand’s forefinger and middle finger. Try to see if the chest rises. Place the ear next to the person’s nose and mouth and listen and feel for breathing. If after about ten seconds you cannot see, hear or feel any breathing, you must assume that the person has a breathing stop.

If the person begins to breathe

It is important to continue with cardiopulmonary resuscitation until healthcare professionals can take over. Cardio-pulmonary resuscitation usually does not start the heart, but sometimes the unconscious can come to life while you are providing cardio-pulmonary resuscitation. Then you should not continue. If the person begins to breathe normally, move, look up or cough, stop the cardiovascular rescue.

Occasional breaths, sighs, groans or hissing sounds can be a reflex and not normal breathing. Controlling breathing during cardiovascular rescue steals time and can affect the unconscious’s chance of survival. Therefore, continue uninterrupted until medical personnel are in place or the unconscious comes to life.

Good if you are several

It is strenuous to provide cardiac resuscitation. Therefore, it is good if there are several who help. In this case, you can change after about two minutes of treatment.

If you know what time the cardiac arrest occurred, it is good to remember it and tell the medical personnel when the ambulance arrives. The health care staff also wants to know how long they have been providing cardiac resuscitation.

You should continue with cardiovascular rescue as long as you can, until the person is breathing normally or someone else is taking over.

Recovery position

If a person is unconscious but breathing normally, place the person in stable lateral position. It doesn’t matter which way you go, only you turn the person towards you.

Advanced cardiovascular rescue

In order to do the simplest form of cardio-pulmonary rescue, no equipment is needed. It is a method that everyone can learn. Sometimes the term basal cardiopulmonary resuscitation is used to distinguish it from the advanced cardiopulmonary resuscitation provided by healthcare professionals. This requires oxygen delivery equipment, breathing assistance, circulation and cardiac monitoring, and medication. Advanced cardiopulmonary resuscitation starts directly at the site, in the home or in the ambulance and continues at the hospital.

At a cardiac arrest, treatment is often given with a cardiac initiator, also referred to as a defibrillator in health care. It is an appliance that can be used to give a shock that can turn the heart back on.

Cardiac starter outside hospital

Today, easy-to-use semi-automatic cardiac starters are available in several locations outside the hospitals. They can be used by anyone and require no medical knowledge. The device provides easy-to-follow voice instructions. It can read for yourself whether or not the unconscious person has cardiac arrest. It is only at cardiac arrest that it works.

There is a national register for cardiac starters operated by the American Council for Cardiac Resuscitation. The register shows on a map where cardiac arrestors are located in USA and aims to increase the survival rate of cardiac arrest in the community.

When is cardiac resuscitation needed?

A life-threatening condition may be due to several causes

A person who gets a cardiac arrest becomes unconscious within 10-20 seconds and then stops breathing. At a breathing stop, the heart also stops after a short while.

The most common cause of sudden, unexpected cardiac arrest in adults is cardiovascular disease.

Respiratory arrest may be due, among other things, to a severe asthma attack or because something has stuck in the throat, for example a food bite.

The heart and respiratory system may also stop working when drowning, poisoning, drug overdosing or a severe electric shock.

Leads to lack of oxygen

When the heart stops beating or breathing stops, the body does not get enough oxygen. The brain is the organ that is most sensitive to oxygen deficiency. If the oxygen supply does not start quickly enough, there is a risk of permanent brain damage. Such damage can occur even after three to four minutes. If the body is cooled down, the brain can handle the oxygen deficiency a little longer.

The goal of cardiopulmonary resuscitation is to try to keep the cardiac activity on hold while waiting for an ambulance, medical staff and a cardiac surgeon.

No medical education is needed

You don’t need to be medical trained to learn cardiovascular rescue. You only need to take a short course of a few hours to learn how to do it. Then you will be trained to perform cardiac resuscitation and to easily use a cardiac starter on a doll. There are several organizations that organize such courses, for example the Red Cross, the American Lifeguard Society, the American Council for Cardiac Rescue, the CPR Council, the Civil Defense Association and the occupational health service.

Heart-lung rescue of children

Some elements of cardiac-resuscitation of children differ slightly from cardiac-resuscitation of adults. Therefore, it is recommended that you also take a course in Child CPR. In addition to turning to organizers of adult CPR courses, you can consult with their child care center if they can offer education aimed at parents.

In an emergency situation, on the other hand, it is better to provide cardiac resuscitation than for adults, but with less force to a child, than to do nothing at all.

Druming experience

You may need to talk to someone

You don’t experience any discomfort with the treatment itself, because you are unconscious if you need cardiovascular rescue. However, when you wake up, the knowledge that you have been so seriously ill can leave its mark. Therefore, as part of the rehabilitation after a cardiac arrest, you may need help processing what you have been through.

If you have taken care of someone who has been unconscious and given heart-lung rescue, you may also need someone to talk to after your relief efforts. You may be given the opportunity to talk to the ambulance staff or staff at the emergency room. It is good to know that the Privacy Act restricts healthcare professionals from providing information about the event itself. You can also contact your health care provider and a curator to talk about what has happened.

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