#14 Every Person Must know How to do CPR

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 CPR is a procedure done to restart a heart of a person when it suddenly stops. This procedure should be started as early as possible when you see no pulse (carotid pulse) and no respiration in the victim

(NOTE: The person should not have any other emergencies such as bleeding). CPR is done by providing chest compressions and rescue breaths in a constant ratio. Proper technique and help at the earliest can save a life.


Checking for the carotid pulse

The ratio of giving CPR is 30:2, in which 30 is the number of chest compression and 2 is the number of rescue breath given by the rescuer. The ratio of 30:2 is when there is only one rescuer per victim. If there are two rescuers per victim then the ratio changes as 15:2, in which 15 is the number of chest compression and 2 is the number of rescue breath given by the rescuer.

Before starting CPR, check:

  1. Is the environment safe for the person?
  2. Is the person conscious or unconscious?
  3. If the person appears unconscious, tap or shake his or her shoulder and ask loudly, "Are you OK?"
  4. If the person doesn't respond and you're with another person who can help, have one person call 108 or the local emergency number and get the AED, if one is available. Have the other person begin CPR.
  5. If you are alone and have immediate access to a telephone, call 108 or your local emergency number before beginning CPR. Get the AED if one is available.
  6. As soon as an AED is available, deliver one shock if instructed by the device, then begin CPR.

The American Heart Association uses the letters C-A-B to help people remember the order to perform the steps of CPR.


C: Compressions

A: Airway

B: Breathing


CHEST COMPRESSION


As the name clearly suggests the action, the rescuer has to compress the chest of the victim to a certain depth and let the chest recoil and again compress, repeat this action for 30 times if only one rescuer is available, if two rescuers are available do the action for 15 times.

The exact position of chest compression is at the middle of the chest between the nipples.

The depth of chest compression differs according the age of the victim, for an adult not more than 2 inches or 5 cm, for a child not more than 1.5 inches or 4 cm, for a baby not more than 1 inch or 2.5 cm.

The method of chest compression for adults and children is:

1. Place the heel of the palm of the rescuer’s non-dominant hand and interlock the finger or the wrist with the dominant hand.

2.  Compress the chest not more than 1.5 to 2 inches according to the age group.

 

The method of chest compression for a baby is:


1. Place the two fingers of the rescuer’s non-dominant hand and interlock the wrist with the dominant hand.

2. Compress the chest not more than 1 inch.


While giving chest compression the rescuer’s elbow should not fold, the power generation for compression should be from his or her shoulder or upper trunk of the body.

RESCUE BREATHING

 Rescue breath blowing air to the mouth or nose of the victim to provide him with oxygen, as there is no breathing. Rescue breath is given 2 in number after completing 30 chest compressions. There are three techniques to provide rescue breath;

1. Mouth-To-Mouth rescue breathing- this is provided by pinching the nose of the victim and sealing the rescuer’s mouth to the victim’s mouth and blow the air till the chest of the victim expands.


2. Mouth-To- Nose rescue breathing- this is provided when the victim’s mouth is severely injured or the victim could not open his or her mouth. Now the rescuer should seal his or her mouth around the opening of the nostrils and blow the air to the victim.


3. Bag-Mask ventilation- this the latest method for giving rescue breath, this requires a special apparatus known as a ambu-bag or resuscitator, the mask of the ambu-bag is sealed around the victim’s mouth and the bulb of the ambu-bag is pressed twice to deliver two rescue breath.


AUTOMATED EXTERNAL DEFIBRILLATOR (AED)

AED is an automated device which requires no training to use. The main function of the device is to
help in delivering shock to the victim if required and assess the cardiac activity (rhythm of heart).

If the rescuer has someone to help, ask the person to bring an AED.

The person who brought the AED has to turn it on and follow the instruction given by the AED.

FIRST AID GUIDE IN PROVIDING CPR AND USING AN AED


1.       CHECK FOR HAZARDS- check and neutralize hazards to victim, yourself and bystanders before treating victim check for:

·         Falling objects

·         Incoming traffic

·         Fire and fumes

·         Electricity

·         Spilled chemicals

 

2.       CHECK LEVEL OF RESPONSE-

·         Check whether victim is conscious or not

·         Ask them to open their eyes. Call their name (if known)

·         Gently shake victim’s shoulders

·         Do not move victim unless there is a hazard.

 

3.       CALL FOR HELP-

·         You should call emergency services immediately.

·         If you are alone, call for help before responding, if you are with someone, ask other person to call while you respond

·         Be ready to provide information regarding your location and the incident.

 

4.       CHECK AIRWAY-

·         Check airway of an unresponsive victim

·         Open victim’s mouth and look for obstruction

·          Free the tongue by lifting chin and tilting head back

·         If victim has suffered a neck or spinal injury, do not move their head.

 

5.       CHECK FOR BREATHING-

·         Look at the victim’s chest- is it rising and falling

·         Listen for breathing- place your ear near victim’s face

·         Feel for moving air on your cheek when near victim’s nose and mouth.

·         Place one hand on their stomach to feel it rise and fall. This indicates normal breathing.

 

A.       If the victim is breathing put them into recovery position.

B.       If the victim is not breathing, call for medical assistance immediately. Start doing full cardiopulmonary resuscitation and then get a defibrillator.

 

6.       PERFORMING CPR- Provide chest compression and rescue breath

 

7.       AED DEFIBRILLATION-

·          Remove any sharp objects from victim’s pockets.

·         Secure the hands of the victim

·         Turn on the AED and follow the instructions.


Reference:

1. GK Pal book of anatomy and physiology

2. https://pubmed.ncbi.nlm.nih.gov  

 Prepared by

Dept of Medicine  PMA



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