CPR for the Layperson

If you live in  a large metro area or way out in a rural area, an ambulance most likely is not going to arrive before seven to ten minutes. There are many events that can require one to know CPR (cardiopulmonary resuscitation.) Heart attacks, drowning(s), electrical shock, anaphylactic shock, suffocation,  drug overdose, trauma, etc… all can result in heartbeat and/or respiratory functions to cease. These things can happen to any of us… at any time. It can save a loved one or strangers life if you know basic CPR.

According to Wikipedia: “only 1/3 of out-of-home arrests have a CPR attempt made on them. However, the effectiveness of this CPR is variable, and the studies suggest only around half of bystander CPR is performed correctly.” CPR is not a difficult thing to learn and through CPR knowledge we can potential increase survival rates for many people.

I should preface explaining CPR with the latest advice from the American Heart Association related to adult CPR. They suggest if you are untrained in CPR, then provide only uninterrupted chest presses every two seconds and omit the rescue breathing to an adult. However, I am going to explain the entire process of CPR here.

Before you begin CPR, you should attempt to wake the person. Ask: “Are you okay?” While asking if they are okay, tap them on the shoulder or rub on their chest with the palm of your hand. If the person does not respond, you should call 911- if an immediate phone is available or you have someone else to do it. If there is not a phone, begin CPR immediately . To remember the basics of CPR think of ABC’s . This stands for Airway, Breathing, and Circulation.

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CPR For An Adult:

A: Airway

Put the person on their back and underneath a firm surface.

Kneel near the person’s shoulders.

Put the palm of your hand on the person’s forehead and push gently to tilt the head backwards. With the other hand, lift the persons chin forward to open the airway. (This step is called the head-tilt chin-lift maneuver.)

Use five seconds to check for breathing. Put your cheek next to the person’s mouth with your eyes facing the persons chest. Watch for the chest going up and down, listen for breath sounds, and feel for the person’s breath on your cheek .

At this point, someone trained in CPR will proceed to B. Those not trained in CPR will skip B and go directly to C.

B: Breathing

Use the head -tilt chin -lift maneuver described above to open airway.

Pinch the nostrils shut and create a seal around the person’s mouth with your mouth. (note: for strangers or if there is any doubt of transmittable disease, you will want to observe universal precautions. There are CPR masks available to prevent mouth to mouth contact.)

Give one rescue breath and watch to see if the chest rises. If it does, then give a second breath. If it doesn’t, then reposition the head -tilt chin- lift, repeat the rescue breath, and then the second rescue breath.

C: Circulation

Place the heel of one hand between the person’s nipples. Then, place the other hand on top. Keep your fingers straight, but interlaced. Position your shoulders directly over the person’s chest and straighten your elbows.

Using your upper body weight, push about 2 inches straight down. Release pressure and then quickly repeat the compress. You should give about 2 compressions per second. Repeat the compressions 30 times.

After 30 compressions are given, tilt the head back and repeat step B. (if someone else is available they can give the breaths.)

Once step B is completed, everything thus far is considered one cycle.

Now, you would continue and repeat step C again.

Continue repeating for 5 cycles.

If the person is not responsive after 5 cycles, then you should use an automatic external defibrillator (AED) *if available. An AED has prompts that instruct you on how to use it.

If you do not have an AED, then you should not stop on five cycles. Just continue giving CPR until the person is responsive or EMT’s arrive.

CPR For A Child (1-8yrs old):

Follow the same ABC “s as above except for the following:

Perform five cycles before calling 911. (Of course, if someone else is there then they should call 911 immediately.)

Instead of two hands, you will only use one. The positioning is the same.

Do not perform the rescue breaths as hard as you would on an adult.

Only compress the chest ½ – 1 inch…. Instead of the 2 inches for an adult.

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CPR For An Infant (1yr or younger):

Rub the child”s chest and look for signs of responsiveness. Never shake the child. If there are no signs of responsiveness, then call 911 if you are near a phone or have a second person to call. If you are not near a phone and are alone, then begin CPR for two minutes before calling 911.

A: Airway

Same as for adults and children.

B: Breathing

You are already in head- tilt chin lift position from step A . Cover the infants mouth and nose with your mouth, creating a seal.

Give a rescue breath by using gentle puffs of air from your mouth. Do not use deep lung breaths. Watch for the chest to rise. If the chest rises, then give a second rescue breath. If it doesn’t, then reposition the chin lift head tilt and try again. If it rises this time give the second rescue breath. If it still doesn’t rise, then examine the mouth for any foreign objects. Remove any object that you might find. If you feel the airway is blocked by an unseen object, then you should begin first aid for choking.

Move to step C once both rescue breaths have been given.

C: Circulation

Center your index and middle fingers between the baby’s nipples.

Compress the chest straight down one inch for 30 times.

The compressions should be given at a rate of about 100-200 per minute. This will be a fairly rapid pace.

After 30 compressions, repeat step B.

Continue CPR until the infant is responsive or EMT’s arrive.

You may be wondering why the pulse taking steps have been omitted if you previously have taken a CPR class. The International Liaison Committee on Resuscitation changed the rules of CPR in 2005 to make it more layman friendly and simple. They omitted the pulse checking step because most lay persons can not accurately find or detect a pulse.

This information is not intended to replace a CPR class, but rather to demonstrate how simple life saving techniques can be. I strongly encourage everyone to take a CPR class from an accredited organization. Here is the link for the American Heart Association and American Red Cross, where you can find a class near you.