Cardiopulmonary resuscitation (CPR) is a combination of mouth-to-mouth resuscitation and chest compressions that delivers oxygen and artificial circulation to a person whose heart has stopped. This is referred to as being in cardiac arrest. CPR can be life-saving first aid.
Cardiopulmonary resuscitation (CPR) is a lifesaving technique useful in many emergencies, including heart attack or near drowning, in which someone’s breathing or heartbeat has stopped. The American Heart Association recommends that everyone — untrained bystanders and medical personnel alike — begin CPR with chest compressions.
The new first step is doing chest compressions instead of first establishing the airway and then doing mouth to mouth. The new guidelines apply to adults, children, and infants but exclude newborns.
The old way was A-B-C — for airway, breathing and compressions.
The new way is C-A-B — for compressions, airway, and breathing.
Circulation: Restore blood circulation with chest compressions
- Put the person on his or her back on a firm surface.
- Kneel next to the person’s neck and shoulders.
- Place the heel of one hand over the center of the person’s chest, between the nipples. Place your other hand on top of the first hand. Keep your elbows straight and position your shoulders directly above your hands.
- Use your upper body weight (not just your arms) as you push straight down on (compress) the chest at least 2 inches (approximately 5 centimeters). Push hard at a rate of about 100 compressions a minute.
- If you haven’t been trained in CPR, continue chest compressions until there are signs of movement or until emergency medical personnel take over. If you have been trained in CPR, go on to checking the airway and rescue breathing.
Airway: Clear the airway
- If you’re trained in CPR and you’ve performed 30 chest compressions, open the person’s airway using the head-tilt, chin-lift maneuver. Put your palm on the person’s forehead and gently tilt the head back. Then with the other hand, gently lift the chin forward to open the airway.
- Check for normal breathing, taking no more than five or 10 seconds. Look for chest motion, listen for normal breath sounds, and feel for the person’s breath on your cheek and ear. Gasping is not considered to be normal breathing. If the person isn’t breathing normally and you are trained in CPR, begin mouth-to-mouth breathing. If you believe the person is unconscious from a heart attack and you haven’t been trained in emergency procedures, skip mouth-to-mouth rescue breathing and continue chest compressions.
Breathing: Breathe for the person
Rescue breathing can be mouth-to-mouth breathing or mouth-to-nose breathing if the mouth is seriously injured or can’t be opened.
- With the airway open (using the head-tilt, chin-lift maneuver), pinch the nostrils shut for mouth-to-mouth breathing and cover the person’s mouth with yours, making a seal.
- Prepare to give two rescue breaths. Give the first rescue breath — lasting one second — and watch to see if the chest rises. If it does rise, give the second breath. If the chest doesn’t rise, repeat the head-tilt, chin-lift maneuver and then give the second breath. Thirty chest compressions followed by two rescue breaths is considered one cycle.
- Resume chest compressions to restore circulation.
- If the person has not begun moving after five cycles (about two minutes) and an automatic external defibrillator (AED) is available, apply it and follow the prompts. Administer one shock, then resume CPR — starting with chest compressions — for two more minutes before administering a second shock. If you’re not trained to use an AED, a 911 or other emergency medical operator may be able to guide you in its use. Use pediatric pads, if available, for children ages 1 through 8. Do not use an AED for babies younger than age 1. If an AED isn’t available, go to step 5 below.
- Continue CPR until there are signs of movement or emergency medical personnel take over.
CPR is most successful when administered as quickly as possible. It should only be performed when a person shows no signs of life or when they are:
- Not breathing normally
- Not moving.
CPR can keep oxygenated blood flowing to the brain and other vital organs until more definitive medical treatment can restore a normal heart rhythm.
When the heart stops, the lack of oxygenated blood can cause brain damage in only a few minutes. A person may die within eight to 10 minutes.
To learn CPR properly, take an accredited first-aid training course, including CPR and how to use an automatic external defibrillator (AED).
Here is a step-by-step guide for the new CPR:
1. Ask someone else to do so.
2. Try to get the person to respond; if he doesn’t, roll the person on his or her back.
3. Start chest compressions. Place the heel of your hand on the center of the victim’s chest. Put your other hand on top of the first with your fingers interlaced.
4. Press down so you compress the chest at least 2 inches in adults and children and 1.5 inches in infants. ”One hundred times a minute or even a little faster is optimal,” Sayre says. (That’s about the same rhythm as the beat of the Bee Gee’s song “Stayin’ Alive.”)
5. If you’re been trained in CPR, you can now open the airway with a head tilt and chin lift.
6. Pinch closed the nose of the victim. Take a normal breath, cover the victim’s mouth with yours to create an airtight seal, and then give two, one-second breaths as you watch for the chest to rise.
7. Continue compressions and breaths — 30 compressions, two breaths — until help arrives.