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CPR Made Easy!
An Introduction by Dr. Ken Jeong
What would you do in an emergency?
You are standing in the line at the grocery store when an elderly man behind you falls down clutching his chest. You quickly check him over and notice that he is not breathing and is pulse-less. What do you do??
This article is all about CPR, which is also known as Cardio Pulmonary Resuscitation. It's a skill that every one of us should know in case the unexpected happens. Knowing this simple skill can mean the difference between saving a life and watching an individual lose a life!
As an Emergency Medical Technician (NREMT) I've performed CPR many times and advocate the teaching of this simple skill to as many people as I can. I have seen the difference CPR makes on a patient and I firmly believe that every individual should know and maintain CPR Certification. This is why in 2014 I became a certified BLS Instructor for the American Heart Association.
In this article I will pass my knowledge and experiences to you on CPR, inform you on how to perform CPR, list to you the benefits of knowing CPR, and how to go about getting a CPR certification. This article does come with a caveat however due to the turnover rate of CPR. Due to medical advancements CPR changes quickly and often and we sometimes take on or lose certain skills for greater outcome. This article was created in 2009 and has been updated throughout the years but I would strongly advise updating yourself on the current standards of CPR via the American Heart Associtation.
So What is This C-P-R Anyway??
CPR in a Nutshell...
The American Heart Association defines CPR (Cardio Pulmonary Resuscitation) as a combination of rescue breathing and chest compressions delivered to victims thought to be in cardiac arrest. When cardiac arrest occurs, the heart stops pumping blood. CPR can support a small amount of blood flow to the heart and brain to "buy time" until normal heart function is restored.The American Heart Association has found that up to 92% of sudden cardiac arrest victims die prior to arriving at the hospital, but knowing CPR can save double the lives, if not triple.
Why should you learn CPR?
Data suggests that there are over 383,000 sudden cardiac events in American in a single year. Four out of Five or statistically 88% of these events will occur in the home setting and many of the victims will appear symptomless or healthy prior to the event. By knowing the the skills of CPR you can save a life and increase the odds of survival dramatically. If you would like to learn more stats I would suggest visiting the American Heart Association Fact Sheet.
Certifying agencies and a Concluding Word
In CPR there are two major accepted organizations for learning and maintaining the skills as a CPR provider. The first and most recognized is the American Heart Association that trains over 12 million people across the world annually and offers classes almost everywhere. The second and lesser used organization is the Red Cross which is also equally accessible.
Of course these fancy words are a great concept but I'll let you in on a secret. This definition is the very LAST thing that you will be thinking about when the time comes to use your CPR skills. While it's important to understand and remember the process it is much more pertinent for you to to be familiar enough with the skill to utilize it in a manner that will make a difference.
Always Have a CPR Mask Available!
Cardiac Arrest; The signs and symptoms
CPR is performed when an individual is in Cardiac Arrest. The common term for when an individuals heart suddenly stops pumping blood. When you find someone in this state they will be pulse-less, will not be breathing, and will not be responsive. Never assume a victim is in Cardiac Arrest because they are not breathing - always check for a pulse. Cardiac Arrest is different from Respiratory Arrest.
REMEMBER: Call 9-1-1 immediately to access the emergency medical system if you see any cardiac arrest warning signs and start CPR.
The Art of CPR.
Below in certain sequence is CPR but remembering that the skill is nothing but a basic pattern when it’s broken apart will aid you. Keep firmly in mind that if you need to perform CPR on ANYONE then you also are in need of an ambulance with fully certified Emergency Medical Technicians. Before you do ANYTHING call 911 and give clear concise information to the emergency dispatcher on what is going on and where you are at. This information will quicken response time and lessen confusion.
The Emergency Dispatcher at 911 will want to guide you through the process until the ambulance arrives. My tip would be for you to place your phone on speaker phone mode and set it next to you. This way you can effectively do the skills needed to be performed and not worry about your phone. Never hang up on the dispatcher or refuse their advice. Cooperation is another key to increasing the odds of survival of a victim.
#1 Check Responsiveness of the Victim
Check the responsiveness of the victim. Shake the victim, pinch them, yell loudly at them ("Hey! Hey! Are you alright?!"), try to provoke some sort of response to see if the individual is really unresponsive. Do not hurt them!
As unbelievable as it may seem some individuals play "possum" for attention. Any EMT will tell you stories of how they have "woken" up patients by using methods that cause the patient to be very uncomfortable; an example being the insertion of a nasal airway in the nose which triggers the gag reflex. Either way this illustrates why checking for responsiveness is the first thing that you do. Sometimes a person just needs a little stimuli to restart the heart.
#2 Open and Establish an Airway
Support the victim's head and carefully tilt their head back so their chin is pointed upwards. This manuever is commonly called a "Head Tilt Chin Lift". Do not force this movement or you could potentially cause a neck injury. Open the victim's mouth. If you see something in the mouth (remove the foreign object) but never blindly sweep for an unseen object. If the patient is vomiting turn them on their side until they finish and suction the airway if you have a suction device available. Do this until the object is removed or until the vomiting ceases. Afterwards re-open the airway as listed above.
Remember safety and keep yourself protected! If you have medical gloves use them! If a patient has something lodged in their throat and all you have is a napkin - use it before you use your bare fingers! Also remember to report anything you see, or anything that happens to the 911 dispatcher and also to the EMT's who meet you on scene.
#3 Check For Breathing
Check to see if the patient is breathing. Perform this by placing you hand over their chest and placing your ear near their mouth and nose. This is so you can hear any air moving through the nose or mouth and feel if any respirations are taken into the lungs. If you cannot hear or feel any breathing you will need to begin compressions.
#4 Give Rescue Breaths
NO LONGER APPLICABLE.
I left this step in place because in years past CPR involved rescue breathing. It changed in 2010. Often one would pinch the nose and seal their lips around the patient’s mouth and blow two breaths of air into the lungs. This is no longer performed due to safety concerns, reluctance of people to use CPR in situations because of the step, and also medical advancements. It's theorized that every time the chest is compressed the lungs expel and inhale anyway. So this is no longer required. The new version of CPR is Hands on Only! Emergency Medical Technicians will still provide rescue breaths via Bag Valve Masks.
#5 Start Compressions
This is where you begin CPR. Lean over the patients chest and place the palms of both your hands (on top of each other) and interlock your fingers straight out. Place your hands between the patients nipples - in the center of the chest. You may be required to undress the patient; tear or cut clothing as needed and keep in mind that an AED requires contact with the skin. The exact point you are looking for is the Xiphoid Process which is a pointy bony prominence the very bottom of the victim's sternum (the breast bone).
Start your compression and keep in mind 30 compressions equals a single cycle. Press down (approximately 1.5 inches in depth) hard and quickly allowing the chest to rise completely up each time. The AHA suggests you "push fast and hard". If you are working with another bystander and doing two person CPR then switch roles every 5 cycles.
If you hear a few pops and feel bones breaking do not be alarmed. The noise you are hearing are the ribs breaking and it is completely normal. Remember that the victim will thank you for a few broken ribs instead of the loss their life. Your main concern is restarting the heart. Any further damage can be addressed in the hospital when the patient alive.
Continue this cycle 5 times. Continue to the next step. Remember if the ambulance arrives at any time you may discontinue CPR and allow the EMT's to take care of the victim - BUT do not stop until the EMT is ready to take over!
If you witness a child going into cardiact arrest start CPR immediately. After appoxmimately 2 minutes activate 911. If you find a child that you did not witness in cardiac arrest activage 911 immediately and then start CPR. You still do 30 compressions as listed for an adult. Please remember that a child is between the ages of 1-8 as defined by the American College of Medicine. If approximate age is unknown look for signs of puberty; growing breasts on girls and chest/facial hair on boys - if signs of puberty are observed perform adult CPR.
#6 Check for Life!
Check for signs of life. Check for breathing and for a pulse. Look for signs of the patient becoming responsive or any other state than unconscious. If the victim displays signs of life discontinue CPR and position the victim on their side. Monitor repeatedly. If there are no signs of life (breathing and pulse) continue CPR until you can transfer care to an EMT. In either case 911 must be activated and a 911 must take over care and responsibility of the patient.
#7 Continue Until Help Comes
Continue CPR until the ambulance arrives and the EMT's take over care of the victim. Do not stop even if you are tired. A life hangs in the balance, remember?
An automated external defibrillator (AED) is a portable electronic device that can automatically diagnose potentially life threatening cardiac conditions in the body such as cardiac arrhythmia, ventricular fibrillation, ventricular tachycardia. In a nutshell it treats cardiac arrest in a patient and is able to treat them. It uses a process called defibrillation which is the application of electrical therapy which stops the arrhythmia (abnormal heart movement) allowing the heart to potentially restart. AEDs are designed to be simple to use and the use of AEDs is taught in many first aid, first responder, and in CPR classes.
The key is if you have an AED...USE IT!! AED's increase the chance of saving a life by ten! They are very easy to use and provide recorded instructions for anyone unfamiliar with how to operate one. There is a video below for your interest on how to use an AED.
*TIP: When using a AED make sure you or any equipment touching you are not touching the victim when shocking, Also make sure the patient is not on metal, or in water. Otherwise you will be shocked too. It's simple, and in most cases you won’t have to worry about this.
Education is the real key when it comes to the topic of CPR. Learn this skill and know it because one day you might need it. As handy and informative as this article is if you are really interested in CPR I would advise that you take an official course and get CPR Certified. In that way at least you can learn all the things listed above and more. Not only will you learn but you will practice!
Most classes can be found for free or for a very small price. I recommend checking out these websites to learn more:
AED Visual Instruction
A Life Saved By CPR (Real)
CPR After Traumatic Incident
The information presented in this hubpage is not intended to take the place of your personal physician’s advice and is not intended to diagnose, treat, cure or prevent any disease. Discuss this information with your own physician or healthcare provider to determine what is right for you. All information is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific medical conditions. I and Hubpages in general cannot and do not give you medical advice. The information should not be considered complete and should not be used in place of a visit, call, consultation or advice of your physician or other health care provider. We do not recommend the self-management of health problems. Should you have any health care-related questions, call or see your physician or other health care provider promptly. You should never disregard medical advice or delay in seeking it because of something you have read here or on the internet.
My pen name is Teito and let me tell you about myself. I am an Emergency Medical Technician Basic who has been a member of various 911 and Specialty Resources in and around the states of PA and VA for nearly 10 years. I am a American Heart Association certified CPR/BLS Instructor as well as an active member of the National Registery of Emergency Medical Technicians (NREMT). I am an Air Force Veteran (2011-2015) who specialized as a Surgical Technologist and separated honorably to pursue higher education in the field of Criminal Justice and Counter Terrorism. I am an avid supporter of EMS classes being held in the high school environment and CPR skills in general being taught to everyone.