FIRST AID/CPR

CPR Basics	A is for Airway
CPR Step-by-Step	B is for Breathing
The ABC's	C is for Circulation

CARDIAC ARREST DIAL 222

CPR Basics:

Cardiopulmonary resuscitation (CPR) is a first-aid technique used to keep victims of cardiopulmonary arrest alive and to prevent brain damage while more advanced medical help is on the way.

CPR has two goals:

While the modern emergency room has high-tech equipment and an arsenal of drugs to help treat victims of cardiopulmonary arrest, CPR is a simple technique that requires little or no equipment.

What you do is pretty basic:

It sounds pretty simple, but as you can see above, CPR must be performed in a specific, timed sequence to accurately mimic your body's natural breathing pattern and the way your heart pumps. When someone collapses right in front of you, your first reaction is often sheer terror. But while you're panicked and unable to act, valuable minutes are slipping away. To counter this, many organizations such as the American Heart Association and the American Red Cross offer classes that train you in CPR and basic first aid and give you hands-on practice to hone your CPR skills. Then, if you are confronted with an emergency situation, you are prepared to jump into action.

CPR Step-by-Step:

What should you do to help a seemingly unconscious victim? The first thing you'll want to do is to figure out whether or not the victim is really unconscious. Just like you were trying to get them out of bed, you should call out to them, tap them, and gently shake them to try and provoke a response. You also should check to see if they are breathing. If you try and perform CPR on someone who is not in cardiopulmonary arrest, you can actually hurt them!

If you can't rouse them, the very next thing to do is have someone call 911 so that professional paramedics will be on their way to the scene while you are performing CPR. This is very important, because, with the exception of choking, CPR doesn't address the underlying causes of cardiopulmonary arrest. It is only meant to buy time until the victim can get intensive medical care.

After you've called for medical assistance, you need to begin CPR. In order for CPR to work, the victim must be lying on his or her back on a flat surface. If the victim is face-down, gently roll the person toward you while making sure that you support their neck. Once the person is on their back, you can then use the American Heart Association's "ABCs of CPR" to guide you through the rest of process:

We'll talk about each of these steps in detail in the following section.

The ABCs:

Here's a summary of how you might perform CPR on a non-responsive adult (There is actually a different procedure used to save infants and young children).To learn all about and practice CPR in detail, you should sign up for training from an organization like the American Red Cross.

A is for Airway

When you pass out, your tongue relaxes, and it can roll back in your mouth and block your windpipe. Before you can start CPR on an unconscious person, you'll probably need move their tongue out of the way. Here's how to clear a blocked airway:

Tilting the head back and lifting the chin move the tongue out of the airway. At this point, you should check again for breathing. If the victim is choking on something, you may see their chest heave as they try to breathe, but you won't be able to feel or hear air being exhaled. You'll have to take additional measures to clear out what's blocking their windpipe, including:

Once this is done, you have to check for signs of breathing again. Just clearing out the windpipe may sometimes be enough to allow the victim to start breathing on their own! If the victim starts breathing and moving around on their own, you can stop CPR. If this doesn't happen, you'll have to help them breath, by providing mouth-to-mouth resuscitation.

B is for Breathing

Your lungs have one main function: remove carbon dioxide and take up oxygen. Normally, the muscles in your chest contract and expand your chest cavity, allowing your lungs to fill up with air. Oxygen and carbon dioxide diffuse across the immense surface area of your lungs. Finally, your chest muscles relax, and you exhale.

Rescue breathing uses your lungs to force air into the victim's lungs at regular intervals. The timing of each breath (about 1.5 to 2 seconds per breath) mimics normal breathing. However, the process is much more like blowing up a balloon than real breathing. You inhale deeply, form a tight seal with your mouth over their mouth, and exhale strongly to push air out of your mouth into theirs. Because you also pinch the victim's nostrils closed, the air has nowhere to go except down into the lungs, which expand as they fill with air.

Mouth-to-mouth breathing is hard work. Normally, when you inhale, the chest muscles drive the process. In artificial respiration, you're working against the victim's relaxed chest muscles. When the chest muscles are relaxed, the chest cavity is small, keeping the lungs in a deflated state. As a rescuer, you have to exhale forcefully into the victim's mouth for 1 to 2 seconds to overcome this resistance. As the lungs fill with air, the victim's chest is pushed up at the same time; you can actually see it rise. When you remove your mouth from the victim's and break the air seal, their chest falls and once again deflates the lungs. As in normal breathing, this results in air being exhaled from the victim's mouth.

Does air exhaled from someone else's mouth really provide enough oxygen to save an unconscious person? Normally, the air you inhale contains about 20 percent oxygen by volume, and your lungs remove about 5 percent of the oxygen in each breath. The air you blow into a victim's mouth thus contains about 15 to 16 percent oxygen, which is more than enough to supply their needs.

After you've given the victim two breaths, you then check to see whether or not they have a pulse and whether they are able to breathe on their own. This will determine what you do next.

If the victim . . .	you should
Is breathing and has a pulse	stop CPR, and stay with them until help arrives
Is not breathing and has a pulse	continue rescue breathing
Has no pulse	begin chest compressions, alternating with rescue breathing

C is for Circulation

If the victim's heart is not beating, all your breathing efforts are for naught; the oxygen that you're getting into their circulation isn't going anywhere! Once again, you have to take over for a failing organ. This time you essentially become a surrogate heart to pump oxygenated blood out to the rest of your body. How can you have any effect on blood flow from outside of the body? All it takes is your hands and some strength. The steps are simple:

In reality, all you are doing is squeezing the heart between the breastbone and the backbone to force blood out. Compressing the chest creates positive pressure inside the chest that pushes oxygenated blood out of the heart through the aorta. From here, it travels to the brain and then on to other parts of the body, delivering oxygen for cellular respiration. When you relax, the pressure inside the victim's chest subsides. Deoxygenated blood moves back into the heart from the veins.

CPR's Role in Rescue

CPR extends the window of opportunity to perform more elaborate first aid procedures. By itself, CPR cannot save the majority of victims of cardiopulmonary arrest. CPR only temporarily restores circulation to only 10 to 30 percent of what it would be with a healthy heart. Further, in about two-thirds of people in cardiopulmonary arrest, the heart goes into what's known as ventricular fibrillation. In this state, the heart muscle quivers rapidly, like a bowl of Jell-O, and is unable to beat properly. CPR cannot stop ventricular defibrillation, and only 4 percent of patients who receive CPR alone will survive an attack.

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How to Do CPR

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