Cardiopulmonary resuscitation – stages, rules, the most important information

Proven content

If the heart stops pumping blood, it is called cardiac arrest. Cardiopulmonary resuscitation (CPR) is a combination of techniques, including chest compressions, designed to influence the movement of the heart muscle to ensure blood circulation and delivery of oxygen to the brain until it can ultimately stimulate the heart to start working again. A heart attack occurs when part of the heart is depleted of oxygen. A heart attack can affect its rhythm and its ability to pump blood. This is because the heart does not get enough oxygen and cannot pump blood around the body. There is no heartbeat (pulse) because the heart is not working. The medical term for a heart attack is acute myocardial infarction. When the blood stops circulating, the brain lacks oxygen, and the person quickly collapses and stops breathing. Without treatment, the person will die.

Cardiopulmonary resuscitation – causes of cardiac arrest

Cardiac arrest can have many causes and the causes vary in adults and children.

For adults, these may include:

1. heart disease – the most common cause of reversible cardiac arrest in adults (70%);
2. injury;
3. respiratory system diseases.

In the case of children, these may include:

1. SIDS (cot death) is the main cause of reversible cardiac arrest in children;
2. heart disease (usually congenital);
3. injury;
4. respiratory system diseases.

See also: Every day 90 Poles die of sudden cardiac arrest. This can be prevented

Cardiopulmonary resuscitation – a way to save lives

CPR can be a life-saving first aid and increases the chances of survival if started soon after the heart has stopped beating. If CPR is not performed, a person’s brain dies from lack of oxygen only takes three to four minutes.

When we perform CPR, we circulate our blood so that it can deliver oxygen to the body, and the brain and other organs stay alive while we wait for an ambulance. There is usually enough oxygen in the blood to keep the brain and other organs alive for a few minutes, but the blood does not circulate unless someone is performing CPR. CPR does not guarantee that the person will survive, but it does give them a chance when they would not be there otherwise.

If you are unsure whether or not a person is in cardiac arrest, start CPR. If a person does not require CPR, they are likely to respond to our attempts. By performing CPR, it is unlikely that we will harm a person who does not actually have a cardiac arrest.

Detailed guidelines for CPR in adults have been established by the European Resuscitation Council, while in Poland, the Polish Resuscitation Council supervises its compliance.

See also: First aid. How to give it? [WE EXPLAIN]

Cardiopulmonary resuscitation – stages

The most effective CPR is to provide help as soon as possible. It should only be performed when the person shows no signs of life or is:

1. unconscious;
2. not responding;
3. not breathing or not breathing normally (in case of cardiac arrest some people will find it hard to breathe from time to time – they still need CPR. Don’t wait until they stop breathing at all).

It is not necessary to look for a pulse when we have found a person with no signs of life. Sometimes it can be difficult to find a pulse in such a person, and the time spent searching may be time wasted. If CPR is necessary, start it immediately.

The basic steps in performing CPR can be used in adults, children, and infants. They follow guidelines that are easy to follow and remember. This information is for guidance only and is not intended to act as a substitute for attending a CPR course.

The basic steps are:

1. Check for dangers;
2. Check if the injured person is in contact;
3. Ask for help;
4. Open the airways;
5. Check that the injured person is breathing;
6. Begin cardiopulmonary resuscitation;
7. Connect a defibrillator (AED).

1. Check for dangers. Consider why the person seems to be in trouble – is there gas in there or has they been electrocuted? Could she be drunk or under the influence of drugs and therefore could she be a threat to you? Approach carefully and don’t put yourself in danger. If a person is in a hazardous area (e.g. on the road), you can transport them as gently as possible in order to protect both themselves and their safety.

2. Check that the victim is in contact. Is the injured person aware? Gently shake her and speak loudly to her as if you are trying to wake her up. If there is no answer, ask for help.

3. Ask for help. Call 112 or 999 – ask for an ambulance. When talking to the trucking planner, remember to first say exactly where you are, what happened, then introduce yourself and give your phone number. Remember never to hang up first! If you are unable to make a phone call, ask someone else to do so. If there is a crowd of people around you, select a specific person to call the emergency medical team.

4. Open the airways. Check the airways. It is wise to gently roll the injured person over, if necessary. Gently tilt her head back, open her mouth and look inside. If fluid and foreign matter are present, gently turn the person on their side. Tilt her head back, open her mouth and very quickly remove any foreign matter (e.g. chewing gum, false teeth, vomit). It is important not to spend too much time on this as CPR is a priority. Chest compressions can help push the foreign body out of the upper respiratory tract.

5. Check that the injured person is breathing. Check your breathing – watch, listen and feel for signs of breathing. If the person is breathing normally, turn him on his side. If he is not breathing or breathing normally, go to step 6. A person in cardiac arrest may occasionally snore or try to breathe, which is not normal breathing. If you are unsure whether or not the person is breathing normally, begin CPR following step six.

6. Begin CPR

Chest compressions:

Place the ball of your thumb on the lower half of the injured person’s sternum.

Place your other hand on top of your first hand and either grasp your own wrist or entwine your fingers, whichever is more comfortable for you.

The pressure depth should be one third of the depth of the injured person’s chest (approximately 5 cm, but not deeper than 6 cm).

The treatment of the injured person presupposes:

1. 30 compressions up to two breaths (mouth-to-mouth as per step 7), waiting for 100 compressions and no more than eight breaths per minute OR
2. If you do not wish to do mouth-to-mouth, give continuous compressions at a rate of approximately 100 compressions per minute.

Sometimes chest pressure causes ribs to break. This is still better than the alternative of not receiving CPR. If this happens, stop and reposition your hands before continuing. Chest compressions are exhausting and fatigue affects the quality of compressions. If other helpers are available and willing to help, change the person giving compressions every two minutes, even if you are not yet feeling tired.

Compression arrangements are clearly a priority. If the rescuer cannot coordinate breathing or finds it too time consuming or too unpleasant, effective chest compressions alone will still benefit. It is important not to avoid any CPR efforts due to the mouth-to-mouth component.

7. Mouth-to-mouth. If the injured person is not breathing normally, make sure that he is lying on his back on a firm surface and:

1. Open her airways by tilting her head back and lifting her chin.
2. Plug your nostrils with your finger and thumb.
3. Cover the injured person’s mouth and blow on their mouth.

Give 2 full rescue breaths. Make sure that there is no air leakage and that the chest rises and falls. If the injured person’s chest is not rising and falling, check that you are tilting their head back by pinching their nostrils tightly and closing their mouth tightly over their mouth. If nothing still changes, recheck the airways for obstruction.

If you are unable to bring air to the lungs, return to chest compressions. If there is airway obstruction, compressions can help displace the object that is causing the obstruction.

Continue CPR by repeating a cycle of 30 compressions followed by 2 breaths until professional help arrives. Chest compressions are tiring and fatigue affects quality. If other helpers are available and willing to help, alternate compressors every 2 minutes, even if you are not yet feeling tired.

8. Plug in a defibrillator (AED) as soon as it becomes available.

Use an AED (automated external defibrillator) only on people over the age of eight who are unresponsive and not breathing normally. For children under the age of eight, it’s best to use a pediatric AED and pads. The devices vary and you should follow the instructions in each case. Defibrillators are available in many places, such as schools, offices and shopping centers, so they can be used quickly when needed. It is worth mentioning that there are many applications that can help us locate defibrillators.

CPR must continue until the AED is turned on and electrodes are attached.

Place the pads as per the diagram on the pads. Skin contact of the electrode is important for successful defibrillation. Remove excess moisture or excessive chest hair (if this can be done with minimal delay).

It is important to follow the instructions on the AED. Do not touch the injured person while analyzing the heart rhythm and electrical discharge.

See also: Defibrillation – what is it?

Cardiopulmonary resuscitation in young children and infants

The steps for CPR for children eight years of age or younger are the same as for adults and older children, but the technique is slightly different.

Cardiopulmonary resuscitation in children aged 1-8 years

To perform CPR in children 1–8 years of age:

1. For compressions, use only the ball of the thumb of one hand, up to a third of the depth of the chest.
2. Follow the basic steps above for CPR.

Cardiopulmonary resuscitation in infants (up to 12 months of age)

To perform CPR in infants (up to 12 months of age):

1. Lay the baby on its back. Do not tilt your baby’s head back or raise his chin (this is not necessary as their heads are still large compared to their body).
2. Perform mouth-to-mouth exercises by covering your baby’s nose and mouth with your mouth – remember to only use a little breath.
3. Perform chest compressions with two fingers of one hand up to about one-third of the depth of the chest.
4. Follow the basic steps above for CPR.

What if a person gets better during CPR?

CPR can revive an injured person prior to the arrival of the ambulance. If this happens:

1. Assess the condition of the injured person if any signs of life (coughing, movement or normal breathing) return. If the person is breathing on his own, stop CPR and lay the person on their side with their head tilted back.
2. If the victim is not breathing, continue with full CPR until the ambulance arrives.
3. Be prepared to resume CPR if the injured person stops breathing, becomes unresponsive, or becomes unconscious again. Stay with her until medical attention arrives. Talk to her reassuringly.

It is important not to stop chest compressions or prematurely stop CPR to check for signs of life – if in doubt, continue with full CPR until help arrives. It is unlikely that you will do any harm if you give chest compressions to someone with a beating heart. Regular heart rate checks are not recommended as they may interrupt chest compressions and delay CPR.

See also: Why do ambulances run before the storm? [WE EXPLAIN]

Stopping CPR

Generally, CPR stops when:

1. the person is awakened and begins to breathe independently;
2. medical assistance, e.g. ambulance workers come to take control;
3. the person performing the resuscitation is forced to stop due to physical exhaustion.

See also: The chain of survival – what is it and what are its links?

Cardiopulmonary resuscitation – things to remember

1. Always call 999 in an emergency (when calling 999, the call is picked up directly by the medical dispatcher).
2. Cardiopulmonary resuscitation (CPR) combines mouth-to-mouth resuscitation and chest compressions to deliver oxygen and circulation to an unresponsive person until medical attention arrives.
3. Chest compressions are a priority in CPR. If you don’t want to do mouth-to-mouth surgery, chest compressions alone can still be life-saving.
4. CPR is a life-saving skill that everyone should learn.

Cardiopulmonary resuscitation – men and women

According to a study published by the Resuscitation Science Symposium, men are more likely to perform CPR in public than women.

1. Women and men receive similar CPR support at home, but 45 percent of men received help in public, compared to just 39 percent of women.
2. Men were 1,23 times more likely to receive CPR from an outsider in a public place, and their chance of survival was 23 percent higher compared to women.

Why is there such a discrepancy? This can come down to an anatomy and a bystander not comfortable enough to perform CPR on women.

See also: Women are less likely to be resuscitated. It’s about… breasts