Cardiopulmonary Resuscitation (CPR) is a critical life-saving technique used to maintain blood circulation and oxygen supply to the brain and other vital organs during cardiac arrest. Without proper blood flow, a person can suffer brain damage or death within minutes. CPR is designed to keep oxygenated blood moving through the body until emergency medical help arrives and can restore a normal heartbeat. As a leading provider of CPR training and education, MyCPR NOW stresses the importance of mastering CPR, including understanding the process and the significance of each step. In this detailed guide, we will walk you through the seven essential steps of CPR, focusing on proper technique, timing, and the role of each step in maximizing the chances of survival. Whether you're a concerned citizen, a healthcare professional, or someone preparing for emergencies, this guide will equip you with the knowledge to perform CPR with confidence and skill.
Assess the Situation and Ensure Safety
Before you begin CPR, it is crucial to take a moment to evaluate the situation and ensure that you and the victim are safe. This first step sets the foundation for effective emergency intervention.
1. Size Up the Scene
-
Ensure your safety: The first priority is your own safety. Quickly assess the environment for potential hazards such as traffic, fire, unstable structures, or dangerous materials. Only approach the victim if it is safe to do so.
-
Ensure the safety of the victim and others: If there are dangers present, such as moving vehicles, try to move the victim to a safer area, but only if it can be done without causing further harm.
2. Check for Responsiveness
-
Approach the victim carefully: Once you've determined that the scene is safe, approach the victim and try to rouse them by tapping on their shoulder or gently shaking them.
-
Shout to get a response: Call out loudly, “Are you okay?” If there is no response or the victim is unresponsive, assume they need help and proceed with CPR.
3. Call for Help
-
Dial 911: If the victim does not respond, immediately call 911 or ask someone nearby to call for emergency medical services (EMS). Time is of the essence, so the sooner help is on the way, the better.
-
Request an AED (Automated External Defibrillator): If an AED is available, ask someone to retrieve it while you begin CPR. AEDs are crucial in cardiac arrest cases and can help restore a normal heart rhythm.
Open the Airway
Once it is clear that the victim is unresponsive, the next step is to open their airway. This allows you to assess their breathing and determine if CPR is needed.
1. Head-Tilt Chin-Lift
-
Position yourself at the victim's side: Kneel next to the victim's head, ensuring you have easy access to their airway.
-
Tilt the head back: Using one hand, place your palm on the victim's forehead and gently push back to tilt the head. At the same time, use the fingers of your other hand to lift the chin upwards. This maneuver opens the airway by moving the tongue away from the back of the throat.
-
Be cautious with spinal injuries: If you suspect a neck or spinal injury, try using a jaw thrust maneuver to open the airway without moving the neck. Place your fingers behind the jawbone and lift upward while keeping the head still.
Check for Normal Breathing
Now that the airway is open, it's time to determine if the victim is breathing normally. This step is critical in deciding whether to begin chest compressions.
1. Look, Listen, and Feel
-
Look: Observe the victim's chest to see if it rises and falls, which indicates breathing.
-
Listen: Bring your ear close to the victim's mouth and listen for any breath sounds.
-
Feel: Try to sense the movement of air on your cheek or hand.
2. Absence of Normal Breathing
-
No breathing or abnormal breathing: If the victim is not breathing, or their breathing is abnormal (such as gasping or irregular breaths, also known as agonal breathing), they are in cardiac arrest. In this situation, you must start CPR immediately to maintain circulation and oxygenation until EMS arrives.
Begin Chest Compressions
Chest compressions are the most important component of CPR. They manually pump blood through the heart and into the rest of the body, providing oxygen to vital organs like the brain and heart. The effectiveness of CPR depends on the quality of chest compressions.
1. Hand Position
-
Kneel next to the victim: Place yourself at the side of the victim's chest, kneeling for stability.
-
Correct hand placement: Place the heel of one hand on the center of the chest, on the lower half of the breastbone (sternum), just below the nipple line. Incorrect hand placement can reduce the effectiveness of compressions and may cause injury.
2. Second Hand Placement
-
Interlock your hands: Place your other hand on top of the first hand, interlocking your fingers. Keep your fingers off the victim's chest to ensure that only the heel of your hand is applying pressure.
3. Compression Technique
-
Use your body weight: Lean directly over the victim and use your body weight to apply pressure, rather than just relying on arm strength. This helps you maintain the energy and consistency needed to perform effective compressions.
-
Depth of compressions: Compress the chest at least 2 inches (5 centimeters) deep for adults. For children and infants, compressions should be about one-third the depth of the chest. Make sure to allow the chest to fully recoil between compressions to enable the heart to refill with blood.
4. Compression Rate
-
Fast and steady pace: The ideal rate for chest compressions is 100-120 compressions per minute. You can use the beat of songs as a reference for maintaining the proper rhythm. Consistency is key, as irregular compressions can reduce the effectiveness of CPR.
Provide Rescue Breaths
After performing 30 chest compressions, the next step is to provide rescue breaths. Rescue breaths help to deliver oxygen to the victim's lungs, which is crucial for oxygenating the blood being circulated by chest compressions.
1. Open the Airway Again
-
Head-tilt chin-lift: Reopen the airway using the head-tilt chin-lift maneuver to ensure the airway is clear for rescue breaths.
2. Pinch the Nose
-
Prevent air escape: Pinch the victim's nose shut using your fingers to prevent air from escaping when you deliver breaths.
3. Administer Rescue Breaths
-
Mouth-to-mouth: Take a deep breath and place your mouth firmly over the victim's mouth, creating an airtight seal. Give one slow, controlled breath, watching to see if the victim's chest rises. Each breath should take about one second.
-
Give a second breath: After the first breath, give a second breath, ensuring the chest rises again. If the chest does not rise, reposition the head and attempt another breath.
Continue Chest Compressions and Rescue Breaths
CPR should be continuous, with minimal interruptions, to maximize blood flow and oxygen delivery to the brain and heart.
1. Compressions to Breaths Ratio
-
30:2 ratio: Continue performing CPR cycles with a ratio of 30 chest compressions followed by two rescue breaths. This ratio applies to adults, children, and infants.
2. Uninterrupted CPR
-
Minimize interruptions: Limit pauses between chest compressions and rescue breaths to keep blood circulating. Each time compressions stop, blood flow to the brain and other organs decreases significantly.
Use an AED (Automated External Defibrillator) if Available
An Automated External Defibrillator (AED) can greatly increase a victim's chances of survival during cardiac arrest. If one is available, it should be used as soon as possible.
1. AED Availability
-
Turn on the AED: If an AED is available, turn it on immediately and follow the voice prompts. AEDs are designed to guide you through the process, so follow the instructions carefully.
2. AED Pad Placement
-
Apply pads to the chest: Expose the victim's chest and apply the adhesive pads as directed. One pad goes on the upper right side of the chest, just below the collarbone, and the other pad goes on the lower left side of the chest, a few inches below the armpit.
3. AED Analysis
-
Allow the AED to analyze: The AED will automatically analyze the heart rhythm to determine if a shock is needed. During this time, make sure no one is touching the victim.
-
Administer the shock if advised: If the AED advises a shock, ensure everyone is clear of the victim, and press the shock button when prompted.
4. Resume CPR
-
Continue CPR after the shock: After the AED delivers the shock, immediately resume chest compressions and rescue breaths. Follow the AED's prompts and continue CPR until EMS personnel arrive.
Conclusion
The seven steps of CPR offer a systematic, effective approach to responding to cardiac arrest and significantly increasing the victim's chances of survival. Each step—from assessing the situation to using an AED—is crucial in keeping oxygenated blood flowing to the brain and vital organs while waiting for professional medical assistance. The key to successful CPR is maintaining the correct rhythm, depth, and timing of chest compressions, while providing timely rescue breaths and utilizing an AED when available.
Understanding and mastering these techniques can make all the difference during an emergency. MyCPR NOW encourages individuals to undergo formal CPR training to gain hands-on experience and stay up to date with the latest CPR guidelines. With regular practice, you can confidently respond to emergencies and potentially save lives, becoming an essential link in the Chain of Survival.
