Understanding the ABCs of CPR

Introduction

If you see someone who is in trouble—whether it's choking, not breathing, or unconscious—it's important to know how to respond. The first thing you can do is call 911 and get help on the way. But if you're alone with the person (or are with a group of people), there are some basic steps you can take that could save their life. Here's what we mean:

Basic life support

If you see someone who is choking and not breathing, call 911 immediately. If you're alone with the person, start CPR right away.

Don't worry about giving mouth-to-mouth resuscitation--it's more important to focus on chest compressions until help arrives. Give 30 chest compressions at the rate of 100 beats per minute (30 compressions for every 2 seconds). These compressions help keep blood circulating in the heart and brain, which can prevent collapse of soft tissue in the chest cavity and allow oxygenated blood to circulate through your friend's body again once breathing resumes on its own or with artificial ventilation via a bag valve mask (BVM).

CPR

CPR is a sequence of compressions and breathing that you give to someone who isn't breathing or is not breathing normally.

  • Look for chest rise and fall. If there's no breathing, call 911 and start CPR.
  • Look for mouth movement--the person may be gasping for air (called agonal respirations). If you see this, don't interrupt it; just continue with your own rescue efforts until help arrives.

Practice CPR on yourself. It's a good way to get comfortable with the procedure and know what it feels like when you're doing it right.

It is recommended that you practice CPR on yourself by pushing on the center of your chest with a closed fist. Use the same amount of force you would if you were giving compressions to someone else. Practice until it feels comfortable and natural, then repeat in 24 hours.

If you see an adult who is unconscious and not breathing normally, call 911 immediately. If you're alone with the person, start CPR right away.

  • Call 911 first. If you're alone with the person, start CPR right away.
  • Check for breathing by placing your ear near their nose and mouth, then look at their chest to see if it's rising and falling naturally. If they aren't breathing normally, push hard on their chest -- about 100 times per minute -- until paramedics arrive or help arrives from someone else who is trained in CPR (for example, a friend).
  • Help an adult who is choking by giving them back blows: Stand behind them and give five firm blows between their shoulder blades with the heel of your hand; then try rescue breaths (which involve pressing down on their abdomen just below where your ribs end). For infants under 1 year old: Lay them face down across your lap with one hand supporting the back of head while squeezing chin toward chest with other hand; give five quick abdominal thrusts followed by two breaths into mouth until help arrives

or a trained practitioner arrives.

Start by calling 911, but then begin CPR if you're alone and the person shows no signs of life.

First, call 911. Then, if you're alone and the person shows no signs of life, start CPR immediately.

  • Compressions should be 100 beats per minute--about twice as fast as a normal heartbeat.
  • Compressions should be 30 compressions followed by two breaths, which means:
  • Push down hard and fast on their chest at least 2 inches (5 cm) with the heel of your hand in the center of their breastbone (sternum).
  • Count out loud while doing this so that if someone else comes to help them they'll know how much time has passed since they called 911 and started giving chest compressions!

Repeat this until help arrives or you are no longer able.

Give 30 chest compressions at the rate of 100 beats per minute. 

To perform chest compressions, place the heel of one hand over the lower half of the breastbone and your other hand on top. Lean forward to press down hard and fast in a straight line from just under one armpit to just past the other. Make sure not to lean back or lift up as you do this; keep your weight directly over your shoulders so that they're supporting most of it, not your arms.

Remember:

  • Give 30 chest compressions at the rate of 100 beats per minute (about 2 seconds per compression). These compressions help keep blood circulating in the heart and brain. They also prevent collapse of soft tissue in the chest cavity.
  • Then give two rescue breaths as quickly as possible (1 second each). Repeat this cycle until help arrives or until you have done 30 cycles total (two minutes), whichever comes first

You can save a person's life if you know what to do when they start choking or going unconscious

If you're alone with a person who is choking or going unconscious, begin CPR right away. If you're with someone else, call 911 first and then begin CPR if they don't respond within 2 minutes.

The steps for performing chest compressions are:

  • Call 911 or send someone else to do so immediately; then perform 30 chest compressions at the rate of 100 beats per minute (which equals one compressions every five seconds).
  • Give two rescue breaths as quickly as possible (1 second each).

If you suspect that the person is bleeding heavily, don't give rescue breaths unless there is visible air in their lungs on a chest compression; this could be a sign of an obstructed airway.

If you can't give ventilations, then do chest compressions only.

Conclusion

If you're alone and encounter someone choking or losing consciousness, dial 911 immediately. Begin CPR promptly. If time allows, aim to transport the person to a hospital quickly for further care. After 30 chest compressions, assess their responsiveness. If unresponsive, continue with 30 compressions followed by two rescue breaths, repeating until help arrives. For no visible air in their lungs, offer up to five rescue breaths. If CPR expertise is lacking, ask someone else to seek help while you start rescue breaths promptly.

CPR/AED CERTIFICATION
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