What Are The Steps Used When Performing CPR?

Cardiopulmonary Resuscitation (CPR) is a crucial life-saving skill that can mean the difference between life and death in emergencies. When a person’s breathing or heartbeat stops, immediate action, including performing compressions on a person's chest, is critical to preserving brain function and increasing the likelihood of survival. Understanding the steps involved in CPR can empower individuals to act confidently during cardiac emergencies, providing vital assistance until professional help arrives.

The Vital Importance of CPR

CPR is designed to manually maintain circulation and oxygenation when the heart stops beating effectively. Its primary objectives are:

1. Restoring partial blood flow to the brain and vital organs.

2. Delaying tissue death.

3. Extending the window of opportunity for successful resuscitation.

Studies show that immediate CPR, especially when paired with early defibrillation, significantly improves survival rates. Unfortunately, cardiac arrests often occur outside medical facilities, making it essential for bystanders to step in and provide help.

Preparation for Cardiopulmonary Resuscitation

Before performing CPR, it’s essential to prepare yourself and the person in need. Here are some steps to follow:

1. Ensure Your Safety: First and foremost, check the scene for any hazards or dangers that could put you or the person in need at risk. This includes looking out for traffic, electrical wires, or any other potential threats.

2. Call for Help: Dial 911 or your local emergency number to alert medical personnel. If others are around, ask someone to make the call while you begin CPR. Clear communication with emergency responders is crucial.

3. Check the Person’s Airway, Breathing, and Circulation (ABCs): Quickly assess if the person is unresponsive, not breathing, or not breathing normally. This will help you determine the need for CPR.

4. Position the Person: Place the person on their back on a firm, flat surface. Ensure their head, neck, and spine are aligned to maintain an open airway.

5. Remove Any Obstacles: Clear the person’s mouth and airway of any obstructions, such as food, vomit, or blood. This step is vital to ensure effective rescue breaths if you are trained to provide them.

Step-by-Step Guide to Performing CPR

1. Ensure Scene Safety

Before approaching the person in need, assess the scene for potential hazards. Look for dangers like electrical wires, chemical spills, or traffic. Ensuring the environment is safe allows you to focus fully on providing care without putting yourself or others at risk. Once safety is confirmed, approach the individual calmly and swiftly.

2. Check for Responsiveness

Tap the person gently on the shoulders and call out loudly, “Are you okay?” This step helps determine if the person is unresponsive, which is a key indicator of cardiac arrest. If the individual doesn’t respond, it’s time to take immediate action.

3. Call for Help

Call 911 or your local emergency number as soon as you confirm unresponsiveness. If others are nearby, delegate someone to make the call and bring an Automated External Defibrillator (AED) if available. Clear and precise communication is vital—provide details about the situation and location to emergency responders.

If you’re alone, call for help yourself before starting CPR unless you are performing CPR on a child or infant. In those cases, perform CPR for two minutes first, then make the call.

4. Check for Breathing

Lean close to the person’s mouth and nose. Look for chest movement and chest rise, listen for breath sounds, and feel for air on your cheek. This should take no more than 10 seconds. If the person is not breathing, or if they are gasping (agonal breathing), start CPR immediately.

5. Begin Chest Compressions

• Position Yourself Properly: Kneel beside the person and place the heel of one hand on the center of their chest, just below the nipple line. Place your other hand on top, interlocking your fingers. Ensure your shoulders are directly above your hands, and keep your arms straight.

• Compress Deeply: Push down at least 2 inches (5 cm) into the center of the chest for adults. For children, compress about one-third of the chest depth.

• Allow Recoil: Let the chest fully return to its normal position between compressions to allow the heart to refill with blood.

6. Push Hard and Fast

• Perform compressions at a rate of 100–120 per minute.

• A song can help you maintain the correct rhythm.

• Ensure your compressions are smooth and continuous, avoiding interruptions unless absolutely necessary.

7. Provide Rescue Breaths (If Trained)

If you’re trained in CPR and confident in giving rescue breaths:

1. Open the Airway: Tilt the person’s head back slightly and lift their chin.

2. Seal and Deliver Breaths: Pinch their nose shut, cover their mouth with yours, and deliver two slow, steady breaths. This technique is known as mouth to mouth breathing. Each breath should last about one second and cause the chest to rise visibly.

3. Continue the Cycle: Alternate 30 compressions with two rescue breaths. If untrained or uncomfortable with giving breaths, continue Hands-Only CPR (compressions only).

8. Use an Automated External Defibrillator (AED)

If an AED is available, use it as soon as possible:

1. Turn on the AED: Follow the voice or on-screen prompts.

2. Attach the Pads: Place the adhesive pads on the person’s chest as indicated by the diagrams on the pads.

3. Analyze the Heart Rhythm: Allow the AED to assess the heart's electrical activity.

4. Deliver a Shock (If Advised): If the AED recommends a shock, ensure no one is touching the person and press the shock button. Resume CPR immediately after the shock.

AEDs are designed for ease of use and can be a game-changer in cardiac emergencies. If no shock is advised, continue CPR until help arrives or the person shows signs of life.

9. Rotate Rescuers (If Possible)

Chest compressions are physically demanding. If another trained individual is present, rotate every two minutes to ensure high-quality compressions. Quick and efficient rotation minimizes interruptions in compressions, which are critical to survival.

10. Continue Until Professional Help Arrives

CPR should continue uninterrupted until one of the following occurs:

• Emergency medical responders take over.

• The person begins breathing and shows signs of life.

• You are physically unable to continue due to exhaustion.

Stopping CPR prematurely significantly decreases the person’s chances of survival.

Special Considerations

There are some special considerations to keep in mind when performing CPR:

1. Infants and Children: CPR for infants and children differs slightly from adults. For infants, use two fingers to perform chest compressions, and for children, use one hand. The depth of compressions should be about one-third of the chest depth.

2. Newborns: Newborns require a different CPR procedure, which involves gentle chest compressions and careful rescue breaths. Specialized training is recommended for handling such delicate situations.

3. Pregnant Women: When performing CPR on a pregnant woman, consider the size and position of the uterus. You may need to adjust the position of your hands slightly higher on the chest to accommodate the baby.

4. People with Disabilities: When performing CPR on someone with a disability, take into account any physical limitations or special needs. Adapt your technique as necessary to ensure effective chest compressions and rescue breaths.

After CPR

After performing CPR, it’s essential to continue providing care until medical help arrives. Here are some steps to follow:

1. Continue Chest Compressions: Keep performing chest compressions until the person starts breathing on their own or medical help arrives. Consistency is key to maintaining blood flow.

2. Monitor the Person’s Breathing and Pulse: Regularly check the person’s breathing and pulse rate to ensure they are stable. This helps you gauge the effectiveness of your efforts.

3. Provide Oxygen: If the person is not breathing, provide oxygen using a bag-valve-mask device or an automated external defibrillator (AED) if available. This can help maintain oxygen levels in the blood.

4. Stay with the Person: Remain with the person until medical help arrives. Offer any additional care as needed and be prepared to provide information to emergency responders.

By following these steps, you can ensure that you are providing the best possible care during and after performing CPR.

Why Early CPR and Defibrillation Matter

Time is critical during cardiac arrest. Without oxygen-rich blood, brain damage can occur within four to six minutes, and death can follow within 10 minutes. CPR provides a vital bridge by maintaining blood circulation and oxygen delivery until advanced care arrives.

When combined with defibrillation, CPR can dramatically improve outcomes. Defibrillation resets the heart’s rhythm, and the sooner it’s administered, the higher the survival rate. Bystanders equipped with both CPR knowledge and access to an AED can make a profound difference.

Empowering Yourself Through CPR Training

Being prepared to act in an emergency can save lives. Consider enrolling in a CPR certification course to learn proper techniques for compressions, rescue breaths, and AED use. Training programs provide hands-on practice, build confidence, and teach how to respond effectively in various scenarios. It is crucial to clear the person's mouth of any obstructions before performing CPR to ensure adequate airflow.

Many organizations offer online and in-person classes tailored to different skill levels. Certification ensures you’re up to date on the latest guidelines and ready to act when needed.

Conclusion

Cardiopulmonary Resuscitation (CPR) is a life-saving procedure that every individual should know. By understanding and applying the correct steps—ensuring safety, checking responsiveness, calling for help, and performing effective chest compressions—you can make a significant difference during cardiac emergencies. Incorporating AED use when available further increases the chance of survival.

Immediate CPR, even by an untrained bystander, can double or triple a person’s chances of survival after sudden cardiac arrest. With proper training and a willingness to act, you can become a vital link in the chain of survival, offering hope and life to someone in need.