CPR (Cardiopulmonary Resuscitation) is a first-aid procedure used to revive an unresponsive person who is not breathing (or is just gasping occasionally).
CPR is given for a cardiac arrest when a person stops breathing. This can happen in heart attack, choking/suffocation/smoke inhalation, road/water accidents, electrocution, and poisoning or drug/alcohol overdose. Knowing the CPR maneuver can help save a life, and keep someone alive till emergency medical services can reach. If someone is not breathing, a lack of oxygen to the brain can cause permanent brain damage or death in 8 minutes or less.
Before starting CPR:
- Tap on the person’s shoulder a few times and call out to him loudly, to check if he is responsive.
- Check if the person is breathing by placing your hand on the chest to feel it rise, for 5 seconds.
- Immediately call for emergency medical service ambulance and any other help who can search for an AED machine (Automated External Defibrillator sometimes kept in public places).
- Thereafter if the person is not responding and not appearing to be breathing, commence CPR.
The traditional method of CPR is CAB – Compressions, Airway, and Breathing.
COMPRESSIONS
- The person should be laid on the back with arms by the side. Kneel on the side of the person near his/her arm and chest.
- With the fingers of both your hands interlocked and your arms straight at the elbow, place the heel of your hand on the center of the chest.
- Give 30 compressions (2 every second) by pressing the chest down by about 2 inches. (For children use only one hand, and in infants 2-3 fingers for compression).
AIRWAY
- Tilt the head slightly backward by lifting his/her chin upwards so that the mouth (airway) opens up.
- If any substance causing obstruction is visible and loose in the mouth (like pieces of food etc.), only then you may remove it with the help of your index and middle finger.
BREATHING
- Pinch the person’s nose with your index finger and thumb.
- Take a deep breath and then blow into the person’s mouth forming a seal with your mouth, so that the person’s chest rises visibly.
- Give 2 such rescue breaths.
Continue CPR by giving 2 rescue breaths for every 30 chest compressions, till the person starts breathing or emergency help (ambulance, or AED device) arrives.
CPR during COVID times
- If you are a lay bystander and need to give CPR in a public place to a person not part of your household, perform ‘compression only’ (hands only) CPR
- Place a cloth or towel on the person’s mouth and nose if he/she is not wearing a mask, and you should also be wearing a mask when in a public area.
- Compression only CPR is not very effective in children, so if the child’s family/household member is present, they can be guided to give the rescue breaths while you give the compressions; (Children have low risk of suffering from or transmitting COVID)
- Traditional CAB CPR can be performed if the person is living with you in your house, (like spouse, parents and children).
Steps for using a roadside AED (Also called PAD – Public Access Defibrillator)
- Turn on the defibrillator (most have a green colour ‘on’ button, while some are ‘auto-on’)
- Peel off the sticky pads and place on the person’s chest on each side
- Now do not touch the patient. The defibrillator will assess heart rhythm and shock to be delivered.
- The AED will have a red button which the device will instruct you to press. Do not touch the patient while they are being shocked.
- The AED will inform when the shock has been delivered. You may need to continue CPR if the person is not revived, till life support emergency care arrives.
Also read:
Know the language of the Heart – Understanding Cardiac conditions
References:
European Resuscitation Council COVID-19 guidelines executive summary
American Heart Association: Advanced Life Support Interim Guidelines 2019