How to perform CPR Step by step

The heartbeat can stop suddenly. In fact, breathing may stop suddenly for a number of reasons from infection to accidents to heart attacks. But fatality (read death) does not have to be the only outcome because CPR (Cardiopulmonary resuscitation) has been developed to increase the survival chances.

What is CPR? The term decoded

CPR is basically a first aid procedure in which the rescuer tries to restart the victim’s heart or more precisely his breathing by compressing his chest to push air into his lungs or by breathing straight into his mouth. This lifesaving technique comes handy in many emergency situations, in which someone’s breathing has stopped. For the uninitiated; CPR can help the oxygenated blood to flow to the heart, brain and to other important organs till definitive medical help arrives.

Importance of CPR – Let’s take a closer look

Yes, time is of essence when it boils down to the point of treating a heart attack victim. It is important to mention here, the moment the heart stops beating, the blood flow also stops. The person loses consciousness in less than 15 seconds. Medically speaking; within another 30 -60 seconds the victim will simply stop breathing and as an obvious next result severe damage to the brain cells will follow.

Statistical records demonstrate more than 70% of the cardiac arrests occur either at the public places or at home. In many cases it has been observed that the next person who is nearest to the victim is often just a bystander without any medical expertise such as a friend, colleague, relative or a passer-by. If they could promptly provide CPR to the victim, his chances of death are significantly reduced. As briefed already when you perform CPR the victim receives oxygenated blood flow straight to the brain and heart.

CPR – The “chain of survival”

CPR is that ultimate link which the ‘American Heart Association’ (AHA) calls as the “Chain of Survival.” Basically CPR is the series of actions, which should be performed correctly and also in sequence to give the victim the biggest survival chance.

The 1st link of the ‘chain of survival’: Well; recognition of cardiac arrest and calling the emergency number is definitely the first link in this chain of survival.

The 2nd link: Performing CPR till definitive help arrives is certainly the obvious next link in this chain of survival.

The 3rd Link: Performing early CPR, emphasizing on chest compressions till medical help arrives is the 3rd link.

Don’t just start pushing the victim’s chest when the victim’s breathing has stopped. First grasp him by his shoulder and simply shake to wake him up. If he does not wake up with a “shake and shout,” start performing CPR without any further delay.

Check the following factors before starting CPR

• Is the patient conscious, semi-conscious or unconscious?
• Tap, shake and shout loudly – “Are you OK?”
• Call local emergency number and begin CPR if the victim does not respond

How to do CPR step by step

Remember the order when performing the steps of CPR. American Heart Association employs the short form ‘CAB’ — ‘Compressions, Airway, Breathing’ to help the rescuers in remembering the order when performing CPR.

Compressions – helps in restoring the blood circulation

• Lay the victim on his back on a hard surface
• Kneel beside him
• Now place the heel of your one hand right on the centre of the victim’s chest. Place your other hand on top of your first hand. Now position your shoulder directly and straight above your and hand. Keep your elbows straight
• Utilize your full upper body weight and start compressing the chest. Push hard. Push the chest at the rate of around 100 compressions per minute.

If you are not a trained CPR, continue this compression method till professional help arrives. On the other hand; if you are trained in CPR, move on to the next step of clearing the airway and rescue breathing.

Airway – Clear the passage

If you have performed at least 30 compressions and if you are trained in CPR then it’s time for you to clear the victim’s airway passage by employing the head-tilt and chin-lift maneuver.

• Place your palm right on the person’s forehead. Tilt the head back gently
• Now with the other hand, lift the chin forward in order to open up the airway passage.
• Take 5-10 seconds to check for breathing. Take closer look at the chest motion, listen for breathing sounds and feel for his breath on your ear and cheeks.

Remember; gasping should not be considered as normal breathing. Check for breathing and if the victim is not breathing and if you trained in CPR then move on to ‘mouth-to-mouth’ breathing.

Breathing – mouth-to-mouth rescue breathing

Also known as rescue breathing it should be performed mouth to mouth or mouth to nose (if incase mouth can’t be opened due to injury or for any other reason)

• Using the chin lift and head tilt maneuver clear the airway passage
• Now shut the nostrils by gently pinching them
• Cover the victim’s mouth with your mouth
• Give 2 rescue breaths

Give the first rescue breath for 1 second and watch whether or not the chest rises. If the chest does not rise, use the chin lift and head tilt maneuver and give one more rescue breath.

Remember; 30 chest compressions followed by 2 rescue breaths = 1 CPR Cycle. Continue the CPR cycle till there are any clear signs of improvement or till medical help arrives.

How to do CPR on a child

The overall process for performing CPR to a child ( age 1 – 8) is almost the same as that for an adult with a few differences such as –

• Use just one hand for performing chest compressions
• Breathe gently

For a child, use 30 chest compressions followed by 2 rescue breaths for completing 1 CPR Cycle and if there is no improvement begin the next cycle immediately. Continue till help arrives or the child moves.

How to do CPR on a baby

Research data demonstrates, most cardiac arrest in babies occurs due to chocking or drowning. If you are aware that the baby has an airway obstructions then give the baby the first aid for choking; however if you are unsure about why the baby is not breathing then perform CPR.

• To start with, assess the situation carefully.
• Do not shake the baby. Simply stroke the baby gently and watch for movement.
• If there is no response follow the CAB procedures and call emergency help.

Compressions – helps in restoring the blood circulation

• Put the baby on a flat and rigid surface
• Kneel down beside the baby
• Place two fingers of one hand right at the centre of the baby’s chest
• Compress the chest gently
• Pump at a rapid rhythm of 100 compressions a minute.

Airway – Clear the passage

• Tilt up the head and lift the chin forward
• Place your ear near the baby’s mouth and check for breathing
• Look for chest motion

Breathing – mouth-to-mouth rescue breathing

• Cover the baby’s nose and mouth with your mouth
• Give two rescue breaths
• Do not give deep breaths from your lungs. Instead deliver gentle puffs of air with your mouth

Continue CPR till you see the signs of movements or till help arrives

Dos and Don’ts of performing CPR

As a responsible CPR Rescuer you should

• Perform the chest compression at the rate of 100-120/min
• Perform the chest compression to the depth of 2 inches at least
• Fully recoil after each compression
• Minimize the pauses in compressions

On the other hand, you should not

• Perform the chest compression at the rate less than 100/ min or faster than 120/min
• Perform the chest compression to the depth of less than 2 inches or more than 2.4 inches
• Lean on the chest between each compression
• Maximize the pauses in compressions

There is no escape from the truth; if the victim needs CPR and you simply don’t perform he will die.

Good luck!