How to Perform CPR

Learning how to perform CPR is not a lifestyle choice, I think it is rather a necessity. In today's world when any emergency can come up any time, and knowing this lifesaving technique can definitely be a blessing for someone who needs it immediately for survival! Did you know that performing CPR on a person dealing with cardiac arrest, doubles the chances of his/her survival?!!! Not only this, if you have small children or even infants at home, knowing this lifesaving technique can help you handle the situation till the emergency team arrives. CPR stands for cardiopulmonary resuscitation, and is extremely useful in dealing with situations like cardiac arrests, drowning, and choking. This article will give you the basic information of how to perform CPR in an emergency.

Performing CPR Steps in an Emergency

The American Heart Association guidelines were updated in 2010, wherein they stated that any person is allowed to perform CPR chest compressions, whether trained or untrained. After all, doing something in an emergency is better than doing nothing at all! When a person stops breathing, or the blood flow stops, even one second counts in saving the person from permanent brain damage or death! Even some simple chest compressions can help someone survive a fatal stroke. Therefore, you must perform CPR on the person in such a situation until medical help arrives. However, when it comes to dealing with infants, extra caution needs to be taken, because even an extra pressure on the infant's body can cause fatal consequences.

Performing CPR on Adults
It is very important to analyze the situation of the person before you begin the steps. Check if the person is conscious or not. If you find that the person is not conscious, then you must tap on his/her shoulder and ask loudly if they are alright! If you see no response from the person then you must call 911 as soon as possible. If you have someone to help you, then ask that person to call 911 and you on the other hand, must begin the CPR on the person. However, if you are alone dealing with this emergency, then you must first perform the CPR steps for a minute and then quickly call for emergency medical assistance and get back to the patient. The basic rule of CPR steps is to remember the word 'CAB', which is an abbreviation of circulation, airway and breathing. These steps are explained as under.

Circulation
This is the first step which emphasizes on giving chest compressions to the patient in order to restore their blood circulation. Here is what you need to do.

• Make the patient lie on a firm surface. Make sure that you have made the person lie on their back.
• Kneel or stand next to the patient's shoulder and neck and make sure that the airways are opened and not blocked by any object.
• You need to place the heel of one hand in between the chest of the person (between both the nipples to be precise), and place the other hand over the first hand. Make sure that both your elbows are straight and your shoulder position is right above your hands.
• Start compressing the chest and push it down using your upper body weight until it compresses at least 5 centimeters. You need to give a minimum of 100 compressions per minute.

Airway
The next step is to clear the airways of the person, enabling him to come back to normal breathing. For this you need to perform the following steps.

• Once you have performed a minimum of 30 chest compressions, you need to check if the person is breathing or not. Check for the chest movements and try to listen to the breathing patterns.
• If there are no signs of breathing, then you need to clear the airways of the person by placing your palm on the forehead of the person, and tilting the head gently at the back. Then use your other hand to lift the chin of the person gently so that it becomes easy for the air to pass through the airways.
• Don't take more than 5 seconds to check for the breathing patterns. Feel the chest, place your ears above the nose to feel the breath. If you see no signs of normal breathing, then move on to the next step. If you are not trained in mouth to mouth breathing, then it is advisable to continue with the chest compressions until help arrives. Or you might end up choking the person.

Breathing
This step involves giving mouth to mouth respiration in order to help the person breathe. If the mouth can't be opened due to some reason, then you can perform mouth to nose breathing. Of course, only when you are trained to do so. You need to perform the steps listed as under.

• Use your palm to tilt the forehead of the person, while your other hand lifts the chin gently. Check for breathing by placing your ears and cheeks above the nose.
• If there are no signs of breathing, then continue lifting the chin gently and use the other hand to pinch the nostrils of the person while you cover the person's mouth with your mouth and blow air into their mouth.
• Seal the mouth and give one rescue breath lasting for not more than a second. See if the chest of the person rises, if it doesn't, then give the second rescue breath. Repeat the head tilting and chin lifting process while giving 2 rescue breaths in the same manner.
• One cycle of CPR consists of 30 chest compressions and 2 rescue breathing. Take about 2 minutes to complete 5 CPR cycles. If you still don't see any signs of normal breathing, then use an AED (if it is available and you are trained to use one) to give one shock and resume chest compressions. If you don't know how to use an AED, then continue performing CPR until help arrives.

Performing CPR on a Child
The basic approach of CPR in this case, remains the same as in case of adults. But before you start, you need to see the mouth and nose of the child to check if something like a chewing gum or an eraser is not stuck in the airways that has resulted the choking. This is what you need to do.

• If you have company, then ask the other person to call 911 while you start giving chest compressions to the child. However, if you are all alone, then you must perform at least 2 minutes of chest compression (about 150-200 chest compressions) and call 911 quickly.
• Since you are dealing with a child, make sure that you give chest compressions using only one hand.
• Follow the same combination of C-A-B as used for adults and continue performing the CPR cycles. Remember, 1 CPR cycle includes 30 compressions followed by 2 rescue breaths.
• Perform at least 5 cycles not taking more than two minutes and wait until help arrives. Use AED if it's available and only if you know how to!

Performing CPR on an Infant
When it comes to an infant, one needs to extra cautious. Although we follow the same C-A-B technique, the approach however is a little different. The main reason why an infant would require CPR is because of lack of oxygen which could be a result of choking or drowning. Babies tend to put anything in their mouth. So the first step would be to check if something is blocking the airways of the infant. If the baby is not responding or is unconscious, then gently stroke the baby or shout out the name loudly. Make sure that you don't shake the baby. If you have some help with you, then one of you should call 911 while the other should attend the baby. If you are all alone, then you must perform CPR for two minutes (that's about 5 cycles) and then call 911 quickly and get back to the baby. Mentioned below are the C-A-B steps which you need to perform until help arrives.

Circulation
The first approach would be to restore the blood circulation of the baby. For this you need to-

• Gently place the infant on a flat surface on his/her back.
• In order to give chest compressions, you need to use only two of your fingers and start giving compressions at the center of the chest. To determine the exact point imagine a straight horizontal line passing through the infant's nipples and start compressing just below that line in the middle of the chest.
• Pump the chest at the rate of 100 compressions in a minute and perform the compressions on the chest till 4 cm.

Airway
After giving about 30 chest compressions, the next step should be to clear the airways of the infant. You need to perform the following steps-

• Use one hand to gently tilt the tip of the head slightly backwards and use your other hand to lift the chin of the baby.
• Place your cheeks and ears near the nose and mouth of the baby to feel the breath. Also observe the chest movement of the baby and do not take more than 5-10 seconds to do this.
• If you see no positive response, move on to the next step.

Breathing
If clearing the airways has not made the baby breathe normally, then you need to switch to mouth to mouth breathing. For this you need to-

• Place your mouth over the infant's mouth and nose and use your cheeks to give gentle air puffs slowly to the baby's mouth. Breathe one puff of air in 1 second and observe the chest movements. If the chest rises, then give the second rescue breath. However, if the chest doesn't rise then continue the lifting of the chin and gentle tilting of the head followed by the second breath.
• If there is no improvement in the condition, then perform about 30 chest compressions followed by two rescue breaths until help arrives.
• You shouldn't perform AED on infants at all!

There are many CPR classes offered by many health care institutions like Red Cross and the American Heart Association. Getting yourself trained and certified in CPR, can definitely prove to be of great help in a lifesaving situation.