Alternative names: rescue breathing, chest compressions - for adults; resuscitation, cardiopulmonary - for adults.

Definition: CPR is a combination of rescue breathing (which provides oxygen to the victim's lungs) and chest compressions (which keep the victim's heart circulating oxygenated blood).

Considerations: CPR can be lifesaving, but it is best performed by those who have been trained in a CPR course. The procedures described here are not a substitute for CPR training. Time is very important when dealing with an unconscious person who is not breathing. Death can occur in 8 to 10 minutes and brain death begins after 4 to 6 minutes without oxygen.

Causes: Cardiopulmonary arrest is a combination of 2 life-threatening conditions: absence of breathing and no heartbeat.

NOTE: The latest CPR procedure does NOT make use of mouth-to-mouth breathing as a part of the protocol for children over 8 years old and adults. The emphasis now being on continuously doing the chest compressions.

Symptoms:

  • NO breathing
  • NO pulse
  • unconsciousness
    •

    DO NOT:

  • give chest compressions if there is a heartbeat; doing so may cause the heart to stop beating.
  • move the victim's head or neck to check for breathing if a spinal injury is suspected.
    •

    Call immediately for emergency medical assistance if:

  • you are NOT alone, have one person call the local emergency number while another person begins CPR.
  • you are alone, shout for help and administer CPR.
    •

    FIRST AID:
    1. Check for consciousness. Shake or tap the victim gently. See if the victim moves or makes a noise. Shout, "Are you OK?"
    2. If there is no response, shout for help. 3. Position the victim on his or her back on a hard surface, keeping the back in a straight line, supporting the head and neck. Unfasten the victim's clothing if necessary to gain access to the victim's chest.
    4. Kneel next to the victim's chin. Tilt the head back and lift the jaw forward to move the tongue away from the windpipe. If a spinal injury is suspected, pull the jaw forward without moving the head or neck. Don't let the victim's mouth close.
    5. Place your ear close to the victim's mouth and watch for chest movement. For 5 seconds, look, listen, and feel for breathing.
    6. If the victim is not breathing, begin rescue breathing. Maintain the head position, close the victim's nostrils by pinching them with your thumb and index finger, and cover the victim's mouth tightly with your mouth. Give 2 slow, full breaths, with a pause in between.
    7. If the chest does not rise, reposition the head and give 2 more breaths. If the chest still doesn't rise, the victim's airway is blocked. Follow instructions for choking (for unconscious adult or child over 1 year).
    8. If the victim's chest does rise, place 2 fingers on the victim's Adam's apple. Slide your fingers into the groove between the Adam's apple and the muscle on the side of their neck to feel for a pulse for 5 to 10 seconds.
    9. If the victim has a pulse, give 1 breath every 5 seconds. Check the pulse after every 12 breaths.
    10. Be sure the local emergency number has been called. Have someone else make the call if possible. Continue giving breaths and checking the pulse.
    11. If the victim has no pulse, begin chest compressions. Maintain the head position and place the heel of your hand 2 finger-widths above the lowest notch of the victim's breastbone (where the lower edge of the ribcage meets in the middle). Place the heel of your other hand directly over the heel of the first hand. Interlock your fingers; don't let them touch the victim's chest. Lock your elbows straight. Lean your shoulders over your hands, and firmly press down about 2 inches into the victim's chest. Repeat the compressions 15 times. Give the compressions in a smooth, rhythmic manner, keeping your hands on the victim's chest. Don't rock back and forth - push straight down. Don't pause between compressions.
    12. Give the victim 2 breaths, followed by 15 chest compressions. Repeat this sequence 4 times. Count aloud as you pump in a regular rhythm. You should pump at a rate of about 80 to 100 times a minute. Count 1 and 2 and 3 and 4 and...15 and (breathe, breathe).
    13. Recheck the victim's pulse for 5 to 10 seconds.
    14. Repeat steps 12 and 13 until the victim's pulse resumes or help arrives. If the pulse resumes, go to step 9.
    15. Once pulse and respiration resume role the person onto his side taking care to move the body as a whole unit. This is called the recovery position, but it should not be used if you suspect there might be a neck or spinal injury. Stay by the person until help arrives.

    Prevention: Be prepared and use good judgment.

    Revised 10/2/2011