CPR stands for cardiopulmonary resuscitation. CPR is a procedure that is performed during the time of emergency when the patient lies unconscious and under cardiac arrest. CPR is a combination of chest compressions and manual artificial ventilation to preserve brain activity intact. This is recommended in patients who are having abnormal breathing or patients who lie unconscious due to unresponsive breathing. The chest compressions should be at least 5cm deep and at the rate of 90 to 120 compressions per minute. Along with this even mouth to mouth resuscitations are given by exhaling air into the patient’s mouth. Mechanical ventilation is also given to patients wherein there will be the use of a device that pushes air into the patient’s lungs.
It is always recommended to opt for chest compressions than the mechanical ventilation when an untrained rescuer is involved for better output. However, in children, chest compression might cause an issue since the problem basically lies in the respiratory system rather than cardiac.
CPR alone is not responsible to revive the heart. Its main purpose is to re-establish partial oxygenated blood flow to the heart and brain. This, in turn, reduces the chances of tissue death-causing minimal damage to the brain. Mechanical way to revive the heart include defibrillation, which is the administration of electric shock to the patient to get back the normal rhythm of the heart. The method defibrillation is effective only for particular heart rhythms which are:
Pulseless ventricular tachycardia
CPR is administered until the normal rhythm of the heart is revived and spontaneous circulation returns or the patient is declared dead.
Before a CPR is carried out on the patient few things need to be taken care of:
We need to check the place whether it is safe for the procedure to be carried out.
One needs to make sure whether the patient is conscious or unconscious.
If two helpers are available on the spot then one person needs to call the emergency and the other person needs to carry out the CPR.
The person who is performing CPR has to be aware of three terms C-A-B.
C is compression, A is Airway, B is breathing and these three terms are coined by the American heart association.
The patient on whom the CPR is supposed to be performed is made to lie down on a flat surface in the supine position. One must make sure the procedure is not carried out on an uneven surface.
The one who is performing the resuscitation needs to check whether the airway of the patient is clear by tilting the patient's head back opening the airway.
Check for breathing, if the person is not breathing, and no breathing sound is heard for more than 10 seconds one should begin the CPR.
Once the CPR process progresses the foremost rule to follow is push hard and push fast. The hands are placed one upon the other in the middle of the chest. The body weight is properly distributed upon the hands and then compressions are started at least with a depth of 2 inches and a minimum of 100 compressions are given per minute.
In between mouth to mouth rescue breaths are also given, during this time the patient's head is slightly tilted back and chin is lifted up, the nose is pinched and the patient's mouth is covered with rescuers mouth properly. Air is blown into the patient's mouth to make the patient’s chest rise. Alternatively, two rescue breaths are given following compression and this is repeated.
These CPR steps are continued with alternate breaths and compressions until the patient shows signs of consciousness and a health professional arrives on the scene.
80% of the cases are not injured during this procedure. The rest 10% sustain a minor injury if the CPR is not performed correctly. The patient is at high risk of damage to the sternum or broken rib or lung injury. The patient might also suffer from internal bleeding if there is any heart contusion.
Other minor side effects include vomiting which needs to be cleared so that the patient does not swallow it.
1. When Should We not Perform CPR?
Ans: If the rescuer notices any signs of life in the patient then the CPR should be stopped immediately. If the patient makes any movement or opens eyes, or coughs you must stop giving compression as well.
2. Is CPR Required If There is a Pulse in the Patient?
Ans: Supposedly there is a pulse in the patient the airway is cleared and rescue breathing is continued. Pulse is checked every two minutes if at any point the pulse goes missing the CPR is administered immediately.