Cochin Cardiac Club

Health Blog by Dr.Uday Nair



CPR (or cardiopulmonary resuscitation) is a combination of rescue breathing (mouth-to-mouth resuscitation) and chest compressions. If someone isn't breathing or circulating blood adequately, CPR can restore circulation of oxygen-rich blood to the brain. Without oxygen, permanent brain damage or death can occur in less than 8 minutes.

CPR may be necessary during many different emergencies, including accidents, near-drowning, suffocation, poisoning, smoke inhalation, electrocution injuries, and suspected sudden infant death syndrome (SIDS)

CPR is most successful when administered as quickly as possible, but you must first determine if it's necessary. It should only be performed when a person isn't breathing or circulating blood adequately.CPR involves chest compressions at a rate of at least 100 per minute in an effort to create artificial circulation by manually pumping blood through the heart. In addition the rescuer may provide breaths by either exhaling into their mouth or utilizing a device that pushes air into the lungs. The process of externally providing ventilation is termed artificial respiration. Current recommendations place emphasis on high quality chest compressions over artificial respirations and a method involving only chest compressions is recommended for untrained rescuers

Steps for CPR-
Step 1;
Check the victim’s pulse. Do not check for more than 10 seconds. If the victim does not have a pulse, continue with CPR and the next steps.

  • To check the neck (carotid ) pulse, feel for a pulse on the side of the victim's neck closest to you by placing the tips of your first two fingers beside his Adam's apple.

  • To check the wrist (radial) pulse, place your first two fingers on the thumb side of the victim's wrist.
  • Other pulse locations are the groin and ankle. To check the groin (femoral) pulse, press the tips of two fingers into the middle of the groin. To check the ankle (posterial tibial) pulse, place your first two fingers on the inside of the ankle
Step 2
  1. Perform CPR for one minute (which is about three cycles of CPR) and then call the Ambulance/hospital before resuming with CPR.

  • Begin chest compressions-If the victim is not breathing, place the heel of your hand in the middle of his chest. Put your other hand on top of the first with your fingers interlaced. Compress the chest at least 2 inches (4-5 cm). Allow the chest to completely recoil before the next compression. Compress the chest at a rate of at least 100 pushes per minute. Perform 30 compressions at this rate (should take you about 18 seconds). If possible, send someone else to get an AED (Automatic External Defibrillator) if there is one in the building.

  • Remember CAB: Chest Compressions, Airway, Breathing. Chest compressions are more critical for correcting abnormal heart rhythms (ventricular fibrillation or pulseless ventricular tachycardia), and because one cycle of 30 chest compressions only require 18 seconds, airway opening and rescue breathing are not significantly delayed
Step 3;
  • Make sure the airway is open. Place your hand on the victim's forehead and two fingers on their chin and tilt the head back to open the airway (if you suspect a neck injury, pull the jaw forward rather than lifting the chin). If jaw thrust fails to open the airway, do a careful head tilt and chin lift.

  • If there are no signs of life, place a breathing barrier (if available) over the victim's mouth.
  • Give two rescue breaths. Keeping the airway open, take the fingers that were on the forehead and pinch the victim's nose closed. Make a seal with your mouth over the victim's mouth and breathe out for about one second. Make sure you breathe slowly, as this will make sure the air goes in the lungs not the stomach. Make sure you keep your eye on the victim's chest.
  • If the breath goes in, you should see the chest slightly rise and also feel it go in. If the breath goes in, give a second rescue breath.
  • If the breath does not go in, re-position the head and try again. If it does not go in again, the victim may be choking. Do abdominal thrusts (the Heimlich manuever) to remove the obstruction.
Step 4;
  • Repeat the cycle of 30 chest compressions and 2 breaths. You should do CPR for 2 minutes (5 cycles of compressions to breaths) before checking for signs of life. Continue CPR until someone takes over for you, emergency personnel arrive, you are too exhausted to continue, an AED is available for immediate use, or pulse and breathing return (signs of life).
Step 5;
  • If an AED becomes available, turn on the AED, place the pads as instructed (one over the right chest and another over the left side), allow the AED to analyze the rhythm, and give one shock if indicated, after clearing everyone from the patient. Resume chest compressions immediately after each shock for another 5 cycles before reassessing.
Please Note-
  • If you are not trained in CPR, continue to do chest compressions until help arrives or the victim wakes up.
  • Chest compressions are extremely important. If you are not comfortable giving rescue breaths, still perform chest compressions! It's called Hands Only CPR.
  • It's normal to feel pops and snaps when you first begin chest compressions - DON'T STOP! You're not going to make the victim worse.
  • If the victim is breathing, briskly rub your knuckles against the victim's sternum. If the victim does not wake,call an ambulance 
  • If the victim wakes up, but is confused or not able to speak, call an ambulance
In the end we like to add-

  • This write up  is not a substitute for actual CPR training. Find a CPR class and get proper training.
  • Not every CPR class is the same. There are CPR classes for healthcare professionals as well as CPR classes for the layperson. Before you take a CPR class, make sure the class is right for you..

No comments: