Cardiopulmonary resuscitation, commonly known as CPR, is an emergency procedure performed to manually preserve intact brain function until further measures are taken. It is indicated in those who are unresponsive with no breathing or abnormal breathing. CPR can keep oxygenated blood flowing to the brain and other vital organs until more definitive medical treatment can restore a normal heart rhythm. When the heart stops, the lack of oxygenated blood can cause brain damage in only a few minutes. A person may die within eight to 10 minutes. To learn CPR properly, take an accredited first-aid training course, including CPR and how to use an automated external defibrillator (AED). If you are untrained and have immediate access to a phone, call 911 before beginning CPR. The dispatcher can instruct you in the proper procedures until help arrives. Some of the basics of CPR are as follows:
- Before starting CPR, check, if the person conscious or unconscious; if the person appears unconscious, one should call 911 or the local emergency number and begin CPR.
- The American Heart Association uses the acronym of CAB — compressions, airway, breathing — to help people remember the order to perform the steps of CPR.
- Compressions: Restore blood circulation. Place the heel of one hand over the center of the person's chest, between the nipples. Place your other hand on top of the first hand. Keep your elbows straight and position your shoulders directly above your hands. Use your upper body weight (not just your arms) as you push straight down on (compress) the chest at least 2 inches (approximately 5 centimeters). Push hard at a rate of about 100 compressions a minute. If you haven't been trained in CPR, continue chest compressions until there are signs of movement or until emergency medical personnel take over. If you have been trained in CPR, go on to checking the airway and rescue breathing.
- Airway: Clear the airway. If you're trained in CPR and you've performed 30 chest compressions, open the person's airway using the head-tilt, chin-lift maneuver. Put your palm on the person's forehead and gently tilt the head back. Then with the other hand, gently lift the chin forward to open the airway. Check for normal breathing, taking no more than five or 10 seconds. Look for chest motion, listen for normal breath sounds, and feel for the person's breath on your cheek and ear. Gasping is not considered to be normal breathing. If the person isn't breathing normally and you are trained in CPR, begin mouth-to-mouth breathing. If you believe the person is unconscious from a heart attack and you haven't been trained in emergency procedures, skip mouth-to-mouth breathing and continue chest compressions.
- Breathing: Breathe for the person. Rescue breathing can be mouth-to-mouth breathing or mouth-to-nose breathing if the mouth is seriously injured or can't be opened. With the airway open (using the head-tilt, chin-lift maneuver), pinch the nostrils shut for mouth-to-mouth breathing and cover the person's mouth with yours, making a seal. Resume chest compressions to restore circulation. If the person has not begun moving after five cycles (about two minutes) and an automated external defibrillator (AED) is available, apply it and follow the prompts. Administer one shock, and then resume CPR — starting with chest compressions — for two more minutes before administering a second shock. If you're not trained to use an AED, a 911 or other emergency medical operator may be able to guide you in its use. If an AED isn't available, continue CPR until there are signs of movement or emergency medical personnel take over.