CPR -- cardiopulmonary resuscitation -- is a potentially life-saving procedure that can restart a person's heartbeat and breathing. CPR is often used to revive victims of electric shock, near-drowning, and heart attack. According to the National Institutes of Health, quick CPR can triple a victim's chances for survival. The best way to learn the technique is to take a certified training class. (See http://www.americanheart.org to find a class near you.) The following tips offer a quick introduction to CPR, but they can't take the place of training.

Before performing CPR, check to see if the victim is responsive. Ask him if he's okay and touch him on the shoulder. If he responds, CPR isn't necessary. If he doesn't respond, you need to get emergency help right away. Call 911 or have someone call for you. If you're alone, you may have to leave the victim for a few moments to call for emergency help. CPR is intended to keep a victim alive until medical help arrives.

Note: If you are alone, there are times when it is more important to start CPR immediately than to take the time to call 911 first.

•If reviving an unresponsive infant or young child, perform CPR for one minute before stopping to call 911. According to the Washington University School of Medicine, an immediate attempt to correct airway blockage -- the number one cause of cardiac arrest in infants -- should take precedence over calling 911.

•If an unresponsive adult has been a victim of near-drowning, trauma, or drug overdose, the American Heart Association says it is more important to start CPR immediately than to delay while you call 911.

Note: In November 2005 the American Heart Association standardized the following CPR instructions for all ages except newborns.

Carefully roll the victim over onto his back if he isn't positioned that way already. If the victim does not appear to be breathing normally, begin CPR. Tilt his head back, pinch his nose closed and cover his mouth completely with your mouth. Give him two, full breaths, each lasting about one second. The victim's chest should rise. If it doesn't rise, check to see if something is blocking his airway. If you see something, try to remove it with your fingers. Try again to get air into his lungs. If this attempt fails, but you see that a solid object is blocking the airway, perform the Heimlich maneuver by giving the victim a quick upward thrust on his upper abdomen until the blockage is expelled. (However, do not use the Heimlich maneuver to expel water, as it’s is quickly absorbed into the body: If the water is causing someone to choke, you need to remove it by suction. In fact, the American Heart Association warns against routine use of the Heimlich maneuver for drowning victims, calling it “unnecessary and potentially dangerous.”)If the victim is still not breathing regularly, coughing, or moving, begin chest compressions immediately. Place the heel of one hand right in the center of the breastbone (between the nipples). Put the heel of your other hand on top of the first and press straight down about one and a half to two inches into the chest. (For small children, you may need to only use one hand or two fingers.) Give the victim 30 compressions without any pauses. The compressions should be at a rate of about 100 per minute, or faster than one per second. The key, according to the American Heart Association, is to "push hard and push fast."

After 30 compressions, tilt the victim's head back, pinch his nose, and give him two more deep breaths.

Repeat the cycle of breaths and compression until help arrives or until the victim shows signs of recovery such as moving, breathing, or coughing.

When performing CPR on a newborn, tilt the baby's head back to open the airway, cover both the nose and mouth with your mouth, and give two gentle breaths. Each breath should be one second long. Then position your third and fourth fingers in the center of the baby's chest, about half an inch below the nipples. Give three quick, gentle compressions, pressing down about one third to one half the depth of the chest. The compression rate should be the same as for adults -- about 100 per minute, or faster than one per second. Repeat a cycle of one breath and three compressions for one minute before calling 911. Continue the cycle of breathing and compressions until the baby starts breathing or help arrives.

Keep in mind:

•Don't perform chest compressions if a person is breathing, coughing, or moving. His heart is already beating, and chest compressions could actually stop it.

•Don't waste time looking for a pulse. Leave this to the professionals.

•If a victim vomits, turn him on his side and clear out the vomit with your fingers.

•It's possible to crack a rib during chest compressions, especially if the victim is elderly.

It is important, regardless of the risk of rib fractures, to perform compressions with enough force to get the heart going. In true emergencies that require CPR, a cracked rib is usually a small price to pay for a chance at survival.

The American Red Cross recommends the use of protective breathing barriers during CPR to protect the rescuer from bodily fluids such as blood, vomit, and saliva. Called "pocket masks," these barriers are either reusable or disposable, and have one-way valves that allow air into the victim but prevent the rescuer from having contact with the victim's fluids. The chances of disease transmission during direct mouth-to-mouth rescue are very low, but if you're worried about bloodborne viruses such as HIV or Hepatitis C, keep a pocket mask at the ready in your first aid kit. Contact your local Red Cross chapter for purchasing information.

-- Chris Woolston, MS, is a health and medical writer with a master's degree in biology. He is a contributing editor at Consumer Health Interactive, and was a staff writer at Hippocrates, a magazine for physicians.

Further Resources

You can find illustrated guides on performing CPR on the University of Washington School of Medicine's Web site.

References

First published December 14, 2004
Last updated February 24, 2007
Copyright © 2004 Consumer Health Interactive

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