Age Ranges
Adult
Adults are 8 years and older.
Child
Children are 1 to 8 years old.
Infant
Infants are ages 0 to 1 years old.
What is CPR?
CPR or Cardiopulmonary Resuscitation is a set of life saving skills utilized when a victim’s heart has stopped circulating blood throughout their body. Our cells require oxygen and other resources to produce energy and keep us alive. Our cells receive oxygen and resources via our circulating blood. In cardiac arrest, the heart is no longer circulating blood through the body and cells quickly starve of the resources they need to survive. By initiating CPR, we are externally taking over these failed body systems. This window provides rescuers time to identify and attempt to reverse the initial cause of cardiac arrest.
In most lay rescuer resuscitations, you will be performing chest compressions until first responders arrive. Performing adequate chest compressions is physically intense and exhausting. If you are unable to perform adequate chest compressions or are becoming fatigued, you should hand the task off to another able person. It is good practice to change compressors every two minutes or when the AED is analyzing for a cardiac rhythm.
Recognizing Cardiac Arrest
Recognizing cardiac arrest is one of the first steps to responding. As a lay rescuer it is acceptable to use responsiveness as an indicator for the need of CPR. As you approach the victim look for signs of life. If you do not see the patient moving, responding to being called, and you do not see their chest moving up and down indicating breathing, you should immediately initiate chest compressions and activate EMS by calling 911 and place them on speaker phone.
Do not spend more than ten seconds looking for signs of life/responsiveness.
If you mistakenly identify cardiac arrest and active EMS and/or start chest compressions and the victim did not need CPR that is okay. You are unlikely to cause significant harm by initiating CPR. However, if you do not initiate CPR and the victim is in cardiac arrest their chance of survival is unlikely.
If you are alone, you should call 911 and place them on speaker as you initiate chest compressions. Stay with the victim and perform CPR.
If you are not alone, initiate chest compressions, then direct a bystander to call 911 and place them on speaker. If you have an additional bystander, direct them to look for an AED and return it to you.
Spend under 10 seconds looking for signs of life.
Immediately start chest compressions.
Activate EMS by calling 911 and placing them on speaker phone.
Chest Compressions
Chest compressions allow you to externally squeeze a failed heart to restore some blood flow. In most lay rescuer resuscitations, you will be performing chest compressions until first responders arrive. Performing adequate chest compressions is physically intense and exhausting. If you are unable to perform adequate chest compressions or are becoming fatigued, you should hand the task off to another able person. It is good practice to change compressors every two minutes or when the AED is analyzing for a cardiac rhythm.
Automated External Defibrillator (AED)
An AED, or Automated External Defibrillator, is a portable device designed to treat people experiencing cardiac arrest, a condition where the heart stops beating. An AED works by checking the heart rhythm and sending an electric shock to the heart to try to restore a normal rhythm. This device can significantly increase the chance of survival if used promptly and correctly.
AEDs are designed to be simple to use for the layperson, with clear instructions, voice prompts, and visual guides. When activated, the AED will instruct the rescuer to place electrode pads on the victim’s chest. The device then assesses the heart’s rhythm and, if necessary, prompts the rescuer to deliver a shock. The shock momentarily stuns the heart, stopping all activity, giving the heart the chance to resume beating effectively.
One of the key advantages of an AED is its ability to be used by non-medical people. They are commonly found in public places like airports, shopping centers, and community centers. Quick access and use of an AED, along with CPR, are critical in the survival for cardiac arrest victims.
When an AED becomes available it is appropriate to utilize during your resuscitation efforts. AEDs have been designed for ease of operation by lay rescuers in an emergency. It is a good idea to become familiar with any AEDs you may be expected to use. Each AED may operate slightly different, however, they all follow the same basic principles:
Turn AED On
Place Pads on Victim
Follow AED Prompts
Turn AED On
Turning the AED on may be as simple as opening the lid or pressing the power button. Each AED will provide instructions on how to power on the AED. You will know it is on when it begins to issue verbal commands.
Place Pads on Victim
All modern AEDs will clearly explain where and how to place the AED pads on the victim. We will also go into further detail in each relevant section.
In no case should a pad be placed on breast tissue or over clothing/garments. Additionally, pads should not be placed over medicine patches or implanted medical devices such as pacemakers.
If the victim is wet, you will want to quickly wipe them dry before placing AED pads or delivering a shock. If the victim is in water or a puddle you will need to move them to a dry surface before placing pads or delivering a shock.
Follow AED Prompts
Once the AED is powered on and pads are placed, the AED will instruct you. The AED will tell you to stop touching the victim so it can analyze the cardiac rhythm. This is the perfect opportunity to switch out compressors for a less fatigued rescuer. After analyzing one of two things will happen:
The AED will charge up and request you make sure that nobody is touching the victim and to deliver a shock. Immediately after delivering a shock, you should resume chest compressions.
The AED will instruct you to immediately resume chest compressions.
Rescue Breathing
Our blood is oxygenated by our breathing, so if we are not breathing we are not oxygenating. In this section we will discuss several techniques for rescue breathing to help oxygenate our victim.
Note: Rescue breathing is not required from a lay rescuer but may be optionally performed with mouth-to-mouth or if present a Bag-Valve-Mask. Rescue breathing will help to replace depleted oxygen in the victim’s blood.
Mouth-to-Mouth
Mouth-to-mouth comes with a risk of disease so it is important to use appropriate PPE. You should use a mouth-to-mouth barrier device when performing mouth-to-mouth. If using a barrier device, follow its operating instructions.
First, start by tilting the patient’s head backwards to open their airway. Pinch the victim’s nose, take in a full breath, place your mouth over the victim’s mouth, and deliver a breath stopping when you see the victim’s chest rise. Repeat these steps to deliver more breaths.
Mouth-to-Mask
Mouth-to-mask ventilations reduce your risk of disease by utilizing a mask barrier between you and your victim. You place the mask over the victims mouth and nose, and breath through a one-way valve to deliver breaths.
Start by tilting the patient’s head backwards to open their airway. Place the mask over the victims mouth and nose forming a secure seal. Then provide one breath over one second or until their chest rises. Release your breath for one second to allow the air to escape from their lungs. Finally, deliver one more breath over one second into the victim or until their chest rises.
Bag-Valve-Mask
In some cases, you may have a Bag-Valve-Mask (BVM) as an option to deliver rescue breaths. A BVM is a device that allows you to form a seal with the victims mouth and deliver rescue breaths by squeezing the bag which automatically inflates with air. This device, when used properly, allows you to control the amount of air being delivered to the person while also providing the best level of protection and body substance isolation for you.
Note: It is very easy to over inflate someone’s lungs, causing damage with a BVM. Pay special attention when operating a BVM and stop the breath once you notice chest rise.
Compressions to Ventilation Ratios
The standard CV or compression-ventilation ratio is 30:2. This means that for every thirty compressions the victim should receive two rescue breaths. If you are going to perform rescue breathing once thirty compressions are reached, the compressor should pause for no more than ten seconds, while rescue breaths are performed.
Choking
Choking occurs when an object becomes lodged in the throat, obstructing airflow. It is a potentially life-threatening emergency that requires immediate action. Choking relief involves performing maneuvers to dislodge the obstruction. If the person becomes unconscious, CPR should be initiated while ensuring that the airway remains clear. It is crucial to seek medical help even after successfully relieving the obstruction to ensure there are no underlying issues or complications.
Review
What does CPR stand for?
Do you have to perform mouth-to-mouth if you do not want to?
What do you look for to indicate starting CPR?
What is an AED?
What are the three steps of using an AED?
What does rescue breathing do?