Adult CPR

CPR and AED:

About 70% of cardiac arrests that occur outside of the hospital happen at home.

  1. The AHA adult Chain of Survival shows the most important actions needed to treat adults who have cardiac arrests outside of a hospital.
  2. The first link in the adult Chain of Survival is to immediately recognize the emergency and phone 9-1-1.
  3. The second link is to perform early CPR with an emphasis on chest compressions.
  4. The third link is to use an AED as soon as it is available.

 

Make Sure the Scene is Safe and Check for Responsiveness:

  1. When you encounter an adult who may have a cardiac arrest, always ensure your own safety by making sure the scene is safe.
  2. Check for responsiveness by tapping and shouting.
  3. Phone 9-1-1 and get an AED.
  4. Check for normal breathing.
    1. When checking for responsiveness, kneel at the victim’s side and tap his shoulders and ask if he is OK.

 

Shout for Help:

  1. If the victim does not respond, shout for help. Tell the bystander to phone 9-1-1 and get an  AED.
  2. If you are alone, use your cell phone on speaker mode so you can speak with the dispatcher while providing emergency care to your victim. If there is an AED nearby, you will have to go get it yourself.

 

Check for Breathing:

  1. If the victim is unresponsive, check for normal breathing.
  2. When checking for breathing, scan the chest from head to waist repeatedly for at least 5 seconds but no more than 10 seconds looking for chest rising and falling.
  3. If the victim is only gasping and not breathing normally, he needs CPR.
  4. If the victim is breathing normally but is unresponsive, roll him onto his side. This keeps the airway clear in the event he vomits.
  5. If you think someone needs CPR but you are unsure, provide CPR anyway.

 

Provide Compressions: 

  1. Compression is the act of pushing hard and fast on the chest. When you push on the chest, you pump blood to the brain and heart.
  2. Provide compressions that are deep and fast enough.
  3. Allow the chest to come back up to its normal position after each compression.
  4. Try not to interrupt compressions for more than 10 seconds, even when you give breaths.
  5. Make sure the person is lying on a firm,  flat surface.
  6. Quickly move clothes out of the way.
  7. Put the heel of one hand on the center of the chest (lower half of the breastbone). Put your other hand on top of the first hand.
  8. Push straight down at least 2 inches.
  9. Push at a rate of 100 to 120 compressions per minute. Count out loud.
  10. If someone else knows CPR, take turns to prevent fatigue. Switch rescuers about every 2 minutes, or sooner if you get tired.

 

Give Breaths:

After each set of 30 compressions, you will need to give 2  breaths. Breaths may be given with or without a barrier device, such as a pocket mask or face shield.

  1. When giving breaths, make the chest rise visibly.
  2. Before giving breaths, open the airway. This lifts the tongue from the back of the throat to make sure your breaths get air into the lungs.
  3. To open the airway, put one hand on the forehead and the fingers of your other hand on the bony part of the chin. Avoid pressing into the soft part of the neck or under the chin because this might block the airway.
  4. To give breaths without a pocket mask: Pinch the nose closed with your thumb and forefinger. Take a normal breath. Cover the victim’s mouth with your mouth. Give breaths (blow for 1 second for each). Watch for the chest to begin to rise as you give each breath.
  5. Try not to interrupt compressions for more than 10 seconds.
  6. If the chest does not rise, allow the head to go back to the normal position and open the airway again by tilting the head back and lifting the chin. Then give another breath. Make sure the chest rises.
  7. If unable to give effective breaths within 10 seconds, go back to providing chest compressions.
  8. Barrier devices, such as Pocket Masks, protect rescuers from blood, vomit, or disease.
  9. To give breaths with a pocket mask, put the mask over the victim’s mouth and nose. If the mask has a pointed end, but the narrow end of the mask on the bridge of the nose, position the wide end so it covers the mouth.
  10. Tilt the head and lift the chin while pressing the mask against the victim’s face.
  11. Make an airtight seal between the victim’s fast and the mask while you lift the chin to keep the airway open.
  12. Give 2 breaths (blow for 1 second each). Watch for the chest to begin to rise.
  13. Do not interrupt compressions for more than 10 seconds.
  14. Give 30 compressions followed by  2  breaths. Repeat.

 

Use of an AED:

  1. CPR combined with using an AED provides the best chance of saving a life.
  2. AED is an acronym that stands for automated external defibrillator.
  3. To use an AED, turn it on by either pushing the “on” button or lifting the lid. Once you turn on the AED, you will hear prompts, which tell you what to do.
  4. AEDs may have adult and child pads. Make sure to use the adult pads for anyone 8 years of age or older.  Before you place the pads, quickly scan the body to see if there are special situations that might require additional steps. Peel away the backing from the pads and attach to the bare chest. Follow the pictures on the pads for proper placement.
  5. Let the AED analyze the heart rhythm. If the AED advises a shock, it will tell you to stay clear of the person. If so, then loudly state “Clear”. Make sure that no one is touching the victim just before you push the shock button. If no shock is advised, continue CPR.
  6. Provide CPR and AED use until someone else arrives to assist you, the victim begins to move, speak, blink, or otherwise react, or until advanced training arrives.

 

Special Situations:

  1.  Before applying pads of the AED, check to see if there are special situations.
  2. If the victim has a hairy chest, the AED pads may not stick. If so, then quickly the area where you will place the pads using the razor provided in the AED kit.
  3. If no razor, then use the second set of AED pads, press firmly onto the chest then rip the pads off forcefully to remove the chest hair. Reapply a new set of pads to bare skin.
  4. If the victim is lying in snow or a puddle of water, you may use the AED. If the chest is covered in water or sweat, quickly wipe it before attaching the pads.
  5. If the victim has an implanted defibrillator or pacemaker, don’t put the AED pad directly over the implanted device.
  6. If the victim has a medicine patch where you need to place the AED pads, remove the medicated patch, wipe the area clean, and attach AED pads.

 

 

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