Saving Lives: A Comprehensive Guide to Performing Adult CPR

Cardiopulmonary resuscitation (CPR) is an emergency procedure that combines chest compressions and rescue breaths to keep oxygenated blood flowing to the brain and other vital organs when someone’s heart has stopped beating. Knowing how to perform CPR can significantly increase the chances of survival for an individual experiencing cardiac arrest. This guide provides a detailed, step-by-step approach to performing CPR on an adult, emphasizing the importance of quick action and proper technique.

Understanding the Importance of CPR

Cardiac arrest can occur suddenly and without warning due to various causes, including heart attacks, drowning, choking, electrocution, and severe trauma. When the heart stops beating, blood circulation ceases, and the brain begins to suffer irreversible damage within minutes due to lack of oxygen. CPR is a critical intervention that can buy time until advanced medical help arrives. It’s not a substitute for professional medical care, but it’s a bridge to survival.

Studies have shown that immediate CPR, performed by a bystander, can double or triple a person’s chance of survival after cardiac arrest. Even if you haven’t received formal training, understanding the basics of CPR can empower you to act decisively in an emergency and potentially save a life.

Recognizing Cardiac Arrest

Before performing CPR, it’s essential to recognize the signs of cardiac arrest. The primary indicators include:

• Unresponsiveness: The person does not respond to verbal or physical stimuli. Try shaking them gently and shouting, “Are you okay?”
• No Normal Breathing: The person is not breathing normally or is only gasping. Gasping or shallow, infrequent breaths is not normal breathing and indicates that the person needs CPR.
• Absence of a Pulse: A pulse may be difficult to check for individuals without training so a lack of responsiveness and normal breathing is enough to begin CPR. However if trained, you can check the pulse at the carotid artery in the neck (located on the side of the neck, below the jaw).

If you observe these signs, assume the person is in cardiac arrest and initiate CPR immediately. Never hesitate to start CPR if you are unsure, as it is better to act than to do nothing.

The Steps of Adult CPR

The American Heart Association (AHA) recommends the following steps for performing adult CPR. This is often remembered using the acronym CAB:

1. C – Compressions:

Chest compressions are crucial for circulating blood to vital organs. Here’s how to perform them correctly:

• Position the Person: Gently lay the person on their back on a firm, flat surface. If they are on a soft surface like a bed, you may need to move them to the floor.
• Locate the Correct Hand Position: Place the heel of one hand in the center of the person’s chest, on the lower half of the breastbone (sternum). Place the heel of your other hand on top of the first hand. Interlace your fingers if comfortable.
• Position Yourself: Position yourself so your shoulders are directly above your hands. Keep your arms straight and locked at the elbows.
• Begin Compressions: Push straight down on the chest, compressing it at least 2 inches (5 centimeters) deep. For most adults, you will need to push quite hard to achieve the correct compression depth.
• Compression Rate: Aim for a rate of 100 to 120 compressions per minute. This means pushing down roughly twice per second which will seem very fast. This is also similar to the tempo of the song ‘Stayin’ Alive’. Allow the chest to recoil completely between compressions so blood can flow back into the heart.
• Minimize Interruptions: Minimize interruptions to compressions. When the AED arrives, turn it on and follow the prompts.

Remember, effective compressions are forceful and fast. Don’t be afraid to push hard; your efforts can make a real difference. Focus on the rhythm and depth for each compression.

2. A – Airway:

Once you’ve performed 30 chest compressions, open the person’s airway. This will allow rescue breaths to enter the lungs. This will improve ventilation, which is crucial for oxygenating the blood that the compressions are circulating. Here’s how to do it:

• Head-Tilt-Chin-Lift Maneuver: Gently tilt the person’s head back by placing one hand on their forehead and the fingers of your other hand under their chin. Lift the chin to open the airway. Be gentle, especially if a head, neck or back injury is suspected. Do not perform a head-tilt-chin lift if a spinal cord injury is suspected. In this case, only perform a jaw-thrust maneuver.
• Jaw-Thrust Maneuver: Place two to three fingers from each hand along the angles of the jaw. Lift the jaw forward to open the airway without tilting the head.
• Check for Obstructions: Briefly look inside the person’s mouth for any obvious obstructions, such as food or vomitus. If you see an obstruction, carefully remove it with your fingers only if easily accessible. Never perform blind finger sweeps.

3. B – Breathing:

After opening the airway, provide rescue breaths. If you are uncomfortable with mouth-to-mouth resuscitation, continue chest compressions without rescue breaths; chest compressions are more important than rescue breaths. In this case, perform uninterrupted chest compressions and skip rescue breaths until an AED is available or EMS arrives. However, if you are willing to provide rescue breaths, follow these steps:

• Mouth-to-Mouth: Pinch the person’s nose closed with the thumb and index finger of the hand that is on their forehead. Make a tight seal over their mouth with your mouth and give two rescue breaths. Each breath should be approximately one second in duration and enough to make the chest rise.
• Using a Pocket Mask or Face Shield: If you have a pocket mask or face shield available, place it securely over the person’s mouth and nose, ensuring a tight seal. Deliver the breaths through the mask or shield as directed by its instructions, as usual, one second for each breath.
• Observe Chest Rise: Look for chest rise with each breath. If the chest does not rise, re-check that the airway is still open and the seal is tight, and try again.

If the initial breaths do not go in, this indicates a blocked airway. The airway must be cleared before providing further breaths. Before continuing to rescue breaths, do another series of 30 chest compressions followed by a jaw thrust maneuver to try and clear the airway and then check for any obstructions as mentioned above.

4. Continue the Cycle:

After completing two rescue breaths, resume chest compressions. Continue cycles of 30 compressions followed by two breaths (30:2) until:

• An Automated External Defibrillator (AED) is available and ready for use.
• The person starts breathing or showing other signs of recovery.
• Qualified medical personnel (paramedics or other first responders) arrive and take over.
• You are too exhausted to continue.

Be prepared to follow the AED instructions, as this can significantly increase the chance of successful resuscitation.

Using an Automated External Defibrillator (AED)

An AED is a portable electronic device that can analyze the heart’s rhythm and deliver an electrical shock (defibrillation) if necessary. If an AED is available, use it as soon as possible. Here’s how:

• Turn on the AED: Follow the voice prompts. They will guide you through each step.
• Attach Electrode Pads: Apply the adhesive electrode pads to the person’s bare chest. One pad should be placed on the upper right side of the chest, and the other pad should be placed on the lower left side of the chest, below the armpit. Some AED pads have pictures on them that show where to place them.
• Analyze Heart Rhythm: Make sure no one is touching the person and press the analyze button on the AED. The AED will analyze the heart rhythm and tell you if a shock is necessary.
• Deliver a Shock: If the AED advises a shock, make sure everyone is clear of the person and press the shock button on the AED. Follow the instructions and always ensure no one is touching the person while a shock is delivered.
• Resume CPR: After the AED delivers a shock (or advises no shock), immediately continue CPR starting with chest compressions, and continue the cycles of 30 compressions and 2 breaths for two minutes, then follow the AED prompts for subsequent shocks.

AEDs are designed to be user-friendly and provide clear instructions. Trust the device and follow its voice and visual prompts.

Important Considerations

• Call Emergency Services: Call for emergency medical assistance (911 or your local emergency number) as soon as possible. If you are alone, call emergency services and place the phone on speaker before starting CPR. If others are around, instruct them to call 911 immediately.
• Do Not Stop: Once you start CPR, do not stop unless any of the termination conditions mentioned above is met or if the person starts to breathe normally. It is essential to maintain continuous compressions to preserve vital organ function.
• Minimize Interruptions: Limit the time during which compressions are not being performed. Interruptions greatly reduce the chance of successful resuscitation.
• Use Proper Technique: Performing CPR effectively requires practice. Consider taking a CPR certification course to learn and practice the proper techniques.
• Universal Precautions: Use protective barriers such as gloves and a face shield if they are available to minimize the risk of infection transmission.
• Be Aware of Your Surroundings: Assess the scene for hazards to ensure your safety and the safety of the individual. If the scene is not safe, move the person to a safe environment, if possible.
• Choking: If the person is choking, perform abdominal thrusts (Heimlich maneuver) instead of chest compressions. Refer to the specific steps for performing abdominal thrusts.

Learning CPR and Regular Training

While this guide provides a comprehensive overview of adult CPR, it’s important to remember that hands-on training is the best way to learn and practice these skills. CPR certification courses offered by organizations like the American Heart Association (AHA) or the American Red Cross will provide you with the necessary knowledge, hands-on practice, and confidence to respond effectively in an emergency. These courses often cover the use of AEDs, CPR for children and infants, and how to relieve choking. Regular refresher courses are also important to ensure your skills remain up to date.

Knowing how to perform CPR is a valuable skill that empowers you to respond in an emergency and potentially save a life. Be prepared, stay informed, and remember that your actions can make a life-saving difference. By learning and practicing these essential life-saving skills, you become a more empowered member of your community, ready to assist in life-threatening situations. Each moment is valuable, and your quick actions can significantly improve a person’s chance of survival. So, educate yourself, train regularly, and stay prepared to help.

Conclusion

Performing CPR on an adult can be intimidating, but knowing the steps and acting quickly can mean the difference between life and death. Remember the steps: compressions, airway, breathing and ensure you call for emergency services. If an AED is available, use it as soon as possible. Regular training and practice will improve your ability to help those experiencing sudden cardiac arrest, which is a valuable life saving skill to have.