In critical moments, cardiopulmonary resuscitation (CPR) emerges as a true life-saver. In this excerpt from Mayo Clinic First-Aid Guide for Outdoor Adventurers by Neha P. Raukar, M.D., M.S., learn the key elements of CPR.
Cardiopulmonary resuscitation (CPR) is a real life-saver. It may need to be used in a range of emergencies that can lead to cardiac arrest, such as a heart attack, drowning or lightning strike, or if a person is choking or has been severely burned. Cardiac arrest is when the person doesn’t have a pulse and isn’t breathing.
CPR can keep oxygenated blood flowing to the brain and other vital organs until an emergency response team arrives.
Performing CPR like a pro means combining two key elements: chest compressions and mouth-to-mouth rescue breathing. Even if you’re uncertain whether your knowledge and abilities are sufficient, the bottom line is that it’s better to do something than nothing.
Follow this advice from the American Heart Association:
Untrained: If you’re not trained in CPR or if you’re worried about giving rescue breaths, then provide hands-only CPR. That means uninterrupted chest compressions at 100 to 120 times a minute until medical help arrives. You don’t need to try rescue breathing.
Trained and ready to go: If you’re well-trained and confident in your ability, perform both chest compressions and rescue breathing. Start CPR with 30 chest compressions before giving two rescue breaths.
Trained but rusty: If you’ve previously received CPR training but you’re not confident in your abilities, just do chest compressions at a rate of 100 to 120 a minute.
Before You Begin CPR
Before starting CPR, assess the situation:
- Quickly scan the scene to make sure there aren’t imminent hazards to your own personal safety.
- Check to see if the person is responsive. Tap their shoulder and shout, “Are you OK?”
- If the person is unresponsive (doesn’t answer, moan or move), have someone call 911 if you’re within cell range, or use the SOS button on an emergency response device.
- Check to see if the person is breathing or if their breathing is abnormal (such as gasping).
- If the person is unresponsive and isn’t breathing or has abnormal breathing, the person is likely in cardiac arrest. Immediately begin CPR. It’s not necessary to check for a pulse if you’re not medically trained.
- If you’ve misread the situation and the person does have a pulse, the act of CPR will be painful enough that they’ll somehow demonstrate that they’re conscious.
- If the person has a pulse but isn’t breathing, performing a head tilt-chin lift can help open the airway (see page 140).
How to Perform CPR
When performing CPR, the first and most important step is to do chest compressions.
Begin Chest Compressions
Forceful, rhythmic compression of the chest should be started as soon as cardiac arrest is suspected. When you perform chest compressions, you’re acting as a pump to push blood and oxygen to the heart and brain.
Perform CPR – Chest Compressions
- Position the person on their back. Find a firm surface. Kneel next to the person’s shoulders and neck.
- Place the heel of one of your hands over the center of the person’s chest, between the nipples. Place your other hand on top of the first hand and interlace your fingers. Keep your elbows straight and position your shoulders directly above your hands.
- Push hard and fast (two compressions per second). Use your upper body weight (not just your arms) as you push down on (compress) the chest between 2 and 2 ½ inches. Let the chest recoil between compressions.
- Continue CPR. If you’re an untrained layperson, continue performing CPR using continuous hard and fast chest compressions – 100 to 120 compressions a minute – until help arrives.
- Seek help. If you’re alone and no one else can call 911 or activate the SOS button on an emergency response device, perform about two minutes of compressions before taking a short break to contact emergency personnel.
Open The Airway
If you’re trained in CPR and are comfortable giving rescue breaths, then after you’ve performed 30 chest compressions, open the person’s airway. If you don’t have CPR training, open the airway after seeking emergency help and before continuing chest compressions.
Perform CPR – Open the Airway
- Perform the head tilt-chin lift. Place your palm on the person’s forehead and tilt the head back. With the other hand, gently lift the chin forward to open the airway. Don’t press deeply into the soft tissue below the chin.
- If a spinal injury is suspected, use the modified jaw thrust and not the head tilt- chin lift. To perform the modified jaw thrust, which protects the neck (cervical spine), use your index and middle fingers to push the lower jaw upward and outward while the thumbs push down on the chin to open the mouth. If another person is available, have that person stabilize the head and neck.
- Return to chest compressions or perform rescue breaths. If you don’t have CPR training, resume chest compressions. Otherwise, perform rescue breaths.
Perform CPR – Breathe for the Person
If you’re trained in CPR:
- Make a seal. 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.
- Give the first breath, lasting one second, with enough air to make the chest visibly rise. If it does, give a second rescue breath, also lasting one second.
- Repeat if needed. If the chest doesn’t rise, repeat the head tilt-chin lift maneuver or jaw thrust and give another breath.
- Check for signs. If there’s no breathing, coughing or movement, resume chest compressions.
Excerpted from Mayo Clinic First-Aid Guide for Outdoor Adventurers by Neha P. Raukar, M.D., M.S.
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