Basic life support and emergency CPR

Written by Amanda Menard, LPN, a practical nurse since 2005 with experience in ICU, cardiac care, and case management. She is pursuing her MSN for Family Nurse Practitioner and is a former Military Medic with the Louisiana National Guard.

Cardiopulmonary resuscitation, commonly abbreviated as CPR, is a form of basic life support used during a life-threatening emergency. Situations that call for CPR include cardiac arrest, near-drowning incidents, suffocation, or any situation in which a person is unresponsive and not breathing normally (e.g., only gasping).

The goal of performing emergency CPR is to ensure the circulation of oxygen-rich blood to the brain. This action can help prevent brain damage or death from occurring. It is essential that both adults and children learn the basics of performing CPR.

Why is it important to learn CPR?

There are many reasons why learning CPR is important. Approximately 350,000 to 360,000 out-of-hospital cardiac arrests occur each year in the United States. A majority of those take place in a home; however, 70 percent of people in the U.S. don’t know CPR or have forgotten how to do it. All parents of infants and young children should also learn how to perform CPR so that they can take appropriate action if their child stops breathing. Acting swiftly often means the difference between life and death in any of these situations.

Learning how to do CPR

The best way to learn CPR is to take a course. Local hospitals and colleges may offer CPR classes to the public.

During these classes, people learn the guidelines for cardiopulmonary resuscitation and how to provide it adequately for adults, children, and infants. Qualified instructors teach these courses and use mannequins to demonstrate the correct steps.

Even if a person is unable to take a CPR course, he or she should learn hands-only CPR; this simple technique is illustrated on the American Heart Association’s website. Hands-only CPR is a simple-to-learn emergency CPR technique that can save the life of a loved one or anyone in need.

Important guidelines

There are a few guidelines for cardiopulmonary resuscitation that people should follow before attempting to administer help. The first instruction is to determine if the person is conscious. To do this, use a loud voice and ask if the person is okay while tapping them. It is okay to gently shake a person only if there is no risk of a back or neck injury.

Another essential rule before attempting emergency CPR or any other type of basic life support is to contact emergency services so that professional help arrives as quickly as possible. If an infant or a child who has not yet reached puberty needs CPR, the parent or guardian should contact emergency services after performing CPR for two minutes if they are alone.

If more than one person is present, one should call 911 while the other begins performing CPR. There are also guidelines on what type of CPR to perform. People who are not trained in CPR, or who are trained but not confident, should perform hands-only CPR for adults, while conventional CPR with compressions and rescue breaths is recommended for infants and children. If trained, a person should begin CPR using the CAB sequence: compressions, airway, and breaths.

To perform hands-only CPR on an adult or a teenager who suddenly collapsed, place your hands together with one on top of the other. The heel of the bottom hand should then be placed on the center of the unconscious person’s chest. The person must then straighten his or her arms, lock the elbows, and press down on the unconscious person’s chest repeatedly.

What to take into account when performing CPR

When performing CPR on a child, use one or two hands depending on the size of the child. For an infant, use two thumbs encircling the chest when two rescuers are present. The pressing motion should be relatively hard and fast, keeping the beat of the disco classic “Stayin’ Alive” from the movie Saturday Night Fever. The American Heart Association recommends the beat from this song because it accurately matches the rate that a person should push on the chest, which is 100–120 beats per minute. Continue this until help arrives.

When performing full CPR, a simple way to remember the three steps is to memorize the acronym CAB. CAB stands for compressions, airway, and breaths; this is the correct order to follow when providing CPR. Compressions are performed in the same manner as hands-only CPR.

Unlike the hands-only method, which continues with compressions until help arrives, 30 compressions should be performed before checking the airway. To open the airway, tilt the head back and lift the chin up. If the person is not breathing normally or not breathing at all, then emergency breaths are needed.

Emergency breaths involve pinching the nose and breathing into the mouth of the unconscious individual to force air into the lungs; this is done twice, with each breath lasting one full second. Thirty chest compressions follow the breaths. The cycle repeats until emergency responders arrive or the individual begins breathing on his or her own. When giving rescue breaths to an infant, a person should use their mouth to cover both the baby’s mouth and nose before delivering gentle puffs of air.

A person can never be sure when or if they will be in a situation where cardiopulmonary resuscitation is required. While everyone should know how to deliver CPR in an emergency situation, it is essential that mothers, fathers, or guardians of small children know how to react if a child is not breathing. Responding quickly and providing the necessary basic life support may save a life. Taking a class can help individuals learn practical facts about CPR, as well as the important steps for performing it safely and accurately on children, infants, and adults.

The following links provide further information about CPR.

• MedlinePlus: CPR
• Family Doctor: Cardiopulmonary resuscitation (CPR)
• Learn CPR: Child CPR video demonstration
• KidsHealth: CPR
• How to perform CPR
• NHS choices: First aid — CPR
• Parents: How to give a baby CPR
• WebMD new CPR guidelines: Chest compressions first
• MayoClinic — Cardiopulmonary resuscitation (CPR): First aid
• The C-A-B of CPR (PDF)
• Palomar Emergency Medicine: CPR links
• Palomar Dental Assisting RDA and CPR links
• The city of Artesia, New Mexico visitor site
• Idaho Health District Four: First aid and CPR training
• California Emergency Medical Services Authority: Education and training related links
• Industrial commission
• Georgia quality management system
• Maternity wellness group
• West Valley city fire department — CPR
• Responder safety learning network
• CPR steps and info links
• Citizen CPR foundation