Cardiopulmonary resuscitation (CPR) is an emergency procedure performed when someone’s breathing or heart has stopped. This immediate intervention can help maintain vital blood flow and oxygen to the brain and other organs. Understanding how to perform CPR is a valuable skill.
The Universal Aims of CPR
The purpose of CPR is to manually circulate oxygen-rich blood throughout the body when the heart is no longer able to pump effectively. This action is important for supplying oxygen to the brain, which can sustain damage within minutes without adequate blood flow. The core principles of CPR are remembered by the sequence C-A-B, standing for Compressions, Airway, and Breathing.
The C-A-B sequence emphasizes starting with chest compressions to quickly deliver oxygenated blood to the brain and other vital organs. This approach helps minimize delays in providing critical blood flow. By understanding these universal aims, rescuers can grasp the underlying goal of CPR, regardless of the patient’s age.
Adult CPR: The Standard Approach
Chest compressions are delivered by placing the heel of one hand on the center of the person’s chest, specifically on the lower half of the breastbone, with the other hand placed on top. The compressions should be at least 2 inches (5 cm) deep, but not exceeding 2.4 inches (6 cm), to effectively circulate blood.
The rate of compressions for adults should be between 100 to 120 compressions per minute. It is also important to allow the chest to fully recoil after each compression, enabling the heart to refill with blood. After 30 compressions, two rescue breaths are administered.
To deliver rescue breaths, open the airway using the head-tilt, chin-lift maneuver, pinch nostrils shut, and seal your mouth over the person’s mouth. Each breath should be given over about one second, watching for the chest to visibly rise. Following these two breaths, the cycle of 30 compressions and 2 breaths continues until emergency medical services (EMS) arrive or the person shows signs of life.
Child CPR: Key Adaptations and Techniques
Performing CPR on a child involves adaptations compared to adult techniques, due to physiological differences and common causes of cardiac arrest. Unlike adults, where cardiac arrest often stems from heart issues, children more commonly experience cardiac arrest secondary to respiratory problems or shock. This distinction makes initial rescue breaths potentially more impactful in pediatric resuscitation.
For chest compressions on a child, the depth should be approximately 2 inches (5 cm) or about one-third the depth of the chest. Hand placement varies with the child’s size; one hand may be used for larger children, while for infants (under age 1), two fingers or the two-thumb encircling technique are often recommended. The compression rate remains consistent with adults, at 100 to 120 compressions per minute.
Rescue breath techniques differ to account for a child’s smaller lung capacity and airway. Breaths should be gentler, delivering just enough air to make the chest visibly rise. For infants, the rescuer’s mouth may cover both the infant’s mouth and nose to create an effective seal. While a single rescuer maintains a 30 compressions to 2 breaths ratio, two rescuers performing CPR on a child should use a ratio of 15 compressions to 2 breaths.
If a rescuer is alone with a child and did not witness the collapse, perform about 2 minutes (approximately 5 cycles) of CPR before calling 911. If the collapse was witnessed, or if multiple rescuers are present, EMS should be activated immediately.
Priorities and Next Steps in Pediatric Resuscitation
Early intervention is paramount for children, especially since respiratory issues frequently precede cardiac arrest in this age group. Prompt recognition of distress and immediate action can significantly improve outcomes.
It is important to continue CPR without significant interruption until professional medical help arrives, the child begins to show signs of life, or the rescuer becomes too physically exhausted to continue. Consistent, high-quality compressions and breaths are vital throughout this period.