Cardio pulmonary resuscitation (CPR)

Emergency is something that can occur anywhere, anytime and to anyone. It is very important to know how to manage it. Most of the time the emergency situation get worsen due to lack of awareness. It is not that only an expertise can handle the emergency situations. Anybody can give the basic life support(BLS), and expertise can take over to give the advance life support(ALS). Taking quick and appropriate step at the right time can save thousands of life.

so what is CPR and when it should be given???

It is very important to know that, when the brain deprive of oxygen supply for 4-10mins maximum, will leads to brain death. To say precisely, the brain will start losing its function when there is a lack of oxygen supply for 4 mins and it tries to withstand maximum upto 10mins. Longer the time, sooner will be the loss.

So when there is no breathing (respiratory arrest) and no blood circulation (cardiac arrest) , immediate action should be taken to preserve intact brain function until further measures are taken to restore spontaneous breathing and blood circulation. This process is called cardio pulmonary resuscitation or CPR. When the person becomes  unconscious/ unresponsive, CPR should be performed. 

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How to perform CPR???

There are certain steps to be followed to perform proper CPR.

  • Check the surroundings and call for ambulance
  • check for the response
  • Check A-B-C ( airway – breathing – circulation )
  • Mouth to mouth resuscitation
  • cardio pulmonary resuscitation

Check the surroundings and call for ambulance:

Whenever a person becomes unconscious, check for the reason. If the reason is out of any poisonous outbreak, do not attempt saving, first clear the spot(along with the victim if possible).

If the surrounding is clear, call the ambulance for the expertise support.

Check for the response:

If the victim is responsive and conscious, Put him in the comfortable position ( lying down flat with legs rised – this helps to increase blood circulation to the heart and brain)

Talking loud or shaking the body will be helpful to know the responsiveness. If the person is unresponsive or unconscious, it is time to initiate CPR

Check airway – breathing – circulation (ABC):

Make the victim to lie flat facing upward and losen the clothes. For clearing the airway, first make sure if there is no spinal injury. On that aspect,sit at one side(right/left) of the victim and push the forehead back and tilt the chin upward, this helps to free the airway from tongue obstruction.

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If the person have spinal injury, sit at the back and hold the lower jaw bone and push up. Do not tilt the neck

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For Breathing,

listen for the breath sound, look for chest expansion and by tactile sense of airflow. In some cases a mild roaring sound will be heard which should not be consider as breath.

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For circulation,

Check the carotid pulse. Place the fingers on the adams apple and slide down on one side to reach the border of the trachea to feel the carotid pulse.

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Mouth to mouth resuscitation:

The above all process should be analyzed quickly say within a minute and no time should be wasted with this.

When there is no breathing but still the carotid pulse is palpable, mouth to mouth resuscitation should be initiated.

Either can use CPR pocket mask (which facilitates one way airflow) or on its absence can go for direct rescue breathing.

Sit on one side of the victim, after clearing the airway (by head tilt/chin lift method as mentioned above), close the nostrils ( this prevents the blowing air from escaping out) and give two slow breathing each for one second.

While doing this, chest expansion should occur, this ensures proper rescue breathing.

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Now check for breathing again, if no improvement then repeat the process. Repeat one breath for every 5 seconds until the breath reverts back.

Simultaneously check for the circulation (carotid pulse). When there is no circulation (cardiac arrest), start with CPR.

Cardio pulmonary resuscitation:

When there is no breath and no blood flow, CPR should be initiated either with the help of artificial defibrillator or compressing manually.

For manual compression,

kneel down on one side of the victim, Elbow should be straight and force should be applied from the shoulder and not merely from the palms.

place the heel of one hand on the middle-lower portion of the sternum. To determine the exact location, place two fingers on the lower part of sternum where the ribs come together and place the heel of the other hand just above these fingers.

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Now take the other hand and interlock with this and start compressing the chest.

The compression force should be 2 inch depth. To combain chest compression and rescue breath, the ratio 30:2 is recommended. Meaning, for every 30 compressions, 2 rescue breaths are given. The rate of chest compression should be 100 pumps per minute.

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After every minute, breath and circulation should be accessed and the procedure should repeat until the air and blood flow reverts back or the emergency team arrives.

Providing timely help with our quick and immediate action will save someone from entering into gods glory. 

References:
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