Cardiopulmonary resuscitation (CPR)

Cardiopulmonary resuscitation (CPR) is a first aid technique that can be used if someone is not breathing properly or if their heart has stopped.

Usually we use the acronym of CAB — compression, airway, breathing — to help people remember the order to perform the steps of CPR.

Compression: Restore blood circulation

1. Put the person on his or her back on a firm surface.
2. Kneel next to the person’s neck and shoulders.
3. Place the heel of one hand over the center of the person’s chest, between the nipples. Place your other hand on top of the first hand. Keep your elbows straight and position your shoulders directly above your hands.
4. Use your upper body weight (not just your arms) as you push straight down on (compress) the chest at least 2 inches (approximately 5 centimeters). Push hard at a rate of about 100 compressions a minute.
5. If you haven’t been trained in CPR, continue chest compressions until there are signs of movement or until emergency medical personnel take over. If you have been trained in CPR, go on to checking the airway and rescue breathing.

Airway: Clear the airway

1. If you’re trained in CPR and you’ve performed 30 chest compression, open the person’s airway using the head-tilt, chin-lift maneuver. Put your palm on the person’s forehead and gently tilt the head back. Then with the other hand, gently lift the chin forward to open the airway.
2. Check for normal breathing, taking no more than five or 10 seconds. Look for chest motion, listen for normal breath sounds, and feel for the person’s breath on your cheek and ear. Gasping is not considered to be normal breathing. If the person isn’t breathing normally and you are trained in CPR, begin mouth-to-mouth breathing. If you believe the person is unconscious from a heart attack and you haven’t been trained in emergency procedures, skip mouth-to-mouth breathing and continue chest compression.

Breathing: Breathe for the person

Rescue breathing can be mouth-to-mouth breathing or mouth-to-nose breathing if the mouth is seriously injured or can’t be opened.

1. 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.
2. Prepare to give two rescue breaths. Give the first rescue breath — lasting one second — and watch to see if the chest rises. If it does rise, give the second breath. If the chest doesn’t rise, repeat the head-tilt, chin-lift maneuver and then give the second breath. Thirty chest compression followed by two rescue breaths is considered one cycle.
3. Resume chest compression to restore circulation.
4. If the person has not begun moving after five cycles (about two minutes) and an automated external defibrillator (AED) is available, apply it and follow the prompts. Administer one shock, then resume CPR — starting with chest compression — for two more minutes before administering a second shock. If an AED isn’t available, go to step 5 below.
5. Continue CPR until there are signs of movement or emergency medical personnel take over.

1. CALL 

Check the victim for unresponsiveness. If the person is not responsive and not breathing or not breathing normally. Call for emergency help.

2. PUMP

If the victim is still not breathing normally, coughing or moving, begin chest compression.  Push down in the center of the chest 2 inches 30 times. Pump hard and fast at the rate of at least 100/minute, faster than once per second.

3. BLOW

Tilt the head back and lift the chin. Pinch nose and cover the mouth with yours and blow until you see the chest rise. Give 2 breaths.  Each breath should take 1 second.

CONTINUE WITH 30 PUMPS AND 2 BREATHS UNTIL HELP ARRIVES

NOTE: This ratio is the same for one-person & two-person CPR.  In two-person CPR the person pumping the chest stops while the other gives mouth-to-mouth breathing.