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Updated 07 November 2013

CPR

CPR (cardiopulmonary resuscitation) saves lives. Someone’s life may depend on your reading this section..

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You and CPR (cardiopulmonary resuscitation) can save a life: here’s how.

Summary

  • CPR is an emergency procedure performed if someone has stopped breathing or if their heart has stopped.
  • The first-aider continues to give CPR until the patient starts breathing unaided or a medical professional can take over.
  • For bystanders untrained in CPR: just give chest compressions, hard and fast, at 100 compressions per minute.
  • For trained first-aiders, CPR involves giving a repeated cycle of 30 chest compressions followed by two breaths.

If the brain is starved of oxygen for more than four minutes, as may occur in a near-drowning or heart attack, permanent brain damage can result. Immediate action is required: every second counts.

The role of the lay rescuer/first-aider (i.e. anyone who is not a certified medic or paramedic) is to continue to give CPR until the patient starts to breathe unaided or professional help arrives to take over.

Even if you are not an experienced first aider, rather err on the side of giving CPR imperfectly than not giving it at all - it is always better to try than not.

Action plan
Remember: H H H CAB:

H: Hazards
H: Hello
H: Help
C: Compressions for Circulation
A: Airway
B: Breathing

Follow these steps:

H is for Hazards
Ask yourself: Are there any life-threatening hazards or dangers to you or the patient? If so, you need to manage them, or move yourself and the patient out of harm’s way.

H is for Hello
Is the patient awake or unconscious? Ask loudly: Are you OK? If there is no response, tap the shoulder.

If there is still no response, it means the patient is not getting enough blood and oxygen to the brain and needs help.

H is for Help
Call for others around you to come and help – there may be a doctor or paramedic within shouting distance.

Phone for emergency medical help on one of the following numbers:

  • 112 on a cellular phone
  • 10177 National medical emergency number for ambulance services
  • 082 911 Netcare
  • 084 124 ER24

Tell the operator that you have an unconscious patient and state exactly where you are. They will ask for a call-back number if you have one. If you need advice on how to do CPR they can assist you telephonically.

C is for CHEST COMPRESSIONS to restore CIRCULATION

You need to perform chest compressions to keep blood circulating to the tissues.

  • Kneel beside the patient. Place the heel of one hand in the centre of the chest on the nipple line (imaginary line joining the two nipples) on the breastbone. Place the heel of your other hand on top of the first hand. Lean over the victim with your arms straight and elbows locked, and your shoulders directly above your hands.
  • Press down vertically on the victim’s breastbone 4-5 cm to a count of “one-and-two-and-three-and-four…”, giving one push each time you say a number. When saying “and”, release the pressure but do not move your hands from their location on the chest. Push hard and fast at a rate of about 100 compressions a minute.

If you haven't been trained in CPR, or have received training but are out of practice, continue chest compressions until there are signs of movement or until emergency help arrives.

If you have been trained in CPR, go on to checking the airway and giving rescue breathing.

A is for AIRWAY

Open the airway.

  • Place two fingers on the forehead and two fingers under the bony part of the chin and gently tilt the head back – the so-called “head- tilt chin-lift” method of opening the airway.
  • Check for normal breathing, taking no more than 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, 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 rescue breathing and continue chest compressions.
B is for BREATHING

If the patient is not breathing you need to breathe for them:

Ensure the airway is open by keeping the head tilted back - keep one hand on the forehead and two fingers of the other hand under the chin to lift the jaw. If you have a pocket mask, place it over the patient’s mouth and nose.

  • Blow gently and slowly while you watch to see if the chest rises.

  • Give 2 breaths. Each breath should take 2 seconds (one in one out). Between breaths, lift your head and see if the chest moves. If the chest rises and falls, it is effective breathing. If it does not, try again. Make up to 5 attempts if necessary. (Airway obstruction is normally related to the tongue and is seldom due to foreign body obstruction. However, if there is no chest movement at this stage, check for a foreign body and, if there is a blockage, switch to obstructed airway manoeuvres.)
  • Continue with chest compressions.The American Heart Association (AHA) recommends a compression-to-ventilation ratio of 30:2 for all lone (single) rescuers to use for all patients from infants (excluding newborns) to adults.
  • Repeat the cycle of 30 compressions and 2 breaths until help arrives or the patient starts to recover. If you are not sure that the patient is breathing unaided, continue with CPR.
  • Even if the patient appears to have fully recovered, stay with them and monitor them closely until medical help arrives.

There is risk of infection with mouth-to-mouth contact and so unless the patient is a family member it is best to use a pocket mask during resuscitation. (This simple mask, which covers the patient’s mouth and nose, prevents any contact with body fluids).

- Olivia Rose-Innes, Health24, updated August 2013

Source: American Heart Association

 

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