Cardiopulmonary Resuscitation (CPR) is a lifesaving technique used when a person’s heartbeat and breathing have stopped, as well as when he is unconscious.
CPR helps to maintain a continuous flow of oxygenated blood to the brain, failing which the brain will die.
Hence, CPR plays an important role in keeping the brain alive during emergencies.
The first four minutes when a person stops breathing and the heart stops pumping is known as clinical death. This state can be reversed by performing CPR to ensure a flow of oxygen to the brain.
After four to six minutes without oxygen, brain cells start to die and in 10 minutes, the brain is dead. This stage is called biological death and is irreversible. At this point, the victim cannot be revived.
This article details the correct way to perform effective CPR, a method encouraged by the National Heart Association of Malaysia (NHAM).
CPR guidelines for adults
When carrying out CPR, always remember the keywords: D-R-C-A-B
D – Danger
• Make sure the surroundings are safe and poses no danger to the victim.
R – Response, Rescue
• Check for the victim’s response – shake his shoulders and ask, “Are you OK?”
• If there is no response, ask for help to call 999 and get Automated External Defibrillators (AED).
• Check for pulse at the carotid artery (neck) for about five seconds (not more than 10 seconds).
• If there is no pulse, start CPR.
C – Chest compressions
• Make sure the victim is lying on a flat surface.
• Position yourself at the victim’s side (between neck and shoulder).
• Put the heel of one hand on the centre of the victim’s chest (lower half of the breastbone) and the heel of the other hand over the first hand. Keep your arms straight when doing chest compressions.
• Push hard for at least 5 cm (2 inches) and not more than 6 cm (2.4 inches) for each compression.
• The compression rate is 100 to 120 per minute.
A – Airway
• To open the airway, tilt the victim’s head back and lift the chin gently (Head Tilt – Chin Lift).
• Jaw Thrust is used when there’s suspected injury to head or neck.
B – Breathing
• Rescue breathing is usually done mouth-to-mouth (For safety reasons, only perform mouth-to-mouth resuscitation when a face shield is available).
• If the victim’s mouth is injured or cannot be opened, perform mouth-to-nose breathing.
• Pinch the victim’s nose while doing mouth-to-mouth breathing.
• Give the first breath and check if the chest rises. If the chest rises, give the second breath. If it does not, do the “Head Tilt – Chin Lift” technique again before giving the second breath.
• A complete cycle of CPR consists of 30 compressions and two mouth-to-mouth breathing. Perform a total of five cycles of CPR before checking the victim’s pulse again. If no pulse is detected, perform another five cycles of CPR until the pulse resumes or the ambulance arrives.
• If there is pulse but no breathing, perform only rescue breathing for one breath every five seconds (12 breaths per minute).
• If you have an AED, turn it on and follow the instructions. If the AED is not available, perform CPR again until the ambulance arrives.
The CPR guidelines for infants (less than one year old) and children (one year old to age of puberty) are quite similar to those for adults.
The table below shows the key similarities and differences of CPR for adults, infants, and children.
This article first appeared in hellodoktor.com and was reviewed by Hello Doktor’s medical panel. The Hello Health Group does not provide medical advice, diagnosis or treatment.