CPR

Check the Scene

Key Questions to ask:

  • Is it safe for me to help?
  • What happened?
  • How many patients are there?
  • Am I going to need assistance from EMS?
  • Do I have my personal protective equipment ready to use?

Check the Patient

Tap and shout. Is there any response?

  • While checking for responsiveness, look for normal breathing by looking at the person’s chest and face. Is the patient breathing normally?
  • Agonal respirations are not normal breathing. They would be characterized as occasional gasps. The chest does not rise.

Activate EMS – Call 911

Send someone to call and tell them to come back. The caller should give dispatch the patient’s location, what happened, how many people are injured, and what is being done.

If you are alone and no one is available:

  • PHONE FIRST for adults and get the AED. Return to start CPR and use the AED for all ages.
  • CARE FIRST for children and in- fants by providing about 5 cycles or 2 minutes of CPR before activating the emergency response number.
  • CARE FIRST for all age patients of hypoxic (asphyxial) arrest (ei., drowning, injury, drug overdose).

Check Pulse

  • Check the Circulation for no more than 10 seconds
    • Adult and Child– Check the carotid artery in the neck.
    • Infant– Check the brachial artery on the inside of the upper arm.
  • If unsure a pulse exists, start CPR. Don’t waste more critical time searching for a pulse.
  • While checking the pulse, look for normal breathing by looking at the person’s chest and face. Is the patient breathing normally?
  • Agonal respirations are not normal breathing. They would be characterized as occasional gasps. The chest does not rise.

Compressions

If the victim is unconscious with no normal breathing, begin chest compressions.

Give 30 chest compressions at a rate of 100-120 compressions per minute for all ages.

Hand placement for compressions:

  • Adult – Place heel of hand of the dominant hand on the center of the chest between the nipples. The second hand should be placed on top. Compress 2-2.4 inches deep.
  • Child – Hand placement is the same as adult. You may choose to use only one hand in the center of the chest between the nipples for a very small child. Compress at least 1/3 the depth of the chest.
  • Infant – Place two fingers on the center of the chest between the nipples. Compress at least 1/3 the depth of the chest.

Airway

Open Airway using head tilt chin lift. Look in the mouth to make sure the air- way is clear. If you see any foreign object, sweep it out right away.

Breathing

Give 2 breaths lasting 1 second each. Watch for chest rise and fall.

Note: If not using a rescue mask, make sure you make a seal over the mouth on an adult or child and pinch the nose closed each time you give a breath. On an infant, make sure to cover the mouth and nose with your mouth.

Continue cycles of 30 compressions to 2 breaths until an AED arrives, advanced medical personnel take over, the patient shows signs of life, the scene becomes unsafe, or you are too exhausted to continue.

CPR Summary

  • Check the Scene for Safety
  • Check the person for responsiveness and normal breathing
  • Call 911
  • Give 30 Chest Compressions
    • (Adult rate of 100-120 per minute, 2-2.4 inches deep)
    • (Child or infant rate of 100-120 per minute, 1/3 depth of chest)
  • Open the Airway
  • Give 2 Breaths
  • Continue cycles of 30 compressions to 2 breaths.

Neonatal CPR

A neonate is defined as a baby under 1 month old. The most common reason for neonate cardiac arrest is ashpyxial. For this reason, the priority of assessment and care is different: Airway, Breathing, and Circulation. A ratio of 3 compressions to 1 breath is recommended. This allows adequate ventilation and oxygenation that a newborn needs.

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