The American Heart Association recently updated its guidelines for cardiopulmonary
resuscitation (CPR), and although the changes are subtle, they can make
all the difference in your confidence to administer CPR to someone in
need. The review was the result of a large study that showed that the
harder and more frequently an individual administered chest compressions,
the more likely they were to tire, directly affecting the number and depth
of the compressions they were able to administer and thus their effectiveness.
The study found that if over 120 compressions were given per minute, rescuers
didn’t push as hard on the chest. A more consistent pace--between
100 to 119 compressions per minute at most--was far more effective because
the rescuers could maintain harder pushes over a longer period of time.
“Being able to compress the chest more than 120 times per minute
is going to be hard for most people, so we see that the typical compression
count ranges from 100 to 110 times per minute,” says
Michael Ritter, MD, the medical director of the emergency department at
Mission Hospital. Dr. Ritter continues, “People are often afraid to administer CPR,
because they worry that they won’t do it right or might push down
too hard on the chest and cause injury. But they really shouldn’t.
Although the ribs naturally bend under the weight of compressions, any
injury from CPR is likely to be minimal and not life-threatening. Administering
CPR, even if you aren’t trained, increases a patient’s potential
to survive and recover.”
So, how does CPR work?
When someone goes into cardiac arrest, their heart stops beating and oxygen,
which is normally distributed throughout the body in the bloodstream,
becomes depleted. Chest compressions act as a temporary heartbeat, keeping
oxygen circulating around the body until a defibrillator can be used and
until an ambulance arrives.
“It’s common for people to mistake heart attacks for cardiac
arrest,” says Dr. Ritter, “but they’re not the same.
During a heart attack there is a sudden interruption of the blood supply
to part of the heart muscle, which is likely to cause chest pain, but
the heart is still beating and the person remains conscious and breathing.
On the other hand, cardiac arrest occurs when the heart suddenly stops
beating and the person suddenly loses consciousness and either stops breathing
or breathes abnormally. Both conditions are life threatening, though,
and require immediate medical help.”
So, if you see someone suddenly collapse, you can help by following the
AHA's steps for emergency treatment:
First, check their responsiveness. Try tapping on their shoulder. Do they respond? Ask if they’re OK.
Do they respond? If the answer to both of these questions is “no”,
they may be in cardiac arrest.
Try to stay calm. Witnessing someone in cardiac arrest can be very scary, but by remaining
calm you can think clearly and administer the help that they need.
Yell for help. Tell someone to call 9-1-1 and get an Automated External Defibrillator
(AED), if one is available. AEDs are usually available in public access
places where people gather in large numbers such as offices, shopping
centers, airports, schools and community centers. If you are alone, call
9-1-1 yourself and try to get an AED if one is available.
Check their breathing and pulse. If breathing is irregular or has stopped, check their pulse. If there are
no signs of a pulse, start administering CPR right away. Place your hands
over the center of their chest and begin chest compressions.
Push hard and push fast, but remember that by pacing yourself you will be able to sustain compressions
until help arrives. Use an AED as soon as it arrives by turning it on
and following the prompt.
Keep pushing until the person starts to breathe or move or until someone with more advanced
training takes over.
Cardiac arrest happens very suddenly, but even if you are untrained, administering
CPR right away can make all the difference. Just remember to stay calm,
call for help and check for the signs. The 911 operator will stay on the
line to help you through the process until the ambulance arrives.
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This information is not intended as a substitute for professional medical
care. Always follow your healthcare professional's instructions.