Be A Lifesaver: Learn CPR

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Dr Ochi Igboko

Cardiopulmonary resuscitation (CPR) is a procedure to support and maintain breathing and circulation for an individual who has stopped breathing (respiratory arrest) and/or whose heart has stopped (cardiac arrest).

Purpose

CPR is performed to restore and maintain breathing and circulation and to provide oxygen and blood flow to the heart, brain and other vital organs. CPR can be performed not only by healthcare personnel but also by trained laypersons.

Respiratory and cardiac arrest can be caused by several conditions such as allergic reactions, ineffective heartbeat, asphyxiation, choking, drowning, drug reactions or overdose, electric shock or trauma etc. Any of these can occur anywhere, at home, in the office, in the school, in the church or in the market place where a trained medical personnel may not be available immediately.

Description

CPR must be performed within four to six minutes after cessation of breathing to prevent brain damage or death. CPR consists of external chest compressions which help circulate blood through the heart to vital organs and rescue breaths which delivers oxygen to the victim’s lungs.

Who requires CPR: Making the diagnosis

If a person does not respond and if that person is not breathing or is only gasping then you need to give CPR.
If you are not sure whether to give CPR, go ahead and give it. It is better to give CPR to someone who does not need it than not to give it to someone who needs it.

Before you access the need for CPR, make sure the scene is safe. Look for anything nearby that might hurt you. You do not want to hurt yourself.

Then check if the person responds. Tap him and shout, ‘Are you Ok?’ If he does not move, speak, blink, or otherwise react, then he is not responding.

If the person does not respond, it is important to get help. You or someone else (yell for help if you need to) should phone your office emergency response number if you have any or call 767 or 112 (Lagos state emergency response numbers).

If the person does not respond check his breathing. If the person is not breathing at all or he is only gasping, then he needs CPR.

CPR has two main parts: compression and giving breath.

Compression

A compression is the act of pushing on the chest..pushing hard and fast on the chest is the most important part of CPR. When you push on the chest, you pump blood to the brain and the heart.

Follow these steps to push hard and fast:

  1. Make sure the person is lying on his back on a firm, flat surface.
  2. Move clothes out of the way.
  3. Put the heel of one hand on the lower half of the breastbone. Put the heel of your other hand on top of the first hand.
  4. Push straight down at least two inches at a rate of at least 100 compressions a minute.

Compressions are very important and doing them correctly is very tiring. The more tired you are, the less effective your compressions are. If someone else knows CPR, take turns. Switch about every two minutes, moving quickly to keep the pause between compressions as short as possible.

Remind each other to push down as least 2 inches (5cm), push at a rate of at least 100 compressions a minute and let the chest come back up to its normal position after each compression.

Compressions are the most important part of CPR. If you are also able to give breaths, you will help even more. Your breaths need to make the chest rise. When the chest rises, you know the person has taken in enough air.

Opening the Airway:

Before giving breaths, open the airway. Follow these steps to open the airway:

  1. Put one hand on the forehead and the fingers of the other on the bony part of the chin.
  2. Tilt the head back and lift the chin.
  3. While holding the airway open, pinch the nose closed.
  4. Take a breath. Cover the person’s mouth with your mouth.
  5. Give two breaths (blow for 1 second each). Watch for chest rise as you give each breath.

Giving breaths to another person is usually quite safe. During CPR there is very little chance that you will catch a disease. Even so, some workplaces require rescuers to have masks or face shield.

Masks are made of firm plastic and fit over the victim’s mouth and nose. It usually comes with a one-way valve that allows air to go only in one direction.

Put the mask over the person’s mouth and nose. Tilt the head and lift the chin while pressing the mask against the persons face. It is important to make an airtight seal between the victim’s face and the mask while you lift the chin to keep the airway open. Give two breaths. Watch for the chest to rise during each breath.

The sequence of chest compressions and giving breath is continued at a ratio of 30 compressions to 2 breaths until the AED is available.

The automated external defibrillator AED is a machine with a computer that can shock the heart and help it work properly again. If you start CPR right away and then use an AED within a few minutes, you will have the best chance of saving a life.

AEDs are safe, accurate and easy to use. The AED will figure out if the person needs a shock and will tell you to give one if needed. It will even tell you when to make sure that no one is touching the person. The pads used to shock the person have a diagram showing you where to place them. Follow the diagram.

The most common way to turn on an AED are to push an ON button or lift the lid of the AED. Ones you turn on the AED, it will tell you everything you need to do.

If you have access to an AED, use it as quickly as possible. Make sure no one is touching the victim just before you push the shock button. If you cannot find an AED quickly, then start CPR. Push hard and push fast.

There are few but important differences between CPR for adults, children and infants. The American Heart Association and the American Red Cross, the two organizations that provide CPR training and guidelines, distinguish infants and children for the purpose of CPR as follows.

INFANTS – from the first month of life up to one year.
CHILD – includes toddlers aged one year to children aged eight years.

Performing CPR on a child

Chest compressions are delivered by placing the heel of one hand over the lower half of the sternum and depressing about two inches per compression. The compression rate is the same-at least 100 per minute at a ratio of 30 compressions to two breaths.

Rescue breaths are delivered using a mouth-to-mouth seal or face mask. Chest compressions are delivered by placing the two fingers of one hand over the lower half of the infant´s sternum slightly below the nipple line and pressing down at least one and half inches (4cm). Compressions are delivered at a rate of at least 100 times per minute, giving thirty chest compressions followed by two breaths in successive cycles.

For an infant, the rescuer opens the airway using a gentle head tilt/chin lift or jaw thrust, place the mouth over the infants mouth and nose then delivers gentle breaths so that the infant’s chest rises with each breath.

Aftercare

Emergency medical care is always necessary after CPR. One’s a person’s breathing and heartbeat have been restored; the rescuer should make the person comfortable and stay there until emergency medical personnel arrive.

Before you perform CPR on anybody, you must undergo hands on training and possibly get certified as a layperson CPR provider.

This training is recommended for everyone from fifteen years and above.

For further information on training please call 08078518998, 08102852246 or send mail to drigboko@yahoo.com

About author

Dr Ochi Igboko

Consultant Anesthesiologist & Critical Care Physician. Email: drigboko@yahoo.com

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Alex Okoronkwo Ezumah

Alex Okoronkwo Ezumah

Civil engineer and public servant clocked 60 on the 16th of October, 2015. A native of Amuvi village, he attended Government College, Afikpo; Institute of ...