Dr Caitlin O’Connor of Tralee Medical Centre, St Brendan’s Park, gives advice on applying CPR to a person suffering cardiac arrest…
Cardiopulmonary Resuscitation (CPR) is a first aid technique which should be administered as soon as possible to a person who has suffered a cardiac arrest (their heart has stopped beating).
A heart attack is the commonest cause of cardiac arrest.
The first few minutes after a cardiac arrest are vital: if the pumping activity of the heart is not restored within a couple of minutes the brain suffers irreversible damage.
CPR involves a combination of mouth-to-mouth rescue breathing and chest compressions to keep oxygenated blood flowing to the brain and other organs.
Adults (including children above the age of puberty)
Check the person for a response and for any sign of normal breathing. If they are unresponsive and are not breathing normally, ring for an ambulance immediately on 999 (or 112) – or if possible, get some else to ring for you.
Begin CPR as follows.
• First give 30 chest compressions: Place the heel of one hand in the centre of the person’s chest (between the nipples) and place your other hand on top of the first.
Keep your elbows straight and position your shoulders directly above your hands. Press down on the chest 4-5cm, pushing hard and fast. Repeat this 30 times, at a rate of 100 compressions/minute (faster than once per second).
• Give 2 rescue breaths: Pinch the person’s nose and seal the patient’s mouth with your own. Blow steadily into the person’s mouth for one second, checking to see whether the person’s chest rises with each breath.
Continue with cycles of 30 chest compressions followed by 2 rescue breaths until help arrives, or the person begins to breathe normally.
An Advisory External Defibrillator (AED) is a small, portable piece of equipment measuring 1ft by 1ft that can deliver an electric shock to a victim of cardiac arrest in order to restore the heart to its normal rhythm.
The defibrillator contains special computer software that can analyse the cardiac rhythm and deliver a shock ONLY if the heart requires it.
Therefore it is not possible to administer defibrillation to a person with healthy, regular cardiac rhythm.
Survival rates of cardiac arrest victims are directly related to the time it takes to resuscitate and administer defibrillation.
If a person receives Cardiopulmonary Resuscitation (CPR) and is defibrillated within five minutes of suffering from cardiac arrest, the survival rate is approximately 50%, and is even higher with younger patients.
If the time taken to resuscitate is 10 minutes or more, the chances of survival are very small.
In order to increase the chances of survival from cardiac arrest, CPR should commence as quickly as possible and the target time for defibrillation should be less than 5 minutes.
Therefore training people in CPR and defibrillation, and making defibrillators available in easy to access, local locations is vital to the survival of cardiac arrest victims in Ireland.
With 6,400 cardiac arrests happening in this country per year, the need for defibrillators and people trained in CPR becomes even more apparent.
Defibrillators are electrical – are they dangerous?
No. They are semi-automatic. They are dust proof, waterproof and they can’t shock you. Obviously in training you are taught how to use a defibrillator safely for both you and your casualty but defibrillators are “smart” machines that read the heart rhythms and will only shock if that reading shows that the person needs to be shocked.
If breathing is restored and signs of circulation are present, roll the patient over onto their side into what is commonly known as the ‘recovery position’ until an ambulance arrives.
The patient may still be unconscious at this point, but placing them on their side means that mucus or vomit which may have accumulated as a result of the trauma they have experienced will be able to get out of the mouth and will not obstruct the airways.
Also, the ‘recovery position’ prevents the tongue from falling back into the mouth and blocking the air passages.
Note: CPR is best learned at a first aid course where hands-on experience of the technique is acquired.