Aspects of Cardiopulmonary Resuscitation

Introduction

Timely first aid can often be vital in saving a person’s life. Its provision through simple manipulations aims to prevent complications, human suffering, and, of course, death. First aid can be provided at the place of an incident while waiting for professional doctors. One type of emergency procedure is cardiopulmonary resuscitation (CPR), used during cardiac arrest. Although this procedure is known, it should be used with caution to prevent negative consequences.

When to apply CPR

Having witnessed a cardiac arrest, people may be confused due to a lack of knowledge and not help. For this reason, it is vital to spread information on CPR, its circumstances, and methods. CPR is a procedure used in emergencies when a person’s heart has stopped. It includes chest compressions, which, if necessary, are combined with artificial ventilation. During cardiac arrest, blood does not circulate through the vessels, and vital organs do not receive the required oxygen and nutrients for work. Chest compression imitates heart function and can trigger stopped blood flow and help body organs work until an ambulance arrives.

It is essential to distinguish cardiac arrest from a heart attack – in the second case, a person can breathe and talk, and when the heart stopper, this is impossible (“Three Things You May Not Know About CPR”). CPR is necessary only in cardiac arrest, and in other cases, there is a possibility of injuries.

Cardiac Arrest Symptoms

To apply CPR, it is necessary to verify the cardiac arrest. The signs of the problem appear immediately and are easy to recognize. Experts at the Mayo Clinic identify such symptoms as sudden collapse, loss of consciousness, and absence of pulse and breathing (“Sudden Cardiac Arrest”). In some cases, a person can demonstrate agonal breathing, which is similar to a situation when someone suffocates. This type of breathing does not provide the necessary oxygen flow and also indicates the need for help. Before cardiac stop, a person may feel discomfort in the chest, breath shortness, and palpitations. Cardiac disease, trauma, or electric impulses can be the cause of cardiac arrest.

Method

Applying the simplest form of CPR does not require special professional certification, but knowledge is essential. The American Heart Association (AHA) has created specific guidelines for CPR, which the organization considers a crucial component of the Chain of Survival (“What is CPR?”). It includes problem identification and call of rescue service, CPR, defibrillation, medical resuscitation, care after the arrest, and recovery (“What is CPR?”). This chain is a way of saving and recovering a person after a cardiac arrest.

Chain of Survival from: "What is CPR?" American Heart Association (AHA).
Fig. 1. Chain of Survival from: “What is CPR?” American Heart Association (AHA).

Considering the presented chain, witnesses of the cardiac arrest can do several critical things. First of all, it is necessary to call for professional assistance – the operators will send an ambulance and can give prompts about the CPR. In some cases, witnesses may be prepared to use a defibrillator. If there are several people around, the best help will be simultaneous CPR, call, and a defibrillator search.

Depending on the level of training and the knowledge available, cardiac arrest witnesses can provide various assistance. Based on this fact, AHA separates two primary forms of CPR: compression-only CPR, also called Hands-Only CPR, and for the trained people (“What is CPR?”). The first type involves using hands only, without mouth-to-mouth breaths and includes two simple steps – to call an ambulance and press on the chest with strong and fast pushes. Assistants can use the song “Staying Alive,” the rhythm of which can help set the necessary pace for compressions (” Three Things You May Not Know About CPR “). Thus, taking first aid courses and even general knowledge about CPR can save lives if a witness applies them.

Trained people and professionals use a 30:2 system, where 30 is the number of pushes and 2 is mouth-to-mouth breaths. It should be considered that the compression frequency should be 100-120 times per minute, and its depth of 2-2.4 inches (5-6 centimeters) (“What is CPR?”). It is essential to consider the age of the victim, as CPR for children is slightly different. AHA recommends five compression cycles and then calls for an ambulance (qtd. in “Cardiopulmonary resuscitation”).

The push depth for a small child should not exceed 2 inches, and for a kid from four weeks to one year – 1.5 inches (“Cardiopulmonary resuscitation”). In order to make artificial mouth-to-mouth breathing, one needs to slightly tilt the victim’s head back and lift the chin. Then the rescuer takes a deep breath, covers the victim’s nose, grabs his or her mouth, and makes two strong breaths, each long in a second.

To improve the quality of CPR, witnesses must consider several important aspects. AHA proposes minimizing breaks in compressions, not leaning on the victim during these intervals, and allowing the chest to return to the initial position before the next push. They also recommend avoiding excessive ventilation and control the depth and frequency of pressing (“What is CPR?”). Another important aspect is the hands’ location – one of the hands’ heels needs to be put in the middle of the chest between the nipples. The second hand should be on top of the first one, elbows should be straightened, and the shoulders held above the hands (“Cardiopulmonary resuscitation”). During CPR, the victim must lie on a hard surface.

The disadvantage of manual resuscitation is the fatigue of rescuers and, as a result, a decrease in the intensity of compressions. For this reason, additional devices have been developed for use in such situations. They can include auxiliary devices, like metronomes, but also can simulate the compressions themselves, for example, Autopulse (Remino). Despite the effectiveness of the devices’ use, their presence while arrest on the street, or at work is unlikely. Therefore, they are more useful for ambulance crews who will not need to be distracted by manual CPR.

Consequences and Side Effects

Cardiac arrest has severe consequences for the human body and especially the brain. However, CPR increases the victim’s chances of survival several times. About 4-16% of those who received CPR were subsequently discharged from the hospital (“Key CPR Facts and Stats 2020”). Even if help was given immediately, there is a chance of brain damage that increases every minute. When up to 4 minutes passed – damage is unlikely, 4-6 minute is the average probability, 6-10 – chance is high, and more than 10 minutes- damage is almost inevitable (“Key CPR Facts and Stats 2020”). For this reason, every minute is crucial, and everyone needs to know about CPR.

Conclusion

Cardiac arrest can occur suddenly and outside the hospital walls. In this case, an accidental passerby, colleague, or family member can become saviors using CPR. Applying this set of actions at the most superficial level does not require special certification but only knowledge. CPR involves chest compression and artificial ventilation to support blood flow and save body organs. However, ventilation is recommended to be used only by people who have received special training. CPR increases the chance of survival, but a small number of people know how to make it, so it is vital to disseminate at least information about it.

Works Cited

Cardiopulmonary resuscitation (CPR): First aid.Mayo Clinic. 2018. Web.

“Key CPR Facts and Stats 2020.” CPR Certification HQ. Web.

Remino, Carlo, et al. “Automatic and manual devices for cardiopulmonary resuscitation: a review.” Advances in Mechanical Engineering, vol. 10, no. 1, 2018. Web.

Sudden Cardiac Arrest.Mayo Clinic. 2020. Web.

“Three Things You May Not Know About CPR.” Centers for Disease Control and Prevention (CDC). 2021. Web.

“What is CPR?” American Heart Association (AHA). Web.

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