How to Perform CPR on an Unresponsive Adult

This article is in no way meant to replace formal CPR training. It is important that you do not attempt rescue procedures that are beyond your skill level.

Many people think CPR succeeds much of the time, when the reality is that out-of-hospital cardiac arrest results in only about a 1-2% survival rate. We train in CPR and perform CPR for that 1 or 2 out of 100 that make it. We train CPR and perform CPR so that a family can know that everything that could be done WAS done. This can help bring closure after the loss of a loved one.

Difficulty: Moderately Challenging

Instructions

Things You'll Need:

• CPR dummy (for practice, never practice on another person)
• Formal training

1. Assess the scene. Determine if it is safe to approach the victim (for instance, somebody may collapse after being electrocuted - will you be standing in the same puddle of water?).

2. Always protect yourself. Assume that bodily fluids of a victim are infected, even if you know the person. Make sure you wear gloves and use some type of breathing barrier.

3. Direct somebody to call 9-1-1 (or your emergency number) and direct somebody else to get the AED (Automated External Defibrillator) if you have one. The sooner you can get an AED on a victim, the greater their chance of survival.

4. 
    
   Look, Listen, and Feel

   Begin checking the victim. Open the airway by pressing gently down on the forehead while lifting the chin (if no injury is suspected, if it is, you will need to perform a jaw thrust). Place your ear to the victim's mouth so that you are looking at their chest. LOOK (to see if the chest rises and falls), LISTEN (for breathing), FEEL (breath on your cheek). Do this for between 5 and 10 seconds. No more.

5. Attempt to give two rescue breaths. While keeping the head tilted and the chin raised, open your mouth over the victims and press to get a seal. Breathe in for about 1 second. If the breath does not go in, reposition the victim's head and try again. If it still doesn't go in, look in the mouth to ensure there is nothing blocking the airway. Sweep it out with two fingers if there is, if not, continue to the next step.

6. The next step is to find a pulse, however, especially for the layperson this can be a waste of time. If you are having difficulty locating it or if it is weak, precious seconds are being wasted. If the victim is breathing and you do not suspect injury, place them on their side in the recovery position while you await professional help. If they are not breathing, you will begin performing CPR. Determining if it is because they are choking or have no pulse doesn't matter because treatment - chest compressions - is the same.

7. Begin chest compressions by kneeling to the side of the victim. Place the heel of your hand halfway between the nipples. Place your other hand on top of the first and interlace your fingers. Keep the fingers of your bottom hand raised to avoid pressing on the wrong part of the chest. Keep your arms straight and your shoulders directly over your hands. This will ensure you're pressing in the right direction and to help you from getting fatigued because you'll be able to utilize your body weight.

8. Compress the chest at about 100 compressions per minute. Ironically, if you compress to the beat of the song "Staying Alive", you will get about 100 beats per minute. Do not bounce off the chest.

9. If you've been taught CPR before, you were probably told to stop compressions after 15 or 30 (most recently 30) to give 2 breaths. However, studies now show that the critical pressure build up in the chest caused by the compressions is almost immediately lost when the compressions stop. This pressure is important to keep the blood flowing to get oxygen where it's needed in your body. Laypersons are now taught to perform 100 compressions without stopping. Then stop and reassess.

10. 
     

    If at any time an AED becomes available, hook it up and follow its instructions. Be prepared to continue CPR if it determines a shock is not needed.

11. Continue CPR until somebody equally or better trained takes over or until you are too exhausted to continue.

Tips & Warnings

• Practice on the floor. Somebody suffering from cardiac arrest, stroke, etc. will not have the courtesy to pass out on a nice, waist-high table.
• Remember that in the event it is necessary to perform CPR, the victim is already clinically dead. Do not fear cracking ribs, cartilage, or other injury. You can't make them more dead.
• When sending somebody to call 9-1-1 or get the AED, make eye contact, point to them, use their name. It can break somebody out of a panic and prevent "I thought He/She was doing it Syndrome".
• Most states protect anybody acting in good faith to save somebody's life with what are known as "Good Samaritan Laws". There is no record of a successful lawsuit brought against somebody in the U.S. who was trying to help in good faith.
• If an adult is conscious, you need their consent to help them. If they are unconscious, you have implied consent. With a child, though we didn't discuss here how to treat them, you need a parent or guardian's consent to treat, but if the situation is life threatening and no parent/guardian is available, you have implied consent whether the child is conscious or not.
• Do not move a victim if you suspect injury, unless you absolutely must.
• If you are the only person around, assess the situation, then alert emergency services. Get the AED or Oxygen (if you're trained to administer) and return to care for the victim. If the victim has suffocated (drowning, etc.), perform 5 cycles of CPR before alerting emergency services.

Resources

• American Safety and Health Institute (ASHI)
• American Red Cross
• American Heart Association
• National Safety Council

[chrisanimelo444]

on 8/21/2009 These are very important tips. Thanks for the info!