How Does CPR Actually Work?

A lifeguard pulls a drowning child from the
ocean. An old man collapses in the street. A woman faints, not breathing. These are all situations that might call for
CPR. CPR stands for cardiopulmonary resuscitation,
and the American Heart Association (AHA) describes CPR as “an emergency lifesaving procedure
performed when the heart stops beating,” which is a condition known as cardiac arrest. CPR is typically done until an automated external
defibrillator (AED) can be applied and/or trained medical professionals can provide
assistance. There are some things you should do before
you perform CPR. One of them is to make sure you and the person
who might need CPR are in a safe area. You should also check to see if the person
really needs help. If the person is an adult, try asking if he
or she is okay in a loud voice. You can also tap or shake the person. If the person does not respond, call 911. There are two common versions of CPR, the
simplest one being called hands-only CPR and involves performing chest compressions after
calling 911. You don’t need special training to do hands-only
CPR, and the American Red Cross describes how to perform this type of CPR: 1. Kneel beside the person who needs help. 2. Place the heel of one hand on the center of
the chest. 3. Place the heel of the other hand on top of
the first hand, then lace your fingers together. 4. Position your body so that your shoulders
are directly over your hands, and keep your arms straight. 5. Push hard, push fast. Use your body weight to help you administer
compressions that are at least 2 inches deep and delivered at a rate of at least 100 compressions
per minute. (Just be sure to let the chest rise completely
between compressions.) 6. Keep pushing. Continue hands-only CPR until you see obvious
signs of life like breathing, another trained responder or EMS professional can take over,
you’re too exhausted to continue, an AED becomes available, or the scene becomes unsafe. How do chest compressions help keep a person
alive? When the heart stops beating, blood flow also
stops, and this can be fatal because blood is how oxygen gets transported to the brain
and other parts of the body. The Mayo Clinic explains it this way: “When
the heart stops, the lack of oxygenated blood can cause brain damage in only a few minutes. A person may die within eight to 10 minutes.” According to the Verywell Health website,
“compressing the chest moves blood through the brain, keeping it alive until the heart
can get started again.” The second common version of CPR is called
traditional CPR. It also involves performing chest compressions
but adds two other actions that require some training: opening the airway and rescue breathing. According to one of its fact sheets, the AHA
“recommends CPR with compressions and breaths for infants and children and victims of drowning,
drug overdose, or people who collapse due to breathing problems.” The purpose of opening the airway and giving
rescue breaths is to provide air to someone who is not breathing or is having difficulty
breathing. It is a form of artificial respiration that
helps to keep the body and brain from dying due to lack of oxygen. While many health professionals agree about
the importance of chest compressions, they disagree about the value of rescue breaths. Verywell Health describes rescue breathing
as “one of the most controversial steps in CPR.” It adds that the “debate is ongoing about
how much is enough (or too much) and whether it’s even necessary.” The American Red Cross provides some instructions
about what to do before performing traditional CPR on an adult. It advises to “check the scene and the person.” Next, you should open the airway. To do this, the American Red Cross instructs
you to “tilt the head back slightly to lift the chin” of the person while he or she
is “lying on his or her back.” After opening the airway, listen for breathing
“for about 10 seconds,” and begin CPR if you don’t hear any breathing. In addition, the American Red Cross lists
the following steps to perform traditional CPR on adults: 1. Push hard, push fast. Place your hands, one on top of the other,
in the middle of the chest. Use your body weight to help you administer
compressions that are at least 2 inches deep and delivered at a rate of at least 100 compressions
per minute. 2. Deliver rescue breaths. With the person’s head tilted back slightly
and the chin lifted, pinch the nose shut and place your mouth over the person’s mouth to
make a complete seal. Blow into the person’s mouth to make the chest
rise. Deliver two rescue breaths, then continue
compressions. Note: If the chest does not rise with the
initial rescue breath, re-tilt the head before delivering the second breath. If the chest doesn’t rise with the second
breath, the person may be choking. After each subsequent set of 30 chest compressions,
and before attempting breaths, look for an object and, if seen, remove it. 3. Continue CPR steps. Keep performing cycles of chest compressions
and breathing until the person exhibits signs of life, such as breathing, an AED becomes
available, or EMS or a trained medical responder arrives on scene. Note: The Mayo Clinic states that “thirty
chest compressions followed by two rescue breaths is considered one cycle.” Other sources such as the AHA also recommend
“using chest compressions and mouth-to-mouth breathing at a ratio of 30:2 compressions-to-breaths”
in traditional CPR. There are some differences in the steps you
take to perform CPR on a child or an infant. For example, the procedure for checking if
the child or infant really needs help is not the same as the one used for an adult. Tap or shake a child more gently than you
would an adult. However, do not shake an infant. The National CPR Association warns that you
should “never shake an infant as this may cause brain damage.” Instead, the American Red Cross advises you
to “flick the bottom of the foot to elicit a response.” The American Red Cross also offers different
advice about when to call 911. You can “ask a bystander to call 911, then
administer approximately 2 minutes of care.” However, “if you’re alone with the child
or infant, administer 2 minutes of care, then call 911.” The “care” involves the following steps: 1. Open the airway. With the child lying on his or her back, tilt
the head back slightly and lift the chin. 2. Check for breathing. Listen carefully, for no more than 10 seconds,
for sounds of breathing. 3. Deliver 2 rescue breaths if the child or infant
isn’t breathing. With the head tilted back slightly and the
chin lifted, pinch the child’s nose shut, make a complete seal by placing your mouth
over the child’s mouth and breathe into the child’s mouth twice. For infants, use your mouth to make a complete
seal over the infant’s mouth and nose, then blow in for one second to make the chest clearly
rise. Now, deliver two rescue breaths. 4. If the child or infant is responsive, you
should still call 911 in order to “report any life-threatening conditions and obtain
consent to give care.” 5. If the child or baby is unresponsive to the
rescue breaths, begin CPR. Here are the steps to perform child and infant
CPR provided by the American Red Cross: 1. Kneel beside the child or baby. 2. Push hard, push fast. For children, place the heel of one hand on
the center of the chest, then place the heel of the other hand on top of the first hand,
and lace your fingers together. Deliver 30 quick compressions that are each
about 2 inches deep. For infants, use 2 fingers to deliver 30 quick
compressions that are each about 1.5 inches deep. 3. Give 2 rescue breaths. 4. Keep going. Continue these baby or child CPR steps until
you see obvious signs of life, like breathing, or until an AED is ready to use, another trained
responder or EMS professional is available to take over, you’re too exhausted to continue,
or the scene becomes unsafe. Modern CPR was created in 1960 as the joint
effort of several doctors and researchers. According to Baylor College of Medicine Professor
William L. Winters, two anesthesiologists at Johns Hopkins Hospital, Peter Safar and
James Elam, came up with an “emergency ventilation technique that involved tipping the victim’s
head back and pulling the jaw forward in order to clear the air passage and then blowing
air into the victim’s lungs through a mouth-to-mouth connection.” The AHA states that Dr. Elam and Dr. Safar
were able to “prove that mouth-to-mouth resuscitation is an effective lifesaving method”
in 1956, and they and another doctor named Archer Gordon promoted its use. In a JAMA article published in 1960, an electrical
engineer named William B. Kouwenhoven and his colleagues James Jude and Guy Knickerbocker
presented the concept of “closed-chest cardiac massage,” which was a “method of restoring
circulation in a heart-attack victim by pushing down rhythmically on the sternum.” Winters states that the “combination of
Kouwenhoven’s technique with Safar’s ventilation technique evolved into the basic method of
CPR.” In 1960, the AHA began a program that became
the “forerunner of CPR training for the general public.” Hands-only CPR is a more recent development. Winters states it emerged from research conducted
at the University of Arizona Sarver Heart Center in the mid-1990s. This research led to the discovery that “continual
chest presses kept blood circulating in adult victims of cardiac arrest better than conventional
CPR techniques.” Hands-only CPR for adults was adopted by the
AHA in 2008. Would you perform CPR on someone who needs
it? Why or why not? Let us know in the comments! Also, be sure to check out our other video
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