How to Perform CPR | Narayana Health

Cardiopulmonary resuscitation (CPR) is an emergency procedure. You can perform CPR when a person stops breathing or has a cardiac arrest. Basic knowledge of emergency first aid and CPR is critical for anyone, as it can maintain circulation and oxygen levels until the emergency room arrives. While receiving CPR does not guarantee survival, it does increase the chance of survival. The CPR technique uses a combination of:

  • Chest compression
  • mouth to mouth

What are the indications for CPR?

Cardiopulmonary resuscitation is the sequence of rapid measures. These measures restore oxygenated blood flow to the brain and other organs before an emergency treatment team arrives. Without CPR, people can lose consciousness within minutes or suffer irreversible brain damage due to lack of oxygen in the brain. The following are some life-threatening signs seeking emergency help:

  • difficulty breathing
  • Stopped breathing
  • loss of consciousness
  • Does not respond to taps, movements or instructions
  • No identifiable pulse

One cannot afford to wait until someone has completely stopped breathing before resuscitating them, as cardiac arrest victims may growl, snort, or hyperventilate, which is not normal breathing.

CPR steps are similar in older children and adults, except for hand placement for heart compression and sequence of artificial respiration and chest compression. But in infants, compression pressure and depth should be one-third that of adults.

What are the steps of CPR?

By performing CPR, you can increase a patient’s chance of survival by up to three times. Only a professionally trained person should perform CPR on a patient who is not breathing normally or unresponsive. The following are the basic preparatory steps of CPR:

  • Clear the area around the person.
  • Stimulate a person’s response by patting the shoulder or asking questions.
  • If there is no response, call the emergency hotline 102 or 108, or ask someone nearby to call the number.
  • Lay the person on their back and check their airways. Remove any blockage in the nose or mouth, such as blood, vomit, or food.
  • Monitor breathing for at least 10 seconds. If a person is breathing normally, keep them in a recovery position and observe and wait for help to arrive.
  • If the person is having trouble breathing, gasping for air, or not breathing, begin CPR as soon as possible.
  • If you have access to a defibrillator, ask someone to bring it, don’t delay CPR to get it.

How to perform CPR on adults and older children?

After the preparatory steps, start CPR as soon as possible. Here are the CPR methods:

  • Chest Compression: The following are step-by-step chest compression methods:
  • Squeeze your hands together by placing one on top of the other and kneeling next to the patient.
  • Place the heel of your interlocking hand on the lower half of the person’s sternum, in the center of the chest.
  • After positioning yourself on top of the person and keeping your arms straight, place one-third of your body weight and press straight down at least two inches.
  • You can compress the chest at least 100 times per minute, but make sure that the chest returns to its normal position between compressions.
  • Release the pressure. Be sure to perform 30 chest compressions in one cycle. Perform rescue breaths after giving compressions.
  • Artificial or Ventilation: After 30 compressions, perform two rescue breaths. After making sure the airway is clear, tilt the patient’s head back slightly and lift the chin. Pinch their nose and open their mouth with your thumb and fingers. Place your mouth over their mouth to cover it and blow into their mouth to make their chest rise.

Tilt the head again and inhale a second time if the chest does not rise on the first breath.

  • Repeat the cycle: You should repeat this cycle of 30 chest compressions and two breaths (30:2). The goal of CPR is to perform five sets of 30:2 in about two minutes until the person starts breathing or a paramedic takes over or tells you to stop.

How to perform CPR on younger children and babies?

CPR steps in younger children and infants are similar to those in adults. The difference is the degree of compression and pressure. Following are the steps of CPR in infants and younger children after performing the preliminary steps:

  • Mouth to mouth: If the child is not breathing or has difficulty breathing, perform two rescue breaths. With children, you need to pinch their nose and place your mouth on their mouth to blow the air. But with infants, you can put your mouth over their mouth and nose and blow the air.

If the child or baby does not begin to breathe even after mouth breathing, begin chest compressions.

  • Chest Compression: After kneeling next to a child, place the heel of one hand in the center of the child’s chest, between and slightly below the nipples. Compress the chest about two inches deep at 100 times per minute.

While resuscitating a baby, use two fingers in the center of the baby’s chest, between and slightly below the nipples. Compress the chest about 1.5 inches deep 30 times.

  • Repeat the cycle: You will need to repeat these two cycles of rescue breaths and 30 chest compressions until the child or baby begins to breathe or help arrives.

CPR is a life-saving first aid procedure and is easy to learn. It increases the chance of surviving a heart attack or shortness of breath after a trauma or accident.

Dr. Sajal Gupta | Advisor – Cardiology | Dshilaharam Narayana Super Specialty Hospital, Delhi

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