CARDIOPULMONARY RESUSCITATION (CPR)

emergency procedure for people in cardiac arrest or respiratory arrest involves physical interventions to create artificial circulation
chest compressions - rhythmic pressing on the patient's chest to manually pump blood through the heart artificial respiration - exhaling into the patient (or using a device to simulate this) to ventilate the lungs and pass oxygen in to the blood

 main purpose is to maintain a flow of oxygenated blood to the brain and the heart helps by delaying tissue death and extending the brief window of opportunity for a successful resuscitation without permanent brain damage generally continued until the patient regains a heart beat (called "return of spontaneous circulation" or "ROSC") or is declared dead

Advanced life support intravenous drugs Defibrillation

the administration of an electric shock to the heart only works for patients in certain heart rhythms, namely ventricular fibrillation or pulseless ventricular tachycardia

Methods
International Liaison Committee on Resuscitation (ILCOR) universal compression-ventilation ratio (30:2) recommended for all single rescuers of infant, child, and adult two hands for the chest compressions for adults, while with children it is only one, and with infants only two fingers (index and middle fingers)

 taking the absence of normal breathing as the key indicator for commencing CPR The removal of the protocol in which lay rescuers provide rescue breathing without chest compressions for an adult victim, with all cases such as these being subject to CPR

Compression-only resuscitation/cardiocerebral resuscitation (CCR) simply chest compressions without artificial respiration Rhythmic abdominal compressions
forcing blood from the blood vessels around the abdominal organs, an area known to contain about 25 percent of the body's total blood volume blood is then redirected to other sites, including the circulation around the heart

 Internal cardiac massage - the process of cardiac massage carried out through a surgical incision into the chest cavity

Breathing (Rescue Breathing) Pinch the persons nose shut using your thumb and forefinger Keep the heel of your hand on the persons forehead to maintain the head tilt Hand should remain under the persons chin, lifting up. Inhale normally (not deeply) before giving a rescue breath to a victim. Immediately give two full breaths while maintaining an air-tight seal with your mouth on the persons mouth. Each breath should be one second in duration and should make the victims chest rise

Circulation (Chest Compressions) After giving two full breaths, immediately begin chest compressions (and cycles of compressions and rescue breaths. Kneel at the persons side, near his or her chest. With the middle and forefingers of the hand nearest the legs, locate the notch where the bottom rims of the rib cage meet in the middle of the chest. Place the heel of the hand on the breastbone (sternum) next to the notch, which is located in the center of the chest, between the nipples. Place your other hand on top of the one that is in position. Be sure to keep your fingers up off the chest wall.

 Bring your shoulders directly over the persons sternum. Press downward, keeping your arms straight. Push hard and fast. For an adult, depress the sternum about a third to a half the depth of the chest. Then, relax pressure on the sternum completely. Do not remove your hands from the persons sternum, but do allow the chest to return to its normal position between compressions. Relaxation and compression should be of equal duration. Avoid interruptions in chest compressions (to prevent stoppage of blood flow). Use 30 chest compressions to every two breaths (or about five cycles of 30:2 compressions and ventilations every two minutes) for all victims (excluding newborns). You must compress at the rate of about 100 times per minute. Continue CPR until advanced life support is available.

Using an AED (Automated External Defibrillator) in conjunction with CPR: single shocks should be followed by immediate CPR for two minutes heart rhythm checks should be performed every two minutes (or after giving about five cycles of CPR

CPR for Infants (Up to One Year Old) Airway be careful not to tilt the head back too far because an infants neck is so pliable that forceful backward tilting might block breathing Breathing Do not pinch the nose of an infant who is not breathing. Cover both the mouth and the nose with your mouth and breathe slowly (one to one and a half seconds per breath), using enough volume and pressure to make the chest rise. With a small child, pinch the nose closed, cover the mouth with your mouth and breathe at the same rate as for an infant. Rescue breathing should be done in conjunction with chest compressions