If the patient isn’t breathing, is unconscious or has no pulse CPR should be

applied immediately. Always remember, proper CPR begins with chest compressions.

important to note: that death is most likely to occur after 10 minutes of loss of
oxygen to the brain. From 6 to 10 minutes brain damage is expected. From 4 to 6
minutes brain damage is very possible and from 0 to 4 minutes brain damage is
virtually non-existent.

When the heart stops beating blood stops flowing throughout the body.
Cardiopulmonary Resuscitation (CPR) is when a person performs chest compressions
and breathing into a patient who has no pulse or who isn’t breathing. Chest
compressions combined with breathing into the patient will carry the now oxygenated
blood throughout the body and into the brain. CPR acts like an artificial heart
moving the blood rich in oxygen to the brain.

The patient's survival rate increases as he/she receives CPR

you can dispense with the mouth-to-mouth breathing - hands-only CPR can be just as
effective as performing CPR with mouth-to-mouth. That means chest compressions
alone are sufficient until trained responders arrive on the scene.

conventional CPR is still the way to go with children and infants. However, as most
pediatric cardiac arrests are caused by asphyxiation, it may not be possible to
perform rescue breaths

To perform hands-only CPR: kneel beside the person who needs assistance. Get into
position by placing the heel of one hand on the center of their chest, and the heel
of the other hand over the first hand. Interlace your fingers. Keep your shoulders
lined directly over your hands and your arms straight.
Once in position, start pushing hard and fast. Make use of your body weight to help
make compressions, which should be at least two inches deep and occur at a rate of
at least one-hundred compressions per minute. Allow the chest to rise completely
between each compression.
Keep pushing until you see breathing or obvious indications of life. You can also
stop once a trained responder or EMS professional is ready to take over or an AED
becomes available. Stopping may also be necessary if you are unable to carry on due
to exhaustion or the scene becomes unsafe.

The Good Samaritan Law protects all who assist those who are injured, ill or in
peril. As long as they’re acting voluntary, without expectation of reimbursement or
compensation while performing such aid, on-site—they’ll have legal protection.

Check the patient and see if he/she is conscious or not - Do not check for a pulse
because time is of the essence - Call out to the patient asking - if the patient
doesn't respond, immediately call 911 and then perform CPR—initiating Circulation,
Airway and Breathing Tasks.

If you feel fear of providing care due to possible legal issues, know that rescuers
who provide care without a legal duty and act in good faith are protected by Good
Samaritan laws.

Chest Compressions: find the point where the patient’s ribs meet
Infant CPR: Compressions on an infant are pressed just below the nipples - One
rescuer will perform compressions while the other uses the rescue valve.

Coronavirus CPR Guidelines: advised to put on PPE before entering the scene - CPR
should consist of cycles of thirty compressions and two rescue breaths - When
giving rescue breaths, a bag-mask that has a tight seal and filter should be used -
Mechanical CPR devices can be used for patients who meet the height and weight
requirements to reduce aerosolization risk.
For adult victims, it is recommended to provide at least hands-only CPR after a
cardiac arrest - For children, chest compressions should be performed and mouth-to-
mouth ventilation may be considered.

PPE: Face shields provide splash and high impact protection, while gloves protect
against exposure from skin contact with chemicals, infectious agents, cold, heat,
and cutting objects. Goggles are designed to reduce the risk of exposure to laser
radiation, chemical splashes, or flying debris. Gowns are used to prevent the
penetration of infectious blood, hazardous materials, or other OPIM. Masks are used
to protect the employee from airborne materials or liquid contaminating the face.

Airway - Check for any obstructions, such as the tongue, foreign objects, vomit,
swelling, or food blocking the patient’s throat or windpipe (finger-swipe, if
necessary) - Make sure the patient is on a solid surface (on the backside) - neel
next to the patient’s neck and shoulders. - Open the patient’s airway by tilting
the head back with the palm of one hand while gently lifting the chin with your
other hand. For no more than 10 seconds, check for life: listen for any sounds, put
your cheek next to the patient’s mouth to feel any breaths while also looking for
any motion. Rescuers can check steps simultaneously. If the patient is assumed
lifeless begin Mouth-to-Mouth procedure.
Perform Chest Compressions on patients who are obese or pregnant.

Breathing - Rescue Breathing: Perform mouth-to-mouth; however, it can also be

performed mouth-to-nose, mouth-to-mask, and mouth-to-stoma, but in rare cases.
While still performing the Airway technique pinch the patient’s nose shut. With a
complete seal over the patient’s mouth, with your mouth, breathe into the patient
until you see the chest inflate. If the chest does not rise, repeat the Airway
technique. When performing the breathing technique make sure to give two breaths
for 1 second each - continue the C-A-B’s.

CPR for Infants (Age Less Than 1 Year, Excluding Newborns)

Witnessed Collapse: call 911 or have someone call
Un-Witnessed Collapse: perform CPR (for 2 minutes), call 911, or have someone call
Chest compressions - 100-120/min
Perform CPR - Circulate, Airway, Breathing (C-A-B’s)
Compressions at about 1½ inches (4 cm) - 1/3 AP diameter of the chest
30:2 compressions over breaths (seal infant’s mouth and nose) - 2 Rescuers 15:2
2 Rescuers: 2 thumbs compression
Use AED( automated external defibrillator) as soon as it's available.

Scene safety

Check the environment – making sure it’s safe for rescuers and victims
Recognition of cardiac arrest

Check responsiveness
No breathing or only gasping – ie., no normal breathing
Within 10 seconds – no positive pulse
(You can check for a pulse and breathing simultaneously in less than 10 seconds)
Hand placement

1 rescuer
Just below the nipple line – 2 fingers in the center of the chest
2 or more rescuers
2 thumb–encircling hands in the center of the chest, just below the nipple line –
encircling hands (2 thumbs) in center of the chest
Chest recoil
Make sure not to lean on the chest of the victim – Allow a full recoil after each
chest compression
Minimizing interruptions

Compression interruptions – limit to less than 10 seconds

Rescuers should never(esp for adults)

Compress slower than 100/min or faster than 120/min

Compress in-depth less than 2 inches (5 cm) or more than 2.4 (6 cm)
Lean on victim’s chest during compressions
Allow interruption during compressions more than 10 seconds
Provide excessive ventilation during breathing task, ie., excessive breathing with
force or too many breaths

When to stop CPR

• When you’re too exhausted to continue
• Broken ribs, lung collapses, etc.
• If an Automated External Defibrillator (AED) is accessible
• If Emergency Medical Services (EMS) arrives

Rescuers should never

Compress slower than 100/min or faster than 120/min
Compress in-depth less than 2 inches (5 cm) or more than 2.4 (6 cm)
Lean on victim’s chest during compressions
Allow interruption during compressions more than 10 seconds
Provide excessive ventilation during breathing task, ie., excessive breathing with
force or too many breaths

For suspected opioid poisoning

Check responsiveness
Shout for nearby help
Activate the emergency response system
Get naloxone and an AED if possible

Is the patient breathing normally?

If yes, prevent deterioration:

Tap and shout

Reposition
Consider naxolone
Continue to assess responsiveness and breathing until EMS arrives
If no, start CPR:

Give naxolone
Use an AED
Resume CPR until EMS(Emergency medical services) arrives

CPR on a pregnant patient

Oxygenation and airway management should be prioritized during resuscitation from
cardiac arrest in pregnancy because pregnant patients are more prone to hypoxia(low
level oxygen to body tissues) - Fetal monitoring should not be undertaken during
cardiac arrest in pregnancy because of potential interference with maternal
resuscitation. - CPR on a pregnant person should be performed as you would on a
non-pregnant patient.