Chapter 5

CPR
 Heart Attack and Cardiac Arrest
• Heart attack occurs when heart muscle
tissue dies because its blood supply is
severely reduced or stopped.
• Cardiac arrest results when the heart
stops beating.
 Caring for Cardiac Arrest
• Chain of survival: Five events that must
occur rapidly and in an integrated manner
during cardiac arrest

Reprinted with permission. 2015 American Heart Association Guidelines: Update for CPR and ECC. Part 4: Systems of Care &
Continuous Quality Improvement. Circulation. 2015; 132:S397-S413. © 2015, American Heart Association, Inc.
 Purpose of CPR
• CPR moves blood to the heart and brain
by giving chest compressions.
• CPR provides periodic breaths to place
oxygen into the person’s lungs.
 Age Classifications
• Adults: Puberty and older
• Children: 1 year to puberty
• Infants: Younger than 1 year
 Check for Responsiveness
• Tap the person’s shoulder and ask if he or
she is okay.
• If the person does not respond, he or she
is said to be unresponsive.
 Activate the EMS System
• Call or ask a bystander to call 9-1-1.
− If a mobile phone is used, it should be kept by
the person’s side.
− If a mobile phone is not available, leave the
person to call 9-1-1 and get an AED.
• If alone with a child or infant, give CPR for
five cycles, and then call 9-1-1.
 Check for Breathing
• Check breathing for 5 to 10 seconds by
looking for the rise and fall of the person’s
chest.
 Give Chest Compressions

• Perform on a firm, • For a child:

flat surface − Use one or two
hands.
whenever possible.
− Compress about 2
• For an adult: inches.
− Use two hands. • For an infant:
− Compress at least 2
− Use two fingers.
inches.
− Compress about 1.5
inches.
 Give Chest Compressions
• Place hands in the center of the chest.
• Give 100 to 120 compressions per minute
(speed not rate).

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 Open the Airway
• Use the head tilt–chin lift maneuver.
• Place one hand on the person’s forehead
and the fingertips of the other hand on the
bony part of the chin.
• Lift the chin upward to help tilt the person’s
head back.
 Give Rescue Breaths
• Keep the person’s airway open using the
head tilt–chin lift maneuver.

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 Give Rescue Breaths
• Pinch the person’s nose shut.
• Take a normal breath, and blow into the
person’s mouth for one (1) second.
• Take a breath for yourself.
• Give another 1-second breath.
 Continue CPR Until…
• An automated external defibrillator (AED)
is available.
• Person shows signs of life.
• Emergency medical services (EMS)
personnel take over.
• You become too tired to continue.
 Methods of Rescue Breathing
• Mouth-to-mouth breathing
• Mouth-to-mask breathing
• Mouth-to-face shield breathing

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 Adult and Child CPR
• Check for responsiveness.
• Activate EMS.
• Breathing?
− Observe chest for movement.

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 Adult and Child CPR
• Provide chest compressions hard and fast.
• Open airway.
• Give two rescue breaths.

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© Jones & Bartlett Learning.
 Adult and Child CPR
• Repeat compression and breath cycles
until an AED arrives.
• Use an AED as soon as it arrives.

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 Infant CPR
• Check for responsiveness.
• Activate EMS.
− If you are alone, give 5 sets of CPR first.
• Check for breathing.

© Jones & Bartlett Learning. © Jones & Bartlett Learning.

© Aleksandra Gigowska/Shutterstock.
 Infant CPR
• Give chest compressions.
• Open the airway.
• Give two rescue breaths.

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Recognizing Airway Obstruction
• Mild obstruction • Severe obstruction
− Good air exchange − Poor air exchange
− Forceful coughing − Breathing difficulty
efforts − Weak and
− Person should be ineffective cough
encouraged to − Inability to speak or
cough. breath
− Cyanosis
 Adult and Child Choking
• Ask, “Are you
choking?”
• If the person nods
yes, provide care.
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 Adult and Child Choking
• Perform the
Heimlich maneuver
by moving behind
the person.
• Reach around the © Jones & Bartlett Learning.

person’s waist with

both arms and
locate the navel.
 Adult and Child Choking
• Place a fist with the
thumb side against
the person’s
abdomen, just
above the navel.
© Jones & Bartlett Learning.
 Adult and Child Choking
• Grasp the fist with
your other hand.
• Press into the abdomen
with quick, inward and
upward thrusts.
• Continue until the object © Jones & Bartlett Learning.

is removed or the person

becomes unresponsive.
 Infant Choking
• Support the infant’s head and neck.
• Lay the infant face down on the forearm.
• Lower the arm to the leg.
• Give five back blows
between the shoulder
blades with the heel
of the hand.

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 Infant Choking
• Roll the infant face up.
• Give five chest compressions on the
infant’s sternum using two fingers.
• Repeat until the object
is removed or the
infant becomes
unresponsive.

© Jones & Bartlett Learning.

 If a Person Becomes
Unresponsive…
• Immediately call 9-1-1.
• Begin CPR.
• Look for an object in the person’s mouth
during CPR.