July 07, 2019 CPR

Everything you need to know for adult, child, infant and pet CPR

Do you dread the idea of a loved one being in an emergency situation?  Many do, and many live with large hopes that they will never experience an emergency situation.  For those not in the medical field an emergency is just plain scary.

What makes something scary?  The unknown, uncertainty, and suddenness of a situation and action where quick decisions are needed is often perceived as scary.  Witnessing a cardiac arrest can be all of these things, and ultimately, scary.  Fortunately, CPR doesn’t have to be.

CPR is easy enough to understand and keep in mind for practical use thanks to the American Heart Association CPR Guidelines.  Cardiac arrest is when the natural rhythm of the heart is disrupted, causing the heart to stop beating.  It can happen under a variety of circumstances including some that can happen right in your own home and to anyone.  Since nearly ninety percent of all cardiac arrests take place outside a medical setting, knowing CPR guidelines can make a big difference in a sudden daunting situation.  Don’t let the idea of CPR or an emergency scare you.  Know CPR, and know you can make the difference.

But, Doesn’t CPR Involve Mouth to Mouth?

What are the rules for CPR you ask?  Do you have to practically kiss the person?  Look, an emergency causes enough variety of concern without the pressure to spontaneously smooch someone.  So, take comfort knowing the American Heart Association CPR guidelines support hands-only CPR.

Hands-only sounds good to me.  What are the current guidelines for CPR?

Hands-only AHA CPR Guidelines contain only two steps.  This form of CPR is best for those untrained or out of practice of conventional CPR.  First thing to do in any emergency situation is to call 911.  Calling 911 will get trained medical help on the way.  Second, push hard and fast in the center of the chest.  Even better is when the call and compressions can occur simultaneously and last until paramedics arrive.  If another person is around, send them to the phone, or use a cellular and begin those vital compressions.  Just remember to answer the 911 operator’s questions as you go, and keep those compressions going.

Current CPR guidelines describe 100-120 pushes or compressions in the center of the chest per minute.  Keeping in mind one hundred compressions per minute is a minimum to reach optimal CPR effectiveness.  It may seem like a lot, but an easy way to practice and keep the speed accurate is provided by American Heart Association CPR guidelines.  Learning the rate of compressions relative to a familiar song will help you help the victim.

Perhaps you’ve heard of the old disco song Stayin’ Alive by the Bee Gees?  The title and the beat are synonymous with CPR.  With the song in your head, you simply compress to the beat.  AHA CPR guidelines have recently expanded the musical selection to other hit songs with appropriate beat measures of 100-120 per minute.  These songs include: Walk The Line by Johnny Cash, Crazy In Love by Beyoncé, MMM Bop by Hanson, One Week by Barenaked Ladies and Hips Don’t Lie by Shakira, just to name a few.  Odds are you know one of these tunes, and now, odds are you can save a life using one of them and your own two hands.

The key to using the tunes of the songs mentioned is to keep CPR going, and keep on compressing to the rhythm.  One hundred compressions per minute can sure seem like a lot, and it can tire you out, but get some good form behind you, and that motivational tune going and go for it.  A life depends on it!

Compression only CPR is one of the latest developments in current CPR guidelines.  When a person suffers cardiac arrest, the lack of blood flow with vital oxygen delivery to the brain can severely impact their outcome.  They may not be breathing new oxygen in, but their blood is still full of oxygen.  The blood just needs some help getting around right now, which is where compressions take over.  Compressions help the blood continue to feed the necessary ingredients for life to important organs.  It buys precious time, and can be the first step in the patient’s recovery from the cardiac arrest.  This development into hands-only current CPR guidelines makes it much easier to remember, and much more comfortable for a bystander to administer, giving more victims a fighting chance.

Conventional CPR Is Best

Now that we’ve learned hands-only CPR guidelines, it is important to know the conventional American Heart Association CPR guidelines.  CPR, or cardiopulmonary resuscitation, is used to pump the heart and circulate blood and oxygen to the brain in the event of cardiac arrest.  Conventional CPR is the combination of rescue breaths and compressions most strongly supported by AHA CPR guidelines for optimum benefit to the victim.  It is also the most commonly recognized and depicted method for proper CPR.  Conventional CPR is best specifically if the victim is a child, or has experienced drowning or another breathing-related emergency.  This form of CPR is often learned through instruction or training.

Conventional CPR has a similar rhythmic simplified structure to it.  American Heart Association CPR guidelines describe the same rate of compressions of 100-120 per minute mentioned in hands-only CPR, but is paced between rescue breaths.  The pace is specified as thirty compressions to two rescue breaths to be exact.  The compressions and breaths combine to create the correct sequence of CPR.

What is the correct sequence of CPR?  We are glad you asked.  AHA CPR guidelines offer a helpful acronym to queue the correct sequence of CPR: Compressions, Airway, Breathing, or CAB.

C is for Compressions

This action begins the sequence of CPR.  The purpose behind it is to promote blood flow.  Begin by ensuring the victim is flat on the floor if at all possible and the surrounding area is safe and clear.  The victim being placed flat on the floor will offer not only a safe position (from falling and additional injuries), but it will give proper leverage and support for the upcoming compressions and breaths.  Next, locate the center of the person’s chest (between the nipples is often a good guide).  Stack your hands on top of each other.  It can be helpful to interlock fingers when stacked for sturdiness.  Using the heel of the lower hand, press down hard and fast in the center of the chest already identified.  Compressions should reach two inches in depth into the chest.  If the victim is an infant, there are some differences in CPR guidelines.  For an infant, the heel of the hand is not used.  Instead, place two or three fingers in the center of the chest and aim for a compression depth of one and a half inches.

The pressure depth and rate if done effectively will pump the blood through the body where the heart is currently not performing that function.  AHA CPR guidelines offer some pointers here with arm positioning for effective compressions.  Keep arms straight and hands together.  Avoid bending the elbows, they are best locked straight.  Use your body weight and in a rocking motion compress the hand against the chest.  Keep the speed at 100-120 per minute.  The hit songs will still help you keep an accurate speed here, but it is important to keep a count.  After a count of thirty compressions, step C is complete for this cycle and leads to the next step, opening the airway.

A is for Airway

This step prepares the airway to properly receive the upcoming rescue breaths in the lungs.  To open the airway, AHA CPR guidelines describe a head-tilt chin-lift action.  Using both hands, place one palm on the top of the victim’s forehead.  The fingertips of the other hand are placed right under the chin.  Push down on the forehead to tilt back while lifting the chin toward the same direction.  The victim’s mouth should open slightly.  In the event the head does not remain tilted and lifted when released, use your hands to steady the head in the head-tilt chin-lift angle when moving on to give breaths in the next step.

B is for Breath

This step will offer rescue breaths for the victim.  Although not breathing on their own, the victim still needs oxygen entering their lungs.  Breathing for them will help deliver the required oxygen to their lungs and offer a better fighting chance.

This step is commonly referred to as mouth-to mouth, but it can be over the nose if needed as well.  If using the mouth, hold the nostrils closed.  The point is to create a seal so the breath enters the victim’s lungs through an open airway effectively and does not escape before it can reach the lungs.  Perform a breath into the mouth lasting and holding for at least one second.  Check effectiveness by seeing if the chest rises during the breath.  If so, give a second breath.  If not, return to the head-tilt chin-lift maneuver and try again.  If the chest does rise, give two breaths lasting one second each, then return to the sequence of thirty hard and fast compressions followed by two breaths.

The pattern of CAB with thirty compressions and two breaths should be maintained as long as possible.  Following the above CAB sequence provided by AHA CPR guidelines, continue until medical help arrives, you can switch out with someone who will continue the CPR, or you cannot go on any longer.

AED

The next level of CPR building up from hands-only and conventional is CPR with an AED.  AED stands for automated external defibrillator.  An AED is an electric medical device that can detect the heart’s rhythm.  It should be used in conjunction with CPR guidelines.  If the AED recognizes a heart rhythm requiring a shock, it can detect and administer the shock to the victim.  AEDs might sound complicated, but once again the American Heart Association CPR guidelines helps make them user friendly.

Using an AED requires specific training in order to know the basic operation and application of the device.  AEDs themselves have helpful images and simplified directions and vocal prompts to aid in their use as well.  Knowing if and where an AED is present can be the first tool to using one properly and efficiently.  Many public places have them available and are often found mounted for ease of access similar to a fire extinguisher.  They are often situated  in elevator lobbies, building entrances, and more.  AEDs are also often registered with local emergency management systems.  This means the 911 operator you should already be on the phone with, may be able to guide you directly to the closest one.

If an AED is available, it should be brought to the victim swiftly.  CPR should continue while the AED is located, prepared and positioned.  Once the AED is in place and powered on, it should give voice and text prompts for the steps it is taking to assess and aid the victim and you as the rescuer.  Most notably, it will warn for when a shock is necessary and bystanders should stand back, and it will prompt when CPR should continue.  Keep practicing the CABs of CPR until prompted otherwise by the AED, medical help arrives, you can switch out with someone who will continue the CPR, or you cannot go on any longer.

You Can Make the Ultimate Difference

Cardiac arrest might stop the heart from beating, but it doesn’t have to remain that way.  The heart can beat again and it can be helped with CPR to return to its function.  Those who suffer cardiac arrest can have their chances of survival multiplied if given CPR.  Recall from earlier that the majority of cardiac arrests occur outside medical settings and inside homes.  This means just by knowing current CPR guidelines, you can multiply your loved one’s chance of recovery and survival.  The ultimate CPR guidelines here are the tools to save a life.  Being familiar with these and having continued education on the matter can help stimulate familiarity and keep a scary situation under control.  Be the part that makes this difference.

Got A Minute To Save A Life?

Beginning CPR should be swift and efficient.  American Heart Association CPR guidelines have made the steps to CPR as clear as possible.  Their current CPR guidelines also offer a helpful prompt to begin CPR with the three C’s: Check, Call, Care.  Check the patient, assess their situation and that the area is safe.  Call 911.  Ideally, use a cell phone and remain with the patient or send someone to call 911.  Care for the victim by beginning CPR with compressions.

Current CPR guideline basics:

Call 911 Infant Child Teen/Adult
Hand Position 2-3 fingers in center of chest between nipples or mid breast bone 2 hands center of chest between nipples or mid breast bone 2 hands center of chest between nipples or mid breast bone
Compression Depth 1 ½ inches 2 inches 2 inches
Compression Rate 100-120 per minute 100-120 per minute 100-120 per minute
Ratio of Compressions to Breaths 30 : 2 30 : 2 30 : 2
Breaths Watch for chest rise, breathe for 1 second Watch for chest rise, breathe for 1 second Watch for chest rise, breathe for 1 second
AED Specialized AED for less than 1 year of age Pediatric AED for 1-8 years old

8 years and up can use a standard AED

Standard AED

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