cardiopulmonary resuscitation
Abbreviation: CPRPatient care
In emergency cardiac care, CPR involves either opening the airway, providing artificial breathing, and assisting circulation with chest compressions (until definitive treatments can restore spontaneous cardiac, pulmonary, and cerebral function) or providing chest compressions alone, without rescue breathing. When trained providers are available, CPR includes defibrillation with automated external defibrillators. In the U.S., the American Heart Association (AHA) develops and disseminates standard techniques for emergency cardiac care.
The first step in CPR is to ensure that an unarousable patient needs cardiopulmonary support and is not merely asleep or unconscious. If the patient does not respond to a loud voice or gentle shaking, the best thing a rescuer can do is to call for skilled assistance because successful resuscitation usually depends on the speed with which the patient can be defibrillated.
Before the defibrillator arrives, the rescuer can either position the patient for chest compressions only or begin rescue breathing. The patient should be placed supine on a firm, flat surface, with care taken to protect his cervical spine if traumatic injury is suspected. Kneeling at the level of the patient's shoulder, the rescuer performing rescue breathing may open the patient's airway, either with the jaw-thrust or the head-tilt chin-lift technique. If foreign bodies are present in the airway, they must be removed; dentures must also be removed if they interfere with resuscitation. Next, breathing is assessed by listening for breath sounds at the nose and lips and watching for the rise and fall of the chest. If these signs are not present, the patient is apneic, and rescue breathing can be performed. Survival rates of patients undergoing CPR are roughly equivalent with or without rescue breathing.
Rescue breathing can be performed with mouth-to-mouth technique or through a mask with a one-way valve if one is available. The rescuer gives two deep, slow positive-pressure breaths to the patient, the duration of each breath depending on the patient's age. If the supplied breaths meet obvious resistance, the rescuer should make another attempt to reopen the airway, and, if this is ineffective, to clear the airway with the Heimlich maneuver in children and adults. Infants should receive chest thrusts and blows to the back instead of the Heimlich maneuver.
The AHA formerly suggested checking the victim for a pulse after the first two breaths but eliminated the pulse check in its revised guidelines of 2000. If the patient is not breathing on his own, rescue breathing continues. If there is no pulse, external chest compression is begun and continued, with periodically interposed ventilations, until a defibrillator arrives or the patient revives. The precise number of ventilations and chest compressions per minute depends on the patient's age and the number of rescuers. For a single rescuer caring for an adult patient, two breaths are given for every 15 chest compressions. According to the AHA, for resuscitation purposes, infants are those who are up to a year old, children are from 1 to 8 years old, and adults are over the age of 8.
Compressions are given to adults (the usual victims of cardiac arrest) at the center of the sternum between the nipples, with the heel of one hand below the other hand; the fingers of the two hands are interlaced for support and to minimize the possibility of fracturing the ribs. The rescuer's elbows should be locked and straight, and the direction of compression should be exactly perpendicular to the patient's chest.
The chest is depressed 1.5 to 2.0 in for a normal-sized adult. For a child, the chest is depressed 1.0 to 1.5 in; for an infant, 0.5 to 1.0 in. The chest should return to its normally inflated position after each compression.
When professional rescuers arrive, the patient should be defibrillated immediately. If a defibrillator is not available, two-person CPR continues; the two rescuers alternate in giving rescue breaths and chest compressions to minimize fatigue. Ventilation and chest compressions are held for 5 sec at the end of the first minute and every few minutes after to determine whether the patient has responded. illustration; advanced cardiac life support; defibrillation; emergency cardiac care;
cardiopulmonary resuscitation
Combined heart compression (CARDIAC MASSAGE) and ‘kiss of life’ (mouth-to-mouth artificial respiration). Commonly abbreviated to CPR. Guidelines, issued by the European Resuscitation Council in 2005, recommend that lay people should no longer to check for a pulse or attempt ventilation before starting chest compressions. If no signs such as breathing, coughing, spontaneous motions, or movements in response to stimulation are present chest compressions should begin. A ratio of 30 chest compressions to 2 ventilations is appropriate and compressions should be restarted for two minutes after defibrillation, regardless of rhythm. In the case of children, if two rescuers are available the ratio should be 15 to 2. For neonates the ratio should be 3 compressions to 1 ventilation. Chest compressions generate enough force to clear most obstructions and therefore rescuers should begin CPR immediately and let chest compressions clear the airway.Cardiopulmonary resuscitation (CPR)
car·di·o·pul·mo·nar·y re·sus·ci·ta·tion
(kahrdē-ō-pulmŏ-nar-ē rē-sŭsi-tāshŭn)
cardiopulmonary resuscitation
Abbreviation: CPRPatient care
In emergency cardiac care, CPR involves either opening the airway, providing artificial breathing, and assisting circulation with chest compressions (until definitive treatments can restore spontaneous cardiac, pulmonary, and cerebral function) or providing chest compressions alone, without rescue breathing. When trained providers are available, CPR includes defibrillation with automated external defibrillators. In the U.S., the American Heart Association (AHA) develops and disseminates standard techniques for emergency cardiac care.
The first step in CPR is to ensure that an unarousable patient needs cardiopulmonary support and is not merely asleep or unconscious. If the patient does not respond to a loud voice or gentle shaking, the best thing a rescuer can do is to call for skilled assistance because successful resuscitation usually depends on the speed with which the patient can be defibrillated.
Before the defibrillator arrives, the rescuer can either position the patient for chest compressions only or begin rescue breathing. The patient should be placed supine on a firm, flat surface, with care taken to protect his cervical spine if traumatic injury is suspected. Kneeling at the level of the patient's shoulder, the rescuer performing rescue breathing may open the patient's airway, either with the jaw-thrust or the head-tilt chin-lift technique. If foreign bodies are present in the airway, they must be removed; dentures must also be removed if they interfere with resuscitation. Next, breathing is assessed by listening for breath sounds at the nose and lips and watching for the rise and fall of the chest. If these signs are not present, the patient is apneic, and rescue breathing can be performed. Survival rates of patients undergoing CPR are roughly equivalent with or without rescue breathing.
Rescue breathing can be performed with mouth-to-mouth technique or through a mask with a one-way valve if one is available. The rescuer gives two deep, slow positive-pressure breaths to the patient, the duration of each breath depending on the patient's age. If the supplied breaths meet obvious resistance, the rescuer should make another attempt to reopen the airway, and, if this is ineffective, to clear the airway with the Heimlich maneuver in children and adults. Infants should receive chest thrusts and blows to the back instead of the Heimlich maneuver.
The AHA formerly suggested checking the victim for a pulse after the first two breaths but eliminated the pulse check in its revised guidelines of 2000. If the patient is not breathing on his own, rescue breathing continues. If there is no pulse, external chest compression is begun and continued, with periodically interposed ventilations, until a defibrillator arrives or the patient revives. The precise number of ventilations and chest compressions per minute depends on the patient's age and the number of rescuers. For a single rescuer caring for an adult patient, two breaths are given for every 15 chest compressions. According to the AHA, for resuscitation purposes, infants are those who are up to a year old, children are from 1 to 8 years old, and adults are over the age of 8.
Compressions are given to adults (the usual victims of cardiac arrest) at the center of the sternum between the nipples, with the heel of one hand below the other hand; the fingers of the two hands are interlaced for support and to minimize the possibility of fracturing the ribs. The rescuer's elbows should be locked and straight, and the direction of compression should be exactly perpendicular to the patient's chest.
The chest is depressed 1.5 to 2.0 in for a normal-sized adult. For a child, the chest is depressed 1.0 to 1.5 in; for an infant, 0.5 to 1.0 in. The chest should return to its normally inflated position after each compression.
When professional rescuers arrive, the patient should be defibrillated immediately. If a defibrillator is not available, two-person CPR continues; the two rescuers alternate in giving rescue breaths and chest compressions to minimize fatigue. Ventilation and chest compressions are held for 5 sec at the end of the first minute and every few minutes after to determine whether the patient has responded. illustration; advanced cardiac life support; defibrillation; emergency cardiac care;