Cardiopulmonary Resuscitation (CPR)
Cardiopulmonary Resuscitation (CPR) is a first aid technique which should be administered as soon as possible to a person who has suffered a cardiac arrest (their heart has stopped beating). A heart attack is the commonest cause of cardiac arrest.
The first few minutes after a cardiac arrest are vital: if the pumping activity of the heart is not restored within a couple of minutes the brain suffers irreversible damage. CPR involves a combination of mouth-to-mouth rescue breathing and chest compressions to keep oxygenated blood flowing to the brain and other organs.
New guidelines concerning the best method for carrying out CPR were published by the American Heart Association in November 2005, and have been adopted by the Irish Heart Foundation since July 2006. This means the following guidelines may differ from advice you have previously received. If you feel more confident using older techniques that you may be familiar with, you can continue to do so; they are still effective and valid.
Adults (including children above the age of puberty)
- Check the person for a response and for any sign of normal breathing.
- If they are unresponsive and are not breathing normally, ring for an ambulance immediately on 999 (or 112) - or if possible, get some else to ring for you.
- Begin CPR as follows.
First give 30 chest compressions:
- Place the heel of one hand in the centre of the person's chest (between the nipples) and place your other hand on top of the first. Keep your elbows straight and position your shoulders directly above your hands.
- Press down on the chest 4-5cm, pushing hard and fast. Repeat this 30 times, at a rate of 100 compressions/minute (faster than once per second).
Give 2 rescue breaths:
- Pinch the person's nose and seal the patient's mouth with your own. Blow steadily into the person's mouth for one second, checking to see whether the person's chest rises with each breath.
- Continue with cycles of 30 chest compressions followed by 2 rescue breaths until help arrives, or the person begins to breathe normally.
Babies and children
There are some differences to the procedure if you need to give CPR to a child or a baby (under one year of age). The key differences are:
- If you are on your own, give one minute of CPR BEFORE calling an ambulance (ideally, have someone else call an ambulance while you begin CPR)
- Babies and children should be given 5 initial rescue breaths BEFORE commencing chest compressions.
- Check the airway for any obvious obstructions before giving rescue breaths by placing one hand on the forehead, gently tilting the head back and lifting the chin.
- For babies, you will need to place your mouth over the infant's mouth and nose to give rescue breaths.
- Use only two fingers for chest compressions for babies, placed just below the nipple line; for children above the age of 1, use one or two hands.
- After the 5 initial rescue breaths, the same adult procedure can be followed (i.e., 30 chest compressions followed by 2 breaths.
If breathing is restored and signs of circulation are present, roll the patient over onto their side into what is commonly known as the 'recovery position' until an ambulance arrives.
The patient may still be unconscious at this point, but placing them on their side means that mucus or vomit which may have accumulated as a result of the trauma they have experienced will be able to get out of the mouth and will not obstruct the airways.
Also, the 'recovery position' prevents the tongue from falling back into the mouth and blocking the air passages.
Note: CPR is best learned at a first aid course where hands-on experience of the technique is acquired. Training is usually performed on a special mannequin, which has been constructed to simulate the signs of cardiac arrest. The above instructions should not be regarded as adequate instruction in CPR.
Reviewed: October 27, 2006