Carrying out CPR In the UK, we have been seeing several showings of a mini film on the television about CPR. This mini clip, which is paid for by the charity British Heart Foundation, is aimed at untrained members of the public (to put it another way, individuals who have not been taught first aid) and they enable anyone, should they decide to help, to deal with an individual who happens to be unconscious and not breathing normally. The short film shows CPR being performed using chest compressions only where in fact first aiders are taught to compress the casualty's chest and then to breathe into the casualty. This article details the complete method as laid down by the British and European Resuscitation Councils, but it should be noted that compressions on their own are better than nothing. Therefore if you feel unable to breathe into a casualty, employing chest compressions only is still worthwhile and much better than no action. Once you have found an unconscious casualty to be not breathing normally (to find out how you make the diagnosis which leads you to CPR, go to Dealing With an Unconscious Casualty), your next step once you have called 999/112 (or are certain that another person is phoning or has already phoned them) is dependant on whether the casualty is an infant (baby), child or adult. From a first aid point of view, an infant is treated as someone between birth and 1 year old, a child seen to be someone between 12 months and 8 years and anyone over 8 is classed as an adult. If you're not sure or don't know the casualty's age, make a quick estimate. Let's consider an adult first. Compress the chest 30 times. Locate the centre of the chest and place the heel of your right or left hand on that spot. Interlock the fingers of your other hand and pull back so that you are only using the heel of your hand to compress the chest. The compressions need to be about a third of the thickness of the casualty's chest and performed at a rate somewhere in the range of 100 and 120 compressions per minute. It's often said that a good way of getting the rate of compressions right is to think about the rhythm of the nursery song "Nellie the Elephant" or the disco song "Staying Alive" by the Bee Gees. The rate of these compressions is very important due to the fact that the effect is depleted at rates under or above the range of 100 to 120 compressions per minute. In order to give effective breaths into a casualty, tilt their head back by the bottom part of the nose and positioning two fingers under the chin. This action removes the casualty's tongue from the airway thus stopping the mouth from opening too far. Make a seal around the casualty's mouth with your mouth (you will need to open your mouth quite wide so that you can seal the mouth effectively). Give the casualty two breaths, don't rush, about a second between breaths is ideal. This will enable the lungs to inflate and deflate.
by about thirty compressions and two breaths until... • •
the casualty shows signs of recovery the ambulance arrives and the paramedics tell you to stop
you become exhausted and you are on your own
another person relieves you*
an Artificial External Defibrillation machine is brough by another person
*Whoever takes over is not required to be a first aider, they merely need to be told/shown how to do CPR. It's recommended that, if there is someone else available, you change over every two minutes (approximately 4 cycles of 30 compressions and 2 breaths).
Infants and children. With Infants and children, CPR commences with 5 rescue breaths and continues with thirty chest compressions and 2 breaths. The initial rescue breaths are done only once, at the beginning.
CPR for infants - age 0 to 12 months: 5 rescue breaths: make a complete seal around their nose and the mouth with your mouth and breathe 5 times extremely gently into the infant (it's important not to breathe too strongly due to potential damage to the lungs). Using 2 fngers (index and middle, do chest compressions thirty times by about a third of the infant's upper body depth Breathe twice into the infant and approximately about thirty compressions and 2 breaths until... • •
the infant comes round the ambulance arrives and the paramedics tell you to stop
you become exhausted and you are on your own (probably not likely as this is not as strenuous as with an adult)
another person relieves you
CPR for children - age 12 months to 8 years: The techniques are similar to adult CPR but starts with 5 rescue breaths and continues with thirty chest compressions and 2 breaths. According to the difference in size between you and the child, you can use one hand only to perform the chest compressions instead of two.