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What we're going to look at now is CPR. So, what we're going to do is look at what CPR is and how to actually do it. Now, the first thing is to look at what CPR is. CPR stands for cardiopulmonary resuscitation. So, what this is, is we're going to run through a process of giving chest compressions and breaths to keep this person with oxygen-rich blood going around the system. The idea is by pushing down on the chest, we're going to squeeze the heart, and when you squeeze the heart, there's blood in the heart, so it's going to force any of that blood out because there are only one-way valves going in and out of the heart. So, when you squeeze it, it has to be going out through the arteries. By pushing down, we force the blood out, and by letting go, we suck more blood back in. It's crude, but it does perform an element of circulation. So, although the heart is not beating on its own, it is still pumping blood out as we push down on the chest. The idea of breaths is we're going to apply breaths into the lungs to flush out the air so we can put more oxygen into the lungs than is in there now. There are other types of CPR we'll cover in different videos, such as chest compression-only CPR, where we just give compressions. The first thing we need to do is approach the scene safely, as we've covered this in other films already. We're making sure there are no dangers. We're going to introduce ourselves, and we're going to give them a tap on the collarbone to make sure that they're actually okay, trying to get an answer back from them. At this stage, we don't actually know if this person requires CPR. The requirement for when we start CPR is: are they breathing, yes or no? With breaths, we are looking for normal breathing. It could be that they have agonal breathing, which is a gaspy, raspy type of noise. It happens in anything up to 40% of cases, so this is not normal breathing; it's just a gaspy type noise. We mustn't mistake that for normal breathing. By doing a breathing check, we're checking the breathing and also looking down at the chest to see the chest rise and fall. As far as starting CPR, what we're trying to do with this is the second link in the chain of survival. The first link is to activate emergency services once we've found out they're not breathing. The second link is early CPR. The sooner we get started on this, the better. Now, watching this film, you might think, "I'm not going to remember all this; it's very difficult." It's not difficult. It is very straightforward. You're learning this information now, and you'll be able to recall it in an emergency. It's going to be stressful, it's going to be tough, but you will make a difference. With a person who's not breathing, their chance of survival is dropping and dropping. We need to make sure the defibrillator, an AED, arrives as soon as possible. The defibrillator is there to shock the heart, and hopefully, it will restart beating in a normal fashion. The chance of survival drops by around 10% every single minute that you delay the AED arriving. The point of CPR is to extend this period, keeping the body oxygenated, blood flowing through it, keeping the brain and vital organs alive so that hopefully, when the shock is delivered, we can bring this person around. We're going to carry this on until the defibrillator arrives. When the paramedics arrive, they will take over. But don't just stop because they walk in the room. They will probably need you to carry on doing chest compressions until they get all their equipment ready. Ask them; they will talk to you anyway, but find out what they need you to do. So, you carry on doing CPR to give them a chance to get the defibrillator ready. The key thing here is shocking them as quickly as possible. Anything you can do to make that shock come quicker is ideal. Now, what I'm going to do is look at the process for CPR. The first thing we do is to assess the scene: stop, think, act. Approach the patient and introduce yourself: "Hello, my name is Keith, I'm a first aider, may I help you?" We're trying to get a response, and then give them a tap on the collarbone: "Are you okay? Are you okay?" Asking a direct question to hopefully get a response. Next, we need to open the airway. With the head in a rested position, it's likely that the tongue has fallen to the back of the throat, which can stop them from breathing. By opening the airway, it pulls the tongue away from the back of the throat, and hopefully, they'll start breathing again. To do this, we use the head tilt-chin lift method: hand on the forehead, the other hand underneath the chin, tilt the head right the way back. This opens the airway, pulling the tongue away from the back of the throat. Then we need to put our ear down and have a listen. We look for anything in the airway, just in case something is obstructing it. We keep the area very close, keeping the airway open the whole time, and look down the body to assess whether they're breathing. You do this breathing check for 10 seconds, counting out loud: "One, two, three, four, five, six, seven, eight, nine, ten." After ten seconds, the next thing we need to do is activate the emergency services. Take out your mobile phone or use a nearby phone. If you're on your own, you must call EMS because if you don't, there's no one to come and help you. When you make that call, provide clear information. Ideally, if you have a mobile phone, put it on speakerphone. You can leave the phone by the head and start CPR while calling emergency services. This can save valuable time. The operator will help guide you through the process until emergency services arrive. If you're sending someone to get EMS, give them clear instructions: "Can you go and dial 999, ask for an ambulance, tell them we have a non-breathing adult, and we are doing CPR. Tell them the address where we're at, and come back and tell me what they say." We need to know that the emergency service has been called and that they haven't gotten distracted. If there's an AED available, ask for it. In a workplace, there might be an AED unit, so send someone to get it. This will speed things up before EMS arrives. Once we've activated emergency services, the next thing we need to do is perform compressions. Place your hands, interlock them, and push down on the center of the breastbone with the heel of your hand. Interlock your fingers, push straight down on the center, keeping your shoulders above, pushing straight onto the breastbone. This is the most effective way of pushing down on the breastbone, hopefully pushing down on the heart to expel the blood out of it. Push to a depth of five to six centimeters at a rate of 100 to 120 compressions per minute, roughly two compressions per second. It's important to fully release between compressions to allow the heart to refill with blood. Keep your arms straight, shoulders above, and push down 30 times, counting out loud: "One, two, three, four, five, six, seven, eight, nine, ten, eleven, twelve, thirteen, fourteen, fifteen, sixteen, seventeen, eighteen, nineteen, twenty, twenty-one, twenty-two, twenty-three, twenty-four, twenty-five, twenty-six, twenty-seven, twenty-eight, twenty-nine, thirty." Next, open the airway again as before, tilting the head back. If you have a barrier, use it. Squeeze the nose to prevent air from escaping when you blow into the mouth. Seal your mouth around theirs and give two breaths, each lasting about a second until you see the chest rise. Avoid putting too much air in, as it can expand the lungs and be less effective. After the two breaths, quickly return to compressions, aiming to keep the transition under five seconds. Continue with 30 compressions, two breaths, repeating this cycle until emergency services arrive. If you get tired, hand over to a second rescuer or focus on chest compressions only. Ideally, perform 30 compressions and two breaths until the AED arrives.
Performing Adult CPR: Vital Steps and Guidelines
1. Checking for Responsiveness
Initiate Adult CPR by assessing patient responsiveness:
- Attempt to rouse the patient.
- If unresponsive, proceed immediately.
2. Contacting Emergency Services
Call for professional assistance:
- Contact the emergency services without delay.
3. Assessing Breathing
Evaluate the patient's breathing:
- Check for breathing for up to 10 seconds.
- Ensure a clear airway.
4. Chest Compressions
Perform effective chest compressions:
- Administer 30 compressions in the chest's centre.
- Maintain a rate of 100 to 120 compressions per minute.
- Reach a compression depth of 5 to 6 cm.
- Ensure even speed on both compression and release.
- Compressions should follow a regular interval.
5. Rescue Breaths
Provide essential rescue breaths:
- Open the airway using the head tilt and chin lift technique.
- Squeeze the soft part of the nose.
- Seal your mouth around the victim's and deliver a gentle breath for approximately one second or until chest rise is observed.
6. Compressions to Breaths Cycle
Repeat the cycle of compressions and breaths:
- Continue until an AED (Automated External Defibrillator) or the emergency services arrive.
- Minimize the pause between compressions and breaths, allowing a maximum of a 10-second break in compression.
- Ensure a continuous supply of oxygen-rich blood circulation.
7. Latest CPR Guidelines
Stay updated with the latest CPR guidelines:
- The current guidelines are based on the 2021 UK and European Resuscitation Council guidelines.
- The next scheduled update is planned for October 2025.