Artificial respiration, commonly known as CPR (cardiopulmonary resuscitation), is a life-saving technique that is useful in many emergency situations, such as heart attacks and drowning when the victim's breathing or heartbeat has stopped. CPR usually involves a combination of chest compressions and exhalations, but the most appropriate method and its duration vary depending on the situation and the victim. CPR can be performed on adults, children, infants, and even pets.
Step
Method 1 of 3: Chest Compression CPR for Adults and Adolescents
Step 1. Check the victim's consciousness
If an adult or adolescent collapses but remains conscious, CPR is usually not needed. If the victim loses consciousness and does not respond, you should perform CPR even if you are not trained or skilled.
- Gently shake the victim's shoulder or ask "Are you okay?" out loud. If there is no response, start the CPR procedure immediately.
- CPR with chest compressions is ideal for people who have never received formal CPR training or are unsure about their ability to perform CPR. This type of CPR does not involve the artificial respiration usually associated with conventional CPR.
Step 2. Call emergency services
If the victim doesn't respond and you decide to do CPR, you should still call emergency services before doing anything else. CPR can save a person's life, but should only be considered a temporary solution while waiting for medical personnel to arrive with adequate equipment.
- If you are with someone else at the time, someone should call for help when you start CPR.
- If the victim does not respond because he or she is unable to breathe (for example, from drowning), it is recommended that you start CPR immediately for one minute and then call for help.
Step 3. Keep the victim in a supine position
To perform chest compressions CPR, the victim must be positioned supine, preferably on a stable surface, with the head up. If the victim's body position is tilted or prone, slowly turn his back while holding his head and neck. Try to see if the victim sustains any significant injury when he falls and passes out.
- Once the victim is on their back, kneel near their neck and shoulders so you can access their chest and mouth more easily.
- Please note that you should not move the victim if you suspect he or she has a serious head, neck or spine injury. In such a case, moving the victim would be life threatening and should be avoided, unless medical assistance is not forthcoming (a few hours or so).
Step 4. Quickly push through the center of the victim's chest
Place one hand in the center of the victim's chest (usually between the nipples), and place your other hand on top of the first hand for a stronger push. Press the victim's chest quickly and firmly-do about 100 compressions per minute until paramedics arrive.
- Use your strength and upper body weight, not just arm strength, to press down on the victim's chest.
- Your pressure should be able to bring the victim's chest down to 5 cm. Push hard and don't worry you'll break the victim's ribs-that's rare.
- Chest compressions take a lot of effort and you may have to alternate with someone else in the location before medical personnel arrive.
- Continue to do this until the victim responds or until the medical team arrives and takes over.
Method 2 of 3: Using Conventional CPR for Adults and Children
Step 1. Perform the same procedure as hand compression CPR
Even if you have received CPR training and are confident in your abilities, you should still examine the victim for a response and turn him or her into a supine position. Try to call emergency services before starting to press the victim's chest and find someone else to take turns.
- If you are performing CPR on a young child between the ages of 1–8 years, use only one hand to apply pressure to the chest, with both hands risking breaking the ribs.
- The number of chest compressions is the same for adults and children (approximately 100 per minute).
- For children ages 1–8, you should lower the sternum (breastbone) 1/3 to 1/2 the depth of the child's chest.
- If you have received CPR training, perform only 30 chest compressions before moving on to rescue breaths.
Step 2. Continue by opening the victim's airway
If you are trained in CPR, are confident in your abilities (not just in doubt), and have performed 30 compressions, continue to open the victim's airway using head tilt and chin lift techniques. Place the palm of your hand on the victim's forehead and tilt his head slightly. Then, with the other hand lift the chin up to open the airway so that oxygen delivery is easier.
- Observe the victim's normal breathing for 5-10 seconds. See if there is any movement of the chest, listen for the breath, and notice if the victim's breath is felt against your cheek or ear.
- Note that gasping for breath is not considered normal breathing.
- If the victim is breathing, you do not need to give artificial respiration. However, if the victim is still not breathing, continue with mouth-to-mouth CPR.
Step 3. Place the mouth in the victim's mouth
Once the victim's head is tilted and the chin is lifted, make sure the mouth is free of any object blocking the airway. Then, use one hand to pinch the victim's nose closed and cover the victim's mouth with yours as well. Lock the victim's mouth with yours so that no air escapes when you try to give artificial respiration.
- You need to be aware that mouth-to-mouth CPR can transfer infectious disease viruses and bacteria between victims and rescuers.
- Before putting your mouth down, clean the victim's mouth of any vomit, mucus, or saliva that may be present.
- Giving artificial respiration can also be done from mouth to nose if the victim's mouth is seriously injured or cannot be opened.
Step 4. Start with two breaths
Once your mouth is in the victim's mouth, breathe deeply into the victim's mouth for at least one full second and watch his chest to see if it rises slightly or not. If the chest rises, give a second breath. If not, repeat the process of tilting your head, lifting your chin, and trying again.
- Even if there is carbon dioxide in your exhaled breath, there is still enough oxygen for the victim during CPR. Again, the goal is not always to save the victim's life, but as a temporary solution waiting for paramedics to arrive.
- One conventional CPR cycle for adults and children is approximately 30 chest compressions and two rescue breaths.
- If you are performing CPR on a child between the ages of 1–8, you can exhale more slowly into his chest.
Step 5. Repeat the cycle if needed
Follow two breaths by repeating chest compressions 30 times and two breaths. Repeat as long as needed until the victim responds or until help arrives and takes over. Remember that chest compressions attempt to restore air circulation, while rescue breaths provide oxygen (but not much) to prevent tissue death, particularly the brain.
- If you are performing CPR on a child aged 1–8 years, perform five cycles of chest compressions and artificial respiration before calling emergency services if you are alone on site. This process takes approximately two minutes. If you are with one other person, he or she should call emergency services while you perform CPR.
- There are no exceptions to the rule for adult victims. If the victim is not responding due to drowning or choking, perform CPR for 1 minute before calling emergency services.
- Calling emergency services will call paramedics to the scene. Usually, the operator can also guide you to perform CPR.
Method 3 of 3: Performing CPR on Infants (Under 1 Year)
Step 1. Assess the situation
The main reason babies can't breathe is choking. You must assess the situation to determine whether the airway is completely or only partially blocked.
- If the baby coughs or chokes, the airway is only partially blocked. Let the baby continue to cough because it is the best way to clear his airway.
- If the baby can't cough and his face starts to turn red or blue, the airways are completely blocked. You should pat his back and press his chest to clear his airway.
- If your baby is sick, has an allergic reaction, or is unable to breathe because his airway is swollen, you can perform chest compressions and artificial respiration, but you should still call emergency services immediately.
Step 2. Position the baby between the forearms
Position the baby so that he is on his back in one of your arms. Cup the back of his head with the same hand. Place your other arm in front of the baby's body and slowly turn it over to face down in the middle of your arms.
- Use your thumbs and fingers to hold the baby's jaw when he is turned.
- Lower your hands to your thighs. The baby's head should be lower than his chest.
- Note that pats on the back should only be done if the baby is still conscious. If the baby faints, do not pat the back and proceed immediately with chest compressions and rescue breaths.
Step 3. Pat the baby's back to clear his airway
Use the base of your dominant hand to pat your baby's back five times, spaced between the shoulder blades.
- Continue to support the baby's neck and head by holding his jaw between his thumb and forefinger.
- CPR in infants is often on the fine line between being effective and causing injury. However, minor musculoskeletal injuries are not worth a lifetime.
Step 4. Turn the baby over
After the back pat, place your free hand behind the baby's head, securing your hand along the spine. Turn the baby over carefully so that he is back on his back.
- The baby should remain tucked between your arms when the position is reversed.
- Remember to stay calm and speak gently to the baby. He can't understand your words, but he can understand your calm and loving tone of voice.
Step 5. Place your fingers in the center of the baby's chest
Place the tips of two or three fingers in the center of the baby's chest while supporting the neck and head with the other hand. Use your thumb and fingers to secure your jaw as you hold your baby between your arms. The arm in the down position should support the baby's head on your opposite thigh, and the baby's head should be lower than the body.
- You can also place your baby on his back on a flat and stable surface, such as a table or floor.
- Your finger should be placed between the baby's nipples in the middle of his chest.
Step 6. Gently press the chest
Push your hands straight into the baby's chest, lowering them to about 4 cm. If the baby is conscious, do only 5 presses. If the baby is unconscious, do 30 presses.
- Pump quickly at a rate of 100 presses per minute.
- Each stroke should be gentle, not rough or bouncy.
- Be careful not to injure the baby's ribs during compression.
Step 7. Cover baby's nose and mouth, then breathe
You don't have to pinch the baby's nose as if you were doing artificial respiration on an adult. Instead, lock the baby's airway by placing your mouth to his nose and mouth at the same time. Make sure you've wiped up any vomit, blood, mucus, or saliva first.
- Give two slow breaths. Give one breath into the baby's mouth. If the chest moves, give a second breath.
- If the chest does not move, try to clear the airway again before repeating rescue breaths.
- Don't take deep breaths coming from your lungs. Use the muscles in your cheeks to exhale slowly.
Step 8. Repeat this cycle if needed
Repeat chest compressions and rescue breaths as many times as needed until baby starts breathing again or paramedics arrive.
- If you suspect your baby is choking on a foreign object, you should check his mouth after each chest compression.
- Each cycle should consist of 30 chest compressions followed by two rescue breaths.
Tips
- There was once a suggestion to check the victim's pulse before attempting to perform CPR, but that advice no longer applies to lay people. However, medical professionals are expected to do so.
- Without enough oxygen, brain tissue begins to die after about 5–7 minutes. In most cases, CPR with rescue breaths can give the victim between 5–10 minutes, which is usually enough until paramedics arrive.
- The best time to start CPR is within five minutes when the victim's breathing has stopped.
- The most suitable condition for providing CPR is an unresponsive victim (human or animal) due to a heart attack, stroke, or drowning.
- CPR is of no use for people with terminal illnesses or serious injuries such as gunshot wounds.
- CPR can be combined with first aid techniques for victims who have stopped breathing due to trauma.
Warning
- If you have never had CPR training, it is recommended that you only perform chest compressions CPR. Apply chest compressions until paramedics arrive, but do not attempt artificial respiration.
- If you are formally trained, follow all the steps above, chest compressions as well as artificial respiration.
