Ideally, CPR/CPR (cardiopulmonary resuscitation) should be performed by people who have attended certified first aid training. However, in a crisis situation when a child has a heart attack, the help provided by the person who happens to be there can play a role in determining the survival of the child. When handling children under one year, follow the CPR protocol for infants and when handling adults follow the protocol for adults. Basic CPR includes the following steps: performing chest compressions, opening the airway and providing rescue breaths. If you have never had formal CPR training, you should only perform chest compressions.
Step
Part 1 of 2: Evaluating the Situation
Step 1. Perform a crime scene inspection to detect hazards
If you come across someone who is unconscious, make sure beforehand that there's no danger in your life if you really want to help them. Is there an exhaust emitting smoke? Gas stove? Is there a fire? Has any power cord fallen off? If something could put you or the victim at risk, find out if you can handle it. Open a window, turn off the stove, or put out the fire if possible.
- However, if there is nothing you can do about the danger, move the victim. The best way to move the victim is to place a blanket or jacket under his or her back, then pull the jacket or blanket off.
- If there is a possibility that the victim has a spinal cord injury, two people are required to move him or her to avoid the mistake of twisting his head or neck.
- If you can't reach the victim without endangering yourself, call an ambulance and wait for help to arrive.
Step 2. Check if the victim is unconscious
Shake or pat her on the shoulder and say in a loud, clear voice, “Are you all right? Are you ok? If he responds, it means he is conscious. He might just be asleep, or he'd been unconscious. If the condition appears to be critical, for example, the victim is having difficulty breathing or is in a state between conscious and unconscious, seek help and initiate basic first aid and take steps to prevent or treat shock.
- Call his name if you know. For example, "Nana, can you hear my voice? Are you okay?"
- If necessary do something to prevent or treat shock. Your child may experience shock if there are symptoms such as cold, wet skin, rapid breathing, or a bluish tint to his lips or fingernails.
Step 3. Check the victim's pulse
If the child is unresponsive, the first thing to do is to check the pulse. If the child does not respond, you should start CPR immediately. Do not check the pulse for more than 10 seconds. If you can't feel the victim's pulse, the heart is not beating and you should do chest compressions.
- To check for a neck (carotid) pulse, feel for a pulse on the side of the victim's neck closest to the tip of the first two fingers by the side of the Adam's apple. (Be aware that Adam's apple is usually not seen in girls, and not even as noticeable in boys who haven't gone through puberty.)
- To check for a pulse at the wrist (radial), place the tips of the first two fingers on the wrist on the side parallel to the thumb.
- Other pulse locations are in the groin and ankles. To check the pulse in the groin (femoral), press the first two fingers into the center of the groin. To check for a pulse at the ankle (tibialis posterior), place the first two fingers on the inside of the ankle.
Step 4. Check if the victim is still breathing
Even if you still have a pulse on the victim, you should still perform CPR if he or she is not breathing. Lay the victim on their back if you can safely shift the body. Then, slightly push his head back and lift his chin. Place your ear near the victim's nose and mouth and listen for the sound of his breathing for no more than 10 seconds. If breath sounds are not heard, prepare to perform CPR.
If you can hear the victim breathing heavily occasionally, this still doesn't count as normal breathing. You should still perform CPR if the victim is breathing heavily
Step 5. Understand that you must act quickly
If you see someone whose heart has stopped beating or has stopped breathing, acting quickly and providing rescue breaths and CPR can save their life. If someone performs CPR before the ambulance arrives, the patient has a much greater chance of survival. The ability to act quickly by performing CPR, which can help oxygenated blood return to the brain, is critical.
- If you can feel the victim's pulse but can't see him breathing, give rescue breaths only, no chest compressions necessary.
- The human brain can usually survive about four minutes without oxygen before experiencing permanent brain damage.
- If the brain is deprived of oxygen for between four and six minutes, the chances of brain damage increase.
- If the brain is deprived of oxygen for six to eight minutes, brain damage is likely to occur.
- If the brain does not get oxygen for more than 10 minutes, brain death will occur.
Part 2 of 2: Performing CPR
Step 1. Perform CPR for 2 minutes
After quickly evaluating the situation and checking the victim's consciousness and circulatory system, you must act very quickly. If there is no pulse you should start CPR immediately, and continue it for two minutes (equivalent to 5 CPR cycles) and then call Emergency Medical Services (119). If you are alone, it is important to start CPR before calling for help.
- If someone else is with you, ask him or her for help. If you are alone, do not call until you have completed two minutes of CPR.
- Call the local emergency number. Contact 119.
- If possible, have someone pick up an automated external defibrillator (AED) if such a device is available in or nearby the building.
Step 2. Remember the CAB
CAB is the basic process of CPR. CAB stands for Chest Compression, Airway, Breathing. In 2010, the recommended sequence was changed by placing chest compressions before opening the airway and giving rescue breaths. Chest compressions are considered more critical for correcting abnormal heart rhythms (ventricular fibrillation or pulseless ventricular tachycardia), and because one cycle of 30 chest compressions takes only 18 seconds, opening the airway and providing rescue breaths will not be significantly delayed.
Chest compressions, or hand-only CPR, are highly recommended if you are untrained or concerned about having to perform mouth-to-mouth resuscitation on a stranger
Step 3. Position your hands for compression
When performing CPR on children, hand position is very important because children are more fragile than adults. Locate the child's breastbone by moving two fingers down the rib cage. Find where the bottom of the ribs meet in the middle and place the base of your other hand on top of your fingers. Use only the base of your palm to perform compressions.
Step 4. Perform 30 compressions
Perform chest compressions, while locked elbows, by pressing straight down about 5 cm inward. A smaller child's body size requires less pressure than an adult's body. If you start to hear or feel a crackling sound, it may indicate that you are pressing too hard. Continue, but reduce the pressure you apply while performing the compression. Do 30 compressions, and do them at a rate of at least 100 compressions per minute if you're the only person who can help.
- Allow the chest to fully expand again after each compression.
- Minimize pauses in chest compressions when you are trying to transfer them to someone else or preparing for a shock. Try to limit interruptions to less than 10 seconds.
- If there are two rescuers, each must complete one round of 15 compressions.
Step 5. Make sure the airway is open
Place your hand on the victim's forehead and two fingers on his chin. Lift the chin slowly with two fingers while gently pushing the forehead with the other hand. If you suspect the victim has a neck injury, carefully pull the jaw upwards instead of lifting the chin. After doing this, you should observe, listen, and feel the breath.
- Put your ear to the victim's mouth and nose and listen carefully for signs of life.
- Watch your chest move and feel the breath against your cheek.
- If there are no signs of life, place a respiratory barrier (if any) over the victim's mouth.
Step 6. Give two rescue breaths
While keeping the airway open, lift the finger you placed on the forehead and pinch the victim's nose. Press your mouth over the victim's mouth and exhale for one second. Make sure you breathe slowly as this will ensure that the air goes into your lungs instead of your stomach. Make sure you pay attention to the victim's chest.
- If the breath goes into your lungs, you will see your chest lift slightly and also feel your chest contract again. If breathing in, give a second rescue breath.
- If the breath doesn't come in, adjust the head position and try again. If the breath is still unable to enter, the victim may choke. If that's the case, you'll need to do chest compressions again. Remember that abdominal thrusts or the Heimlich maneuver should only be performed on a conscious person.
Step 7. Repeat the cycle of chest compressions 30 times and two rescue breaths
You should perform CPR for two minutes (5 cycles of compressions plus rescue breaths) before checking for signs of life, such as pulse or breathing. Continue CPR until someone replaces you, or until emergency services personnel arrive, or until you are too tired to continue, or until the AED is inserted, charged, and the person operating it asks you to move away from the victim's body, or until the victim's pulse and breathing have returned.
- Don't forget to call emergency services after two minutes of CPR.
- After contacting them, continue performing CPR until they arrive.
- If someone else is also available to help, reduce the number of compressions per 2 breaths in half. That is, do 15 compressions on your own, followed by 2 breaths. Next, let the other person do 15 compressions and 2 breaths.
Step 8. Use the AED
If an AED is available, turn it on, and place the pads as instructed (one on the right chest and the other on the left chest). let the AED analyze the heart rhythm, and administer one shock if suggested, after ordering everyone to stay away from the patient (scream “CLEAR!” first). Continue chest compressions immediately after each shock and perform another 5 cycles before reevaluating the patient.
If the victim begins to breathe, gently help him or her into the recovery position
Tips
- Always call Emergency Medical Services.
- You can obtain proper CPR guidance from an emergency services operator if needed.
- If you must move the victim, try to minimize shock to the body.
- Take proper training from an authorized organization in your area. Getting training from an experienced instructor is the best way to prepare for an emergency.
- If you are unable or unwilling to provide rescue breaths, perform chest compressions only on the victim. This action can still help him recover from cardiac arrest.
- Don't forget to place your hands in the middle of your ribs, more or less parallel to your nipples.
Warning
- Do not move the patient, unless he or she is in danger or in a life-threatening area.
- Keep in mind that there are different CPR protocols for adults, children and infants. CPR in this article is intended to be given to children.
- Always wear gloves and use a respiratory barrier whenever possible to minimize the chance of disease transmission.
- Be sure to check your surroundings for danger if you try to perform CPR.
- If the victim is breathing normally, coughing, or moving, it is advised to: not doing chest compressions. If you do, it can cause the heart to stop beating.