Everyone understands what CPR is on a basic level, all you need to do is watch a few TV dramas, or dramatic movies to see what it is.
However, in real life, there is a lot more to it. And if you are new to giving CPR, you will want to make sure that you are doing it properly. One area where there is a lot of confusion is around the maximum interval that you can pause for when you are doing chest compressions.
When you are performing CPR chest compressions, the maximum interval for pausing chest compressions is 10 seconds. This is a large enough space of time to ventilate, check for a pulse, and defibrillate before you resume the chest compression cycle.
Today we will talk about the basics of CPR (cardiopulmonary resuscitation), and why it is important to limit any breaks or pauses in the chest compressions. We will also talk about the compression depth in different types of patients.
While we can tell you plenty about CPR and explain how it works, we cannot teach you CPR just by talking about it here. If you want to learn CPR, you will need to sign up for an accredited CPR class. It is worth it to do so, you could save a life one day.
CPR- The basics
CPR is an acronym for cardiopulmonary resuscitation. These are some rather big words that simply represent the act of saving a life when someone's heart suddenly stops beating.
CPR is not something to joke about, research actually states that if you can provide someone with effective CPR at the moment that their heart stops, you can actually double, or even triple their chances of survival!
In fact, in the USA alone, almost half a million people die because they go into cardiac arrest… EVERY YEAR!
So, being able to effectively deliver CPR is a massively important life skill, in fact, if every person was trained in performing CPR, there would be tens of thousands of people who would die when their heart suddenly stops.
CPR is a very vital step in the process of saving a life.
It is done to keep the patient's blood flowing- and therefore the oxygen moving around their system- which prevents any organ damage and allows trained medical staff to have a better chance of reviving and saving the persons' life.
It is considered to be the second step in something known as ‘the chain of survival’ as defined by the American Heart Association.
Step 1. Call for help- dial 911 and get emergency assistance.
Step 2. Give CPR.
Step 3. Provide rapid defibrillation- if available, this will help to get the heart started again.
Step 4. Paramedics will now perform additional services.
Step 5. The patient will receive ongoing care.
When should you do Chest Compressions?
Before we say anything, it is very important that you understand that you do not do CPR on anyone who looks like they might be in some distress.
CPR is performed in a set of certain situations. These are as follows;
- If they are unconscious- If this is the case, they will not be able to open their eyes.
- If they are unresponsive- When you call their name, or lightly tap on their skin, they do not respond with any verbal or physical reactions.
- If they are not breathing- They may take quick gasping breaths which are known as agonal respirations or guppy breathing, however these will not actually be effective, and so they will still need CPR.
Before you perform chest compressions, you need to perform 5 steps.
- Check the local area for any dangers. Assess why the persons' heart has stopped. Have they been bitten by a snake? Were they electrocuted? Are they high or drunk? Check around for hazards to both the patient and to yourself. Remember to never endanger your own safety in order to give CPR, medics do not need two patients. If there are any hazards, try to move them. In ideal situations, you should never move the patient unless they are in danger. If they are in danger where they are, then they may need to be moved.
- Next, check the victim for any response. Give them a gentle shake, shout at them (not scold them, just try to wake them up), see if you get any response.
- Now it is time to call for an ambulance, which is 911 in the United States. CPR can only assist while you wait for emergency medical care, they will have the tools to get a victims' heart restarted.
- Then you need to open up their airway. It is okay to turn the victim onto their back if needed to do this. Ensure that it is safe to do so. If they have any foreign objects in them, do not do this, as you may move it and may make it worse. You need to tilt their head back and try to open the mouth and peek inside. If there is fluid or obstructions, you need to turn them on their side to remove it. Do this as quickly as possible, as you want to get into performing CPR quickly now.
- Now you need to check their breathing. You need to ensure that the person is not breathing at all before you perform CPR. Do not perform CPR on someone who is breathing.
How do you perform Chest Compressions?
Once you have done all of the above it is time to perform chest compressions, we will go over how you do this.
- Place the heel of your hand on the bottom of the victims' breastbone.
- Put your other hand over the first and either grab your wrist or interlock your fingers.
- You should compress to a level no less than 2” deep, and no more than 1/3rd depth of the persons' chest.
- If you do not wish to, or cannot offer mouth-to-mouth, then this will need to be done at 100-120 compressions per minute. However, if you are going to deliver mouth-to-mouth then you need to do 30 compressions at the same rate (100-120 per minute) followed by two breaths. Remember that the maximum pause in compressions to ventilate should be no more than 10 seconds.
- To get the right beat for compressions, you can imagine that you are listening to the Bee Gees 'Staying’ Alive’ (irony?) and match it. Or, the other option is ‘Baby Shark’ although you might regret that one.
- Be aware, you may break someone's ribs while you are delivering chest compressions, but it is okay, their only other alternative is death.
Complete Chest Recoil- Why is it important?
The rate of which CPR is provided is based around the notion that the chest needs to fully recoil each time that you deliver a compression.
This should allow more blood to flow back to the heart with every chest compression completed.
Complete Chest Recoil- The effectiveness of CPR
If chest recoil is not able to take place, then the heart will not get the required viable blood flow. This means that you have to ensure that the chest is compressed effectively and then allowed to return to normal before you complete the next compression.
Doing will ensure that blood flow will reach the heart, and you will essentially be working as the pumping function of the heart.
What is the ideal Chest Compression depth for a newborn?
A newborn does not require CPR to be applied in the same way as it is applied to an adult. Instead, you must do a more gentle and specific form of CPR. These are the steps to take and do this properly;
- Lie the child on its back, do not adjust the angle of their head or their chin.
- Gently give mouth-to-mouth by covering their nose and mouth with your mouth.
- Use only two fingers on the lower half of their breastbone to give them chest compressions to a depth of no more than a third of their chest depth.
- Use the same rhythm as you would use for an adult's CPR (100-120 compressions per minute) “Baby Shark Doo Doo Doo.”
You do CPR like this for children, as you need to ensure that you do not damage the baby when you provide them with CPR. Newborns are much more fragile than adults are, and heavy CPR may further endanger the child's life.
Do not let this make you think that CPR is any less essential for a baby, though. It is just as important. If you do find that a baby is not breathing, you need to give CPR, just be more careful and only use two fingers when you do.
Chest Compressions and CPR for a child
Similar to a baby, children under the age of 8 also need slightly different treatment when it comes to performing CPR.
- You should only use the heel of ONE hand to do chest compressions on a child of this age, not two!
- Give chest compressions at a depth of no more than 1/3rd of the child's chest depth.
- Use the same rhythm as you would use for an adult's CPR.
Like babies, children under the age of 8, are more delicate than adults too, therefore it is imperative to use a technique that is about halfway between adult CPR technique and baby CPR technique.
Giving CPR is always more important than not in cases where the child is not breathing, is unconscious, or unresponsive.
To overview, in CPR the maximum interval for pausing chest compressions is 10 seconds. This is an established recommendation based on the requirement to maintain blood flow to the heart during an incident such as cardiac arrest.
It is important to always remember that CPR is a life-saving technique, and everyone should try to learn it, as knowing CPR makes the world a safer place for everyone.
The technique for chest compressions for babies, children, and adults is all slightly different in how you use your hands, however the beat remains the same, at a beat of 100-120 compressions for a minute.
Now go and get some training in CPR, you might save a life one day!