How toCPR.docx

How toCPR.docx

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HowtoCPR

HowtoPerformCPR

Learninghowtoperformcardio-pulmonaryresuscitation（CPR）saveslives.  Whilenostatisticsareavailableontheexactnumberoflivessuddencardiacarrestclaimsperyear,approximately335,000peopledieannuallyofcoronaryheartdiseasewithoutbeinghospitalized–orabout918Americanseachday,accordingtotheAmericanHeartAssociation（AHA）. 

ConventionalCPRconsistsofchestcompressionsandrescuebreathing.TheAmericanHeartAssociationcontinuestosupportthisapproachtoCPR,butrecentresearchdemonstratesthatrescuebreathingmaybeunnecessaryandpotentiallydetrimentalincasesofcardiacarrest.Intheinterestofpresentingcompleteinformation,however,ACEPisincludinginstructionsonhowtoproviderescuebreathsinthisguideforlaypersonswhochoosetoemploythem.

ThetipsprovidedbelowarebasedonproceduresrecommendedbytheAHAandarenotasubstituteforformaltraininginCPR.TheAHAandtheAmericanRedCrossofferCPRcourses;toregister,contacttheAHAat1-800-AHA-USA1oryourlocalAmericanRedCrosschapter.Everyoneinyourfamilyshouldtakeoneofthesecourses,andyoushouldhaveyourCPRskillstestedatleasteverytwoyears.

AutomatedExternalDefibrillators（AEDs）areincreasinglyavailableatmanylocations,suchasshoppingmallsandairports.Theyaresmall,lightweightdevicesusedtoassessaperson’sheartrhythm.AnAEDcandetecttheneedforandadministeranelectricshocktorestoreanormalheartrhythminpeoplewithsuddencardiacarrest.ACEPsupportswidespreaddistributionofAEDs,aslongasitiscoordinatedwithexistingEMSsystemsandincludespropertraining.LogicalplacesforAEDsincludepolicecars,theaters,sportsarenas,publicbuildings,businessofficesandairports.AnincreasingnumberofcommercialairplanesarenowequippedwithAEDsandenhancedmedicalkits.

CPRistypicallyadministeredincasesofcardiacarrest.Signsofcardiacarrestincludeanabsenceofheartbeats,bloodflowandpulse.Whenbloodstopsflowingtothebrain,thepersonbecomesunconsciousandstopsregularbreathing.

TheABCsofCPRareAirway,Breathing,andCirculation.ThisacronymisusedtohelpyourememberthestepstotakewhenperformingCPR.

Airway

∙Ifapersonhascollapsed,determineifthepersonisunconscious.Gentlyprodthevictimandshout,“Areyouokay?

”Ifthereisnoresponse,shoutforhelp.Call911oryourlocalemergencynumber.

∙Ifthepersonisnotlyingflatonhisorherback,rollhimorherover,movingtheentirebodyatonetime.

∙Opentheperson’sairway.Liftupthechingentlywithonehandwhilepushingdownontheforeheadwiththeothertotilttheheadback.（Donottrytoopentheairwayusingajawthrustforinjuredvictims.Besuretoemploythisheadtilt-chinliftforallvictims,evenifthepersonisinjured.）

∙Ifthepersonmayhavesufferedaneckinjury,inadivingorautomobileaccident,forexample,opentheairwayusingthechin-liftwithouttiltingtheheadback.Iftheairwayremainsblocked,tilttheheadslowlyandgentlyuntiltheairwayisopen.

∙Oncetheairwayisopen,checktoseeifthepersonisbreathing.

∙Takefiveto10seconds（nomorethan10seconds）toverifynormal breathinginanunconsciousadult,orfortheexistenceorabsenceofbreathinginaninfantorchildwhoisnotresponding.

∙Ifopeningtheairwaydoesnotcausethepersontobegintobreathe,itisadvisedthatyoubeginprovidingrescuebreathing（or,minimally,beginprovidingchestcompressions）.

Breathing（RescueBreathing）

Pinchtheperson’snoseshutusingyourthumbandforefinger.Keeptheheelofyourhandontheperson’sforeheadtomaintaintheheadtilt.Yourotherhandshouldremainundertheperson’schin,liftingup.

∙Inhalenormally（notdeeply）beforegivingarescuebreathtoavictim.

∙Immediatelygivetwofullbreathswhilemaintaininganair-tightsealwithyourmouthontheperson’smouth.Eachbreathshouldbeonesecondindurationandshouldmakethevictim’schestrise.（Ifthechestdoesnotriseafterthefirstbreathisdelivered,performtheheadtilt-chinliftasecondtimebeforeadministeringthesecondbreath.）Avoidgivingtoomanybreathsorbreathsthataretoolargeorforceful.

Circulation（ChestCompressions）

Aftergivingtwofullbreaths,immediatelybeginchestcompressions（andcyclesofcompressionsandrescuebreaths）.Donottakethetimetolocatetheperson’spulsetocheckforsignsofbloodcirculation.

∙Kneelattheperson’sside,nearhisorherchest.

∙Withthemiddleandforefingersofthehandnearestthelegs,locatethenotchwherethebottomrimsoftheribcagemeetinthemiddleofthechest.

∙Placetheheelofthehandonthebreastbone（sternum）nexttothenotch,whichislocatedinthecenterofthechest,betweenthenipples.Placeyourotherhandontopoftheonethatisinposition.Besuretokeepyourfingersupoffthechestwall.Youmayfinditeasiertodothisifyouinterlockyourfingers.

∙Bringyourshouldersdirectlyovertheperson’ssternum.Pressdownward,keepingyourarmsstraight.Pushhardandfast.Foranadult,depressthesternumaboutathirdtoahalfthedepthofthechest.Then,relaxpressureonthesternumcompletely.Donotremoveyourhandsfromtheperson’ssternum,butdoallowthechesttoreturntoitsnormalpositionbetweencompressions.Relaxationandcompressionshouldbeofequalduration.Avoidinterruptionsinchestcompressions（topreventstoppageofbloodflow）.

∙Use30chestcompressionstoeverytwobreaths（oraboutfivecyclesof30:

2compressionsandventilationseverytwominutes）forallvictims（excludingnewborns）.Youmustcompressattherateofabout100timesperminute.

∙ContinueCPRuntiladvancedlifesupportisavailable.

UsinganAEDinconjunctionwithCPR:

∙IfusinganAEDinthecaseofaheartattackorcardiacarrest,singleshocksshouldbefollowedbyimmediateCPRfortwominutes.Heartrhythmchecksshouldbeperformedeverytwominutes（oraftergivingaboutfivecyclesofCPR）;theAEDwillprovideaudiblepromptsattheappropriateintervals.See AEDsection fordetails.

∙IfusinganAEDonaone-toeight-year-oldchild,useachild-dose-reductionsystemifavailable.（However,donot usechildpadsorachilddoseonadultsincardiacarrestbecausethesmallerdosemaynotdefibrillateadultsproperly.）

CPRforInfants（UptoOneYearOld）

Airway

Withinfants,becarefulnottotilttheheadbacktoofar.Aninfant’sneckissopliablethatforcefulbackwardtiltingmightblockbreathingpassagesinsteadofopeningthem.

Breathing

Donotpinchthenoseofaninfantwhoisnotbreathing.Coverboththemouthandthenosewithyourmouthandbreatheslowly（onetooneandahalfsecondsperbreath）,usingenoughvolumeandpressuretomakethechestrise. 

Withasmallchild,pinchthenoseclosed,coverthemouthwithyourmouthandbreatheatthesamerateasforaninfant.Rescuebreathingshouldbedoneinconjunctionwithchestcompressions.（Seenextsection.）

ChestCompressionsonInfants 

∙Ifalonewithanunresponsiveinfant,givefivecyclesofCPR（compressionsandventilations）forabouttwominutesbeforecalling911oryourlocalemergencynumber.

∙Useonlythetipsofthemiddleandringfingersofonehandtocompressthechestatthesternum（breastbone）,justbelowthenippleline,asdescribedinthetablebelow.Theotherhandmaybeslippedunderthebacktoprovideafirmsupport.（However,ifyoucanencircleyourhandsaroundthechestoftheinfant,usingthethumbstocompressthechest,thisisbetterthanusingthetwo-fingermethod.）

∙Depressthesternumbetweenathirdtoahalfthedepthofthechestatarateofatleast100timesaminute.

∙Twobreathsshouldbegivenduringapauseafterevery30chestcompressions onallinfants（excludingnewborns）.

∙ContinueCPRuntilemergencymedicalhelparrives.

SmallChildren（agesonetoeight）

∙GivefivecyclesofCPR（compressionsandventilations）forabouttwominutesbeforecalling911.

∙Usetheheelofoneortwohands,asneeded,andcompressonthebreastboneataboutthenippleline.

∙Depressthesternumaboutathirdtoahalfthedepthofthechest,dependingonthesizeofthechild.Therateshouldbe100timesperminute.

∙Givetwobreathsforevery30chestcompressions（30:

2ratio）.

∙ContinueCPRuntilemergencymedicalhelparrives.

ReducingWoundPain

Woundsalwayshurt,butthedegreeofpainwillvaryaccordingtothenature,location,andseverityoftheinjury.Burnsareparticularlypainful,asaremanyblisters,cuts,andscrapes.Whileapuncturewoundmayhurtless,itcouldpotentiallybemoreseriousifleftuntreated.

Foranywound,youshouldtakethefollowingsteps:

∙Takecareofthewoundimmediately,becauseevenaminorwoundcangetinfectedifbacteriaareallowedtobuildupinthewoundsite.Ifthewoundisminor,youshouldgivefirstaidathome.

∙Ifyougetapuncturewoundorsteponarustynail,youshouldseeadoctorimmediately,becauseyoumayneedatetanusshot.Ifyoudon'tknowwhetheryou'redueforatetanusshot,don'ttakeanychances.Callyourdoctor.Ifthepuncturewoundisfromahumanoranimalbite,seekemergencymedicalattention.Ifthecutisdeeporhasjaggededges,youmayneedstitchestoclosethewound. 

∙Cleanthewoundwithwater.Avoidusingsoap,hydrogenperoxide,oriodine,whichcanirritatetheinjury.Holdthewoundunderrunningwatertoremovedirt,andusesteriledtweezerstoremoveremainingdebris.Ifyoucan'tgetthewoundclean,seeadoctor,becausethedirtcouldtriggeraninfection.Ifthereisalargeobjectembeddedinthewound,leaveitaloneandseekemergencyhelp.