What is CPR and how to perform it

One must check the affected person’s heartbeat and pulse before performing CPR. The cases where CPR might be required are: 

• Cardiac arrest: complete heart shut down
• Head injuries that lead to loss of consciousness
• Ventricular fibrillation: erratic and rapid quivering heartbeats
• Ventricular tachycardia with no pulse: irregular heartbeats
• Pulseless Electrical Activity (PEA): heart shows a rhythm but there is no pulse
• Asystole: no heart rhythm (flatline in an ECG/EKG)
• Bradycardia: slow heartbeat
• Lost consciousness after choking
• Drowned (and is not breathing)

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CPR certification classes can help people provide assistance when someone is faced with a cardiac or breathing emergency. The basic steps that must be taken care of before performing the CPR are:

• Ensure that the surroundings are safe and then ask the person for their wellbeing by tapping them. 
• Check if the person is breathing. Wait for no more than 10 seconds and in the absence of breath sounds, start CPR.
• Call for medical help and ask for an AED (automated external defibrillator) if possible.
• Make the person lay on their back and then open their airway by tilting their head slightly back.
• CPR is most effective when the person is laid on a relatively hard surface. 
• The person who is intending to perform CPR should be positioned high enough above the patient so that he or she can use their body weight to compress the chest adequately.

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Since infants (babies who are less than a year old) are more sensitive than children, extra care should be taken when providing CPR. As infants’ bones are more flexible and delicate than adults’, the way of performing CPR is completely different. 

• Gently tilt the infant’s head back by placing your hand on their forehead and lift the chin up to open the infant’s airway. Open the infant’s mouth and look for any obstruction that could be present in their mouth. Do not tilt the head too far back because this may close the infant's airway.
• If there is no obstruction in the infant’s mouth, place your mouth over their mouth and nose to form an airtight seal. Now blow steadily and firmly into their mouth. Give 5 breaths initially and check if their chest rises. 
• After the breaths, place 2 fingers in the middle of the infant’s breastbone, between the nipples and push it down by 4cm (1.5 inches). You can use the heel of one of your hands if you can't achieve the required depth while using fingers.
• After every 30 chest compressions give 2 rescue breaths. The rate of compression should be 100 to 120 compressions a minute. 
• Continue with chest compressions and rescue breaths until the infant begins to regain consciousness or medical help arrives.

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Performing CPR in a child is slightly different than in infants.

• Gently tilt the child’s head back by placing your hand on their forehead and lift the chin up to open up the child’s airway. Do not tilt the head too far back because this may close the child's airway instead.
• Open the child’s mouth and look for any obstruction that might be present in their mouth. Remove any visible blockage from the mouth and nose.
• If the mouth and nose are clear, pinch their nose and put your mouth over their mouth, forming an airtight seal. Now, blow steadily and firmly into their mouth and keep checking if the chest rises. 
• After at least 5 breaths, place the heel of one of your hands on the centre of the child’s chest and push down by 5cm (2 inches). You can use two hands to achieve the required depth of compressions if necessary. 
• After every 30 chest compressions give 2 rescue breaths. The rate of compression should be 100 to 120 compressions a minute. 
• Continue with chest compressions and rescue breaths until they regain consciousness or medical help arrives.

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The one performing CPR must be certified and trained or else they might end up worsening the condition of the victim. The steps involved in CPR are:

• Deliver rescue breaths by tilting the head slightly back and lifting the chin. Pinch the nose shut and put your mouth on the person’s mouth creating a seal. Now blow into the person's mouth and see if the chest rise. 
• If the chest does not rise with the initial rescue breath, re-tilt the head before delivering the second breath. After delivering two rescue breaths, start the compressions.
• Place one of your hands on top of the other, interlock your fingers by folding the fingers of the hand on top. Place them in the middle of the chest, lock your elbows and by using the entire body weight, administer compressions.
• The compressions should be at least 5cm (2 inches) deep and delivered at a rate of 100 compressions per minute.
• Keep performing cycles of chest compressions and breathing until the person exhibits signs of breathing, or medical help arrives on the scene.

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There is another kind of CPR which can be performed to increase the survival chances of a person with cardiac arrest.

The hands-only-CPR does not involve artificial ventilation. The procedure involves:

1. Kneel beside the person who needs help and place the heel of one hand at the centre of the chest.
2. Place the heel of the other hand on top of the first hand, then lace the fingers together.
3. Positioning the body in such a way that hands and shoulders are in the same line and the arms are straight.
4. Using the body weight, administer at least 100 compressions per minute that are at least 2 inches deep in case of both adults and children.
5. Keep performing cycles of chest compressions until the person exhibits signs of breathing, or a trained medical responder arrives on the scene.

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The possible complications of CPR could be the following:

• Fractured ribs or the sternum from chest due to hand compressions.
• In some cases, the patient may also suffer from gastric insufflation (filling of stomach with air) due to improper artificial respiration. It usually occurs due to mouth to mouth ventilation while performing CPR. This can be prevented by using a bag-valve-mask, also called the Ambu bag, to give artificial ventilation.

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