Heart attacks are commonplace in our modern society and at least eight out of ten attacks take place far away from doctors or hospitals. Would you know what to do to save a friend, colleague or family member’s life if you are first on the scene?

Cardiopulmonary resuscitation (CPR)

Time is critical when someone’s heart and breathing has stopped as in the case of a heart attack (cardiac arrest). A delay in starting resuscitation efforts could cost that person his or her life. Unfortunately, at least eight out of ten attacks take place far from doctors or hospitals with mostly untrained members of the public present to help. Fortunately, the process of assessing and rendering aid has been further simplified to make it possible for any bystander to start CPR immediately.

CPR in three easy steps

In the past the CPR process consisted of these three steps (AB and C)

    • First step: Check Airways
    • Second step: Check Breathing
    • Third step: Check Circulation

Out with the old and in with the new

The new guidelines stress the importance of recognising the signs of cardiac arrest and not fiddling around to find a pulse or open airways when a victim unexpectedly collapses, becomes unresponsive, stops breathing or struggles to breathe (gasps for breath or makes snoring sounds).

In such a case immediate action is needed and the abovementioned ABC process of CPR changes to the following new, CAB order of steps:

    • New first step: Circulation (must be restored immediately with the help of chest compressions)
    • New second step: Airways (need to be opened)
    • New third step: Breathing (should be simulated by mouth-to-mouth breathing).

Chest compressions should be:

    • Done by placing the victim on his or her back, placing the heel of the rescuer’s one hand in the centre of the victim’s chest and the other hand right on top of the first with fingers intertwined, locking the elbows and pushing
    • Hard (to a depth of 5 cm) but toned down for child victims
    • Fast, at least 100 per minute
    • At a ratio of 30 compressions to two (2) breaths.

Airways should be opened by:

    • Tilting the victim’s head back by the forehead
    • Lifting the victim’s chin.

Breaths should be given:

    • By pinching shut the victim’s nose using the forefinger and thumb
    • By alternating 30 chest compressions with two normal breaths delivered over one second while looking for the victims chest to rise
    • Without stopping and at the ratio of two breaths per 30 compressions until professional rescuers arrive. Different lay rescuers can take turns as this form of CPR can be very tiring.

When in doubt

According to the latest research by the International Liaison Committee on Resuscitation (ILCOR), addressing a lack of circulation through compressions is more important initially than addressing airway or breathing. Even chest compressions only, that is without mouth-to-mouth breathing, can increase a victim’s chance of survival, according to studies undertaken at the University of Arizona’s Sarver Heart Centre.

The moral of the story is to act fast and do what you can even if you are an untrained bystander. Your actions may just save a life!

 

Sources

 

BLS C-A-B algorithm. Retrieved from: https://www.acls.net/bls-cab-algorithm.htm
Resuscitation Research: Cardiocerebral Resuscitation. Retrieved from: http://heart.arizona.edu/resuscitation-research
Taylor, D. AHA official guidelines for CPR. Latest 2014/2015. Retrieved from: http://www.cprcertificationonlinehq.com/aha-cpr-guidelines-latest-jan-2014/