Lay Person Cpr On Adults

GENERAL INFORMATION:

What is lay person CPR?

• CPR is also called cardiopulmonary resuscitation. CPR is used when a person stops breathing and his heart has stopped beating. Adult CPR should be used on people over the age of about eight years old. "Lay person" refers to anyone who is not a trained healthcare worker. If you start CPR early and do it correctly, you may be able to save someone from dying. Practice the steps of CPR and know them well.
  
  
• Rescue breathing means breathing into the mouth of a person who is unable to breathe well enough on their own. A chest compression is the placement of pressure on and off the chest with your hands. A compression presses the heart between the spine (backbone) and sternum (breastbone). This forces blood out of the heart and into the rest of the body. Chest compressions done with rescue breathing is called CPR. An automatic external defibrillator (AED) is often found in public places such as airports, casinos, and shopping malls. The use of an AED device in addition to correctly doing CPR may help save a person's life.

Why might an adult need CPR?

• Accidents and injuries.
  
  
• Breathing in smoke, such as when trapped in a fire.
  
  
• Drowning.
  
  
• Drug overdose.
  
  
• Foreign body airway obstruction (an object blocking the airway).
  
  
• Heart attack.
  
  
• Lightening strike.
  
  
• Severe (very heavy) bleeding.
  
  
• Stroke (blood supply to part of the brain is stopped).

What should I do if I find a person who may need help? When you find a person who is unresponsive (does not speak or move when spoken to), follow these steps:

• Make sure the area is safe to enter, and approach the person. Move someone only if the area is dangerous, such as in a fire.
  
  
• Find out if the person is OK. Tap the person's shoulder. Ask loudly, "Are you OK?"
  
  
• If the person responds, leave to call 911 immediately, send someone to call for help, or call from a cell phone. If you leave the person, return as soon as possible and stay with them until help arrives. Check often to see if the person is having trouble breathing or other problems.
  
  
• If the person does not respond, leave to call 911 immediately, send someone to call for help, or call from a cell phone. If you are alone, call 911 before beginning CPR on an adult. The faster caregivers arrive, the greater the chance the person will live. Stay on the telephone with the 911 operator until they tell you to hang up. Look quickly in the area for an AED device while calling 911. You may find an AED mounted on the wall in a glass-front box, with a sign stating that it is an AED. If an AED is found, quickly bring it back to the person who needs help.

How do I give CPR? By following the "ABC's", you can remember the steps to use when giving CPR. The letter A stands for airway, B stands for breathing, and C stands for circulation.

• A irway:
  
  
  • Kneel beside the person and look at him to check if the head, neck, or back may be hurt. Carefully turn the person onto their back, while supporting the head and neck. Keep the person's body in a straight line (with no twisting) as you turn the person onto his back. The person should be lying on a hard surface.
    
    
  • Open the person's airway by tilting the head back and lifting the chin. Put one hand on the person's forehead and press firmly backward to tilt the head back. Do not place your hand on the back of the neck to tilt the head. Put the fingers of the other hand under the chin and lift the chin forward. Keep the person's mouth open. Do not press deeply into the soft tissue under the chin because this can close the airway.
  
  
• B reathing:
  
  
  • Check for breathing: Look, listen and feel for normal breathing while keeping the airway open. Put your ear close to the person's mouth and nose. Look at the person's chest to see if it goes up and down with breathing. Listen for the sound of normal breathing. Feel for any air movement on your cheek. Spend only ten seconds checking for normal breathing. If you hear or see the person occasionally gasping for air, that is not normal breathing.
    
    
    • If the person is breathing normally and there are no signs of injury , carefully turn the person on his side. Support the head and neck as you turn the person onto his side. Place his lower arm in front of his body. This is called the recovery position, and this position may help stop a person from choking if he throws up. Wait for caregivers to arrive.
      
      
    • If the person is breathing and there are signs of injury , leave the person on his back and hold his airway open. Wait for help to arrive.
    
    
  • If the person is not breathing, or their breathing is not normal, you should begin CPR: Begin by giving two breaths to the person.
    
    
    • Keep the airway open by the tilting the head back and lifting the chin.
      
      
    • Gently pinch the nose closed using the hand on the person's forehead. This stops air from escaping through the nose. Take a deep breath and put your lips around the person's mouth, making an airtight seal.
      
      
    • Give two breaths (one second for each breath) into the person's mouth. Do not give very large breaths, or breathe hard or fast. Take a normal breath for yourself after each breath that you give.
      
      
    • The person's chest should rise each time you give a rescue breath. The airway may not be open if you do not see the chest go up and down with each breath. Change the person's head position to reopen the airway, and try to rescue breathe for him again. If you still cannot get air into the person, the airway may be blocked by food or another object. Look into the person's mouth to check if there is something that may be blocking the airway. If you see something that looks easy to get, carefully scoop it out with your finger.
      
      
    • If you carry a special mask or device for giving breaths during CPR and you have it with you, use it. Do not leave the person to get it. Give rescue breaths without it.
  
  
• C irculation:
  
  
  • After giving rescue breaths, begin compressions immediately:
    
    
    • Hand position for chest compressions:
      
      
      • Kneeling beside the person's chest, put the fingers of your hand on the person's lower rib cage on the side nearest you. Move your fingers up the rib cage to the place where the ribs meet in the middle of the chest. This area is called the sternum.
        
        
      • Put the heel of one hand on the lower half of the sternum (at the nipple line) and put the heel of the other hand on top of it.
        
        
      • Lace your fingers together or extend them above the chest. Do not lay your fingers on the chest. By laying your fingers on the chest, you may do compressions in the wrong place. Incorrect hand positioning can break the ribs during compressions.
        
        
      • Lock your elbows with your arms straight. Your shoulders should be directly over the center of the person's chest. Look down at your hands.
      
      
    • Chest compressions:
      
      
      • Press down on the sternum about one and one-half to two inches. The compressions should be constant and equal. This means that it should take the same amount of time to press down as it does to release the compression. Allow the chest to relax completely between compressions while leaving your hands on the chest in the correct hand position. This is necessary because it allows blood to come back into the heart before you compress again.
        
        
      • Do 30 chest compressions at a rate of about 100 every minute (almost two compressions per second). Push hard and push fast. Do not delay or stop the compressions. Count the compressions out loud if that will help you do them at a steady, even speed. Counting may also help you remember how many compressions you have done.
    
    
  
  
• Putting it all together:
  
  
  • After 30 compressions, quickly move up to the person's head. Open the airway by tilting the head and lifting the chin. Give two rescue breaths (about one second for each breath).
    
    
  • Give 30 compressions and two rescue breaths. Keep doing this until the person starts to move around, an AED is available, or caregivers arrive.
    
    
  • If the person begins to respond or move around, stop doing CPR. Carefully turn the person on his side if there are no signs of head or neck injury. Support the head and neck as you turn the person onto his side. Place his lower arm out in front of him in the recovery position. Being in this position will help prevent him from choking if he begins to throw up. If there are signs of injury, leave the person on his back and hold the airway open. Stay with the person and watch him closely until caregivers arrive.
    
    
  • If an AED becomes available and the person is still unresponsive, stop doing CPR and quickly follow the directions for using the AED.

How do I use an automatic external defibrillator (AED)?

• An AED is a device that finds the heart rhythm of the person and tells you if the person needs a shock. The device will only deliver a shock if one is needed. After a shock is delivered, the heart may begin beating in a more normal pattern. Using an AED may help save a person's life.
  
  
• AED's give verbal directions and have pictures to help you use them. They are battery-operated, and have computers inside. The devices can be different sizes, colors and shapes, but are often light weight and about the size of a small kitchen appliance. The AED usually has a central device and two electrode pads. There may be step-by-step directions for how to use the device on or inside it. Follow those directions for using the device. The following are general directions for how to use an AED:
  
  
  • Remove all clothing from the person's chest.
    
    
  • Open the device. There may be a latch on one or both sides of the device to open it. Turn the device on with a button, switch or by other means. The on button or switch should be clearly marked.
    
    
  • Find the electrode pads. You may need to pull a handle or open or unwrap the pads. The pads may be attached to the device by thin wires. Do not detach the electrode pads from the device.
    
    
  • Electrode pads may have a sticky side that will stick to the person's chest. You may need to remove paper backing from the pads to expose the sticky side before they can be used.
    
    
  • The pads may have pictures on them to show you where to place them on the chest. The right pad should be placed on the right upper chest towards the middle, and below the clavicle. The left pad should be placed on the left side of the chest, just below and to the side of the left breast. You may also place each pad on each side of the rib cage, just below and to the outside of the breasts.
    
    
  • If you see that the person has an implanted medical device, be sure the pad is placed at least one inch (2.5 centimeters) away from it. If you see a medicine patch anywhere on the persons' skin, remove the patch and wipe the area before placing the electrode pad. If a person is lying in water, move them out of it before placing the electrode pads. If a person's chest is covered with water, liquid, or sweat, wipe their chest dry before applying the electrode pads.
    
    
  • The AED will tell you if the person needs or does not need a shock, and will deliver one only if needed.
    
    
  • After a shock is delivered, the person's heart may take a minute or more to begin beating correctly. Because of this, begin the steps of CPR again. Give two rescue breaths followed by 30 compressions until the person starts to move around, or caregivers arrive.

When do I stop doing CPR on a person?

• When someone else that knows CPR or trained caregivers arrive and take over for you.
  
  
• When you are exhausted and unable to continue.
  
  
• If the area suddenly becomes unsafe, such as if a fire starts or spreads.
  
  
• When the person becomes responsive. He may move around or speak.

What else should I know about CPR and the AED?

• Do not delay giving CPR. When a person stops breathing, their heart may continue to beat for several minutes. After that, the heart will not beat, and brain damage is possible. Brain damage happens because there is no oxygen going to the brain. To avoid brain damage, and death in some cases, begin the steps of CPR right away.
  
  
• Do chest compressions. The risk of catching a disease or getting sick from giving rescue breaths is very low. If you are unable to, or don't want to give rescue breaths, do chest compressions. Chest compressions alone make it more likely that the person will live than if you do nothing at all.
  
  
• Use an AED if one is available. AED's are generally easy to use, a person will not be hurt by the AED, and they cost you nothing to use. The AED may save a person's life.
  
  
• When giving chest compressions, push hard and push fast. Hard, fast compressions are more likely to keep the person's brain and heart muscle alive. They also increase that chance that a shock delivered by the AED will make the heart beat correctly again.

Where can I get support or more information? To become a certified CPR provider, you must take classes through an organization like the ones listed below. Never practice CPR on another person if they do not need it. You can seriously hurt someone if you practice CPR on him. Never remove an AED from it's storage case unless you intend to use it. Contact the following or more information:

• American Red Cross National Headquarters
  2025 E Street NW
  Washington, DC 20006
  Phone: 1-202-303-4498
  Web Address: http://www.redcross.org
  

• American Heart Association National Center
  7272 Greenville Avenue
  Dallas, TX 75231-4596
  Phone: 1-800-242-8721
  Web Address: http://www.americanheart.org
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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