Cardio-pulmonary resuscitation

Cardio-pulmonary Resuscitation

Cardio-pulmonary resuscitation (CPR) is an emergency procedure that combines chest compressions with artificial ventilation in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person who is in cardiac arrest. CPR is a critical component of basic life support (BLS) and is a fundamental skill taught to medical students, healthcare professionals, and laypersons alike.

History

The concept of CPR has evolved over centuries, with early methods of resuscitation dating back to the 18th century. Modern CPR techniques were developed in the 1960s, with the American Heart Association (AHA) playing a pivotal role in standardizing the procedure.

Indications

CPR is indicated in cases of cardiac arrest, where the heart has stopped beating effectively, leading to a cessation of blood flow to vital organs. It is also used in cases of respiratory arrest, where breathing has stopped but the heart may still be functioning.

Technique

CPR involves two main components:

Chest Compressions

Chest compressions are performed by placing the heel of one hand on the center of the patient's chest, with the other hand on top, and pressing down hard and fast at a rate of 100 to 120 compressions per minute. The depth of compressions should be at least 2 inches (5 cm) in adults, allowing full recoil of the chest between compressions.

Artificial Ventilation

Artificial ventilation can be provided through mouth-to-mouth resuscitation or using a bag-valve-mask device. The rescuer delivers breaths at a rate of 1 breath every 6 seconds (10 breaths per minute) in adults, ensuring visible chest rise.

CPR in Special Populations

CPR techniques may vary slightly in different populations, such as infants and children, where the compression depth and hand placement are adjusted. In pregnant women, modifications are made to accommodate the gravid uterus.

Advanced Cardiac Life Support (ACLS)

While CPR is a component of basic life support, it is also a critical part of advanced cardiac life support (ACLS), which includes additional interventions such as defibrillation, airway management, and the administration of medications.

Outcomes and Prognosis

The success of CPR depends on several factors, including the cause of cardiac arrest, the time to initiation of CPR, and the quality of the resuscitation efforts. Early defibrillation and high-quality CPR are associated with improved survival rates.

Training and Certification

CPR training is widely available and often required for healthcare professionals. Certification courses are offered by organizations such as the American Heart Association and the Red Cross, providing both theoretical knowledge and practical skills.

Also see

• Basic life support
• Advanced cardiac life support
• Defibrillation
• Cardiac arrest
• First aid