New guidelines by the American Heart Association recommend that the three steps of cardiopulmonary resuscitation (CPR) be rearranged. The new first step is doing chest compressions instead of doing mouth-to-mouth breathing. The new guidelines apply to adults, children, and infants, but exclude newborns.
CPR: Adult & Children older than 1-year of age
1.) If you find an unresponsive victim (i.e., no movement or response to stimulation) or witness an individual who suddenly collapses, attempt to wake him by tapping on his shoulder and shouting at him. If the victim also has absent or only occasional gasping breathing, assume the victim is in cardiac arrest. If you are trained in how to detect a pulse, take no more than 10 seconds to check for a pulse (30 seconds if the victim is severely hypothermic) and, if you do not definitely feel a pulse within that time period, start chest compressions.
2.) Place the victim on his back on a firm surface. Place the heel of your hand in the middle of his chest and put your other hand on top of the first with your fingers interlaced.
3.) Compress the chest at least 2 inches (4-5 cm). Allow the chest to completely recoil before the next compression. Your shoulders should line up directly over the victim’s breastbone, with elbows straight
4.) Keeping your arms stiff and using a smooth motion, compress the breastbone at a rate of at least 100 pushes per minute. That’s about the same rhythm as the beat of the Bee Gee’s song “Staying’ Alive.” Do not remove your hands from the victim’s chest between compressions. You may feel pops and snaps when you first begin chest compressions. Don’t Stop! You’re not going to make the victim worse.
5.) After 30 compressions, open the victim’s airway using the head-tilt, chin-lift method, pinch the victim’s nose and make a seal over the victim’s mouth with yours. Use a CPR mask if available or improvise one from materials at hand. Give the victim a breath big enough to make the chest rise. Let the chest fall, then repeat the rescue breath once more. If the chest doesn’t rise on the first breath, reposition the had and try again. If you don’t feel comfortable with this step just continue to do chest compressions at a rate of at least 100/minute without rescue breathing (hands-only CPR).
6.) Use a compression to breathing ratio of 30 chest compressions for every 2 breaths.
7.) If two rescuers are working together, switch off doing compressions and breathing every 2 minutes to prevent fatigue. Check every 5 minutes for the return of a pulse or spontaneous breathing.
8.) If you have access to an automated external defibrillator (AED), continue to do CPR until you can attach it to the victim and turn it on. Turn the AED on, follow the prompts and if a shock is administered, reassess the victim for return of a pulse and breathing. Resume chest compressions immediately after the shock if there is no change.
When do I stop CPR?
You stop when you can’t continue, help arrives or the victim starts breathing on their own. You can’t perform CPR for hours – when you become tired, when you can’t do CPR any longer stop. You have done all you can.