1 How to Perform CPR on a Cardiac Arrest Victim (Adult Victim Only) A cardiac arrest occurs when the heart stops pumping blood throughout the human body, either because it stopped beating or it is beating irregularly. It is important to note that cardiac arrest is different than a heart attack, where blood flow to the heart is impaired, although a heart attack can cause cardiac arrest. A cardiac arrest is more deadly than a heart attack and can lead to death within minutes, so it is important for the population to be ready to aid a victim in the case of an emergency. Cardiac arrest is so deadly because when the heart stops pumping blood, oxygen and glucose delivery to the brain stops. Severe brain damage can occur within seconds, so emergency responders need to perform cardiopulmonary resuscitation (CPR) on the victim as soon as possible to ensure a steady oxygen supply to the brain until the victim receives medical attention. This involves compressing the victim s chest with your hands 100 times per minute to temporarily maintain blood flow to the brain. CPR should be performed as soon as possible on a cardiac arrest victim. WARNING: Performing CPR requires training and in some cases the use of potentially dangerous equipment. Bodily harm can occur if the improper techniques are used. Important Items: 1. Presence of mind: It is important not to panic in the event of an emergency 2. Cell phone or bystander to call for help Figure 1: Cell phone examples 3. Technique and stamina: CPR can sometimes require intense physical exertion for 10 minutes or more. Figure 2: Correct CPR administering position
2 4. Automated External Defibrillator (AED): AED s are commonplace in schools, malls, gyms, etc. They are stored on a wall in an accessible area and clearly labeled. They use an electric shock to restart the victim s heart. Figure 3: Example AED stored in a public facility DANGER: Automated External Defibrillators emit a powerful electric shock that can kill. Do not use unless properly trained. Checking for Cardiac Arrest Cardiac arrest is associated with many signs and symptoms, and it can be diagnosed in seconds, but it often occurs without a warning. Be on the lookout for the following signs as they may foreshadow a cardiac arrest. 1. Physical Symptoms a. Fainting/Blackouts b. Fatigue c. Shortness of breath d. Weakness e. Vomiting 2. Check for a pulse. Do NOT use your thumb. If a person has no pulse, he/she will most likely go unconscious if he/she has not already done so. CPR must be exercised immediately. a. Place your index and middle fingers on the victim s neck to the side of the victim s windpipe. b. Hold for 10 seconds and note any pulse irregularities or the absence of a pulse. In the absence of a pulse, perform CPR immediately. Figure 4: Proper finger placement for checking the victim s pulse
3 Performing CPR 1. Call 911 and tell them your exact location, how long the victim has been unconscious and the nature of the accident if you witnessed it. Inform them that you are performing CPR on the victim. Do NOT hang up the phone unless instructed to. WARNING: DO NOT just shout Someone call 911! No one will actually call unless you directly tell a person to. 2. If someone else is around, directly tell them to call 911 while you begin to administer CPR. Tell them to find an AED as well. 3. Position the victim s body so that he/she is lying flat on their back, with their airway open, and legs elevated (if possible). Figure 5: Positioning the victim. The victim s head is tilted back to open the airway and the victim is lying flat on his back. 4. Kneel beside the victim so that you can effectively use your weight to perform chest compressions 5. Place one hand over the other with interlocking fingers and then place your hands on the center of the victim s chest with your palms over the victim s sternum. Your arms should make a 90 degree angle with the victim s chest. Figure 6: Proper hand placement. The palms are directly over the sternum and the top hand s fingers are interlocked with the bottom s fingers.
4 6. Press down until the victim s chest has compressed about an inch. Keep your arms straight. Only bend your body at the fulcrum (hip joints). Then release. Figure 7: Correct CPR administering position NOTE: Breathing: Exhale on your downstroke and inhale on your upstroke to maximize your stamina. 7. Relax and repeat Step 6 at a rate of 100 times per minute 8. Perform chest compressions until someone has arrived with and AED or until paramedics arrive. For best chances of survival, the AED must be used within minutes of the cardiac arrest. NOTE: Rescue breaths are sometimes performed with chest compressions to aid in oxygen flow. They are not required and are not recommended here because the oxygen supply in the blood is sufficient for a few minutes before emergency responders arrive. Perform chest compressions only so that you save energy.
5 Using the Automated External Defibrillator 1. Open the AED. It will unzip or unfold similar to a lunchbox Figure 3: Example AED opened and ready for use. 2. Plug the electrodes into the AED if they are not already plugged in (looks similar to a cell phone jack). Turn the AED on by using the power button. 3. Connect electrodes (pads) to the victim s bare chest as shown in the diagram. There will be clear instructions on the pads. Make note of any instructions on the AED. Figure 8: Proper AED pad placement. Critical for restarting the victim s heart. WARNING: Pad placement is critical to restarting a victim s heart. DO NOT deviate from the diagram above.
6 NOTE: Once the AED is powered on, it will attempt to read the victim s heart. If the AED cannot read the victim s heart, then the AED may be damaged or the pad placement may not be correct. 4. Get ready to press the shock button. Yell Clear! and make sure no one is touching the victim. DANGER: DO NOT touch the victim during the electric shock. The shock administered from the AED is powerful enough to kill anyone touching the victim. 5. Check to see if the AED recommends that a shock be administered (most AED s have a built in Electrocardiograph to determine the exact nature of the victim s ailments and will tell the operator if the victim needs a shock or not). WARNING: DO NOT administer a shock to the victim if the AED does not recommend it. If the victim does not need a shock, the AED will most likely not administer one even if the operator presses the shock button. 6. Deliver the shock and repeat steps 3 6 until the victim s heart is restarted. NOTE: The AED will need to charge itself between every shock. While the AED is charging, perform chest compressions on the victim, following the steps outlined in the Performing CPR section (Page 3).
7 Glossary Cardiac Arrest sudden stop in blood circulation due to the fact that the heart has stopped beating or is beating irregularly. Cardiopulmonary Resuscitation An emergency medical procedure in which a person manually pumps blood through a victim s body through chest compressions. Rescue breaths and AED s may be used as well. Rescue Breaths Exhaling into an unconscious person s mouth periodically between chest compressions during CPR. This is thought to aid in improving oxygen flow through the victim s body. Automated External Defibrillator (AED) An electronic device that is used to administer a shock to a victim of cardiac arrest. The shock stops the arrhythmia, which allows the heart to restart itself using its own electrical system. Most modern AED s will diagnose the victim s arrhythmia and instruct the user on how to proceed via a screen or by vocal prompts. Arrhythmia an irregular or stopped heartbeat Electrocardiograph (ECG or EKG) A device that records the electrical activity of the heart