When the heart stops beating, blood stops flowing around the body. Chest compressions work to artificially stimulate the heart, helping it to pump blood around the body.
- The patient should be laying flat on a solid surface usually the floor. Quickly move clothes out of the way. The rescuer should place the heel of one hand on the center (middle) of the victim’s chest (which is the lower half of the sternum) and the heel of the other hand on top of the first so that the hands are overlapped. The rescuer should then lock their elbows and position themselves directly over the patient.
- The rescuer will use their own body weight to compress the chest of the patient in a rhythmic fashion. The chest should compress at least a minimum of two inches for adult. The rescuer performing the compressions should ensure they remove their full body weight in between each compression in order to let the heart refill with blood. For an idea of rhythm, try matching the beats of the song “Staying Alive” in your head. Be consistent in the timing and rhythm of the compressions.
- Start compressions and do at least 100 – 120 compressions per minute. Allow complete chest recoil after each compression to allow the heart to refill with blood.
- After 30 compressions, open the airway and give breaths.
- Performing chest compressions correctly is hard work. The more tired you become, the less effective your compressions will be. If someone else knows CPR, you can take turns providing CPR. Switch rescuers about every 2 minutes to avoid rescuer fatigue.
Clear the airway and give breaths. Open the patient’s airway by tilting the head back with the palm of one hand while gently lifting the chin with your other hand. (Head tilt-chin lift)
Give 2 breaths, each for 1-second duration, then look for chest rise. If the first breath doesn’t make the chest rise and fall, then reposition the head i.e. head tilt-chin lift, and re-administer the breaths. If chest does not rise after the 2nd breath, then return to chest compressions. To protect yourself from exposure, use a face shield or pocket mask with a one-way valve.
Mouth to Mouth:
While still performing the airway technique, pinch the patient’s nose shut. With a complete seal over the patient’s mouth with your mouth, breathe until you see the chest inflate. If the chest does not rise, repeat the head tilt-chin lift technique. Give 2 breaths. If the chest does not inflate after the 2nd attempt, then return to chest compressions.
Continue 30 compressions followed by 2 ventilations, i.e. ratio of 30:2.
AED should be used as soon as it is available. Resume chest compressions immediately after shock is given. If AED is not available, continue with CPR.
Note: If not using a rescue mask, make sure you make a seal over the mouth on an adult or child and pinch the nose closed each time you give a breath. On an infant, make sure to cover the mouth and nose with your mouth.
Continue cycles of 30 compressions to 2 breaths until an AED arrives, advanced medical personnel take over, the patient shows signs of life, the scene becomes unsafe, or you are too exhausted to continue.