Advanced CPR: Step-by-Step Procedure

Advanced CPR: Step-by-Step Procedure

By Prof.Midhu Kurian

Senior Writer, Healthcare Digital

Cardiopulmonary Resuscitation (CPR) is a life-saving technique used during cardiac arrest to maintain blood circulation and oxygen delivery to vital organs. This guide combines the best practices from various global standards into a single, advanced procedure.

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VIDEO EXPLANATION

Step 1: Assess the Scene & Victim

• Ensure the environment is safe for both the rescuer and the victim.
• Check for responsiveness by tapping the person’s shoulders and shouting, "Are you okay?"
• If unresponsive, immediately call for emergency medical services (EMS) and get an Automated External Defibrillator (AED), if available.

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Step 2: Check for Breathing & Pulse

• Place your ear near the victim’s mouth and nose to look, listen, and feel for normal breathing.
• Simultaneously, check the carotid pulse (in adults) or brachial pulse (in infants) for no more than 10 seconds.
• If no pulse and no normal breathing (or only gasping), start CPR immediately.

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Step 3: Begin Chest Compressions

• Hand Positioning:
  • Adults & Children: Place both hands (one on top of the other) on the center of the chest (lower half of the sternum).
  • Infants: Use two fingers (single rescuer) or two thumbs (two rescuers) on the lower half of the sternum.
• Compression Depth & Rate:
  • Adults & Children: At least 2 inches (5 cm) deep.
  • Infants: About 1.5 inches (4 cm) deep.
  • Rate: 100–120 compressions per minute.
• Allow full chest recoil between compressions to enable proper blood flow.

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Step 4: Provide Rescue Breaths

• Open the airway using the head-tilt, chin-lift method (unless spinal injury is suspected, then use jaw-thrust).
• Deliver 2 breaths after every 30 compressions (for single rescuer) or every 15 compressions (for two rescuers in infants/children).
• Breath technique:
  • Mouth-to-mouth: Pinch the nose and provide a full breath, watching for chest rise.
  • Bag-Valve Mask (BVM) ventilation: If trained, use a BVM to provide breaths, ensuring a tight seal over the victim’s mouth and nose.
• Each breath should last about 1 second, with visible chest rise.

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Step 5: Use an Automated External Defibrillator (AED)

• As soon as the AED arrives, turn it on and follow voice prompts.
• Attach electrode pads to the victim’s bare chest:
  • Adults & Children: One pad on the upper right chest, the other on the lower left chest.
  • Infants: If pads risk touching, place one on the chest and one on the back.
• Allow the AED to analyze the heart rhythm.
• If a shock is advised, ensure no one is touching the victim and press the shock button.
• Resume CPR immediately after the shock (or if no shock is advised), starting with compressions.

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Step 6: Continue CPR Until…

• Professional medical help takes over.
• The victim shows signs of life (breathing, movement).
• An advanced provider determines to stop resuscitation.
• You are physically unable to continue.

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Special Considerations

• Drowning Victims: Start with 5 initial rescue breaths before chest compressions.
• Pregnant Victims: Place the victim in a slightly left-tilted position to relieve pressure on the heart.
• Opioid Overdose: Administer naloxone (if available) alongside CPR.
• Trauma Victims: Maintain spinal precautions while opening the airway.

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Conclusion

This advanced CPR protocol integrates the best techniques from various international guidelines, ensuring the most effective resuscitation approach. Early and high-quality CPR, combined with rapid defibrillation, significantly improves survival rates.

VIDEO EXPLANATION