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CPR, all we need to know

Posted by Xanit Internacional Xanit Internacional | Posted in cardiology with heart | Posted on 05-09-2019


CPR stands for cardiopulmonary resuscitation. It consists of a series of universal and standardised manoeuvres implemented in the face of a cardiorespiratory arrest and included in what is known as the survival chain.

The cardiorespiratory arrest is defined as a sudden, unexpected and potentially reversible loss of consciousness, accompanied by a cessation of breathing and signs of life.

It is estimated that there are about 65 cardiorespiratory arrests per 100,000 inhabitants per year, resulting in arrest every 20 minutes. The leading cause of cardiorespiratory arrest is cardiac aetiology, 75% occur at home, and a high percentage are witnessed. For this reason, it is of huge importance to raise awareness among the population on CPR manoeuvres that will allow us to intervene in the face of a cardiac arrest.

Today Dr Pablo De Rojas, Head of the Intensive Medicine Department at our hospital, offers us some guidelines for action should we be a witness of a cardiorespiratory arrest.

In the event of a suspected cardiac arrest, the first thing to do is to stay in a safe, danger-free place (move the victim from the road, the water in case of drowning, etc.). Next, we should check the absence of consciousness by vigorously moving the victim and even causing pain with energetic stimuli. If the patient does not respond to stimuli and we are not dealing with a case of severe trauma, we should perform the face-chin manoeuvre pulling the head and raising the jaw, in this way we will open the patient’s airway. We should then check if the victim breathes by bringing our ear to his mouth and also examining whether the chest rises, HEAR if air comes out and FEEL the exhalation of the air.

If we check that the victim is not breathing, we determine the cardiac arrest situation and begin CPR manoeuvres.

How are the CPR manoeuvres performed?

To carry out CPR manoeuvre we must take off the victim’s clothes and perform chest compressions: with the palm of our hand and in the centre of the victim’s chest with our hands crossed, over the patient’s sternum and with a force that depresses the victim’s chest about 5 — 6 cm and at a rate of 100-120 compressions per minute. In this way, we will “squeeze” the heart temporarily replacing its pump function.

The chest compressions are then accompanied by mouth-to-mouth breathing. To do this we should seal the lips of the patient with our lips and pinch his nose, blowing into his mouth twice and making sure that the chest rises (only this way the manoeuvre is effective). It should be performed at a rate of 30 compressions alternating with 2 air blows.

It has been widely demonstrated that many lives can be saved with the chin manoeuvre and with early and correct chest compressions.

The third link in the survival chain is early defibrillation. The first cause of out-of-hospital cardiac arrest is cardiac aetiology secondary to infarction and is caused by an arrhythmia. Such arrhythmia responds in a high percentage to early defibrillation. That is why the use of defibrillation is recommended as soon as possible.

With regard to cardiac arrest of paediatric origin, its most frequent cause is by airway obstruction secondary to the intake of a foreign body, therefore prevention and knowledge of airway removal techniques are essential. As for performing cardiopulmonary resuscitation manoeuvres for the paediatric population, they are similar to those for adults, considering that chest compressions, obviously, in this case will be performed with a pair of fingers or with the palm of the hand, depending on the size of the child.

The usefulness of these simple manoeuvres, monitored and recommended by associations that advocate and standardise their use, is now widely demonstrated, recommending their knowledge to the general population and early and universal access to defibrillators.

There are multiple options to access relevant courses, where on mannequins we can learn basic life-saving techniques.

In our Vithas centres, we have a standardised training plan that ensures that all workers are trained to act in this type of incidents.

What should we do if we witness a cardiorespiratory arrest?

In case of suspected cardiorespiratory arrest, it is important to know the chain of survival, which consists of 4 steps:

  1. Notify the universal emergency phone number 112 and follow their recommendations.
  2. Remember the time of the suspected cardiac arrest, later you’ll be asked so.
  3. Start with cardiopulmonary resuscitation manoeuvres
  4. Request, if possible, an automatic external defibrillator.
  5. Expect the arrival of advanced medical services, while continuing to perform chest compressions.