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CPR – Circulation and Chest Compressions

The fundamental principle of CPR is that we want blood and oxygen circulating throughout the body at all times. Circulation equates to potentially prolonging and mitigating cellular injury and death. The primary intervention to be performed for circulation is Chest Compressions. Chest Compressions circulate blood and oxygen. When performing CPR with rescue breathing, give 30 compressions followed by 2 breaths (30:2 Compressions to Breaths Ratio). Transition from compressions to breaths and back to compressions as quickly as possible. Your goal should be not to delay compressions for more than 10 seconds to give breaths.

To perform chest compressions effectively remember:
1.) Push Hard and Push Fast
Pushing hard and pushing fast helps keep circulation moving.
2.) Continue CPR continuously without delay or pause unless needed.
Reasons to stop or pause CPR include: The person wakes up/shows signs of life, someone else takes over, to use an AED, or you can no longer continue.
3.) Aim for the rate of 100 compressions per minute.
Think “Staying Alive”

How to Perform Chest Compressions

Make sure the victim is laying flat on their back, face up, on a HARD FIRM SURFACE. The floor is typically the best option in most situations. The transition of the victim from their location to the floor does not have to be a graceful one. You must get them on the floor (or other firm surface) as quickly as possible. Recognize that if the victim is not on a firm surface compressions will likely move the body up and down and not compress the chest (Visualize doing compressions on a waterbed).

Next, quickly remove any clothing covering the chest. This allows us to find the correct location to perform compressions and use an AED when it arrives.

Locate the center of the chest, between the breasts and place the palm of one hand on top of the sternum. Place the second hand on top of the first hand in a manner that is comfortable for you. You may overlay or interlock your fingers. Position yourself over the victim and use your entire body to push up and down on the persons chest. Keep you elbows locked and think of moving at the waist. This ensures you use your entire body to perform compressions. If you use your arms and not your body – your arms will become fatigued quickly and you will not be pushing at the right rate and depth.

Compress the chest at the rate of 100 compressions per minute. Think of the beat of the song “Staying Alive” by the Bee Gees. The beat of “Staying Alive” is 100 beats per minute. If you match compressions with this song – you will be performing compressions at the right speed. Remember to pace yourself so not to get fatigued. After each compression, allow the chest to return to its normal position before compressing again. This chest recoil allows the heart to refill with blood and provide the most effective CPR possible.

If performing rescue breathing, perform 30 compressions, perform a head-tilt/chin-lift, give two rescue breaths (looking for chest rise and fall) and resume compressions as quickly as possible. If performing “Compression Only CPR” simply compress the chest at the rate of 100 compressions per minute without interruption or delay.

Remember that when CPR is not being performed, blood and oxygen are not circulating, and cellular injury and death may occur.

2 Rescuers Present: If another rescuer is arrives or is present during the rescue effort perform CPR as described above expect you may alternate and switch roles as needed. One rescuer should perform 30 compressions and the second rescuer provide 2 rescue breaths. You should change roles every 2 minutes (or 5 sets of 30:2) or as needed to prevent fatigue. When working with another rescuer counting out loud when doing compressions will allow them to know when to give breaths. Teamwork is very important and each rescuer should evaluate the rescue effort and provide feedback as needed.

Next: Checking for a Pulse?

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