1. Cardiopulmonary resuscitation (CPR) is a combination
of rescue breathing and chest compressions delivered
to victims thought to be in cardiac arrest. When
cardiac arrest occurs, the heart stops pumping blood.
CPR can support a small amount of blood flow to the
heart and brain to “buy time” until normal heart
function is restored.
Causes of cardiac arrest
- Heart disease – this is the most common cause of
cardiac arrest
- Drowning
-Head injury
- Drug overdose
-Suffocation
-Poisonous gases
-Electric shock.
CPR can be life-saving first aid and increases the
person’s chances of survival if started soon after the
heart has stopped beating. If no CPR is performed, it
only takes 3–4 minutes for the person to become brain
dead, due to lack of oxygen. By performing CPR, you
provide the needed oxygen and circulate the blood, so
that the brain and other organs can stay alive while
you wait for the ambulance. CPR does not guarantee
that the person will survive but it does give that person

2. a chance when otherwise there would have been none.
CPR must be performed for minimum 20 minutes.
CPR is most successful when administered as quickly as
possible. It should only be performed when a person
shows no signs of life; that is, when they are:
- Unconscious, Unresponsive
-Not breathing normally
-Pulseless
-Not moving.
Positioning
- CPR is most easily and effectively performed by
laying the patient supine on a relatively hard
surface, which allows for effective compression of
the sternum. Delivery of CPR on a mattress or
other soft material is generally less effective.
- The health care provider giving compressions
should be positioned high enough above the
patient so he or she is able to gain leverage and
use his or her body weight to adequately compress
the chest.
Remember the ABCs- airway, breathing and circulation
— to remember the steps explained below. Move
quickly through airway and breathing to begin chest
compressions.

3. Airway: Clear the airway
- Put the person on his or her back on a firm
surface.
- Kneel next to the person's neck and shoulders.
- Open the person's airway using the head-tilt, chinlift maneuver. Put your palm on the person's
forehead and gently tilt the head back. Then with
the other hand, gently lift the chin forward to
open the airway.
- Check for normal breathing, taking no more than
five or 10 seconds. Look for chest motion, listen
for normal breath sounds, and feel for the
person's breath on your cheek and ear. Gasping is
not considered to be normal breathing. If the
person isn't breathing normally and you are
trained in CPR, begin mouth-to-mouth breathing.
If you believe the person is unconscious from a
heart attack and you haven't been trained in
emergency procedures, skip mouth-to-mouth
rescue breathing and proceed directly to chest
compressions.
Breathing: Breathe for the person

4. - Rescue breathing can be mouth-to-mouth
breathing or mouth-to-nose breathing if the
mouth is seriously injured or can't be opened.
- With the airway open (using the head-tilt, chin-lift
maneuver), pinch the nostrils shut for mouth-tomouth breathing and cover the person's mouth
with yours, making a seal.
- Prepare to give two rescue breaths. Give the first
rescue breath — lasting one second — and watch
to see if the chest rises. If it does rise, give the
second breath. If the chest doesn't rise, repeat the
head-tilt, chin-lift maneuver and then give the
second breath.
- Begin chest compressions to restore circulation.
Circulation: Restore blood circulation with chest
compressions
- Place the heel of one hand over the center of the
person's chest, between the nipples. Place your
other hand on top of the first hand. Keep your
elbows straight and position your shoulders
directly above your hands.

5. - Use your upper body weight (not just your arms)
as you push straight down on (compress) the chest
2 inches (approximately 5 centimeters). Push hard
at a rate of 100 compressions a minute.
- After 30 compressions, tilt the head back and lift
the chin up to open the airway. Prepare to give
two rescue breaths. Pinch the nose shut and
breathe into the mouth for one second. If the
chest rises, give a second rescue breath. If the
chest doesn't rise, repeat the head-tilt, chin-lift
maneuver and then give the second rescue breath.
That's one cycle. If someone else is available, ask
that person to give two breaths after you do 30
compressions. If you're not trained in CPR and feel
comfortable performing only chest compressions,
skip rescue breathing and continue chest
compressions at a rate of 100 compressions a
minute until medical personnel arrive.
- If the person has not begun moving after five
cycles (about two minutes) and an automatic
external defibrillator (AED) is available, apply it
and follow the prompts. Administer one shock,
then resume CPR — starting with chest
compressions — for two more minutes before

6. administering a second shock. If you're not trained
to use an AED, a 911 operator may be able to
guide you in its use. Use pediatric pads, if
available, for children ages 1 to 8. Do not use an
AED for babies younger than age 1. If an AED isn't
available, then continue CPR until there are signs
of movement or until emergency medical
personnel take over.
Key points
- The key thing to keep in mind when doing chest
compressions during CPR is to push fast and hard.
- Chest compressions can become quickly tiring.
Another bystander should be prepared to take
over if the initial rescuer becomes fatigued.
- Care should be taken to not lean on the patient
between compressions, as this prevents chest
recoil and worsens blood flow.
- A key determinant of survival is the rapid delivery
of high-quality CPR (within minutes of cardiac
arrest).
- Attempting to perform CPR is better than doing
nothing at all, even if the provider is unsure if he

7. or she is doing it correctly. This especially applies
to many people’s aversion to providing mouth-tomouth ventilations. If one does not feel
comfortable giving ventilations, chest
compressions alone are still better than doing
nothing.
Complications
- Performing chest compressions may result in the
fracturing of ribs or the sternum, though the
incidence of such fractures is widely considered to
be low.
- Artificial respiration using noninvasive ventilation
methods (eg, mouth-to-mouth, BVM) can often
result in gastric insufflation. This can lead to
vomiting, which can further lead to airway
compromise or aspiration. This problem is
eliminated by inserting an invasive airway, which
prevents air from entering the esophagus.
- When done properly, CPR can be quite fatiguing
for the provider. If possible, in order to give
consistent, high-quality CPR and prevent provider
fatigue or injury, new providers should intervene
every 2-3 minutes (ie, providers should swap out,

8. giving the chest compressor a rest while another
rescuer continues CPR).
- Infection
What to do if the person recovers during CPR
- CPR may revive the person before the ambulance
arrives.
- Review the person’s condition if signs of life return
(coughing, movement or normal breathing). If the
person is breathing on their own, stop CPR and
place them on their side with their head tilted
back.
- If the person is not breathing, continue full CPR
until the ambulance arrives.
- Be ready to recommence CPR if the person stops
breathing or becomes unresponsive or
unconscious again. Stay by their side until medical
help arrives. Talk reassuringly to them if they are
conscious.
- It is important not to interrupt chest compressions
or stop CPR prematurely to check for signs of life –
if in doubt, continue full CPR until help arrives. It is
unlikely you will do harm if you give chest

9. compressions to someone with a beating heart.
Regular recovery (pulse) checks are not
recommended as they may interrupt chest
compressions and delay resuscitation.
Stopping CPR
Generally, CPR is stopped for one of the following
reasons:
- The person revives and starts breathing again on
their own.
- Medical help, such as ambulance paramedics,
arrive to take over.
- The person performing the CPR is forced to stop
from physical exhaustion.

10. compressions to someone with a beating heart.
Regular recovery (pulse) checks are not
recommended as they may interrupt chest
compressions and delay resuscitation.
Stopping CPR
Generally, CPR is stopped for one of the following
reasons:
- The person revives and starts breathing again on
their own.
- Medical help, such as ambulance paramedics,
arrive to take over.
- The person performing the CPR is forced to stop
from physical exhaustion.