In this lesson, we'll cover how to administer CPR on an adult victim.
In situations where CPR is needed, you personally may have witnessed the victim exhibit symptoms and go unresponsive. Others may have witnessed the incident. Or no one was around to see what really happened. If someone was there to witness the incident, what they likely would have noticed is a victim who:
- Loses their balance
- Clutches their chest
- Collapses to the ground or floor
If you arrive on the scene after this happens, in cardiac arrest emergencies, the victim will usually also be unresponsive and not breathing normally, if at all. Let's assume for this lesson that that's how you found the victim. And that CPR is required.
CPR is a combination of chest compressions and ventilations that circulates blood and oxygen to the brain and other vital organs for a person whose heart and breathing have stopped. Oxygen is vital for life and it's only a matter of minutes before the brain begins to be negatively impacted.
How to Provide Care
Warning: Don't let the repetition of this next paragraph lull you into overlooking or dismissing the importance of scene safety. What if you show up to the scene and there's a live electrical wire, or poisonous gases in the air, and this is why the victim collapsed? Don't make assumptions, and don't become another victim.
Of course, the first thing you want to do is make sure the scene is safe, your gloves are on, and that you have your rescue shield available and begin calling out to the victim to assess whether or not he or she is responsive.
Are you OK? Can you hear me?
If you don't get an initial response, place your hand on the victim's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps.
- Call 911 and activate EMS. If there is a bystander nearby, you can ask for their help – calling 911, locating an AED, etc.
Pro Tip #1: As long as you have your cell phone, you're never alone. If no one is around to help you and you aren't sure what to do, call 911 on your cell phone, put it on speaker, and follow their instructions. Dispatch can help coach you through the situation.
- If you've determined at this point that the victim is unresponsive and not breathing normally continue immediately with CPR, beginning with chest compressions.
Pro Tip #2: Chest compression landmarks: Aim for the center of the chest, between the nipples and on the lower one-third of the sternum. Hand placement: Place your first palm on that landmark and interlock the fingers on your top hand over your first.
- Lean over the victim, position your hands as indicated above, and in the video, and lock your elbows.
- Use your upper body weight to supply the force needed for chest compressions and compress at a depth between 2 – 2.4 inches.
- Perform 30 chest compressions at a rate between 100 – 120 compressions per minute, which amounts to around two compression every second. Make sure you allow the victim's chest to come all the way back up before performing your next compression.
Pro Tip #3: To maintain a steady rhythm, count out loud while performing chest compressions – one, as you press down, and, as you allow the chest to recoil. When you reach 13, drop the and to maintain a two-syllable cadence on the compressions and not disrupt the rhythm.
- Lift the victim's chin and tilt his or her head back.
- Grab the rescue shield and place it over the victim's mouth and nose.
- Pinch the victim's nose and open their mouth.
- Deliver two rescue breaths – Breathe into the rescue mask and wait for the chest to rise and fall before administering the next breath.
Pro Tip #4: Don't forget to watch the victim's chest when performing chest compressions. If the chest doesn't rise, then you might be dealing with another problem and one that likely includes an obstructed airway.
- Go right back into 30 chest compressions followed again by two rescue breaths.
Continue to perform 30 chest compressions to two rescue breaths until EMS arrives, an AED is located, someone equally trained can relieve you, or the victim becomes responsive and begins breathing normally again.
A Few Common Questions About Adult CPR
Why is it important to use your upper body weight when performing chest compressions?
If you need to perform CPR for a longer period of time, using only your upper body strength will begin to fatigue you. As you become fatigued, your compression rate and depth may falter, as would the quality of CPR and the victim's chances of recovering.
Can I stop doing CPR once I've started?
Once you begin CPR, it's important not to stop. If you must stop, do so for no longer than 10 seconds. Reasons to discontinue CPR include more advanced medical personnel taking over for you, seeing obvious signs of life and the patient breathing normally again, an AED being available and ready to use, or being too exhausted to continue.
Is there anything else I can do to help a cardiac arrest victim?
The best thing you can do in these situations is to provide high-quality CPR, as performing CPR correctly will give the victim the best chance of survival. So, what constitutes high-quality CPR?
High-Quality CPR
- Performing chest compressions at a rate of 100-120 per minute
- Compressing to a depth of at least 2 inches but not exceeding 2.4
- Allowing for full recoil after each compression
- Minimizing pauses in compressions
- Ventilating adequately – two breaths after 30 compressions, with each breath delivered over one second, and each causing the patient's chest to rise
Pro Tip #5: Make sure you're directly over the victim's chest to maximize cardiac output, and not off to one side. If you're not directly over the chest, you may not adequately compress the heart.
Low-Quality CPR
- Compressing at a rate slower than 100 per minute or faster than 120 per minute
- Compressing to a depth of less than two inches or greater than 2.4 inches
- Leaning on the chest between compressions or performing compressions while not directly over the victim's heart
- Interrupting compressions for greater than 10 seconds
- Providing excessive ventilation – too many breaths or breaths with excessive force