critical care medicine
Cardiopulmonary Resuscitation (CPR) in Adults
Overview of CPR
(See also the American Heart Association [AHA]2020 guidelinesfor CPR and emergency cardiovascular care and2022 AHA Interim Guidanceto Health Care Providers for Basic and Advanced Cardiac Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19.) Guidelines for health care professionals from the AHA are followed (see figure). If a person has collapsed with possible cardiac arrest, a rescuer first establishes unresponsiveness and confirms absence of breathing or the presence of only gasping respirations. Then, the rescuer calls for help. Anyone answering is directed to activate the emergency response system (or appropriate in-hospital resuscitation personnel) and, if possible, obtain a defibrillator. Basic life support should be started immediately. If no one responds to the call for help, the rescuer first activates the emergency response system and then begins basic life support by giving 30 chest compressions at a rate of 100 to 120/minute and a depth of 5 to 6 cm, allowing the chest wall to return to full height between compressions, and then opening the airway (lifting the chin and tilting back the forehead) and giving 2 rescue breaths. The cycle of compressions and breaths is continued (see table) without interruption; preferably each rescuer is relieved every 2 minutes. It is crucial that even untrained bystanders begin and maintain continuous chest compressions until skilled help arrives. Therefore, many emergency response providers now give pre-arrival instructions to callers, including phone instruction in compressions-only CPR. When a defibrillator (manual or automated) becomes available, a person in Ventricular Fibrillation (VF) (VF) or pulseless * If an adequate number of trained personnel are available, patient assessment, CPR, and activation of the emergency response system should occur simultaneously. Based on the 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. The techniques used in basic 1- and 2-rescuer CPR are listed in Table CPR Techniques for Health Care Practitioners . Mastery is best acquired by hands-on training such as that provided in the US under the auspices of the American Heart Association (1-800-AHA-USA1) or corresponding organizations in other countries. 