This is an abbreviated version of the complete article.*
||During cardiac arrest, also known as sudden cardiac death, the heart stops beating and a person is unable to breathe.
||Cardiopulmonary resuscitation, or CPR, is an emergency technique used to supply oxygen to the brain and other vital organs of a person whose heart has stopped pumping on its own.
||CPR involves repeated manual chest compressions alternated with breathing into a person's mouth. This mimics the heart's natural pumping and keeps oxygenated blood circulating to the brain and other vital organs.
Cardiopulmonary resuscitation, or CPR, is an emergency procedure used to restart a person's heart after breathing, pulse or both have stopped because of cardiac arrest.
CPR incorporates two primary therapies:
CPR can be taught to anyone, but should be performed by someone who has learned the technique in a class. It is not possible to learn CPR on the Internet or from a book.
- Basic life support, often referred to as emergency CPR, which includes breathing and chest compressions; and
- Advanced cardiac life support, which includes electric shock defibrillation, drugs, artificial respiration and other medical interventions.
Symptoms that may indicate cardiac arrest include:
If the person is unconscious, a bystander should gently shake the person on the shoulders and ask the person if he or she is all right. If the person is still unresponsive after being shaken, 911 should be called immediately.
- Unexplained chest pain;
- Unexplained shortness of breath; and
- Syncope (loss of consciousness).
WHO IS ELIGIBLE?
Patients who have elected to have a "do not resuscitate"?a DNR-order issued by a physician?are not eligible for CPR.
WHAT TO EXPECT
The three steps of basic life support are referred to as the ABCs, for Airway, Breathing, and Circulation.
Airway: The rescuer opens the patient's airway by lifting the chin or tilting back the head. Once the airway is open, the rescuer:
Breathing: If there is no evidence of breathing, the rescuer clears the person's mouth of any foreign material, pinches the nose shut, and makes an airtight seal with his or her mouth on the patient's mouth. Two full breaths are given.
- Looks to see if the chest is rising and falling;
- Listens for the sounds of breathing; and
- Feels for breath on his or her cheek.
Circulation: The rescuer checks for a pulse at the arteries in the person's neck. If a pulse is not detected, CPR must be performed.
To perform CPR, the rescuer presses down on and releases the patient's sternum (breastbone) about 80 to 100 times per minute. Two breaths are provided for every 15 chest compressions. CPR must be continued uninterrupted until medical help arrives.
The patient's chances of survival improve if emergency medical personnel equipped with a defibrillator arrive within 12 minutes of the collapse. The defibrillator sends a jolt of electricity through the heart to restore its natural rhythm.
Because the brain is susceptible to damage from oxygen deprivation, a person who is successfully revived with CPR may experience neurological complications.
Possible post-CPR complications include:
- Neurological problems;
- Congestive heart failure;
- Very low blood pressure;
- Heart arrhythmias;
- External injuries such as bruising or burns from defibrillator paddles;
- Internal injuries such as damage to the liver, spleen, or stomach;
- Vomiting followed by inhalation of the gastric contents, which can cause aspiration pneumonia;
- Separated and broken ribs; and
- Depression, fear, grief, and a sense of loss.
Immediately after resuscitation, continuous blood pressure, electrocardiogram (ECG) monitoring, and blood tests will be done. Medications will most likely be administered to stabilize and strengthen the heartbeat. If the person remains unconscious or comatose after the cardiac arrest, he or she will be transferred to a hospital intensive care unit or a cardiac care unit. If the cardiac arrest lasted less than 2 minutes, there is a good chance that the person will regain consciousness quickly and may only need supplemental oxygen.
Patients who are resuscitated after cardiac arrest have a 40 percent chance of recurrence in 2 years, so follow-up care with a cardiologist is crucial.
Medical Review Date: November 15, 2007
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