How to Save Somebody's Life

Steps of Cardiopulmonary Resuscitation for Dummies

If you live with people you care about, you must know exactly what to do
during a medical emergency.

This knol teaches the most basic and most important steps in dealing with a
person who suddenly becomes unconscious or unresponsive; the steps of
cardiopulmonary resuscitation.

What is this About

This tutorial is a 7 step approach in dealing with a person who suddenly becomes unconscious or unresponsive in front of
you.

You dont need to be a healthcare professional to learn these steps. Anybody who can read and understand a few simple
principles can learn Cardiopulmonary Resuscitation (CPR).

This knol was specifically prepared for NON MEDICAL persons. So whether you are software engineer, school teacher,
internet surfer, glass blower, milkman or an astronaut, this maybe the most important learning in your life.

If you prevent somebody from dying, it is like giving them another life. And this is the most exhilarating feeling you may
ever experience.

But since you are too lazy to go to a CPR course, the least you can do is focus on this tutorial for the next 30 minutes. Get
some coffee and switch off that music before you start. The 7 steps must be embedded in your mind at the end of this
interesting reading. You'll definitely enjoy this education.
Minimum Requirements to Perform CPR
One Rescuer (You!)
One Telephone or Cellphone
 Recommended Requirements
First Rescuer (Performs CPR)
Second Rescuer (Assists the first rescuer in CPR)
Third Rescuer (Gets more help)
Cellphone
Face shield or a barrier device, for maintaining personal hygiene during mouth-to-mouth breathing
 Step-by-Step Instructions
Example scenario:
You and your girlfriend are at the mall eating icecream, when a middle aged man standing in front of you complains of
chest pain, suddenly clutches his chest and falls down onto the ground. He is not moving. People start screaming and your
girlfriend shouts at you to do something. Anything!
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STEP 1

CHECK FOR RESPONSIVENESS

Check for responsiveness by shouting and shaking the unconscious victim

How to do I do this?
- Kneel beside the victim
- Put both your hands over the victim's shoulders
- Shake vigourously and shout into the victim's ear, "Are you okay?" or "Can you hear me?"
- Victim must respond immediately (i.e within 3 - 5 seconds)

DECISION TO BE TAKEN - Is the victim responsive? YES or NO

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STEP 2

CALL FOR HELP

Call for help by dialling the local medical emergency response number in your city
OR
Call for help by telling someone next to you, to get medical help immediately
 What should I tell the operator?
- Your name and what work you do
- Type of medical emergency
- Location or address of the victim
- Call back number

Example

Medical Emergency Call Center - " Hello? This is 108 emergency service. How can I help you?"
Don't do this
"Hello? This is an emergency!! Please send an ambulance!!"
CLICK (Call Ends)
Don't get into a long conversation
"Hello?"
"Hello?"

"Emergency?"
"Yes?"

"Do you have an ambulance?"

"What is the emergency?"

"I dont know. I think... maybe.....something like a heart attack. He was having chest pain and all of a sudden he complained
of breathing difficulty. I was eating icecream and I saw him holding his chest and fall down. There are a lot of people here.
We are at the mall."
"Okay, Is it a adult or a child?"

"I think he is about......say......35 - 40 years."

"Is he responding?"
 "I dont know. He's unconscious now. He was talking to me and held his chest before falling down."
"Okay, we'll send an ambulance. Can you give us your address?"

"He's not breathing....I think."

"Please tell us where you are."

"We are at the mall near the main road next to the big flyover."
"Which main road? Which flyover?"

.......and so on

The right method is this

"Hello? My name is Danny and I am a college student. I have a man here who has collapsed in front of me. I think
he is having a heart attack. Please send an ambulance quickly. I'm in 3rd floor, ABCD mall, EFGH street. Next to
the Chinese Hotel. My mobile number is 1234567890. I starting CPR on him now. Okay?"

How do I convince the person next to me to get help?

- It is extremely important to make people understand the urgency of the situation.
- Take an authoritative position while you give the orders.
- Be loud and clear.
Don't do this
"Hey, Can somebody please get some help here?"

The right method is this

"You!!! Go to the security desk or reception and call an ambulance. They will have a phone directory. Tell them the
proper address. Page for a doctor if available. Quickly! Go!! Go!! Go!!"

REMEMBER - Do not ever (Ever!) miss this step. Always call for help first.
- Success of resuscitation depends on how quickly the victim can recieve advanced medical care.
- For an normal person, performing CPR is like running uphill. A single rescuer can perform CPR only for a few minutes
(5-10) before getting exhausted. CPR must be continous without interruptions. You need more people to help you.
- Advanced high quality resuscitation is done by trained paramedics* or doctors, using oxygen, injectable drugs, electric
shocks, interpreting cardiac rhythms, etc. So either a well equiped ambulance with a paramedic must reach the victim or
the victim must reach a hospital.

(* A Paramedic is a medical professional, who primarily provides pre-hospital advanced medical and trauma care. A paramedic is charged with providing emergency on-scene treatment, crisis
intervention, life-saving stabilization and, when appropriate, transport of ill or injured patients to definitive emergency medical and surgical treatment facilities, such as hospitals and trauma centers.
- Wikipedia)

Still with me?

CHECK FOR RESPONSIVENESS
CALL FOR HELP
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STEP 3

OPEN AIRWAY
Open the airway by performing head tilt-chin lift
 What is airway?
It is the path air takes during breathing. It includes mouth, oral cavity, pharynx (area at the back of the tongue) and trachea
(windpipe leading to our lungs).

How do I perform head tilt-chin lift?

- Kneel on the side of the victim's head.
- Put one hand over forehead and with the other hand, hold under the chin.
- Tilt the victim's head and lift the chin at the same time so that it appears as if he/she is 'looking up' (i.e. away from the
feet).

Correctly performed, the maneuver will open the lips and lift the tongue off the back of the throat in an unconscious victim.
This will open the airway (i.e. open a clear path from the mouth to the lungs).
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STEP 4

LOOK, LISTEN, FEEL

Look for movement of breathing
Listen for breathing sounds
Feel for airflow of breaths
 How do I do this?
- Kneel on the side of victim's head.
- Bend down over the victim's head so that your ear & cheek is almost touching the victim's nose & mouth and you are also
simultaneously looking at the victim's chest.
- Look of rise & fall of chest (indicates breathing).
- Listen for breath sounds at the victim's nose & mouth.
- Feel for the airflow of victim's breathing on your cheek.

Do this only for upto 10 seconds.

DECISION TO BE TAKEN - Is the victim breathing? YES or NO

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STEP 5

GIVE TWO RESCUE BREATHS

Give two rescue breaths by mouth-to-mouth breathing
 How do I give mouth-to-mouth breaths?
- Kneel next to the victim's head
- Take a deep breath
- Bend down and place your mouth over the victim's mouth.
- Press on the sides of the victim's nose with your fingers to seal the nostrils.
- Seal your lips with the victim's lips.
- Deliver or blow your breath into the victim's lungs over 2 seconds.
- When the first breath is delivered, just turn your head and look at the victim's chest. You will see the chest fall as the
victim exhales passively after your 'rescue breath'.
- Repeat this one more time.

How do I keep myself clean?

If the victim is a loved one, you will not bother about this. But if you are helping an unknown person, you can use a barrier
to prevent direct contact with the victim's lips or saliva.
Use any plastic sheet with a coin sized hole in the center which can be placed over the victim's mouth.
Professionally designed barrier devices or face shields are available with some pharmacies.

How do I know if I am giving the breaths correctly?

If you see the chest fall, then you have delivered a breath correctly.
If you dont see any chest rise or fall, then perform the head tilt - chin lift again, close the nostrils tightly, seal your lips
properly with the victim's lips and give a deep breath again.
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STEP 6

CHECK FOR PULSE

Feel for presence of a carotid pulse in the neck
 Where should I feel for the carotid artery?
- Use your index & middle fingers to find the hard prominence in the front upper part of the neck This is commonly known
as Adam's Apple. Also known in medical terminology as Thyroid Cartilage.
- Slide your fingers to one side away from the center for about 1-2 inches. The carotid artery* is present in the groove.
(*The carotid artery is a blood vessel supplying blood from the heart to the brain. There are two carotid arteries, one on each side of the neck.)

Do this only for upto 10 seconds.

Exercise for you!

Feel for your own carotid pulse right now. Are you feeling the regular steady pulsations of your carotid artery?

DECISION TO BE TAKEN - Does the victim have a pulse? YES or NO

Still with me?

CHECK FOR RESPONSIVENESS No response
CALL FOR HELP
OPEN AIRWAY
LOOK, LISTEN, FEEL. Not breathing
GIVE TWO RESCUE BREATHS
CHECK FOR PULSE No pulse
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STEP 7

START CHEST COMPRESSIONS

Begin chest compressions and breaths at 30:2 ratio
 Feel for the depression just below the edge of the breastbone

Place your left palm, two fingers width above this depression

Place your other hand on the first hand and interlock your fingers.
Now you hands will be in the center of a line connecting the nipples.
Compressions should be delivered on the breastbone, not over the soft depression.
 Begin chest compressions at speed of 100 per minute, pressing down about 1.5 to 2 inches.
Count "One thousand One, One thousand Two, One thousand Three, One thousand Four..."
Compress the chest whenever you say One, Two, Three, Four... and so on.

Keep your elbows straight, locked and in-line with the victim's chest, so that you use your upper body weight for chest
compression.
Give 30 continuous chest compressions within 18 to 23 seconds.
The stop chest compressions and give TWO breaths as described earlier.

30 chest compressions then 2 breaths constitute one cycle of CPR. This is 30:2 ratio.
Do five cycles of CPR without interruption and then check for the carotid pulse again.

Still with me?

CHECK FOR RESPONSIVENESS No response
CALL FOR HELP
OPEN AIRWAY
LOOK, LISTEN, FEEL. Not breathing
GIVE TWO RESCUE BREATHS
CHECK FOR PULSE No pulse
START CHEST COMPRESSIONS
30 compressions
2 breaths
30 compressions
2 breaths
30 compressions
2 breaths
30 compressions
2 breaths
30 compressions
 Check for pulse

If pulse can be felt, continue rescue breaths at one breath every 5 to 6 seconds.
If the victim starts breathing, turn him/her on his/her side. Wait for medical help to arrive.

When can I stop CPR?

You can stop CPR if you have one of the 3 conditions given below:
- You can clearly feel a pulse and the victim begins to breath.
- Advanced medical help arrives and more trained personnel take over the resuscitation.
- You get so tired that you cannot continue the CPR further and no help arrives. (You did your best.)

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Exercise for you!

Practice all these steps on a mannequin or a dummy or even a pillow!