Hands only CPR

The Red Cross says that everyone should at least learn hands-only CPR, businesses are being urged to train 25% of their employees, and high schools all of their students. (Laws in more than ten states currently require CPR training before High School graduation.)

This webpage is for my students to read before they take the class. For better retention of what you will learn, mark a date on your calendar a week or two after the class to come back and read this webpage again.

This webpage is not complete training and will not substitute for a CPR class.

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Cardiac arrest is a life-threatening emergency when a person's heart stops beating. They will also stop breathing at the same time. Often it is the first sign of heart trouble.

Cardiac arrest is the leading cause of death in the United States, every year killing more people than cancer, stroke, lung disease, accidents, firearms, or diabetes. Cardiac arrest affects people of all ages, even teens, twenty somethings and the very young.

Most cardiac arrests happen away from a hospital where care needed to correct the condition is not readily available. If more people are trained to at least recognize the emergency, call for professional help (call 911 or the local emergency number), and do hands only CPR, more cardiac arrest victims can be saved.

An automated external defibrillator (AED) is a small computer that analyzes a victim's heart rhythm and if necessary, tells you to deliver a lifesaving shock to a victim of sudden cardiac arrest.

When you turn it on it talks to you and tells you the steps to use it.

Many models even have a map on the pads you place on the victim's chest showing you where to put them:

An AED won't shock someone who does not need it.

You do not need a certification to use one

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Heart attacks are the leading cause of death for men and women. Almost half of the people who have heart attacks die from them. Medications to treat a heart attack and limit the damage from a heart attack must be given as soon as possible.

A heart attack can happen before cardiac arrest, or the heart attack and cardiac arrest can be sudden and happen at the same time. A heart attack victim might or might not have a lot of pain; extreme weakness or tiredness might be the main symptoms. Symptoms might start out slowly or come and go. Not all heart attacks lead directly to cardiac arrest and some heart attack victims do not notice a mild heart attack.

Signs and symptoms of a heart attack include:

Persistent chest discomfort, pain or pressure that lasts longer than 3 to 5 minutes, or goes away and comes back, or persists even during rest.

Discomfort, pain or pressure in either arm, back or stomach.

Chest discomfort, pain or pressure that spreads to the shoulder, back, neck, jaw or arms.

The pain is sometimes described as a feeling of fullness, squeezing, aching or heaviness in the chest that can be mild or strong.

Shortness of breath or trouble breathing that can start before pain or along with the chest discomfort or even without the chest discomfort.

Nausea (feeling sick to your stomach) or vomiting.

Dizziness, light-headedness, loss of consciousness or fainting.

Pale, ashen, grayish or bluish skin, especially around the face.

Sweating—face may be moist or person may be sweating profusely. It is sometimes described as breaking out in a cold sweat.

Unexplained fatigue (tiredness) or lightheadedness.

Denial of signs or symptoms. Denial can happen even when the victim is in extreme pain. For example, you might notice a family member who looks very uncomfortable, who is pale and sweating. When you ask them how they are doing you notice that they are having trouble breathing but they say it's only a little indigestion/the flu/normal aging. If you suspect a heart attack is happening, even if they insist that you should not call 911, you should call.

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A person who is fully oriented to their surroundings is conscious. People can be partially conscious, for example, if they hit their head they might not know what happened to them but might know who they are and where they are. Conscious or partially conscious people do not need CPR compressions.

Fainting is loss of consciousness caused by a temporary, often sudden, lack of oxygen to the brain. Example: stood up too fast after prolonged sitting or lying down (more likely for pregnant, elderly), or after a large meal (especially with alcohol). Fainting usually corrects itself when people collapse, since blood flow to their brain increases when they become horizontal and their head is at the same level as their heart.

Being asleep is not the same as being unconscious (not conscious). Someone who is sleeping will wake up when you tap them on the shoulder and/or speak loudly to them, someone who is unconscious will not respond.

You do not have to get consent (permission) from an unconscious victim to help them. But there are rules you will learn in a first aid class about how you should not force first aid on a conscious, sane, sober adult who doesn't want it.

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You can download a copy of the training handout at:

http://www.redcross.org/images/MEDIA_CustomProductCatalog/m6440194_HandsOnlyCPRsheet.pdf

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Your first step when you witness a person suddenly collapse will be to check the scene for safety. For example, if a person walks out of a chemical storage area coughing and suddenly collapses, you could be affected by the same chemical leak if you get too close too quickly. Do not risk becoming a victim yourself. Stop briefly and be sure it is safe for you to approach the victim.

Other dangers you should avoid could include traffic, unstable structures, downed powerlines, explosions, smoke/fire, gas or fuel leaks, broken glass, swift-moving water, an angry dog, a crime scene or violent behavior. You might need to turn off power / a circuit breaker.

If you have disposable gloves you should put them on, but should not take time to go looking for them.

and determine if the victim is conscious or not. You tap them on the shoulder and shout "Are you okay?" and quickly look for normal breathing.

(Normal breathing is regular, quiet and effortless. Agonal gasps are common in the early stages of cardiac arrest. Bystanders often report to dispatchers that victims of cardiac arrest are 'breathing' when they have agonal gasps, as a result CPR is not given to victims who might benefit from it. An irregular, gasping or shallow breath is not normal breathing and should be cared for as if the person is not breathing at all.)

(If the person is face down, determine if the victim is conscious or not and if they are unconscious (not conscious), carefully but quickly roll them over, protecting their head, and then quickly look for normal breathing, which can be as simple as noticing if their chest is rising and falling from breaths they inhale/exhale.)

If they do not respond when you tap and yell call 911, (or have a bystander call),

and if they are not breathing, start chest compressions.

Elements of Effective, Quality CPR Compressions

- For chest compressions to be effective, they must be performed on a firm, flat surface. (For example, a victim who collapsed on stairs would need to be moved.)

- Use the heel of the hand, not your palm, to give compressions.

- Place your hands on the center of the chest.

If you could see through to the rib cage, this is what it would look like where you correctly place your hand on the center of the chest, but not as low as the abdomen (belly/stomach area):

- Keep your arms as straight as possible

- Position your shoulders directly over your hands. The photo below shows the wrong way, arms at an angle, and the heel of the hand not quite on the center of the chest:

- Compress the chest at least 2 inches

- Compress at least 100 times per minute

- Let the chest rise completely before pushing down again

Continue CPR chest compressions until:

you are too exhausted to continue

the scene becomes unsafe (examples: fire is moving through a building towards you, rising floodwater or aftershocks from an earthquake that are making the building unstable)

you notice an obvious sign of life, such as normal breathing

EMS personnel (fire, EMT, paramedic) arrive and take over

an AED is ready to use (as soon as it arrives turn it on and do what it says to do)

(Don't stop when you hear the ambulance sirens, it will still take a few more minutes for help to get to where you are. Don't stop when the EMT comes on scene, they might want you to continue compressions while they unpack the AED.)

If you become tired realize that since you either called 911 or had someone else call, help is on the way. Concentrate on pushing hard and fast.

The European Resuscitation Council is also promoting this method and estimates using it could save at least 100,000 more lives in Europe alone each year. "Push fast and firmly, and start immediately...Everyone, including children, can do this. This simple procedure is safe and markedly increases the victim's chance of survival."

The British Heart Foundation is also promoting hands only CPR. "At the moment less than 10 percent of the 30,000 people in the United Kingdom who have a cardiac arrest out of hospital each year survive long enough to leave hospital alive. If someone carries out early CPR, it may double a casualty's chances of survival. Hands-only CPR should increase the number of bystander interventions and save lives."

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To a large extent, heart disease is preventable. You might be at risk of a heart attack if you:

have uncontrolled high blood pressure

have high cholesterol

are overweight or obese

are diabetic

are not active

use recreational drugs, especially if the drugs had added toxic substances such as talc, herbicides, or poisons

smoke (one year after you quit smoking your risk of coronary heart disease is cut in half)

have a family history of heart disease.

OTHER NOTES

When you call 911 from a land line telephone, such as in your house, you get dispatch for the city the phone (your house) is located in. When you call 911 from a cell phone you most often get the Highway Patrol at a central location. Sometimes, especially if you are not calling about something on the freeway/highway, it would be faster to get dispatch for the specific city the problem is happening in. This requires knowing the direct dial seven digit phone number for each dispatch.

Direct dial emergency phone numbers for most cities in Santa Clara County, California, can be found at the Santa Clara County ARES/RACES (Amateur Radio Emergency Services/Radio Amateur Civil Emergency Services) website.

http://www.scc-ares-races.org/dd-emer-nos.html

San Mateo County cities (and the San Francisco airport) direct dial phone numbers can be found at:

http://www.blackberryreact.org/smco911phones.html

When you are planning a camping trip, try to get the direct dial number for the park/Sheriff or agency in charge before you go.

In a lot of Canada you can dial 911 in an emergency just like in the U.S. But in other countries it's often a different number. http://www.sccfd.org/travel.html has most of them.

Do it yourself earthquake preparedness

http://www.youtube.com/watch?v=wkXZLfd8f2E