cardiopulmonary resuscitation

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cardiopulmonary

 [kahr″de-o-pul´mo-nar″e]
pertaining to the heart and lungs.
cardiopulmonary resuscitation (CPR) the manual application of chest compressions and ventilations to patients in cardiac arrest, done in an effort to maintain viability until advanced help arrives. This procedure is an essential component of basic life support (BLS), basic cardiac life support (BCLS), and advanced cardiac life support (ACLS).

The preliminary steps of CPR, as defined by the American Heart Association, are (1) calling for help; (2) establishing unresponsiveness in the victim by tapping or gently shaking and shouting at him or her; (3) positioning the victim in a supine position on a hard surface; (4) giving two breaths; and (5) checking the pulse. These are begun as quickly as possible; prompt action is essential for successful outcome. At the moment breathing and heart action stop, “clinical death” ensues. Within four to six minutes the cells of the brain, which are the most sensitive to lack of oxygen, begin to deteriorate. If breathing and circulation are not restored within this period of time, irreversible brain damage occurs and “biological death” takes place.

Although CPR is strongly recommended as a life-saving measure, it is not without danger; specific risks include rib fracture, damage to the liver or heart, and puncture of lungs or large blood vessels. All health care providers should receive instruction and practice in CPR under the direction of a qualified instructor. The public in general should also be encouraged to learn CPR for use in emergency situations.

Once it has been established that a person is in need of CPR, the rescuer immediately begins the “ABC's” of CPR: Airway, Breathing, and Circulation. Opening the airway and determining by look, sound, and feel is the first step for determining whether the person will be able to resume unassisted breathing. This is accomplished by lifting the chin up and back and bringing the mandible forward. If there is no evidence of spontaneous breathing, the rescuer corrects obstruction of the airway by a foreign body, when this is indicated. This is done by one or more of the following methods: back blows, manual chest thrusts, and finger sweeps. Once the airway is open, rescue breathing is started by means of mouth-to-mouth resuscitation (see artificial respiration).

The third element of CPR is circulation, which begins by establishing the presence or absence of a pulse. If there is no pulse, compression of the chest is begun. This consists of rhythmic applications of pressure on the lower half of the sternum (NOT on the xiphoid process, which may injure the liver). For a normal-sized adult, sufficient force is used to depress the sternum about 4 to 5 cm (1½ to 2 in). This raises intrathoracic pressure and produces the output of blood from the heart. When the pressure is released, blood is allowed to flow into the heart. Compressions should be maintained for one-half second; the same length of time is allowed for the relaxation period.

Chest compression is always accompanied by rescue breathing. The two must be coordinated so that there is regular and uninterrupted circulation of blood and aeration of the lungs.

CPR is a psychomotor skill and all health care providers should keep their certification current in order to be proficient in this procedure in case of emergency. The techniques of CPR provide basic life support (BLS) in all cases of respiratory and cardiac arrest. Standards and guidelines for CPR and emergency cardiac care (ECC), including BCLS and ACLS, have been developed cooperatively by the American Heart Association and the National Academy of Sciences–National Research Council. Reprints of these standards can be obtained from local chapters of the American Heart Association or from the American Heart Association, Distribution Department, 7272 Greenville Ave., Dallas, TX 75231-4596, telephone (800) 553–6321.
 Cardiopulmonary resuscitation. Airway: One hand is placed under the neck to extend it. With the other hand the chin is lifted so that it points upward. Sometimes this maneuver clears the airway and is all that is necessary to reinstate spontaneous breathing. Breathing: The nostrils are pinched and the chin held in position so that the rescuer's mouth can make a tight seal over the victim's mouth. Circulation: Compression of the chest with a downward thrust is alternated with breathing. If one person is performing CPR, he or she first blows into the victim's lungs, applies pressure to the sternum 15 times, and then continues a cycle of 2 breaths to 15 compressions.

resuscitation

 [re-sus″ĭ-ta´shun]
1. restoration to life or consciousness of one apparently dead, or whose respirations had ceased; see also artificial respiration.
2. in the nursing interventions classification, a nursing intervention defined as administering emergency measures to sustain life.
cardiopulmonary resuscitation see cardiopulmonary resuscitation.
resuscitation: fetus in the nursing interventions classification, a nursing intervention defined as administering emergency measures to improve placental perfusion or correct fetal acid-base status.
fluid resuscitation
1. the correction of fluid volume imbalances, especially in patients with burn injuries.
2. in the nursing interventions classification, a nursing intervention defined as administering prescribed intravenous fluids rapidly.
mouth-to-mouth resuscitation a method of artificial respiration in which the rescuer covers the patient's mouth with his own and exhales vigorously, inflating the patient's lungs.
resuscitation: neonate in the nursing interventions classification, a nursing intervention defined as administering emergency measures to support adaptation of the neonate to extrauterine life.

car·di·o·pul·mo·nar·y re·sus·ci·ta·tion (CPR),

restoration of cardiac output and pulmonary ventilation following cardiac arrest and apnea, using artificial respiration and manual closed-chest compression or open-chest cardiac massage.

cardiopulmonary resuscitation

n. Abbr. CPR
An emergency procedure, often employed after cardiac arrest, in which cardiac massage, artificial respiration, and drugs are used to maintain the circulation of oxygenated blood to the brain.

cardiopulmonary resuscitation (CPR)

a basic emergency procedure for life support, consisting of artificial respiration and manual external cardiac massage. It is used in cases of cardiac arrest to establish effective circulation and ventilation in order to prevent irreversible cerebral damage resulting from anoxia. External cardiac massage compresses the heart between the lower sternum and the thoracic vertebral column. During compressions, blood is forced into systemic and pulmonary circulation, and venous blood refills the heart when the compression is released. Mouth-to-mask breathing or a mechanical form of ventilation is used concomitantly with CPR to oxygenate the blood being pumped through the circulatory system.

cardiopulmonary resuscitation

Emergency medicine The restoration of cardiopulmonary function after cardiac arrest Components Compression of anterior chest wall to stimulate blood flow through the heart, artificial ventilation–eg, mouth-to-mouth breathing, defibrillation. See ABC method, CAB method.

car·di·o·pul·mo·nar·y re·sus·ci·ta·tion

(CPR) (kahrdē-ō-pulmŏ-nar-ē rē-sŭsi-tāshŭn)
Restoration of cardiac output and pulmonary ventilation following cardiac arrest and apnea, using artificial respiration and manual or mechanical closed chest compression or open chest cardiac massage.
Enlarge picture
CARDIOPULMONARY RESUSCITATION: open airway by raising chin and tilting head backward from chest
Enlarge picture
CARDIOPULMONARY RESUSCITATION: external chest compression

cardiopulmonary resuscitation

Abbreviation: CPR
In emergency cardiac care, the opening of the airway, provision of artificial breathing, and assisting the circulation until definitive treatment can restore spontaneous cardiac, pulmonary, and cerebral function. Synonym: basic life support (2)

Patient care

In emergency cardiac care, CPR involves either opening the airway, providing artificial breathing, and assisting circulation with chest compressions (until definitive treatments can restore spontaneous cardiac, pulmonary, and cerebral function) or providing chest compressions alone, without rescue breathing. When trained providers are available, CPR includes defibrillation with automated external defibrillators. In the U.S., the American Heart Association (AHA) develops and disseminates standard techniques for emergency cardiac care.

The first step in CPR is to ensure that an unarousable patient needs cardiopulmonary support and is not merely asleep or unconscious. If the patient does not respond to a loud voice or gentle shaking, the best thing a rescuer can do is to call for skilled assistance because successful resuscitation usually depends on the speed with which the patient can be defibrillated.

Before the defibrillator arrives, the rescuer can either position the patient for chest compressions only or begin rescue breathing. The patient should be placed supine on a firm, flat surface, with care taken to protect his cervical spine if traumatic injury is suspected. Kneeling at the level of the patient's shoulder, the rescuer performing rescue breathing may open the patient's airway, either with the jaw-thrust or the head-tilt chin-lift technique. If foreign bodies are present in the airway, they must be removed; dentures must also be removed if they interfere with resuscitation. Next, breathing is assessed by listening for breath sounds at the nose and lips and watching for the rise and fall of the chest. If these signs are not present, the patient is apneic, and rescue breathing can be performed. Survival rates of patients undergoing CPR are roughly equivalent with or without rescue breathing.

Rescue breathing can be performed with mouth-to-mouth technique or through a mask with a one-way valve if one is available. The rescuer gives two deep, slow positive-pressure breaths to the patient, the duration of each breath depending on the patient's age. If the supplied breaths meet obvious resistance, the rescuer should make another attempt to reopen the airway, and, if this is ineffective, to clear the airway with the Heimlich maneuver in children and adults. Infants should receive chest thrusts and blows to the back instead of the Heimlich maneuver.

The AHA formerly suggested checking the victim for a pulse after the first two breaths but eliminated the pulse check in its revised guidelines of 2000. If the patient is not breathing on his own, rescue breathing continues. If there is no pulse, external chest compression is begun and continued, with periodically interposed ventilations, until a defibrillator arrives or the patient revives. The precise number of ventilations and chest compressions per minute depends on the patient's age and the number of rescuers. For a single rescuer caring for an adult patient, two breaths are given for every 15 chest compressions. According to the AHA, for resuscitation purposes, infants are those who are up to a year old, children are from 1 to 8 years old, and adults are over the age of 8.

Compressions are given to adults (the usual victims of cardiac arrest) at the center of the sternum between the nipples, with the heel of one hand below the other hand; the fingers of the two hands are interlaced for support and to minimize the possibility of fracturing the ribs. The rescuer's elbows should be locked and straight, and the direction of compression should be exactly perpendicular to the patient's chest.

The chest is depressed 1.5 to 2.0 in for a normal-sized adult. For a child, the chest is depressed 1.0 to 1.5 in; for an infant, 0.5 to 1.0 in. The chest should return to its normally inflated position after each compression.

When professional rescuers arrive, the patient should be defibrillated immediately. If a defibrillator is not available, two-person CPR continues; the two rescuers alternate in giving rescue breaths and chest compressions to minimize fatigue. Ventilation and chest compressions are held for 5 sec at the end of the first minute and every few minutes after to determine whether the patient has responded. illustration; advanced cardiac life support; defibrillation; emergency cardiac care;

See also: resuscitation

cardiopulmonary resuscitation

Combined heart compression (CARDIAC MASSAGE) and ‘kiss of life’ (mouth-to-mouth artificial respiration). Commonly abbreviated to CPR. Guidelines, issued by the European Resuscitation Council in 2005, recommend that lay people should no longer to check for a pulse or attempt ventilation before starting chest compressions. If no signs such as breathing, coughing, spontaneous motions, or movements in response to stimulation are present chest compressions should begin. A ratio of 30 chest compressions to 2 ventilations is appropriate and compressions should be restarted for two minutes after defibrillation, regardless of rhythm. In the case of children, if two rescuers are available the ratio should be 15 to 2. For neonates the ratio should be 3 compressions to 1 ventilation. Chest compressions generate enough force to clear most obstructions and therefore rescuers should begin CPR immediately and let chest compressions clear the airway.

Cardiopulmonary resuscitation (CPR)

An emergency procedure used to restore circulation and prevent brain death to a person who has collapsed, is unconscious, is not breathing, and has no pulse.

cardiopulmonary resuscitation

; CPR maintenance of circulation of oxygenated blood to the brain during cardiac arrest, by closed chest massage ± assisted respiration (see basic life support; external chest message)

cardiopulmonary resuscitation,

n life-saving technique for restarting cardiac function and respira-tion. Includes manual pumping with a rhythmic pressure on the chest and breathing mouth to mouth.

car·di·o·pul·mo·nar·y re·sus·ci·ta·tion

(kahrdē-ō-pulmŏ-nar-ē rē-sŭsi-tāshŭn)
Therapeutic restoration of cardiac output and pulmonary ventilation after cardiac arrest and apnea.

resuscitation

restoration to life or consciousness of an animal apparently dead or dying, or whose respirations have ceased. See also artificial respiration.

cardiopulmonary resuscitation
an emergency technique used in cardiac arrest to re-establish heart and lung function until more advanced life support is available. See also cardiopulmonary resuscitation.
cerebral resuscitation
treatment to counteract the cerebral edema resulting from low cerebral blood flow and hypoxia that occurs during cardiopulmonary resuscitation.
resuscitation equipment
inludes cardiac defibrillator, laryngoscope, endotracheal tubes, tracheotomy tubes, plus the stimulants and the administration sets needed in an emergency.
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Arming himself with the qualifications needed to become a personal trainer including cardio-pulmonary resuscitation (CPR) and a first aid certificate, as well as an NVQ in health and fitness, David gained years of experience working in gyms throughout Merseyside and trained in self-defence at David Thompson's Martial Arts Academy.
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These will include recognition of cardiac conditions, cardio-pulmonary resuscitation and the use of a defibrillator.
There was an ex-Army man in the area who knew cardio-pulmonary resuscitation so he started trying to resuscitate him.