Resuscitation is the name given to the set of procedures that are applied when a person is not breathing, and their heart has possibly stopped. The full set of procedures is known as cardiopulmonary resuscitation (CPR). Cardio relates to the heart and pulmonary to the lungs.

A person whose heart stopped (cardiac arrest), or who is not breathing (respiratory arrest), needs immediate treatment to improve the chances of survival. Since speed is a key factor in survival, treatment needs to be started before the arrival of the emergency ambulance and, since most cardiac arrests happen in home or in the presence of a family member, friend, or colleague, CPR skills are essential for everyone to know.

The best outcomes from cardiac or respiratory arrest are achieved when all the steps in the Chain of Survival (see panel) are in place.

CHAIN OF SURVIVAL
 

• Early call for help
• Early CPR
• Early defibrillation
• Early medical care

The first two of these steps are often in the hands of the first aider.

ABC OF THE RESUSCITATION

Lay the victim on his back, tilt the head back, and lift the chin to open the airway. Look at the victim’s chest for signs of breathing. If the victim is not breathing, pinch the nose shut and keep the chin tilted. Seal your mouth over the victims’ and give 2 breaths.

Place interlocked hands on the victim’s breastbone, press down. Then release. Alternate 15 chest compressions with 2 rescue breaths.

WHAT CAN BLOCK THE AIRWAY
 

The airway is made up of nose, mouth, and windpipe (trachea). These carry air, containing oxygen, to the lungs and remove the waste product carbon dioxide from the lungs. If the airway becomes blocked, the oxygen levels in the body drop and eventually the vital organs such as the brain and heart stop working. Death will follow unless action is taken.

A number of things can block the airway: blood, food, and vomit are among the main culprits. In an unconscious person, however, the biggest risk is from the tongue. When a person loses consciousness the muscles relax. If the person is lying on his back the tongue will fall to the back of the mouth, blocking off the windpipe and stopping the oxygen getting into the body.

Clearing the airway is the first step of the essential ABC of first aid. The method of clearing an airway blocked by the tongue is very dimple. By tilting the head back and lifting the chin, the tongue is prevented from falling to the back of the throat and the windpipe remains clear.

AN EARLY CALL FOR HELP

Ambulances today carry a range of equipment and treatments vital to the survival of seriously ill victims. Calling for an ambulance early is an essential part of the Chain of Survival, particularly for a victim whose heart has stopped.

EARLY CPR

CPR Works by putting the oxygen into the blood through breathing into the victim’s mouth or nose and by pushing the blood around the body by pressing on the chest and compressing the heart.

The goal is to keep the person alive until emergency help arrives. Sometimes CPR alone will revive somebody whose heart has stopped but more often it is used to buy time until more advanced procedures are available.

EARLY DEFIBRILLATION

The most effective treatment for an adult whose heart has stopped pumping blood is defibrillation. In simple terms, this is an electric shock delivered in a very specific way to encourage the heart to begin beating effectively again.

Defibrillators are carried in most ambulances but are also increasingly found in public places such as shopping malls, railway stations, and airports, where local workers will have been trained in their use. Their early use is an essential factor in their effectiveness, highlighting again the need for an early call for help.

Medical treatments following cardiac and respiratory arrest are improving all the time. Early access to such treatments in the ambulance and in hospital play a major role in long-term survival rates.

• Check for danger to yourself and the victim.
• Check for a response from the victim.

If is no response

• Open the airway.
• Check for breathing.

If there is no breathing

• Give 2 effective rescue breaths.
• Check for signs of circulation.

If there are no signs of circulation

• Start CPR

CALLING FOR AN AMBULANCE

• Dial 911
• Ask for the ambulance service.
• Listen to the operator--- you will be asked for your name, contact details, and where you are.
• The operator will ask a series of questions about the victim and what has happened--- give as much information as you can.
• Often the operator will give you advice on what to do next.
• Do not hang up the phone until you are told to do so.

WHEN TO CALL AN AMBULANCE

1. If you are alone, breathing is absent, and the victim is an adult, call for an ambulance and/or for access to a defibrillator as soon as you realize the victim is not breathing. The cause is most likely to be a heart attack leading to cardiac arrest, and the most effective treatment is CPR and very early access to defibrillation.
 

2. If you are alone and the victim is an infant or a child under 8 years of age, provide 1 minute rescue breathing or full CPR before calling an ambulance. The cause is most likely to be a problem with breathing, such as choking or drowning, etc., and the most effective treatment is to get oxygen into the lungs.
 

3. If you are not alone, send a bystander for the ambulance as soon as you have confirmed that the victim is not breathing.

Above
 

Call an ambulance immediately if you are alone the victim has stopped breathing. The person is likely to have had a heart attack and will need early defibrillation from trained person.

SOURCES OF MEDICAL HELP
 

• Ambulance
• Hospital Emergency Department
• Doctor’s office
• Urgent case clinics
• Pharmacies

There is a variety of sources of medical assistance throughout the country. Investigate what is available locally before an emergency happens, and keep a list of useful numbers by the phone or stored in your cellular phone.