What is basic cardiopulmonary resuscitation? Also known as CPR, the definition of the cardiopulmonary resuscitation is the set of measures that must be taken to restore cardiac and respiratory functions when, due to cardiac or respiratory arrest, a person is in a state of apparent death for a few minutes; before, within a period of 4 to 6 minutes, apparent death turns into definitive death or biological death.
HOW TO PERFORM CARDIORESPIRATORY RESUSCITATION
In the United States, where this subject has been well studied for educational purposes, the successive steps of this aid have been outlined in such a way that it is easy to remember them. These successive steps have been given the names A, B, C and D.
To be useful where Spanish is spoken, the following words have been proposed, which do not correspond to the literal translation from English, but do correspond to the 4 stages:
A corresponds to "opening of the airways."
B corresponds to "mouth to mouth" (artificial respiration method).
C corresponds to "cardiac compression" (cardiac massage).
D corresponds to "definitive treatment" or "medications," which will be applied in some medical center.
The state of apparent death can begin with the heart stopping (due to myocardial infarction, cardiac arrest, circulatory collapse, certain cases of electrocution, etc.). Between 30 and 60 seconds after cardiac arrest, respiratory arrest also occurs.
Other times, apparent death begins due to respiratory arrest (due to asphyxia, certain cases of electrocution, etc.). It is common for the heart to continue beating for a few minutes and brain damage may take a little longer to become irreversible.
Below we show you how to perform the process of the cardiopulmonary resuscitation and thus restore breathing and pulse to a patient who is apparently dead.
Artificial respiration techniques or respiratory resuscitation using the "mouth-to-mouth" or "mouth-to-nose" method
The steps of the CPR process is:
- Maintain the airway. To keep the airway open, try to extend the head of the person who is choking as far back as possible.
- This is achieved by lifting the neck with one hand, while with the other, extending the head as far back as possible.
- Then, hold the chin up with one hand and the head extended backwards with the other.
- If necessary, clear the mouth of foreign bodies (teeth, mucus, etc.) with a finger covered with a handkerchief or with your fingers.
- If a fracture of the cervical spine is suspected, the head hyperextension maneuver should not be performed due to the possibility of injuring the spinal cord.
- If there is difficulty breathing, in this case, lift the jaw from the angles of the maxilla (below the ears). The problem can also be solved by introducing the thumb covered with a handkerchief into the mouth and the index finger under the chin, pulling the maxilla upwards with both fingers.
- Open your mouth wide, inhale deeply, then place your mouth over the nose or the mouth of the person who is suffocating (or over both in the case of children) and blow until you see the chest rise. When you blow into the mouth, compress the nose between your thumb and index finger; in this way, the person providing help will prevent the air blown into the mouth from escaping through the nose of the unconscious person.
- At this point, stop blowing so that the air comes out only from the chest, repeating the blowing about 12 times per minute. (In children, the number of blows will be 20 to 30 per minute, and the amount of air blown in will be proportionally less. In the case of a newborn or small child, care must be taken not to tilt the head back too much.)
- You will know that the air is entering the lungs of the person being helped by the following three checks: a) The chest expands when you blow and decreases in size when you stop blowing. b) When inflating, you feel some resistance as the lungs expand. c) You hear air escaping from the nose or mouth, or both, when you allow time for expiration after inflation.
- If there is no pulse or heartbeat, it is essential that another person perform cardiac massage at the same time. If you are alone, perform two rapid breaths for every 15 heart compressions.
Guidelines for performing external cardiac massage
Here are the guidelines for performing an external cardiac massage:
- Place the patient face up on a flat, rigid surface, for example a board. If there is no other option, lay the patient on the floor. Uncover the chest. If the patient is not breathing and you are alone, begin the treatment with five mouth-to-mouth breaths. Then, after every five pressures on the heart, alternate one breath.
- Place the base of one hand on the lower half of the sternum, resting the other hand on the first. Do not press on the lower end of the sternum (xiphoid process) which extends to the upper abdomen.
- Press quickly with your hands until the middle part of the chest sinks about 4 to 5 cm, and release quickly. (To prevent fatigue, it is advisable for the person providing assistance to keep his arms extended and lean forward so that his shoulders are almost directly over the patient's chest.) Perform this movement about 60 times per minute.
- These movements should be performed continuously, with equal duration of pressure and release.
- If for some reason this cardiac massage must be interrupted, it should not be for more than 5 seconds. When the person providing assistance is alone, every 15 cardiac compressions, the patient's chest should be rapidly inflated twice. Continue the massage until the heart begins to beat again or until death is certain.
- If another person is present, he should simultaneously perform "mouth-to-mouth" artificial respiration.
- It helps to avoid injury to the ribs and abdominal organs if you avoid touching the chest wall with the palm of your hands or fingers. Apply pressure only with the "heel" of your hands.
