CPR for First Aiders

If a person is not breathing normally after an accident you should call for an ambulance and then, if you are able to, start CPR (also known as mouth-to-mouth resuscitation) straight away.

CPR, or cardio-pulmonary resuscitation, is a combination of rescue breaths and chest compressions to keep blood and oxygen circulating in the body.
For adults

Place your hands on the centre of the person's chest and, with the heel of your hand, press down (4-5cm) at a steady rate, slightly faster than one compression a second.
After every 30 chest compressions, give two breaths.
Pinch the person’s nose. Seal your mouth over their mouth and blow steadily and firmly into their mouth. Check that their chest rises. Give two rescue breaths, each over one second.
Continue with cycles of 30 chest compressions and two rescue breaths until they begin to recover or emergency help arrives. For babies under one.

For children aged one to puberty.

Open their airway by placing one hand on the child’s forehead and gently tilting their head back and lifting the chin. Remove any visible obstructions from the mouth and nose.
Pinch their nose. Seal your mouth over their mouth and blow steadily and firmly into their mouth, check that their chest rises. Give five initial rescue breaths.
Place your hands on the centre of their chest and, with the heel of your hand, press down one-third of the depth of the chest using one or two hands.
After every 30 chest compressions (at a steady rate, slightly faster than one compression a second) give two breaths.
Continue with cycles of 30 chest compressions and two rescue breaths until they begin to recover or emergency help arrives.
For babies under one.

Open the baby's airway by placing one hand on their forehead and gently tilting the head back and lifting the chin. Remove any visible obstructions from the mouth and nose.
Place your mouth over the mouth and nose of the infant and blow steadily and firmly into their mouth, check that their chest rises. Give five initial rescue breaths.
Place two fingers in the middle of the chest and press down one third of the depth of the chest. After 30 chest compressions at a steady rate (slightly faster than one compression a second) give two breaths.
Continue with cycles of 30 chest compressions and two rescue breaths until they begin to recover or emergency help arrives.

The Effectiveness of CPR

Used alone, CPR will result in few complete recoveries, and those who do survive often develop serious complications. Estimates vary, but many organizations stress that CPR does not "bring anyone back," it simply preserves the body for defibrillation and advanced life support.

However, in the case of "non-shockable" rhythms such as Pulseless Electrical Activity (PEA), defibrillation is not indicated, and the importance of CPR rises. On average, only 5–10% of people who receive CPR survive.

The purpose of CPR is not to "start" the heart, but rather to circulate oxygenated blood, and keep the brain alive until advanced care (especially defibrillation) can be initiated. As many of these patients may have a pulse that is impalpable by the layperson rescuer, the current consensus is to perform CPR on a patient who is not breathing.

Studies have shown that immediate CPR followed by defibrillation within 3–5 minutes of sudden VF cardiac arrest improves survival. In cities such as Seattle where CPR training is widespread and defibrillation by EMS personnel follows quickly, the survival rate is about 30 percent. In cities such as New York, without those advantages, the survival rate is only 1–2 percent.

Compression-only CPR is less effective in children than in adults, as cardiac arrest in children is more likely to have a non-cardiac cause. In a 2010 prospective study of cardiac arrest in children (age 1–17), for arrests with a non-cardiac cause, provision by bystanders of conventional CPR with rescue breathing yielded a favorable neurological outcome at one month more often than did compression-only CPR. For arrests with a cardiac cause in this cohort, there was no difference between the two technique.

For more information on our Paediatric First Aid training courses visit the courses section of our website. Active First Aid training deliver 2 day Paediatric First Aid (linkable) training courses across the UK.

CPR - Definition & General Information

Cardiopulmonary resuscitation (CPR) is an emergency procedure which is performed in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person in cardiac arrest. It is indicated in those who are unresponsive with no breathing or abnormal breathing, for example agonal respirations. It may be performed both in and outside of a hospital.

CPR involves chest compressions at least 5 cm deep and at a rate of at least 100 per minute in an effort to create artificial circulation by manually pumping blood through the heart. In addition, the rescuer may provide breaths by either exhaling into the subject's mouth or utilizing a device that pushes air into the subject's lungs. This process of externally providing ventilation is termed artificial respiration. Current recommendations place emphasis on high-quality chest compressions over artificial respiration; a simplified CPR method involving chest compressions only is recommended for untrained rescuers.

CPR alone is unlikely to restart the heart; its main purpose is to restore partial flow of oxygenated blood to the brain and heart. The objective is to delaytissue death and to extend the brief window of opportunity for a successful resuscitation without permanent brain damage. Administration of an electric shock to the subject's heart, termed defibrillation, is usually needed in order to restore a viable or "perfusing" heart rhythm. Defibrillation is only effective for certain heart rhythms, namely ventricular fibrillation or pulseless ventricular tachycardia, rather than asystole or pulseless electrical activity. CPR may succeed in inducing a heart rhythm which may be shockable. CPR is generally continued until the subject regains return of spontaneous circulation (ROSC) or is declared dead.

For more information on our Paediatric First Aid training courses visit the courses section of our website. Active First Aid training deliver 2 day Paediatric First Aid training courses across the UK.