Cardiopulmonary resuscitation

"CPR" redirects here. For other uses, see CPR (disambiguation).
"Cpr" redirects here. For a common abbreviation of copyright, see Copr.

Cardiopulmonary resuscitation
CPR being performed on a medical-training mannequin
SpecialtyCardiology
ICD-999.60
MeSHD016887
OPS-301 code8-771
MedlinePlus000010

Cardiopulmonary resuscitation (CPR) is an emergency procedure consisting of chest compressions often combined with artificial ventilation, or mouth to mouth in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person who is in cardiac arrest. It is recommended for those who are unresponsive with no breathing or abnormal breathing, for example, agonal respirations.[1]

CPR involves chest compressions for adults between 5 cm (2.0 in) and 6 cm (2.4 in) deep and at a rate of at least 100 to 120 per minute.[2] The rescuer may also provide artificial ventilation by either exhaling air into the subject's mouth or nose (mouth-to-mouth resuscitation) or using a device that pushes air into the subject's lungs (mechanical ventilation). Current recommendations place emphasis on early and high-quality chest compressions over artificial ventilation; a simplified CPR method involving only chest compressions is recommended for untrained rescuers.[3] With children, however, 2015 American Heart Association guidelines indicate that doing only compressions may actually result in worse outcomes, because such problems in children normally arise from respiratory issues rather than from cardiac ones, given their young age.[1] Chest compression to breathing ratios is set at 30 to 2 in adults.

CPR alone is unlikely to restart the heart. Its main purpose is to restore the partial flow of oxygenated blood to the brain and heart. The objective is to delay tissue 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 to restore a viable, or "perfusing", heart rhythm. Defibrillation is effective only for certain heart rhythms, namely ventricular fibrillation or pulseless ventricular tachycardia, rather than asystole or pulseless electrical activity, which usually requires the treatment of underlying conditions to restore cardiac function. Early shock, when appropriate, is recommended. CPR may succeed in inducing a heart rhythm that may be shockable. In general, CPR is continued until the person has a return of spontaneous circulation (ROSC) or is declared dead.[4]

Welsh Government training video of how to perform CPR on a person in cardiac arrest
  1. ^ a b Atkins DL, Berger S, Duff JP, Gonzales JC, Hunt EA, Joyner BL, et al. (November 2015). "Part 11: Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 132 (18 Suppl 2): S519–S525. doi:10.1161/CIR.0000000000000265. PMID 26472999.
  2. ^ Neumar RW, Shuster M, Callaway CW, Gent LM, Atkins DL, Bhanji F, et al. (November 2015). "Part 1: Executive Summary: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 132 (18 Suppl 2): S315–S367. doi:10.1161/cir.0000000000000252. PMID 26472989. S2CID 20651700.
  3. ^ Leong BS (August 2011). "Bystander CPR and survival". Singapore Medical Journal. 52 (8): 573–575. PMID 21879214.
  4. ^ Werman HA, Karren K, Mistovich J (2014). "Shock and Resuscitation". In Werman HA, Mistovich J, Karren K (eds.). Prehospital Emergency Care (10th ed.). Pearson Education, Inc. pp. 410, 426. ISBN 978-0-13-336913-7.