All adults should know the technique of CPR. Thousands of lives a year could be saved if oxygen is fed into the blood and the heart is kept pumping whilst awaiting emergency services.
It is important not to move anyone who has been involved in an accident because of possible damage to the spine and neck. However, if there is no pulse or respiratory movement the patient will need to be moved. The first step, therefore, is to establish whether breathing is occurring and the heart is beating.
Watch the chest. If there is no movement, place your ear by the nose and mouth and listen. The mirror test (placing a mirror or glass by the nose and mouth to see if it mists) is an ancient but effective technique.
To establish if the heart is beating place two fingers, index and third, on the patient’s Adam’s apple and push gently but firmly to one or the other side. The carotid artery is easily felt pulsating below your fingers. You can also try the pulse in the wrist which is found less easily one inch (2cm) up the arm from the wrist on the side of the thumb.
The first aspect is to remember ABC – Airway, Breathing, Circulation. of the throat and ensure that there are no obstructions. Look as well. Remove false teeth.
Place the patient flat on the ground. Tip the chin upwards, which will automatically open the mouth and straighten the trachea (the airway tube).
Place a handkerchief or piece of material over the patient’s mouth. Clamp your mouth over the patient’s mouth through the material.
Take a deep breath and breathe into the patient’s mouth, holding the chin up with one hand and with your other hand on their forehead.
Look at the chest to see that it is rising. If it is not, double check that there is no obstruction in the upper airway.
Perform this twice before commencing cardiac massage.
Cardiac massage. Place yourself on your knees next to the patient. Place one hand on the sternum (breast bone) and the other hand on top of the first. Rocking forward and applying firm downward pressure, imagine compressing the sternum onto the heart lying below. Successful cardiac massage may result in broken ribs. This is not a pleasant sensation or sound but is an indication that the massage is efficient. Judgement is required because you do not want to push too hard for fear of pushing a rib into the lungs.
Repeat this five times before repeating the breathing technique.
Carry on until the emergency services arrive or the patient starts to breathe spontaneously.
It is important to stop occasionally to check for a carotid pulse or chest movements. Cardiopulmonary resuscitation is not beneficial if the heart is beating and breathing is occurring.
RECOMMENDATIONS • Ensure that the airway is clear. Pushing with one hand on the jaw muscles will open the mouth. With your other hand push one finger to the back
I recommend that everybody take a first-aid course and practise this technique on a dummy. Do not practise this technique on patients who do not have an arrested heart or breathing.