Cardiopulmonary Resuscitation or CPR Training Part 1

About how to perform cardiopulmonary resuscitation or CPR, information on breathing, circulation and cardiac arrest.

CARDIOPULMONARY RESUSCITATION

In cases of heart attack, drowning, suffocation, electric shock, hemorrhage, strangulation, or drug overdose

Cardiopulmonary resuscitation, also known as CPR, is a combination of artificial respiration and artificial circulation, which should be started immediately as an emergency procedure when cardiac arrest occurs, by those properly trained to do so, until the victim can be transferred to a medical facility or assisted by medical authorities. It has been used widely and successfully for some time by doctors and nurses and allied health personnel, and it is now recommended that as many members of the general public as possible be trained in this technique. Information regarding free instruction, which is offered frequently in most communities in the U.S., should be obtained through your local branch of the American National Red Cross or the American Heart Association.

BACKGROUND AND GENERAL PRINCIPLES

BREATHING AND CIRCULATION

Air that enters the lungs contains about 21% oxygen and only a trace of carbon dioxide. Air that is exhaled from the lungs contains about 16% oxygen and 4% carbon dioxide.

The right side of the heart pumps blood to the lungs, where the blood picks up oxygen and releases carbon dioxide.

The oxygenated blood then returns to the left side of the heart, from where it is pumped to the tissues of the body.

In the body tissues the blood releases oxygen and takes up carbon dioxide, after which it flows back to the right side of the heart.

All tissues of the body require oxygen, but the brain requires more than any other tissue. It is generally estimated that if the brain is totally deprived of oxygenated blood for a period of 4 to 6 minutes, it will suffer irreversible damage.

When breathing and circulation stop, this is called clinical death.

When the brain has been deprived of oxygenated blood for a period of 6 minutes or more and irreversible damage has probably occurred, this is called biological death.

Both ventilation and circulation are required to maintain life.

When breathing stops, the pulse and circulation may continue for some time, a condition known as respiratory arrest. In this case only artificial respiration is required, since the heart action continues to circulate blood to the brain and the rest of the body. Common causes of respiratory arrest are drowning, electric shock (usually high voltage), suffocation, strangulation, and drug overdose.

When circulation stops, the pulse disappears and breathing stops at the same time or soon thereafter. This is called cardiac arrest. When cardiac arrest occurs, both artificial respiration and artificial circulation are required to oxygenate the blood and circulate it to the brain. Common causes of cardiac arrest are heart attack, electric shock (usually low voltage), hemorrhage, and--as a final phase of drowning--suffocation and other forms of respiratory arrest.

CARDIAC ARREST

Cardiac arrest is any one of the following three conditions in which circulation is either absent or inadequate to sustain life:

1. Cardiovascular Collapse. The heart is still beating, but its action is so weak that blood is not being circulated through the vascular system to the brain and other body tissues. This condition may result from severe hemorrhage, from shock, or from various drugs.

2. Ventricular Fibrillation. Individual muscle fascicles of the heart beat independently rather than in the usual coordinated, synchronized manner that produces a rhythmic heartbeat. It occurs sometimes following heart attacks, and frequently follows low-voltage electric shocks.

3. Cardiac Standstill. The heart has stopped beating. This condition may be terminal and is usually due to a severe lack of oxygen (anoxia) of the heart muscle.

All three types can be recognized by absent respiration and an absent pulse in an unconscious person with a deathlike appearance. Begin cardiopulmonary resuscitation immediately when you recognize cardiac arrest.

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