eWellness: Hands-only CPR Guidelines
Dr KK Aggarwal, 24 February 2019
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- Bystanders should initiate compression-only CPR 10.
- Chest compression should be done at the rate of 100–120 per minute (updated from “at least” 100 per minute).
- Compression depth should be 2–2.5 inches (upper limit added) but no more than 6 cm.
- Compression time should be maximized.
- After each compression allow the chest to recoil completely and minimize interruptions in compressions.
- Feedback devices may be used to optimize compression rate and depth.
- The bystander who is trained and able should assess the collapsed victim rapidly to determine if the victim is unresponsive and not breathing normally and then immediately alert the emergency services.
- The victim who is unresponsive and not breathing normally is in cardiac arrest and requires CPR.
- The emergency medical dispatcher plays an important role in the early diagnosis of cardiac arrest, the provision of dispatcher-assisted CPR (also known as telephone CPR), and the location and dispatch of an AED.
- Social media may be used to summon rescuers to perform CPR.
- Bystanders and emergency medical dispatchers should be suspicious of cardiac arrest in any patient presenting with seizures and should carefully assess whether the victim is breathing normally.
- CPR providers should perform chest compressions for all victims in cardiac arrest.
- CPR providers trained and able to perform rescue breaths should combine chest compressions and rescue breaths.
- High-quality CPR remains essential to improving outcomes.
- When providing rescue breaths/ventilations spend approximately 1 s inflating the chest with sufficient volume to ensure the chest rises visibly. The ratio of chest compressions to ventilations remains 30:2.
- Do not interrupt chest compressions for more than 10 s to provide ventilations.
- Defibrillation within 3-5 min of collapse can produce survival rates as high as 50-70 %. Early defibrillation can be achieved through CPR providers using public access and on-site AEDs. Public access AED programmes should be actively implemented in public places that have a high density of citizens.
- The adult CPR sequence can be used safely in children who are unresponsive and not breathing normally. Chest compression depths in children should be at least one third of the depth of the chest (for infants 4 cm, for children 5 cm).
- A foreign body causing severe airway obstruction is a medical emergency and requires prompt treatment with back blows and, if that fails to relieve the obstruction, abdominal thrusts. If the victim becomes unresponsive CPR should be started immediately whilst help is summoned.