During
the CPR, what is the percentage of heart
efficiency as a pump?
I heard
that no matter if a person is unconscious
that you should perform CPR. Is this true?
When should you not perform CPR?
It is true that sometimes a person
may be unconscious and their heart is
still beating and they may still be
breathing. Such a situation, for
example, may occur in someone who has
just had a grand mal seizure. If you
tried to do CPR on such a person he or
she would probably groan and even try to
push you away. This would be your clue
that CPR was not needed. CPR is intended
only for someone whose heart and
breathing has stopped. If the victim
moves or pushes you away, you should
stop CPR.
What is the
ratio of 2-person CPR?
The ratio of chest compressions to
mouth-to-mouth is the same for 2 person
CPR as for 1 person CPR, namely 30:2.
How do I
perform CPR on a person who has a tracheal
stoma? Do I have to cover their mouth or
just breath directly into the stoma?
There are two types of stomas, one
which communicates to the nose and mouth
and one which doesn't. Since you won't
know which type you are dealing with, it
is best to pinch the victim's nose
closed, keep the victim's mouth closed
and breathe directly into the stoma
opening.
When you
are giving mouth to mouth are you
actually breathing oxygen into the victim's
lungs or are you trying to stimulate
breathing by breathing carbon dioxide into
their lungs?
You are breathing oxygen into the
lungs. Your exhaled breath contains 16%
oxygen which is close to the 20%
contained in the air you breathe in.
When
performing CPR, how do I know if it's
working?
You can tell if the chest rises with
ventilation. It is hard to determine if
the chest compression results in a
pulse. Do the best you can and don't
stop. It's better to perform CPR
imperfectly than not at all.
If a
person has had bypass surgery, and a
situation occurs that they require CPR, are
there any special considerations that need
to be made?
No, CPR should be done in the regular
fashion.
Is it
easier to break an overweight person's
ribs or a skinnier persons ribs when
performing cpr?
The weight of the victim has little
to do with the chances of breaking a
rib, instead the age of the victim seems
to determine the fragility of the bones.
Can I kill
someone if I do CPR incorrectly?
No. Remember the person in cardiac
arrest is already clinically dead. CPR
can only help. Even if it's not done
"letter perfect" it will probably
provide some benefit to the victim.
What if
I crack a rib when I do CPR?
Frequently ribs are broken with the
pressure CPR places on the sternum. Some
studies quote up to 30% of cardiac
arrest victims have broken ribs as a
result of CPR. This happens more
frequently the older the victim since
the cartilage is less compliant and the
bones more easily crackable. But
remember, it's better to have a cracked
rib than be dead.
Will CPR
always save a life?
No, in fact, most instances of CPR
for cardiac arrest are unsuccessful.
What is the recovery position?
Assuming the person has a pulse and
is breathing, the recovery position
means placing the person on his or her
side. This allows for the person not to
choke on saliva and helps keep the
airway open. The downside arm may be
raised to suport the head.
What
should you do for a person who has been
accidentally shocked by electricity?
A person with electric shock
(assuming the shock doesn't severely
damage the body) often dies from the
heart going into ventricular
fibrillation. Such a person needs CPR
and it should be performed in the
regular fashion. If CPR begins quickly
and if a defibrillator arrives quickly
this person has an excellent chance of
survival.
I
want to know what the current teachings
are on helping a choking victim. I have
heard conflicting information on back blows
for an adult. Is it still recommended, or
discouraged?
The first action to take in adults
and children is the Heimlich maneuver.
Back blows are the first thing to do
only in infants who are conscious. In
doing the back blows the infant should
be in a face down position with the head
lower than the body.
What if
the victim vomits?
Vomit is obviously unpleasant. If it
happens (and it may in one out of 20
cardiac arrests) merely turn the head to
the side and wipe out the vomit as best
you can with your finger.
If
someone has an asthma attack and
collapses, what should a person do? Will CPR
help?
If someone collapses from an asthma
attack, it is because he or she is not
getting enough oxygen. This is because
all the lung's small airways have
narrowed and are not allowing enough air
to reach the air sacs. Mouth to mouth
respiration may help a little. The real
need is to get this person to an
emergency department so that the patient
can receive medications and emergency
endotracheal intubation (a tube in the
main airway).
What are
some of the causes of CPR being used for
in infants and children?
Usually CPR in infants and children
is performed for respiratory arrest such
as severe asthma. Ventricular
fibrillation is rare in children but
very common in older adults.
In
regards to administering the Heimlich
Maneuver to a victim while they are lying
down, should the head be facing up, as when
administering CPR (in order to clear the
airway), or to the side?
The victim's head should be facing up
with the victim on his/her back. Since
the airway is blocked you shouldn't
spend much time positioning the head.
The Heimlich maneuver is the most
important thing to do and should unblock
the airway
What if the victim is wearing dentures?
Can I
get AIDS from doing CPR?
Can I
get sued if I perform CPR?
You theoretically could but there has
never been a successful suit brought
against someone performing CPR.
Does the
Good Samaritan law protect me?
Yes, if you give assistance,
including CPR, for a medical emergency
Good Samaritan laws cover you.
What are
agonal respirations?
When the heart stops beating in
cardiac arrest the breathing center in
the brain is still alive for a couple of
minutes and will cause the victim to
take a few abnormal breaths. These
abnormal breaths associated in dying are
called agonal respirations. They may
appear like snoring, gasping, or
snorting and will disappear in a couple
of minutes. Don't let abnormal breathing
stop you from starting CPR.
In
cardiopulmonary arrest occurring outside
of a hospital what are statistics regarding
successful uncomplicated recovery? Also in
this situation how many patients are
successfully resuscitated but are then in a
vegetative state?
The statistics vary from locale to
locale. In New York City or Chicago the
survival rate (discharge alive from the
hospital) is 2 or 3%. In Seattle the
survival rate is 20% overall and 35% for
ventricular fibrillation. Less than 5%
of those discharged have severe
neurologic damage. Over 60% return to
their prior level of mental status.
Persistent vegetative states (PVS)s are
very unusual.
Can CPR be performed on dogs?
CPR can be performed on dogs. To give
respiration you will need to keep the
dogs mouth and lips closed and breathe
through the nose. Cover the dogs nose
completely with your mouth to prevent
air from leaking out. You should see the
chest rise if you are doing it properly.
To give chest compressions you might
need to press side to side instead of
straight down on the chest. This is
especially true for funnel chested dogs.
The rates of respiration to chest
compression are the same as for humans.
In general, most instances of CPR for
dogs will involve accidents of smoke
inhalation or drowning. Respirations may
indeed prove life saving especially if
the dog has a heart beat. Once the dog's
heart stops beating it is unlikely that
CPR will be of benefit. By the way, the
name gingy in my address is for my 13
year-old golden retriever.
If a
person moves when I do CPR should I
stop?
Yes, if a person moves his arms or
legs they don't need CPR.
When
should I stop CPR?
When help arrives to take over, or
the victim starts to move.
What
chance does the person (on whom I
perform CPR) have of surviving?
If you do CPR on a person whose heart
has stopped beating there is a 30%
chance the person will live if a
defibrillator can arrive within several
minutes to shock the heart.
What
should I do if I'm alone and I do not
know CPR?
If you are alone and don't know how
to do CPR call 911 and ask the emergency
dispatcher to give you instructions over
the phone.
If
a pregnant women chokes should I do the
Heimlich Maneuver or can it harm the baby?
You should do the chest thrust in a
very pregnant woman. This is like the
Heimlich except you grab around the
middle chest instead of the upper
abdomen.
What
is the reason calling 911 occurs after 2
minutes of CPR for infants and children
whereas for adults, the call is made
immediately?
It is because airway problems are the
main cause of cardiac arrest in infants
and trying to correct that problem takes
precedent over calling 911.
If
successful CPR is dependent on a
defibrillator arriving, are there any
portable defibrillators available?
Portable defibrillators which operate
automatically (they are called automated
external defibrillators - AEDs) are
available and may be purchased without a
prescription. They cost around $1500.
The training is very simple and takes
only minutes. You should talk to your
doctor as to whether one of these might
be indicated in your situation.
In a
trekking guidebook I own it states that
if there has been a trauma fall and the
victim has no pulse, then CPR is futile, is
this true?
Doing CPR in the wilderness is
futile. I would, however, make an
attempt to open the airway and perhaps
give several ventilations. You may be
dealing with respiratory arrest and a
little mouth to mouth could be
lifesaving.
Is
it true that if a victim "regains" a
pulse after doing CPR he/she has probably
had a pulse all along?
You are partially correct. The most
common cause of cardiac arrest is VF and
this cannot be converted with CPR alone.
Electricity is required. However there
are some instances when the heart is
going very slowly and CPR can oxygenate
the system enough to get the heart going
again. Also there are instances when the
person is really in respiratory arrest
and the heartbeat is too faint to feel.
In this situation CPR may be enough to
get the heart beating stronger.
