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Hands-only CPR is the only hope for 350,000 Americans

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Each year, around 350,000 cardiac arrests happen on the streets, and at homes, throughout the U.S. The cause is a sudden cardiac arrest (most often). Just like its name says- the heart suddenly stops. Understanding the causes is less important, but knowing what to do in such situations is what makes the difference between life and death.

“CPR, if performed immediately, doubles or triples victim’s chance of survival “- American Heart Association.

Doctors know about this. Training a layman to provide “full “CPR treatment is simple. The training sessions are performed on specialized plastic mannequins. Those things have sensors that signal if the chest compression is strong enough, if the airway is clear, and if mouth-to-mouth is performed accurately. Before a trainee begins the session, he/she cleans the mannequin with alcohol wipes. Also, an instructor observes entire process and suggests if something is wrong.

The real-life situations are a bit different. Usually, years pass before a trainee stumbles upon the first case of cardiac arrest. Years is more than enough to forget essentials of the CPR (it’s more than enough to get over the first love, not to mention CPR principles!). People with cardiac arrest do not clean themselves with alcohol wipes before the event, nor do you as the rescuer have time for that. Some of them are dirty, drunk. Some vomited before the event, others bleed or have other injuries that make the rescue unpleasant.

If you are not trained to provide CPR, this article is written for you!

hands only cpr

Cardiac arrest

The victim usually just drops to the ground. In one moment everything is fine, then the victim says he/she is not feeling well and seconds later loses consciousness. The cause is most often heart disease. Some people vomit before fainting (which is a sign that heart attack is a probable cause of cardiac arrest).

How to determine if there is a need for hands-only CPR?

The person with cardiac arrest can’t be consciousness! If the victim reacts, the heart does its job (probably not the best it can, but no need for the CPR).

How to check responsiveness:

    • Shake the victim gently and ask if he/she is ok.
    • If you get no response, rub the chest bone with your knuckles using fast, strong, brisk movements, asking the question again. You can try this for yourself right now- just make sure to press hard enough to cause pain.
    • The whole point of this action is to cause pain. Of course, don’t do this if the victim responds.
    • If you don’t get any response to pain, check the upper airways.
    • Call 911

Calling 911

It is an emergency, if there are other people around, ask some of them to call for help instead. If you are alone, keep it as short as possible. Explain the situation calmly. While talking to the operator, check the upper airways and pulse.

Check the upper airways

    • Open the victims mouth and look for food, dirt, dental, or any other obstruction.
    • DO NOT put fingers into the mouth of a conscious person or someone with a seizure- you could sustain severe biting injuries.
    • Check the pulse

Checking the pulse:

      • Carotid pulse is closest pulse point to the heart. Therefore it is the last one that disappears (it can be felt even if the slightest heart action is present).
      • Check it with your index and middle finger.
      • Always check one side at a time (never on both sides simultaneously!)
      • DO NOT use the thumb (it has its own pulsating artery so you could feel your pulse and mistakenly interpret it as a victim’s)
      • If there is no pulse, begin hands-only CPR



How to do hands-only CPR?

    • Place the casualty on the back, on a hard, flat surface at ground level. Soft surfaces, such as a bed, or a thick layer of grass will compensate the pressure and make the maneuver ineffective. Elevated surfaces (a table, for example), will make it impossible to lock the elbows and efficiently “pump the heart.“
    • Place the heal of your dominant hand in the center of the casualty’s chest, about 1-2 inches from the bottom of the breastbone.
    • Place the other hand over the dominant, locking them with fingers.
    • Lock the elbow joint. Your shoulders should be above the hands at the center of the casualty’s chest now.
    • Press down the breastbone by 2-2.5 inches (1.5 inches if the casualty is under one-year-old infant) and release.
    • Repeat the process at the rate of 100-120 beats per minute.
    • Do this until someone more competent arrives or until the ambulance arrives.
    • You can check for heart action every 2-3 minutes.
    • Hands-only CPR includes only chest compressions (no mouth-to-mouth) and that’s why it’s easier to perform.

Hands-Only CPR Adult Chest Compression

CPR Adult Chest Compression by Bruce Blaus | Creative Commons 4

Last thoughts

Keep in mind that, by performing hands-only CPR to a person in cardiac arrest you are doing the most for him/her as a layman. Even a trained medical professional couldn’t do more with his bare hands (he/she could perform mouth-to-mouth, but it doesn’t make much difference if help arrives quickly). Rely on your assessment! Maybe you won’t be 100% sure if you can feel the pulse or not. Just do your best to asses. After all, performing hands-only CPR on a person with heart action is a less mistake than not performing CPR on a person with heart arrest!

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