Introduction:
CPR is an emergency procedure performed in cardiac arrest individuals, where survival rates and neurologic outcomes are poor. This procedure comprises chest compressions and artificial ventilation to maintain blood circulation and oxygenation during cardiac arrest, leading to improved chances for survival and neurologic outcomes. The history of CPR dates back to ancient civilizations. It was first introduced by the Paris Academy of Sciences by providing mouth-to-mouth resuscitation that involved blowing air into the victim's lungs. But then, modern CPR began to take shape in the mid-20th century. The CRP techniques and devices have evolved significantly, enabling efficient chest compressions and rescue breaths. This article explains various CPR techniques and devices used in recent times.
What Is Cardiopulmonary Resuscitation (CPR)?
Cardiopulmonary resuscitation (CPR) is a life-saving technique performed in emergencies when someone’s heart can no longer pump blood or breathing has stopped. It is a simple technique that anyone can learn and perform, and it consists of chest compressions, mostly combined with mouth-to-mouth breathing or artificial ventilation. While performing chest compression, it helps to maintain the blood flow to vital organs until a regular heartbeat returns. Providing oxygen through mouth-to-mouth breathing or artificial ventilation provides more oxygen in a person with cardiac arrest. It plays an important role in increasing the chances of survival during cardiac arrest and preventing brain damage.
What Are the Techniques Involved in CPR?
As the American Heart Association recommends, CRP has three primary components: chest compression, airway, and breathing. These techniques aim to maintain blood flow and oxygenation until professional medical help arrives.
Chest Compressions:
Chest compressions are the cornerstone of CPR. In this technique, the attendee should use their hands to push down hard and fast in a specific way to maintain blood circulation.
The following are the steps involved in the chest compression technique:
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Place the patient on their back on a firm and flat surface. Tilt the patient's head back slightly by lifting their chin. Also, check for any obstruction in their mouth, such as food or vomit. If it is present and the obstruction is loose, try to remove it. Removing the obstruction may push it farther into the airway if the obstruction is tight.
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Kneel next to the patient's neck and shoulders.
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Place the heel of one hand over the center of the patient’s chest, usually between the nipple, and place the other over the top of the first hand. The elbows should be straight, and the shoulders should be placed directly above the hands.
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Push straight down on the chest at least two inches but no more than 2.4 inches for adults and 1.5 inches for children and infants.
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While compressing, the entire body weight should be used, not just pressing with arms.
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Administer chest compressions at a rate of 100-120 compressions per minute.
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If the attendee is not a trained person in CPR, chest compressions should be continued until there are signs of movement or until the arrival of emergency medical personnel. In the case of trained persons, CPR should be continued till opening the airway and rescue breathing.
Open the Airway:
After 30 chest compressions, the person's airway should be opened using the head-tilt and chin-lift maneuvers. This is done by placing the palm on the patient’s forehead and gently tilting the head back. With the other hand, gently lift the patient’s chin forward to open the airway.
Breathing:
Rescue breathing involves providing oxygen to the patient’s lungs. It can be given using mouth-to-mouth breathing or mouth-to-nose breathing techniques. A bag-mask device with a high-efficiency air filter can also provide artificial ventilation.
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To provide breathing support, head-tilt and chin-lift maneuvers open the airway. The nostrils are pinched, and mouth-to-mouth breathing is given.
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Prepare to give two rescue breaths after 30 compressions should be given.
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Use a lower air volume for children and infants, and be gentle.
These CPR steps should be continued until signs of movement or emergency medical personnel arrive.
What Are the Types of CPR Devices?
Even though manual CPR is a very effective technique, recent technological advancements have developed various devices that enhance the quality and consistency of CPR. Both trained medical professionals and bystanders can effectively use these devices in delivering effective chest compressions and breathing. The following are some commonly used CPR devices:
1) Automated External Defibrillators (AEDs):
AEDs are portable devices used to revive someone from sudden cardiac arrest. It delivers an electrical shock to the heart in victims with sudden cardiac arrest. This device's use is not limited to a hospital setting; it can be used at home, in schools, and in public places. AEDs are user-friendly and equipped with visual instructions and voice prompts to guide users through CPR. They can remarkably increase the chances of survival when used promptly.
2) Bag-Valve-Mask (BVM) Resuscitators:
These devices aid in delivering breathing more effectively while minimizing the risk of infection transmission. It has a self-inflating bag attached to a nonrebreathing valve and to a face mask that conforms to the face of the patient. The BVM resuscitators provide a barrier between the rescuer and the patient, ensuring safe ventilation.
3) Mechanical Chest Compression Devices:
Mechanical chest compression devices, such as the LUCAS Chest Compression System, provide automated chest compressions to sudden cardiac arrest patients. It provides consistent and high-quality chest compressions. These devices are particularly beneficial when manual compressions are challenging, such as during transportation or in cramped spaces. The main types of mechanical chest compression devices currently in use are pneumatic piston devices such as Michigan and LUCAS and load-distributing band devices such as Zoll auto pulse.
Extracorporeal Techniques and Invasive Perfusion Devices (ECPR):
ECPR is more effective in postcardiotomy (circulatory failure after cardiac surgery) patients than in those with cardiac arrest. This technique is usually performed in the hospital.
Conclusion:
CPR techniques and devices have evolved significantly through the years, enhancing the chances of survival for victims experiencing cardiac arrest. Technology continues to play a pivotal role in improving outcomes from traditional mouth-to-mouth resuscitation to the recent innovations of AEDs, mechanical compression devices, and bag-valve-mask resuscitator devices by saving many patients life.
