Your questions answered on how to handle a cardiac arrest.
Q. What is CPR?
CPR stands for cardiopulmonary resuscitation. It is the technique used to pump oxygenated blood around the body by pushing on the chest. Effectively, CPR does the job of the heart.
Q. How can I perform effective CPR?
Kneel up straight with your knees next to the person’s chest. Knees should be as wide apart as your shoulders. Put the heel of your hand in the middle of the chest right between the nipples. Now place your other hand on top and lock your fingers. Try and keep your fingers off the chest. Lean over the chest with your arms straight and elbows locked. Push on the chest between the nipples, hard and fast.
Q. Why is CPR necessary?
When performing CPR, you pump oxygenated blood through the body to the brain and other organs. It is essential to maintain this blood flow until the paramedics arrive and take over.
Q. Why ‘straight arms’ when pumping the chest?
CPR is strenuous. If you pump the chest using straight arms you will use the weight of your upper body and you will find it easier and less tiring. If there is another bystander, ask them to help and take over the CPR when you tire. Keeping hands on the chest, continue to rotate when each person tires, until the paramedics arrive.
Q. Why do you no longer check for a pulse?
Finding a pulse before starting CPR is no longer considered necessary. It can be difficult to find a pulse in a stressful situation and doing so can waste vital time. Recognising if the person is unconscious and not breathing normally is far more reliable. If you start CPR on someone who has a pulse, it is highly unlikely you will do any harm. If in doubt, it is better to start CPR than not.
Q. How do you perform CPR on a baby?
The technique is basically the same. For babies (up to 1-year-old), keep the head in the neutral position, push on the chest with two fingers in the centre of the chest. If instructed by the call taker, cover both the mouth and nose with your mouth to deliver small breaths. For children under 10 years, use one hand instead of two and follow the call taker’s instructions.
Q. Can I break the patient’s ribs while performing compressions?
Yes, there is a chance you could break ribs during CPR. This is not unusual. If you feel a rib break, re-check your hand position, but don’t stop. A broken rib can heal if the patient can be resuscitated.
Q. When do I stop CPR?
Only stop CPR when the paramedics arrive and are ready to take over from you or when the patient starts to breathe on their own. Every minute CPR is performed can make a difference to the patient’s survival and minimises the risk of brain damage and/or death.
Q. If I do CPR correctly can I expect the patient to start breathing or recover before the ambulance arrives?
CPR buys time for the patient. Very rarely will a person who has been in cardiac arrest start breathing spontaneously. However, if bystanders use a publicly accessible AED before the paramedics arrive, the patient’s condition may change. Tell the call taker and follow their instructions
Q. What if the patient is in a bed or on a chair?
You need to move the patient to a hard surface. Performing CPR on a soft surface is ineffective. A person slumped in a chair or a car seat who is not conscious and breathing normally will need to be placed on a hard surface to allow for effective CPR. Remember, a bruise is nothing in the context of a person who is not breathing.
If you’re struggling to get them to the floor, just do the best you can within your limitations – anything is better than doing nothing at all. Adrenaline may also allow you to get to the floor to perform CPR. When medical assistance arrives, they will be able to help you get up from the floor.
Q. What legal issues could I face performing CPR?
The risk of being sued for providing first aid or CPR is very low. There are no reported cases of anyone being sued for this in Australia. Good Samaritan laws protect people who provide assistance, advice, or care in good faith at the scene of an emergency or accident.
Under the Wrongs Act 1958, legal protections from civil liability apply if:
• the patient is injured or appears to be at risk of injury or death.
• the good Samaritan acts with honest intent and didn’t expect any financial reward for providing assistance.
These laws seek to reassure people that if they step up to help in an emergency, they will not be liable for their honest attempts to help, regardless of the outcome.
Q. What are Automated External Defibrillators (AEDs)?
AEDs are automated devices that are used during a cardiac arrest to shock the patient’s heart back into normal function. AEDs analyse a heart’s rhythm and only shock when it is necessary. CPR, together with the use of an AED in the critical minutes before paramedics arrive, dramatically increases the patient’s chance of survival. If no AED is available, continue CPR until the ambulance paramedics arrive and are ready to take over. If an AED is available, send a bystander to retrieve it while you start CPR. Place the AED close to the right upper side of the upper chest, open the AED and follow the instructions. If unsure the call taker will assist you to use the AED.
Q. Do I need training to use an AED?
Anyone can use an AED. No training is necessary.
Q. Can I hurt someone with an AED?
An AED will only deliver a shock if it is necessary. It will also warn all bystanders to stand back when a shock is about to be administered, as well as when the shock is complete and CPR can recommence.
Q. What is the AED register?
All AEDs should be registered on the AED Register through your local ambulance service.
This will allow the emergency (000/111) call taker to ‘see’ AEDs near a cardiac arrest and direct bystanders to them. AED owners are encouraged to make their AED publicly accessible 24 hours a day. This may dramatically increase the survival chances of cardiac arrest patients in the community. If AEDs are not registered, the emergency (000/111) call taker will not be able to direct bystanders to the closest AED. If AEDs are registered and used in an emergency, your ambulance service will check the AED afterward to ensure it is ready to save another life.