Emergency Care For You

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Be ready to be a hero. Learn CPR

CPR TrainingLearning how to perform cardio-pulmonary resuscitation (CPR) saves lives. Approximately 325,000 people in America die each year from cardiac arrest. – or about 890 each day, according to the American Heart Association (AHA).

Conventional CPR consists of chest compressions and rescue breathing. However, the AHA and the American College of Emergency Physicians (ACEP) now recommend hands-only CPR, after studies have shown that rescue breathing may be unnecessary and potentially detrimental in cases of cardiac arrest.

The tips provided below are based on the procedures recommended by the AHA and are not a substitute for formal training in CPR. The AHA and the American Red Cross offer CPR courses.  To register, contact the AHA at 1-877-AHA-4CPR or your local American Red Cross chapter. Everyone in your family should take one of these courses, and you should have your CPR skills tested at least every 2 years.

Hands-Only CPR

CPR is typically administered in cases of cardiac arrest. Signs of cardiac arrest include an absence of heartbeats, blood flow and pulse. When blood stops flowing to the brain, the person becomes unconscious and stops regular breathing.

If someone goes into cardiac arrest, immediately call 9-1-1 or ask someone to call while you begin CPR.  And then immediately begin chest compressions. You do not need to take time to locate the person's pulse or check for signs of blood circulation.

  • Kneel at the person's side, near his or her chest.
  • With the middle and forefingers of the hand nearest the legs, locate the notch where the bottom rims of the rib cage meet in the middle of the chest.
  • Place the heel of the hand on the breastbone (sternum) next to the notch, which is located in the center of the chest, between the nipples. Place your other hand on top of the one that is in position. Be sure to keep your fingers up off the chest wall. You may find it easier to do this if you interlock your fingers.
  • Bring your shoulders directly over the person's sternum. Press downward, keeping your arms straight. Push hard and fast about 100 times per minute to the beat of the 1980’s disco song “Stayin’ Alive.” Avoid interruptions in chest compressions (to prevent stoppage of blood flow).
  • If an automated external defibrillator (AED) is available, use it.
  • If using an AED in the case of a heart attack or cardiac arrest, single shocks should be followed by immediate CPR for two minutes. Heart rhythm checks should be performed every two minutes (or 200 compressions); the AED will provide audible prompts at the appropriate intervals. See AED section for details.
  • If using an AED on a one- to eight-year-old child, use a child-dose-reduction system if available. (However, do not use child pads or a child dose on adults in cardiac arrest because the smaller dose may not defibrillate adults properly.)
  • Continue CPR until advanced life support or EMS is available and takes over.

CPR for Infants (Up to One Year Old)

Chest Compressions on Infants

  • If alone with an unresponsive infant, perform CPR for about 2 minutes before calling 911 or your local emergency number.
  • Use only the tips of the middle and ring fingers of one hand to compress the chest at the sternum (breastbone), just below the nipple line, as described in the table below. The other hand may be slipped under the back to provide a firm support. (However, if you can encircle your hands around the chest of the infant, using the thumbs to compress the chest, this is better than using the two-finger method.)
  • Depress the sternum between a third to a half the depth of the chest at a rate of at least 100 times a minute or about the rhythm of the 1980s disco song “Stayin’ Alive”.
  • Continue CPR until emergency medical help arrives.

Chest Compressions on Small Children (ages one to eight)

  • Perform chest compressions for about 2 minutes before calling 911.
  • Use the heel of one or two hands, as needed, and compress on the breastbone at about the nipple line.
  • Depress the sternum about a third to a half the depth of the chest, depending on the size of the child. The rate should be 100 times per minute. The 1980s disco song “Stayin’ Alive” is a perfect match for this rhythm.
  • Continue CPR until emergency medical help arrives.

Automated External Defibrillators

Automated External Defibrillators (AEDs) are increasingly available at many locations, such as shopping malls and airports. They are small, lightweight devices used to assess a person's heart rhythm. An AED can detect the need for and administer an electric shock to restore a normal heart rhythm in people with sudden cardiac arrest. ACEP supports widespread distribution of AEDs, as long as it is coordinated with existing EMS systems and includes proper training. Logical places for AEDs include police cars, theaters, sports arenas, public buildings, business offices, schools and airports. An increasing number of commercial airplanes are now equipped with AEDs and enhanced medical kits.

  • Each year in the United States, there are approximately 350,000 cardiac arrests. Less than 10 percent of victims survive whose cardiac arrests occur outside the hospital setting.
  • Having more people who can respond to medical emergencies and are trained to use AEDs will greatly increase survival rates for people in sudden cardiac arrest.
  • When a person suffers from sudden cardiac arrest, chances of survival double or triple if a bystander performs CPR while waiting for EMS to arrive. A victim's best chance for survival is when there is revival within 4 minutes.
  • ACEP supports increased public access to AEDs that is coordinated with community EMS systems and with appropriate training.
  • AEDs are most effective when standards are in place for appropriate training, equipment maintenance and ongoing monitoring of the quality of care.
Q. What is an Automated External Defibrillator?
A. An AED is a small, lightweight device used to assess a person's heart rhythm. If necessary, it administers an electric shock to restore a normal rhythm in victims of sudden cardiac arrest. Built-in computers assess the patient's heart rhythm, judge whether defibrillation is needed, and then administer an appropriate level of shock. Audible and/or visual prompts guide the user through the process.

Q. How does an AED work?
A. A microprocessor inside the defibrillator analyzes the victim's heart rhythm through adhesive electrodes (some AED models require the person to press an ANALYZE button). The computer then advises the operator whether a shock is needed. When the operator responds to the prompt to give a shock, an electric current is delivered through the victim's chest wall through adhesive electrode pads.

Q. Why are AEDs important?
A. AEDs can restore a normal heart rhythm in victims of sudden cardiac arrest, which may be a heart attack or sudden death. New, portable AEDs enable more people to respond to a medical emergency that requires defibrillation.

Q. Who can use an AED?
A. Anyone trained to use CPR can be trained to use an AED. Most AEDs are designed to be used by people without medical backgrounds. AEDs are most effective when standards are in place for appropriate training, equipment maintenance and ongoing quality-of-care monitoring. However, if there is a public access defibrillator available, it can be safely used by someone without AED or CPR training (if trained personnel are not available).

Q. When a person's heart stops beating, why should an AED be used?
A. When a heart's rhythm goes into an uncoordinated electrical activity called fibrillation, the heart twitches ineffectively and can't pump blood. This condition often accompanies severe heart attacks when the patient's heart appears to have stopped beating. The AED delivers electric current to the heart muscle, momentarily stunning the heart, stopping all activity. This gives the heart an opportunity to resume beating effectively. The AED will determine if such a shock will be effective – it does not require the user to make a decision.

Q. Will an AED always resuscitate someone in cardiac arrest?
A. No. The AED treats only a heart in ventricular fibrillation, an irregular heart rhythm. In cardiac arrest without ventricular fibrillation, the heart does not respond to electric currents, but needs medications. AEDs are less successful when the victim has been in cardiac arrest for more than a few minutes, especially if no CPR was provided.

Q. Should AEDs be available on airplanes and in other public places?
A.

Yes. Since seconds count when a person experiences a heart attack, ACEP supports widespread distribution of AEDs, as long as it is coordinated with existing EMS systems and includes proper training. Logical places for AEDs include police cars, theaters, sports arenas, public buildings, business offices, schools and airports. An increasing number of commercial airplanes are now equipped with AEDs and enhanced medical kits.

Approximately 325,000 people die from cardiac arrest every year. The broad deployment of portable defibrillators for use by trained lay rescuers can help to save countless lives from this deadly and unpredictable event. Some companies may be concerned about liability from employees using AEDs, but many states already have passed Good Samaritan laws to protect laypersons.

Q. Do AEDs replace the use of CPR?
A.

No. When a person experiences cardiac arrest, CPR will help keep oxygen flowing to the brain, but the electric shock of an AED vastly improves the chances of restarting the heart. AEDs can be used as part of cardiopulmonary resuscitation. CPR is still needed, starting with determining whether a person is unconscious, breathless or pulseless.

To help spread the use of AEDs, the American Red Cross has incorporated AED training into standard CPR training for the nation's businesses. The American Red Cross trains millions of people each year in lifesaving first aid and CPR.

Q. What's the difference between an AED and the defibrillators used in hospitals?
A.

In-hospital defibrillators are manual and larger than AEDs.  They are designed to be used only by qualified medical personnel with special training to use the device and to recognize heart rhythms. Medical personnel who use the device must decide whether or not to shock the person. Manual defibrillators also have additional capabilities such as pacing and cardioversion.

AEDs are programmed to recognize different heart rhythms and to make the shock/no shock decision, so that users don't have to. They were designed so that lifesaving defibrillation could be performed as quickly as possible.

Q. Can I be harmed using an AED?
A. No. If used properly, only the unresponsive patient will receive a shock.