Written by 20/01/2017on
Cardiopulmonary Resuscitation (CPR)
This guideline applies to all persons who are unresponsive and not breathing normally.
This guideline is for use by bystanders, first aiders or first aid providers, first responders and health professionals.
The Australian and New Zealand Committee on Resuscitation (ANZCOR) make the following recommendations:
1. Rescuers must start CPR if the person is unresponsive and not breathing normally.
2. Bystander CPR should be actively encouraged.
3. Compression-to-ventilation ratio be 30:2 for all ages.
4. All rescuers perform chest compressions for all who are not breathing normally. Rescuers who are trained and willing to give rescue breaths are encouraged to do so.
5. Chest compressions should be provided at a rate of approximately 100 – 120 /min.
6. Rescuers should aim to minimise interruptions to chest compressions.
What is Cardiopulmonary Resuscitation?
Cardiopulmonary resuscitation (CPR) is the technique of chest compressions combined with rescue breathing. The purpose of CPR is to temporarily maintain a circulation sufficient to preserve brain function until specialised treatment is available. Rescuers must start CPR if the person is unresponsive and not breathing normally. Even if the person takes occasional gasps, rescuers should start CPR. CPR should commence with chest compressions and interruptions to chest compressions must be minimised.
Early high-quality CPR saves lives. ANZCOR recommends that CPR is started for presumed cardiac arrest without concerns of harm to persons not in cardiac arrest.
Compression-to-Ventilation Ratio ANZCOR suggests a compression–ventilation ratio of 30:2 compared with any other compression–ventilation ratio in people in cardiac arrest. Compressions must be paused to allow for ventilations.
Steps of Resuscitation
Initial steps of resuscitation are:
1. DANGERS Check for danger (hazards/risks/safety)
2. RESPONSIVENESS Check for response (if unresponsive)
3. SEND Send for help
4. AIRWAY Open the airway
5. BREATHING Check breathing (if not breathing / abnormal breathing)
6. Start CPR (give 30 chest compressions followed by two breaths)
7. DEFIBRILLATION Attach an Automated External Defibrillator (AED) as soon as available and follow the prompts.
All rescuers should perform chest compressions for all those who are unresponsive and not breathing normally. ANZCOR suggests that those who are trained and willing to give breaths do so for all persons in cardiac arrest. If rescuers do continuous chest compressions they should be at a rate of approximately 100 – 120 /min.
Minimise Interruptions to Chest Compressions
CPR should not be interrupted to check for response or breathing. ANZCOR places a high priority on minimising interruptions for chest compressions. We seek to achieve this overall objective by balancing it with the practicalities of delivering 2 effective breaths between cycles of chest compressions to the patient without an advanced airway.
When more than one rescuer is available ensure:
• that an ambulance has been called
• all available equipment has been obtained (e.g. AED).
Duration of CPR
The rescuer should continue cardiopulmonary resuscitation until any of the following conditions have been met:
• the person responds or begins breathing normally
• it is impossible to continue (e.g. exhaustion)
• a health care professional arrives and takes over CPR
• a health care professional directs that CPR be ceased.
CPR should be initiated for presumed cardiac arrest without concerns of harm to persons not in cardiac arrest. In making this recommendation, ANZCOR places a higher value on the survival benefit of CPR initiated by rescuers for persons in cardiac arrest against the low risk of injury in persons not in cardiac arrest. The risk of disease transmission during training and actual CPR performance is very low. A systematic review found no reports of transmission of hepatitis B, hepatitis C, human immunodeficiency virus (HIV) or cytomegalovirus during either training or actual CPR when high-risk activities, such as intravenous cannulation were not performed. If available, the use of a barrier device during rescue breathing is reasonable. After resuscitating a person, the rescuer should reassess and reevaluate for resuscitation-related injuries.