Cardiopulmonary resuscitation (CPR) Causes symptoms types and procedure

Cardiopulmonary resuscitation (CPR) is one of the most important first-aid procedures that can help preserve a person’s life in the event of sudden cardiac or respiratory arrest. Its importance lies in the fact that prompt intervention may help maintain blood and oxygen flow to the brain and vital organs until emergency medical services arrive. CPR techniques vary depending on the age of the person affected, so some steps differ between children and adults.In this article on Dalili Medical, we discuss the causes that may require CPR, the signs of cardiac and respiratory arrest, the different types of CPR, how to perform it, as well as important tips and frequently asked questions.

What Is Cardiopulmonary Resuscitation (CPR)?

Cardiopulmonary resuscitation (CPR) is an emergency procedure used when a person is unresponsive and not breathing normally. Its purpose is to help maintain blood flow carrying oxygen to the brain and vital organs until emergency medical care arrives.

When Is CPR Necessary?

CPR should be performed when a person is unconscious and unresponsive, with no normal breathing or with abnormal breathing. In this situation, emergency medical services should be contacted, and appropriate first-aid measures should be started as quickly as possible.

Is CPR Different for Children and Adults?

Yes. Some aspects of CPR vary depending on the age and size of the person, particularly the technique used for chest compressions and rescue breaths. However, the main goal remains the same: supporting circulation and breathing until trained medical professionals arrive.

Should CPR Be Performed on an Unconscious Person Who Is Breathing Normally?

Generally, CPR should not be performed if a person is unconscious but breathing normally. In this situation, medical assistance should be requested, and the person's breathing and responsiveness should be continuously monitored while following the instructions provided by emergency services.

Should You Call Emergency Services Before Starting CPR?

If another person is available, it is best for one person to call emergency services and request an automated external defibrillator (AED) while the other person begins CPR. If the rescuer is alone, they should seek help as quickly as possible according to the local emergency system while starting the appropriate first-aid measures.

What Is the Importance of an Automated External Defibrillator (AED)?

An automated external defibrillator (AED) is an important device used in cases of cardiac arrest. It can analyze the heart rhythm and determine whether an electrical shock is appropriate. The AED should be used according to its audio or visual instructions, and no one should touch the person while the shock is being delivered.

Can CPR Cause Injuries?

Chest compressions may sometimes cause injuries. However, delaying CPR when cardiac arrest has occurred can be more dangerous. Therefore, CPR should be started when signs of cardiac arrest are present, while following available training or instructions provided by emergency medical personnel.

Can an Untrained Person Perform CPR?

Yes. An untrained person can perform chest compressions when cardiac arrest is suspected, while contacting emergency services and following instructions provided by an emergency dispatcher over the phone, if this service is available.

Is Rescue Breathing Always Required During CPR?

Not necessarily in every situation. Recommendations vary depending on the person's age, the cause of cardiac arrest, the rescuer's level of training, and local emergency service guidelines. An untrained rescuer can begin chest compressions and follow the instructions provided by the emergency dispatcher.

Does CPR Always Restart the Heart?

No. CPR does not guarantee that the heart will return to a normal rhythm. Its primary purpose is to help maintain oxygenated blood flow to the brain and vital organs, which may improve the chances of survival until medical professionals arrive. The person may also require defibrillation or advanced medical treatment depending on their condition.

What Is the Difference Between CPR and Defibrillation?

CPR aims to support circulation and breathing through chest compressions and may include rescue breaths. Defibrillation, on the other hand, involves delivering an electrical shock using a defibrillator to treat certain abnormal heart rhythms that can lead to cardiac arrest.

Can an AED Be Used on Children?

Yes, an automated external defibrillator (AED) can be used on children when necessary. Pediatric settings or pediatric pads should be used if the device provides them and they are appropriate for the child's age. Always follow the instructions provided by the device carefully.

What Should I Do If the Person Starts Breathing or Moving?

If the person regains normal breathing or begins to respond, stop chest compressions and continue to monitor them until emergency medical services arrive. If the person remains unconscious but is breathing normally, follow appropriate first-aid guidance and continue monitoring their breathing.

Does the Person Need to Go to the Hospital After Successful Resuscitation?

Yes. Even if the person regains consciousness or their heart starts beating again, they require urgent medical evaluation to determine the cause of cardiac arrest, monitor their condition, and identify any potential complications.

Are the Causes of Cardiac Arrest Different in Children and Adults?

Yes. The causes may differ between the two groups. Cardiac arrest in children is more commonly associated with breathing problems, choking, or certain medical conditions, while cardiac arrest in adults is often associated with heart disease. However, the underlying cause varies from one case to another.

When Should Emergency Medical Services Be Called Immediately?

Emergency medical help should be requested immediately if a person is unresponsive and not breathing normally, or if they experience sudden loss of consciousness or severe difficulty breathing. A rapid response is particularly important in cases of cardiac arrest.

Can Anyone Learn CPR?

Yes. People are encouraged to learn CPR through accredited first-aid and CPR training courses, as hands-on training can help them develop the skills needed to respond appropriately to emergencies.

Important: In an actual emergency, contact your local emergency medical services immediately and follow the instructions provided by the emergency dispatcher. Do not delay seeking medical assistance.

Types of CPR for Children and Adults

Cardiopulmonary resuscitation (CPR) varies depending on the person's age and condition, as well as the level of training of the person providing assistance. CPR aims to help maintain blood flow and oxygen delivery to the brain and vital organs until medical help arrives.

1. Basic Life Support (BLS)

Basic Life Support is an initial approach for managing cardiac and respiratory arrest and may include:

• Recognizing unresponsiveness and the absence of normal breathing.

• Calling emergency medical services.

• Performing chest compressions.

• Using an automated external defibrillator (AED) when available.

• Continuing CPR until trained professionals arrive or signs of life appear.

BLS is used for adults, children, and infants, with differences in chest-compression techniques depending on the person's age and size.

2. CPR for Adults

Adult CPR is used when an adult experiences cardiac arrest or becomes unresponsive and is not breathing normally.

It focuses on:

• Chest compressions.

• Rescue breathing when the rescuer is trained and able to provide it.

• Using an AED when available.

• Continuing CPR according to emergency medical service instructions.

3. CPR for Children

CPR for children takes into account differences in body and chest size compared with adults.

It may include:

• Chest compressions using a technique appropriate for the child's age and size.

• Rescue breathing when the rescuer is trained and able to provide it.

• Using an AED when available, with pediatric settings or pads when available and appropriate.

• Continuing CPR until emergency medical services arrive or signs of life appear.

4. CPR for Infants

Infant CPR is intended for babies, and the chest-compression technique differs from that used for older children because of their smaller body and chest size.

It may include:

• Chest compressions using the appropriate technique for the infant.

• Rescue breathing when the rescuer is trained and able to provide it.

• Using an AED according to its instructions, with pediatric settings or pads when available and appropriate.

5. CPR With Rescue Breathing

This approach combines chest compressions and rescue breathing to support circulation and provide oxygen.

Rescue breathing can be particularly important in some cases of cardiac arrest in children, especially when the cause is related to a breathing problem such as drowning or choking.

6. CPR With an Automated External Defibrillator (AED)

An AED can be used during CPR when available.

The device analyzes the heart rhythm and, if it detects a rhythm that may be treated with an electrical shock, provides audio or visual instructions on the necessary steps.

The device's instructions should be followed carefully, and CPR should be continued as directed.

7. Advanced Life Support (ALS)

Advanced Life Support is provided by trained medical professionals and goes beyond basic life-support measures.

It may include:

• Securing the airway.

• Providing respiratory support using specialized equipment.

• Monitoring the heart rhythm.

• Administering medications appropriate for cardiac arrest.

• Using advanced methods to support circulation.

• Identifying and treating a potentially reversible cause of cardiac arrest.

What Is the Main Difference Between CPR for Children and Adults?

The main differences involve the technique, depth, and method of chest compressions, including whether one or both hands or fingers are used according to the person's age and size. Respiratory causes of cardiac arrest are also more common in children, so respiratory support may be an important part of pediatric resuscitation when the rescuer is trained to provide it.

Causes That May Require CPR in Children and Adults

Cardiopulmonary resuscitation (CPR) is not a treatment for a specific disease. Rather, it is an emergency procedure used when a person becomes unresponsive and is not breathing normally, or when the heart is no longer effectively pumping blood. The causes that may lead to the need for CPR can differ between adults and children. Cardiac arrest in adults is often associated with heart disease, while cardiac arrest in children frequently begins with a breathing problem that results in a lack of oxygen.

First: Causes That May Require CPR in Adults

Some of the main causes include:

1. Heart Attack

Some heart attacks can cause serious disturbances in the heart's rhythm, and in severe cases, this may progress to cardiac arrest.

2. Heart Rhythm Disorders

Certain severe heart rhythm disorders can prevent the heart from pumping blood effectively and may result in cardiac arrest.

3. Choking and Airway Obstruction

An obstructed airway can cause severe oxygen deprivation, followed by respiratory arrest and, if not treated promptly, potentially cardiac arrest.

4. Drowning

Drowning can result in severe oxygen deprivation, which may cause respiratory arrest followed by cardiac arrest in severe cases.

5. Severe Injuries and Accidents

Serious injuries or significant blood loss can cause a severe reduction in blood flow to the body's organs, potentially progressing to cardiac arrest.

6. Severe Neurological Conditions

Certain acute neurological conditions can affect consciousness or the ability to breathe. In severe cases, they may lead to respiratory or cardiac arrest.

7. Poisoning or Accidental Ingestion of Dangerous Medication Doses

Certain toxic substances or medications can affect breathing or heart rhythm and may result in cardiac or respiratory arrest.

8. Severe Electrolyte and Metabolic Disorders

Severe changes in the levels of certain electrolytes, such as potassium, or certain acute metabolic disorders can cause dangerous heart rhythm disturbances.

9. Acute Respiratory Failure

Certain lung diseases or conditions that prevent adequate oxygen from reaching the body can cause respiratory failure, which may progress to cardiac arrest.

10. Electrical Injuries

Severe electric shocks can seriously affect the heart rhythm and breathing and may lead to cardiac or respiratory arrest.

Second: Causes That May Require CPR in Children

The causes of cardiac and respiratory arrest in children differ from those in adults. In many cases, the problem may begin with severe breathing difficulties and a lack of oxygen, which can then progress to cardiac arrest.

Some of the main causes include:

1. Choking and Airway Obstruction

Airway obstruction is an important cause, particularly among infants and young children. It may occur when a foreign object enters the airway or when severe obstruction develops while eating.

2. Drowning

Drowning can cause severe oxygen deprivation, which may result in respiratory arrest followed by cardiac arrest in severe cases.

3. Severe Breathing Problems

Certain serious respiratory conditions, such as severe asthma attacks or serious respiratory infections, may lead to respiratory failure if they are not treated promptly.

4. Injuries and Accidents

Severe injuries or accidents may cause significant blood loss or affect breathing and circulation, potentially requiring resuscitation.

5. Congenital Heart Disease

Some children with severe congenital heart defects or serious heart rhythm disorders may be at increased risk of cardiac arrest.

6. Severe Infections

Certain severe infections can cause serious disturbances in circulation and breathing and may progress to cardiac arrest in critical cases.

7. Poisoning

Accidental exposure to certain medications or toxic substances can affect consciousness, breathing, or heart rhythm.

8. Electrical Shock

Electrical accidents can cause dangerous heart rhythm disturbances or respiratory arrest.

9. Severe Metabolic Disorders

Severe abnormalities in blood sugar or electrolyte levels can affect the functions of the heart, brain, and respiratory system.

10. Undiagnosed Medical Conditions

Certain previously unknown diseases or medical conditions may cause sudden deterioration in breathing or circulation, requiring urgent emergency intervention.

Signs That May Require CPR in Children and Adults

It is important to clarify that CPR itself does not cause symptoms. Rather, it is performed when signs indicate cardiac arrest, respiratory arrest, or the absence of normal breathing. Some signs may differ between children and adults.

First: Signs That May Require CPR in Adults

The main signs include:

• Loss of consciousness and unresponsiveness when the person is called or an attempt is made to wake them.

• Absence of normal breathing.

• Abnormal breathing or occasional gasping, which should not be considered normal breathing.

• Sudden collapse and loss of consciousness.

• Lack of normal movement or response.

• Changes in skin or lip color may occur in cases of severe oxygen deprivation.

Cardiac arrest may sometimes be preceded by symptoms such as chest pain or pressure, shortness of breath, heart palpitations, or severe dizziness. However, cardiac arrest can also occur suddenly without obvious warning symptoms.

Second: Signs That May Require CPR in Children

Signs may include:

• Loss of consciousness and unresponsiveness.

• Absence of breathing or normal breathing.

• Gasping or abnormal, intermittent breathing.

• Lack of normal movement or response.

• Sudden collapse.

• Bluish skin or lips or severe paleness in cases of oxygen deprivation.

• In infants, the condition may appear as unresponsiveness, absence of normal breathing, or sudden limpness.

Important Signs to Watch For

Abnormal gasping or intermittent breathing does not mean that the person is breathing normally. If a person is unresponsive and not breathing normally, this is an emergency requiring emergency medical services and the initiation of CPR according to the rescuer's level of training, while following instructions from an emergency dispatcher by phone.

Important: CPR is an emergency procedure and is not a treatment for ordinary symptoms. In an actual emergency, call emergency medical services immediately and follow the instructions of trained professionals.

How to Perform CPR for Children and Adults

Cardiopulmonary resuscitation (CPR) is an emergency procedure used when a person becomes unresponsive and is not breathing normally. Some steps vary depending on whether the person is an adult, child, or infant.

Important: In a real emergency, contact emergency medical services immediately and follow the instructions of the emergency dispatcher. The following information is for general education and does not replace certified hands-on training.

First: How to Perform CPR on Adults

1. Make Sure the Area Is Safe

Make sure there are no hazards that could put you or the person at risk.

2. Check for Responsiveness

Call out to the person clearly and check whether they respond. If there is no response, seek help immediately.

3. Call Emergency Services and Get an AED

Call emergency medical services or ask someone else to call. If an automated external defibrillator (AED) is available, ask someone to bring it.

4. Assess Breathing

If the person is unresponsive and not breathing normally, or is breathing abnormally, such as with occasional gasping, begin CPR according to emergency instructions.

5. Begin Chest Compressions

• Place the person on a firm, flat surface.

• Place the heel of one hand in the center of the chest, then place the other hand on top.

• Keep your arms straight.

• Perform compressions at a rate of 100–120 compressions per minute.

• Allow the chest to return to its normal position after each compression.

6. Rescue Breathing

If you are trained and able to provide rescue breaths, the usual sequence is 30 chest compressions followed by 2 rescue breaths.

If you are not trained in rescue breathing or are unable to provide it, you can continue chest compressions for an unresponsive adult who is not breathing normally while following emergency dispatcher instructions.

7. Use an AED

• Turn on the device and follow its audio or visual instructions.

• Apply the pads according to the diagram shown on the device.

• Do not touch the person while the device is analyzing the heart rhythm or delivering a shock.

• Resume chest compressions immediately when instructed by the device.

Second: How to Perform CPR on Children

When you find a child who is unresponsive and not breathing normally:

1. Make sure the area is safe.

2. Gently check the child's responsiveness.

3. Call for help and contact emergency services.

4. Check the child's breathing.

5. If the child is not breathing normally, begin CPR according to your training and emergency instructions.

6. Place the child on a firm surface.

7. Perform chest compressions using one or both hands, depending on the child's size, with the hand positioned in the center of the chest.

8. Maintain a rate of 100–120 compressions per minute.

9. If you are trained in pediatric CPR, combine chest compressions with rescue breaths according to your training.

10. Use an AED when available, with pediatric settings or pads when available and appropriate.

Third: How to Perform CPR on Infants

Some CPR techniques differ for infants because of their smaller body and chest size.

• Place the infant on a firm surface.

• Check responsiveness and breathing.

• Call for help and contact emergency services.

• If the infant is unresponsive and not breathing normally, begin CPR according to certified training and emergency instructions.

• Perform chest compressions using a technique appropriate for the infant's size.

• A trained rescuer may combine chest compressions with rescue breaths.

• An AED may be used when available, with pediatric settings or pads if available and appropriate.

How to Perform CPR on Pregnant Women

Cardiopulmonary resuscitation (CPR) should be performed on a pregnant woman who is unresponsive and not breathing normally, with some important considerations because of pregnancy, particularly during advanced pregnancy.

Important: In a real emergency, call emergency medical services immediately and follow the emergency dispatcher's instructions. The following information is for educational purposes and does not replace certified hands-on training.

1. Make Sure the Area Is Safe

First, make sure there are no hazards that could put the rescuer or the pregnant woman at risk.

2. Check Responsiveness and Breathing

• Check whether the pregnant woman responds.

• If she does not respond, seek help immediately.

• If she is not breathing normally or is breathing abnormally, treat the situation as cardiac arrest and begin CPR.

3. Call Emergency Services and Get an AED

Ask another person to call emergency medical services and bring an automated external defibrillator (AED) if one is available.

Pregnancy is not a reason to avoid using an AED when it is needed. Rapid resuscitation is important for both the mother and fetus.

4. Place the Pregnant Woman on a Firm Surface

Place the pregnant woman on her back on a firm surface to allow effective chest compressions.

In advanced pregnancy, the rescuer or a member of the emergency team should manually move the uterus to one side, usually toward the left, to reduce pressure on the major blood vessels and improve blood return to the heart, while continuing chest compressions.

5. Perform Chest Compressions

• Place your hands in the center of the chest, as with other adults.

• Keep your arms straight.

• Perform compressions at a rate of 100–120 compressions per minute.

• Allow the chest to fully recoil after each compression.

• Avoid delaying compressions while attempting to reposition the pregnant woman.

6. Rescue Breathing

If the rescuer is trained and able to provide rescue breaths, chest compressions and rescue breathing are generally combined according to adult CPR training.

An untrained person can continue chest compressions while following the emergency dispatcher's instructions by phone.

7. Use an AED

An AED can be used on a pregnant woman when needed:

• Turn on the device and follow its instructions.

• Apply the AED pads to the chest according to the diagram on the pads.

• Do not touch the woman while the device is analyzing the heart rhythm or delivering a shock.

• Resume chest compressions immediately when instructed by the device.

What About the Fetus?

In the event of maternal cardiac arrest, the priority is to resuscitate the mother and restore her circulation. Improving the mother's circulation and oxygenation is the best initial approach for supporting the fetus.

If the mother does not respond to resuscitation, a specialized medical team will perform the emergency procedures necessary for both the mother and fetus. In some cases of advanced pregnancy, an emergency delivery may be required, depending on the medical circumstances.

Important Tips When Performing CPR on Children and Adults

Cardiopulmonary resuscitation (CPR) is one of the most important first-aid procedures when cardiac arrest is suspected. Acting quickly and seeking medical assistance may be important factors in improving the chances of survival. Key recommendations include:

• Make sure the area is safe first before approaching the person to avoid putting yourself or others at risk.

• Check the person's responsiveness and breathing. If they are unresponsive and not breathing normally, seek help immediately.

• Call local emergency medical services or ask someone else to call and bring an automated external defibrillator (AED) if one is available.

• Start CPR promptly when cardiac arrest is suspected. Do not delay seeking help or starting chest compressions while trying to establish an exact diagnosis.

• Perform chest compressions using the appropriate technique at a regular rate, allowing the chest to return to its normal position between compressions.

• If you are trained in rescue breathing, follow the appropriate technique based on the person's age and condition, according to your training and emergency service instructions.

• For children and infants, some compression and rescue-breathing techniques differ from those used for adults, so pediatric CPR training should be followed.

• Use an AED as soon as it becomes available and carefully follow its audio or visual instructions.

• Do not stop CPR without a reason. Continue until emergency medical services arrive, normal breathing and responsiveness return, or you are unable to continue.

• If the person begins breathing normally or regains responsiveness, stop chest compressions and continue monitoring their condition and breathing until medical help arrives.

• Do not give an unconscious person food, drinks, or oral medications.

• Do not attempt advanced procedures you are not trained to perform; follow the emergency dispatcher's instructions while waiting for medical assistance.

• Family members and caregivers can benefit from learning CPR and first aid through an accredited hands-on training course.