Be the Difference for Someone You Love. " It is better to inconsistently save some lives than to consistently save none" Nicholas D. Kristof

Greeting steemian.

For someone who is suddenly arrested in someplace like the park, at work or even at home (most arrests happen at home), what this person need is not a specialised health care provider or advance medical equipments, this person need chest compression now.  Time is muscle and every second count, even if a doctor or nurse is there what they will do is to start chest compression now. This person could be family, friend, coworker or someone you just met. Maybe no one else with you so you are the only hope for this person, either you know how to start CPR and give this person chance to live or you don't and the probability of him\her making it is very low. Please bare with me and read this blog like you are trying to learn something practical (skill) not just info. Here I will try my best to describe how to do high-quality Chest compression which is the most vital part of CPR (CardoPulmonary Resuscitation). 

CPR is simple, easy and saves lives, everyone can and should learn it.

As a BLS (Basic life support) provider and ACLS (Advance Cardiac Life support) provider and as a Doctor who worked in ER (Emergency room) since 2013, I think it is very important for anyone to know how to do proper chest compression and this valuable skill will make you save someone life.

Just think about it, I know there is a small chance of someone being arrested in front of you but it could happen and it did. I have seen many arrested cases when patient relatives or friends started CPR at home and when they just call an ambulance, guess which one has better outcome? I have a friend who is ER resident, the first question he asked is when the patient arrested? and when CPR started? simply because it the most vital factor for survival.

Let me tell you real hero story

            

17 y old female high school student collapsed in break time at school, everyone including teachers was wondering around, and the best thing they thought about is calling Emergency service. One teacher came, and immediately she checked for pulse and started chest compression, she taught other teachers to do the same, and they switch when they got tired. The ambulance came after 10 minutes and toke over the case, she brought to us after about 20 minutes in the hospital, our resuscitation was successful and the she recovered. we found that she had hidden uncorrected congenital heart disease which caused irregularity in her heart activity (rythm) and this lead to cardiac arrest. This student won't survive without her teacher because irreversible brain damage starts in about 5 minutes. So if no one knows how to start CPR and 5 minutes already passed, the chance of survival is extremely low.

Some Facts

1 - Irreversible brain damage will start in 4-6 minutes so time is muscle in arrested patient there is no alternative for immediate high-quality chest compression.

2 - Approximately 95% of sudden cardiac arrest victims die before even reach the hospital.

3 - About 75% of all out-of-hospital cardiac arrests happen at home, so knowing how to do CPR can mean the difference between life and death for a loved one. 

4 - CPR doubles a person's chance of survival from sudden cardiac arrest.

5 - CPR provides a trickle of oxygenated blood to the brain and heart and keeps these organs alive until defibrillation can shock the heart into a normal rhythm if needed.

How to start CPR

1 - Check for a response, you can call the arrested patient loudly by their name or just say Mr\Ms are you OK?, while you are calling tap the patient shoulders gently with your both hands for tow time.

2 - If no response shout for help if someone is there ask him\her to call an ambulance now. If no one with you, you can go quickly to call an ambulance by yourself then come back to proceed.

4 - check for a pulse in the victim neck, just beside Adam's apple with tow or three fingers. You should spend only 10 seconds checking for a pulse. If pulse is absent or you are not sure just proceed.

                                                          

5 - Start high-quality Chest compression: because this is the most vital step in whole CPR, i will describe it in details below in separate paragraph.

If you're not trained in CPR, then provide Compression-only (hands-only) CPR. You don't need to try rescue breathing. 

6 - Rescue breathing : Check airway for any foreign body and give 2 rescue breath, 1 second per breath and 1 second in between, total 3 seconds. You can give breath mouth to mouth or mouth to nose. If you don't want to give a direct breath you can use a suitable barrier but you should make sure when you give a breath to look for chest rising. If there is no chest rising, your breath is not effective at all.

Why is high-quality Chest compression the most important part in CPR?

Chest compression is basically replacing the function of the heart, by pumping blood to the brain and heart itself, these are the most vital organ for survival. With effective chest compression and ventilation, most human function is preserved until you stop. Another important thing is that ventilation without compression is nothing and have no benefit at all because chest compression is the dynamic force which can move oxygen from the lung to blood. Actually, chest compression alone can save the victim because there is enough oxygen in his\her blood to operate the body for more than 10 minutes after arrest witch in enough for ambulance to arrive.

The most important skill, high-quality Chest compression

You should first make sure that the environment is safe for you and the victim. for example if there is fire, you should move the victim to safe place before starting chest compression.
Put the person on his or her back on a firm surface.

Location
Identify the land mark spot for chest compression. It is the centre of the chest between the tow nipples, exactly in the middle. the bony part is the breast bone or the sternum ( (the spot where the lower ribs meet) ). take a look at the blue point in the picture below:

                                               

Hands manoeuvre
It is important to do the right manoeuvre for effective chest compression
Place the heel of one hand over the point describe above (center of the person's chest). Place your other hand on top of the first hand and interlace the fingers. You should make sure that you are pushing with your lower hand heel not fingers. 

                                      

                               
 

Your position during chest compression
Keep your elbows straight (Lock your elbows) and position your shoulders directly above your hands. You should be vertical to the person's chest. use your body's weight to push.

                               

Start chest compression
Push hard: At least 2 inches depth (6 cm)
Push fast: 100 to 120 per minutes
Wait for chest to fully recoil with each push
Don't stop: minimised chest compression interruption,if there is someone with you switch position every 2 minutes tell ambulance arrived.

                                     

                                    

Common asked question :

Do I need to be BLS or CPR certificates to start CPR?

Hell no, doing CPR is not like driving a car, and it doesn't need a certificate. It is a skill and can be easily learned. Although taking a course will make sure that you got the skill properly but being there make you the only hope, you should take action and do your best. If you afraid from medico-legal issue, relax in this scenario you are fully protected. 

What if I broke a rib while doing chest compression?

This happens frequently, especially in children and old people. However, you should continue effective chest compression which is the most vital part of CPR because ribs can heal but life can't. If you lost this victim, you lost them forever so stop worrying about ribs and focus on his\her life.

Images :   (1) -  (2)  -  (3)  -  (4)  -  (5)  -  (6)  -  (7)  -  (8) -  (9)  -  ()  -  ()  
Gif cards : (1) -  (2)  -  (3)  -  (4)
Sources :
uptodate.com
emedicine.medscape
nice.org.uk
american heart association

Finally, Because I believe this is very important skill, I spent my free time of two days writing this article. Please read it carefully, learn a skill for people you love most. I will be very grateful if you resteem this blog.