CPR What should you do if someone has a heart attack?
If someone has a cardiac arrest or heart attack , there are only a few minutes
to act before it is too late. It is vital to know what to do beforehand.
To perform CPR (cardiopulmonary
resuscitation) and artificial respiration (mouth to mouth resuscitation) effectively, training and frequent practice on resuscitation
dummies is essential.
First aid courses are offered all over the country at night
schools or by voluntary organisations such as St John Ambulance or The Red Cross or by contacting your local Ambulance Service.
How can you tell if someone
is having a heart attack?
If the person is unconscious:
If the patient has a
pulse but is not breathing:
- are they breathing? Look at the patient's chest to see if it is rising and falling.
- do they have a pulse? Place two fingers on one or other side of the person's voice
box in their throat to feel if they have a carotid pulse.
If there is no breathing or pulse, the patient has had a cardiac arrest.
- could it be because of suffocation? Feel inside the mouth with a finger to see if there is anything
blocking it or the windpipe and remove any food or other objects. Provided that dentures are not broken, it is better not
to remove them.
- call for help immediately, stating that the casualty is not breathing, and provide resuscitation (see
below) until the patient begins to breathe or the ambulance arrives.
What help is needed?
If these actions do not restore a pulse or if the subject doesn't begin to breathe again:
- If possible, raise
the legs up 12 to 18 inches to allow more blood to flow towards the heart
- Immediately place the palm of your hand flat on the patient's chest just over the lower part of the sternum (breast
bone) and press your hand in a pumping motion once or twice by using the other hand. This may make the heart beat again.
for help, stating that the casualty is having a cardiac arrest but stay with the patient.
- find out if any one else present knows CPR.
- provide artificial
respiration immediately (see below).
- begin CPR immediately (see below). How to give artificial respiration
- Tilt the head back and lift up the chin.
- Pinch the nostrils shut with two fingers to prevent leakage of air.
- Take a deep breath and seal your own mouth over the person's mouth.
- Breathe slowly into the person's
mouth - it should take about two seconds to adequately inflate the chest.
- Do this twice.
- Check to see if the chest rises as you breathe into the patient.
- If it does, enough air is being blown
- If there is resistance, try to hold the head back further and lift the chin again.
- Repeat this procedure until help arrives
or the person starts breathing again.How
do I perform CPR (cardiopulmonary resuscitation)?
See if there is breathing. If not, start artificial respiration
as described above. Checking for a pulse in the neck (carotid artery) may waste valuable time if the rescuer is inexperienced
in this check. The procedure is:
If there is no pulse,
or if you are unsure, then proceed without delay thus:
- place your fingers in the groove between the windpipe and the muscles of the side of the neck. Press backwards here
to check for a pulse.
Artificial respiration and CPR should both be performed at the same time
- look at the person's
chest and find the 'upside-down V' shaped notch that is made by the lower edge of the ribcage. Place your middle finger
in this notch and then place your index finger beside it, resting on the breastbone. Take the heel of your other hand and
slide it down the breastbone until it is touching this index finger. The heel of your hand should now be positioned on the
middle of the lower half of the breastbone.
- now place the heel of your other hand
on top of the first. Keep your fingers off the chest, by locking them together. Your pressure should be applied through the
heels of the hands only.
- keep your elbows straight, and bring your body weight over your hands to make it easier to press down.
- press down firmly and quickly to achieve a downwards movement of 4 to 5cm, then relax and repeat the
- do this 30 times, then give artificial respiration twice, and continue this 30:2 procedure until
- aim for a rate of compression of about 100 per minute. You can help your timing and counting by saying
out loud 'one and two and three and four ...' etc.
Make sure the patient continues breathing and has a pulse until the ambulance arrives
- If possible, get someone else to help - one person to perform artificial respiration and the other
to perform CPR. (This is not easily done without prior practice and it is well worth attending sessions on CPR training to
become familiar with the technique.)
- The ratio of chest compressions to breaths is 30:2 for both one-person and
- Continue until
the ambulance arrives or the patient gets a pulse and starts to breathe again.
- If the pulse returns and breathing begins but the person remains unconscious, roll them gently onto their side into
the recovery position. This way mucus or vomit can get out of the mouth and will not obstruct the patient's breathing.
It also prevents the tongue from falling back and blocking the air passage.
Again, it needs to be emphasised that the only way to provide proper first aid and
resuscitation is through learning the technique, then regular practice and guidance. REMEMBER THE FIRST ACTION IS TO DIAL 999
- If you succeed in resuscitating the person who has
been taken ill, he or she may be confused and alarmed by all the commotion. Keep the patient warm and calm by quietly, but
clearly, telling them what has happened.
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