The chest compressions when doing CPR for an adult are between 5 cm and 6 cm deep at a rate of 100 to 120 times in one minute. Whoever is doing CPR has to ventilate the person through moth to mouth, nose to mouth, or through an Ambu bag of the appropriate size. Some literature recommends only chest compression for an unskilled rescuer or those who are skilled but can not perform mouth to mouth and have no Ambu bag. Chest compression to breathing ratio is usually 30 to 2.
In an ideal situation, chest compressions are supposed to save a person’s life and have the person living a normal life afterward, however, no situation is real, truly ideal when you look critically at it.
When is it supposed to be done?
CPR is to be done immediately a person becomes unconscious and has no pulse. Doctors use a rhythm strip to record and analyze the type of cardiac arrest and give options for treatment.
A nonpefusing arrhythmia can cause cardiac activity to be lost, this is sometimes called a malignant arrhythmia. Even if a pulse rhythm is not yet found Cardiopulmonary resuscitation should begin. When defibrillation shock is being given also, Cardiopulmonary resuscitation should be done after the shock.
When should it not be done?
The main reason why Cardiopulmonary resuscitation should not be done is when a patient for any reason has indicated that they do not want to be resuscitated. This is called a DNR which stands for Do-Not-Resuscitate. Sometimes, it should also not be done if a medical professional has evaluated the situation and knows that it would be of no use.
Tool for Resuscitation
Cardiopulmonary resuscitation done in a normal situation does not need special equipment, ideally, however, basic precautions are to be taken such as wearing gloves, masks, and scrubs but in the majority of the cases outside the hospital, this is not done. In advanced hospitals, EMS systems available can give chest compressions. Electrical shocks a delivered by electrodes on the chest of the patient through the cardiac defibrillator. The electrical shock can bring back normal rhythm to the heart.
How Cardiopulmonary Resuscitation is done
Normally when Cardiopulmonary resuscitation is done, the steps comprise Chest compressions, Airway, and Breathing (CAB).
As stated earlier, only chest compressions are required for an untrained rescuer.
If Cardiopulmonary resuscitation is to be done then the patient is to be placed on their back on a hard surface, making it easy for the sternum to be compressed. If Cardiopulmonary resuscitation is done on a soft surface like a bed then it won’t be effective. The person carrying out Cardiopulmonary Resuscitation should be at the upper body of the patient so that the person can use his or her body weight to perform chest compressions.
When an adult is unconscious, 30 chest compressions should be done with the head-chin-tilt maneuver to keep the airway open and to make sure the patient is breathing. When you want to start giving breaths, always check for obstructions in the airway.
Complications of Cardiopulmonary resuscitation
It is possible that the sternum or ribs could be fractured by forceful chest compression although this is very uncommon. When gastric insufflation takes place due to ventilatory techniques like mouth-to-mouth or through Ambu bagging, this can cause airway aspiration (fluid moving to the lungs) and further worsening the case.
I can totally agree with the sentiments towards medical series and TV shows, I don’t think anything has solidified a doctor’s place as a hero than what people see in movies. Doctors in real life are involved with life-and-death situations almost every day and to see them handle those situations safely in your home without strong emotional attachments to the characters as would be in real life can be somewhat entertaining.
Among the medical series being floated out there I have to admit, I go crazy for some even when they depict unrealistic situations.
My favorite medical series is Scrubs, because of my affinity for laughing out my pain, I’ve loved the TV show since I was like 10, but I’ve never gone through a whole season. My biggest problem however is that I take life more seriously than I like to enjoy it so, I have suffered watching House.MD more than I have watched scrubs. Those who follow the medical series around me have been watching The resident and Gray’s Anatomy though.
What Studies Say
The results of many studies have shown that those who have cardiopulmonary arrest survive by only a 10-15% chance of survival with discharge from the hospital, even if a medical professional carries out the procedures of cardiopulmonary resuscitation. Survival rates vary from 1% to about 18% and are affected by certain factors such as if the arrest was seen by someone, where the arrest occurred.
It is more a common thought among the general public that the results of cardiopulmonary resuscitation are much higher than what is seen in reality. This overestimation of the results leads to added pressure on the physician if the attempts at resuscitation do not work.
These expectations are brought about from medical movies and series and also the medical scenes in movies that depict successful resuscitations. In the medical community, it is already known that Cardiopulmonary Resuscitation is misrepresented by the misinformation people receive from TV shows and other sources, the extent to which this has spread to involve the general public has not been fully examined.