Basic Life Support (CPR)
Category: Emergency Procedures
Overview
Emergency procedure performed to maintain circulation and oxygenation in patients experiencing cardiac arrest, following current American Heart Association 2020 guidelines.
Indications
Cardiac arrest (no pulse), respiratory arrest with no pulse, unresponsive patient with absent or agonal breathing, witnessed sudden collapse, drowning or choking with subsequent cardiac arrest.
Contraindications
Obvious signs of death (rigor mortis, dependent lividity, decomposition), valid do-not-resuscitate (DNR) order, dangerous environment unsafe for rescuer, severe trauma incompatible with life.
Equipment Needed
Personal protective equipment (gloves, face shield), barrier device for rescue breathing or bag-mask device, AED (automated external defibrillator), hard surface or backboard, emergency medications if available (epinephrine, amiodarone).
Procedure Steps
1. Ensure scene safety and check responsiveness (tap shoulders, shout 'Are you okay?')
2. Check for breathing and pulse simultaneously (no more than 10 seconds)
3. Call for help immediately - dial 911 and request AED
4. Position patient supine on firm surface, open airway
5. Place heel of one hand on lower half of breastbone (between nipples)
6. Place other hand on top, interlacing fingers, keep arms straight
7. Position shoulders directly over hands, compress hard and fast
8. Compress chest at least 2 inches (5cm) at rate of 100-120 compressions per minute
9. Allow complete chest recoil between compressions
10. Minimize interruptions - compressions should not stop for more than 10 seconds
11. Provide 30 compressions followed by 2 rescue breaths (30:2 ratio)
12. Continue CPR cycles until AED arrives, advanced help takes over, or patient shows signs of life
13. Use AED as soon as available - follow voice prompts
14. Switch compressors every 2 minutes to prevent fatigue
Safety Considerations
Ensure scene safety before beginning CPR. Use barrier protection when available. Switch providers every 2 minutes to prevent fatigue and maintain effective compressions. Minimize interruptions in chest compressions. Stand clear during AED analysis and shock delivery.
Potential Complications
Rib fractures (common and acceptable), sternal fracture, pneumothorax, hemothorax, liver laceration, gastric distension, regurgitation and aspiration, skin abrasions on chest.
Documentation
Record time of arrest discovery, duration of CPR, number of AED shocks delivered, medications administered, response to interventions, time of advanced life support arrival, and final outcome (return of spontaneous circulation, time of death).
References
American Heart Association. (2020). 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 142(16_suppl_2), S366-S468. doi:10.1161/CIR.0000000000000916