Hands-only CPR: How to offer help in an emergency
Posted on 10 December 2019
Hands-only CPR is now the recommended form of cardiopulmonary resuscitation, as new findings show dramatically increases the likelihood of surviving breathing and cardiac emergencies that occur outside of medical settings.
A 56-year-old man clutches his chest and collapses at his workplace in Parow, Cape Town. A toddler in Free State falls in a pool and appears to have drowned. These are two isolated medical emergencies on opposite ends of the country.
But both of these people are saved by the same thing. By the time ER24 paramedics arrive on the scene, bystanders have begun urgent and effective CPR.
Cardiopulmonary resuscitation (CPR) is an emergency response procedure that usually combines chest compressions with artificial ventilation for a person who is in cardiac arrest. This is to manually maintain proper blood and oxygen flow to the brain until paramedics arrive to administer further treatment measures to restore spontaneous blood circulation.
But you don’t need to be trained in first aid to administer CPR effectively. “You should begin CPR whenever you see someone who has stopped breathing and they don’t have a pulse,” says Dr Vernon Wessels, a medical doctor with ER24’s Site-Based Medical Services. “These are major warning signs. Left without treatment, a person in this condition could suffer from long-lasting brain damage.”
The key for bystanders is understanding the basics of what is known as “hands-only” CPR, explains Dr Wessels. “The old way of administering CPR is complicated and difficult to remember for most people. It also involved a mouth-to-mouth rescue breathing element, which carries the risk of inadvertently spreading infection.”
Research by the American Heart Association shows hands-only CPR performed by a bystander, performed within the first few minutes of a heart attack event, is just as effective as standard CPR with rescue breaths
How does it work? This technique prioritises hard and fast chest compressions.
“If you are on the scene where someone is not responding, you should call 084 124 immediately,” advises Dr Wessels. “Our emergency resource officers are trained in asking the right questions to understand your emergency and if needed, to walk you through the steps of providing CPR correctly, while dispatching emergency services.”
Begin by placing the person on their back, on the floor, and shaking them by the shoulders while shouting, “Hello,” repeatedly. Next, look, listen and feel for signs of breathing: “Lower your ear to the person’s mouth and watch their chest carefully. Do that for between 5 and 10 seconds, and if you do not hear or feel air moving on your ear or cheek, place two fingers on the person’s neck to feel for a pulse.”
If you don’t feel a pulse, interlock your fingers of both hands, straighten your arms, and place your hands between and in line with the patient’s nipples. Then push downwards, hard and fast, at a rate of between 100 and 120 beats per minute – about two compressions per second. Press between 5-6 cm deep for an adult and 4cm for children.
Continue to push down at this rate until professional emergency medical assistance arrives.
These guidelines vary slightly depending on the age of the patient, says Dr Wessels. “If the patient is a child, the principle of CPR is largely the same, but the force you would use is different. For children between one and eight years old, we recommend that you push hard and fast, but that you only use one hand, not two. And for infants, use two fingers between the nipple line, not the whole hand.”
When a person suffers a cardiac arrest, Dr Wessels explains, their heart rate has slowed. “It’s as though their heart has become lazy, and you need to get it moving again as soon as possible.” The earlier their heart is restored to normal function, the earlier normal blood flow is restored to the brain.