Cardiopulmonary resuscitation

880: 904: 520:—the bone that is along the middle of the chest from the neck to the belly— and leave it rise up until recovering its normal position. The rescue breaths are made by pinching the victim's nose and blowing air mouth-to-mouth. This fills the lungs, which makes the chest to rise up, and increases the pressure into the thoracic cavity. If the victim is a baby, the rescuer would compress the chest with only 2 fingers and would make the ventilations using their own mouth to cover the baby's mouth and nose at the same time. The recommended compression-to-ventilation ratio, for all victims of any age, is 30:2 (a cycle that alternates continually 30 rhythmic chest compressions series and 2 rescue breaths series). Victims of drowning receive an initial series of 2 rescue breaths before that cycle begins. 3618:, revolutionized the field of emergency medical care. Introduced in the early 20th century, this technique involved positioning the patient in a supine position (lying flat on their back) and the performer of the technique kneeling beside or above the patient. The Holger Nielsen technique utilized a manual resuscitator, commonly referred to as the "Holger Nielsen bag," to administer rescue breaths. The performer would place a mask or the bag's mouthpiece over the patient's mouth and nose while manually compressing the bag. This action would deliver a controlled flow of air into the patient's lungs, aiding in oxygenation and facilitating the exchange of gases. 1478:, survival varies even more across the US, from 3% in Omaha to 45% in Seattle in 2001. This study only counted heart rhythms which can respond to defibrillator shocks (tachycardia). A major reason for the variation has been delay in some areas between the call to emergency services and the departure of medics, and then arrival and treatment. Delays were caused by lack of monitoring, and the mismatch between recruiting people as firefighters, though most emergency calls they are assigned to are medical, so staff resisted and delayed on the medical calls. Building codes have cut the number of fires, but staff still think of themselves as firefighters. 838:

the patient's jewels or piercings, but it should be avoided placing the patches of the defibrillator directly on top of them. The patches with electrodes are put on the positions that appear at the right. In very small bodies: children between 1 and 8 years, and, in general, similar bodies up to 25 kg approximately, it is recommended the use of children's size patches with reduced electric doses. If that is not possible, sizes and doses for adults would be used, and, if the patches were too big, one would be placed on the chest and the other on the back (no matter which of them).

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survival among cancer patients, 12% among dialysis patients, 14% over age 80, 15% among blacks, 17% for patients who lived in nursing homes, 19% for patients with heart failure, and 25% for patients with heart monitoring outside the ICU. Another study, of advanced cancer patients, found the same 10% survival mentioned above. A study of Swedish patients in 2007–2015 with ECG monitors found 40% survived at least 30 days after CPR at ages 70–79, 29% at ages 80–89, and 27% above age 90.

1360:(ROSC), all organs can be considered for donation. If the patient does not achieve ROSC, and CPR continues until an operating room is available, the kidneys and liver can still be considered for donation. 1,000 organs per year in the US are transplanted from patients who had CPR. Donations can be taken from 40% of patients who have ROSC and later become brain dead. Up to 8 organs can be taken from each donor, and an average of 3 organs are taken from each patient who donates organs. 49: 738: 12534: 11103: 585: 494: 11115: 746: 449: 118: 298: 506: 3366:

suggest only around half of bystander CPR is performed correctly. One study found that members of the public having received CPR training in the past lack the skills and confidence needed to save lives. The report's authors suggested that better training is needed to improve the willingness to respond to cardiac arrest. Factors that influence bystander CPR in out-of-hospital cardiac arrest include:

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Peter Nagele of Washington University in St. Louis. A study published Oct. 6 in the Journal of the American Medical Association found that bystanders who applied hands-only CPR were able to boost survival to 34% from 18% for those who got conventional CPR or none at all. In addition, the percentage of people willing to provide CPR rose from 28% in 2005 to 40% in 2009.

955:, where manual compressions are difficult, and they allow ambulance workers to be strapped in safely rather than standing over a patient in a speeding vehicle. However the disadvantages are cost to purchase, time to train emergency personnel to use them, interruption to CPR to implement, potential for incorrect application and the need for multiple device sizes. 404:(AHA) guidelines of 100–120 compressions per minute, this can cause a net decrease in venous return of blood, for what is required, to fill the heart. For example, if a compression rate of above 120 compressions per minute is used consistently throughout the entire CPR process, this error could adversely affect survival rates and outcomes for the victim. 1467:(CARES). CARES reports CPR results from a catchment area of 115 million people, including 23 state-wide registries, and individual communities in 18 other states as of 2019. CARES data show that in health care facilities and nursing homes where AEDs are available and used, survival rates are double the average survival found in nursing homes overall. 7642:"Practice guideline update recommendations summary: Disorders of consciousness: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology; the American Congress of Rehabilitation Medicine; and the National Institute on Disability, Independent Living, and Rehabilitation Research" 3613:

In the 19th century, Doctor H. R. Silvester described a method (the Silvester method) of artificial ventilation in which the patient is laid on their back, and their arms are raised above their head to aid inhalation and then pressed against their chest to aid exhalation. The Holger Nielsen technique

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In at least one case, it has been alleged that CPR learned from a film was used to save a person's life. In April 2011, it was claimed that nine-year-old Tristin Saghin saved his sister's life by administering CPR on her after she fell into a swimming pool, using only the knowledge of CPR that he had

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cardiac arrest dramatically improves survival. In cities such as Seattle where CPR training is widespread and defibrillation by EMS personnel follows quickly, the survival rate is about 20 percent for all causes and as high as 57 percent for a witnessed "shockable" arrest. In cities such as New York,

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Compression-only CPR is not as good for children who are more likely to have cardiac arrest from respiratory causes. Two reviews have found that compression-only CPR had no more success than no CPR whatsoever. Rescue breaths for children and especially for babies should be relatively gentle. Either a

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The most important aspects of CPR are: few interruptions of chest compressions, a sufficient speed and depth of compressions, completely relaxing pressure between compressions, and not ventilating too much. It is unclear if a few minutes of CPR before defibrillation results in different outcomes than

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In the exception of a rescuer who is completely alone with a victim of drowning, or with a child who was already unconscious when the rescuer arrived, the rescuer should perform two minutes of CPR before calling. And, after the call, the rescuer would get a nearby defibrillator to use it, or continue

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Most people in comas start to recover in 2–3 weeks. 2018 guidelines on disorders of consciousness say it is no longer appropriate to use the term "permanent vegetative state." Mental abilities can continue to improve in the six months after discharge, and in subsequent years. For long-term problems,

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Mental abilities are about the same for survivors before and after CPR for 89% of patients, based on before and after counts of 12,500 US patients' Cerebral-Performance Category (CPC) codes in a 2000–2009 study of CPR in hospitals. 1% more survivors were in comas than before CPR. 5% more needed help

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before a defibrillation. Anyway, a nearby AED defibrillator should be used on the patient as soon as possible. And, as a general reference, defibrillation is preferred to performing CPR (but only if the AED can be got in a very few minutes). All these tasks (calling by phone, getting an AED, and the

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When a patient does not have heart beatings (or they present a sort of arrhythmia that will stop the heart immediately), it is recommended that someone asks for a defibrillator (because they are quite common in the present time), for trying with it a defibrillation on the already unconscious victim,

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and thus decrease venous return. It is therefore recommended that the uterus be pushed to the woman's left. This can be done by placing a pillow or towel under her right hip so that she is on an angle of 15–30 degrees, and making sure their shoulders are flat to the ground. If this is not effective,

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It is feasible to perform CPR on animals, including cats and dogs. The principles and practices are similar to CPR for humans, except that resuscitation is usually done through the animal's nose, not the mouth. CPR should only be performed on unconscious animals to avoid the risk of being bitten; a

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For CPR outside hospitals, a Copenhagen study of 2,504 patients in 2007-2011 found 21% of survivors developed moderate mental problems but could still be independent, and 11% of survivors developed severe mental problems, so they needed daily help. Two patients out of 2,504 went into comas (0.1% of

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As another possible variation, if a rescuer is completely alone and without a phone near, and is aiding to any other victim (not a victim of drowning, nor an already unconscious child), the rescuer would go to call by phone first. After the call, the rescuer would get a nearby defibrillator and use

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As a slight variation for that sequence, if the rescuer is completely alone with a victim of drowning, or with a child who was already unconscious when the rescuer arrived, the rescuer would do the CPR maneuvers during 2 minutes (approximately 5 cycles of ventilations and compressions); after that,

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As an exception for the normal compression-to-ventilation ratio of 30:2, if at least two trained rescuers are present and the victim is a child, the preferred ratio is 15:2. Equally, in newborns, the ratio is 30:2 if one rescuer is present, and 15:2 if two rescuers are present (according to the AHA

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An earlier study of Medicare patients in hospitals 1992–2005, where overall survival was 18%, found 13% survival in the poorest neighborhoods, 12% survival over age 90, 15% survival among ages 85–89, and 17% survival among ages 80–84. Swedish patients 90 years or older had 15% survival to hospital

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Water and metals transmit the electric current. This depends on the amount of water, but it is convenient to avoid starting the defibrillation on a floor with puddles, and to dry the wet areas of the patient before (fast, even with any cloth, if that could be enough). It is not necessary to remove

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The standard defibrillation device, prepared for a fast use out of the medical centres, is the automated external defibrillator (AED), a portable machine of small size (similar to a briefcase) that can be used by any user with no previous training. That machine produces recorded voice instructions

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In all victims, the compression speed is of at least 100 compressions per minute. Recommended compression depth in adults and children is of 5 cm (2 inches), and in infants it is 4 cm (1.6 inches). In adults, rescuers should use two hands for the chest compressions (one on the top of the

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may be more appropriate, but due to the difficulty people have in accurately assessing the presence or absence of a pulse, CPR guidelines recommend that lay persons should not be instructed to check the pulse, while giving healthcare professionals the option to check a pulse. In those with cardiac

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An analysis of 3,700 cardiac arrests published Friday in the journal Lancet found that hands-only CPR saved 22% more lives than the conventional method. All told, the switch could save up to 3,000 additional lives a year in the USA and 5,000 to 10,000 in North America and Europe, says lead author

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CPR is likely to be effective only if commenced within 6 minutes after the blood flow stops because permanent brain cell damage occurs when fresh blood infuses the cells after that time, since the cells of the brain become dormant in as little as 4–6 minutes in an oxygen deprived environment and,

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to prove the effectiveness of mouth-to-mouth resuscitation. The first effort at testing the technique was performed on a dog by Redding, Safar and JW Pearson. Soon afterward, the technique was used to save the life of a child. Their combined findings were presented at the annual Maryland Medical

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A 1996 study published in the New England Journal of Medicine showed that CPR success rates in television shows was 75% for immediate circulation, and 67% survival to discharge. This gives the general public an unrealistic expectation of a successful outcome. When educated on the actual survival

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Various studies show that in out-of-home cardiac arrest, bystanders in the US attempt CPR in between 14% and 45% of the time, with a median of 32%. Globally, rates of bystander CPR reported to be as low as 1% and as high as 44%. However, the effectiveness of this CPR is variable, and the studies

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A study of King County WA patients who had CPR outside hospitals in 1999–2003, where 34% survived to hospital discharge overall, found that among patients with 4 or more major medical conditions, 18% survived; with 3 major conditions 24% survived, and 33% of those with 2 major medical conditions

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The type and frequency of injury can be affected by factors such as sex and age. A 1999 Austrian study of CPR on cadavers, using a machine which alternately compressed the chest then pulled it outward, found a higher rate of sternal fractures in female cadavers (9 of 17) than male (2 of 20), and

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was still recommending an 'ABC' order, with the 'C' standing for 'Circulation' (check for a pulse), if the victim is a child. It can be difficult to determine the presence or absence of a pulse, so the pulse check has been removed for common providers and should not be performed for more than 10

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In the exception of a rescuer who is completely alone and without a phone near, and is aiding to any other victim (not a victim of drowning, nor an already unconscious child), the rescuer would go to call by phone first. After the call, the rescuer would get a nearby defibrillator and use it, or

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CPR methods continued to advance, with developments in the 2010s including an emphasis on constant, rapid heart stimulation, and a de-emphasis on the respiration aspect. Studies have shown that people who had rapid, constant heart-only chest compression are 22% more likely to survive than those

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Mouth-to-mouth resuscitation was combined with chest compressions based on the assumption that active ventilation is necessary to keep circulating blood oxygenated, and the combination was accepted without comparing its effectiveness with chest compressions alone. However, research in the 2000s

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Broken ribs are present in 3% of those who survive to hospital discharge, and 15% of those who die in the hospital, for an average rate of 9% (2009-12 data) to 8% (1997–99). In the 2009-12 study, 20% of survivors were older than 75. A study in the 1990s found 55% of CPR patients who died before

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These items can be devices to be placed on top of the chest, with the rescuer's hands going over the device, and a display or audio feedback giving information on depth, force or rate, or in a wearable format such as a glove. Several published evaluations show that these devices can improve the

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The time in which a cardiopulmonary resuscitation can still work is not clear, and it depends on many factors. Many official guides recommend continuing a cardiopulmonary resuscitation until emergency medical services arrive (for trying to keep the patient alive, at least). The same guides also

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Cerebral performance category (CPC scores) are used as a research tool to describe "good" and "poor" outcomes. Level 1 is conscious and alert with normal function. Level 2 is only slight disability. Level 3 is moderate disability. Level 4 is severe disability. Level 5 is comatose or persistent

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To support training and incident management, mobile apps have been published on the largest app markets. An evaluation of 61 available apps has revealed that a large number do not follow international guidelines for basic life support and many apps are not designed in a user-friendly way. As a

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A defibrillator is a machine that produces a defibrillation: electric shocks that can restore the normal heart function of the victim. The common model of defibrillator out of an hospital is the automated external defibrillator (AED), a portable device that is especially easy to use because it

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blood infusion resulted in a 79.4% survival rate with cardiac arrest intervals of 72±43 minutes, traditional methods achieve a 15% survival rate in this scenario, by comparison. New research is currently needed to determine what role CPR, defibrillation, and new advanced gradual resuscitation

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There is a relation between age and the chance of CPR being commenced. Younger people are far more likely to have CPR attempted on them before the arrival of emergency medical services. Bystanders more commonly administer CPR when in public than when at the person's home, although health care

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The American Heart Association guidelines say that survival rates below 1% are "futility," but all groups have better survival than that. Even among very sick patients at least 10% survive: A study of CPR in a sample of US hospitals from 2001 to 2010, where overall survival was 19%, found 10%

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A normal CPR procedure uses chest compressions and ventilations (rescue breaths, usually mouth-to-mouth) for any victim of cardiac arrest, who would be unresponsive (usually unconscious or approximately unconscious), not breathing or only gasping because of the lack of heart beats. But the

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Kitamura T, Iwami T, Kawamura T, Nagao K, Tanaka H, Nadkarni VM, et al. (April 2010). "Conventional and chest-compression-only cardiopulmonary resuscitation by bystanders for children who have out-of-hospital cardiac arrests: a prospective, nationwide, population-based cohort study".

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The patient's head is commonly tilted back (a head-tilt and chin-lift position) for improving the air flow if ventilations can be used. However, in the case of babies, the head is left straight, looking forward, which is necessary for the ventilations, because of the size of the baby's

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There are several advantages to automated devices: they allow rescuers to focus on performing other interventions; they do not fatigue and begin to perform less effective compressions, as humans do; they are able to perform effective compressions in limited-space environments such as

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the CPR. The reason is that the CPR ventilations (rescue breaths) are considered the most important action for those victims (because the origin of the cardiac arrest for a victim of drowning would be the lack of oxygen, and a child would probably not suffer from cardiac diseases).

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guidelines indicate that doing only compressions may actually result in worse outcomes, because such problems in children normally arise from respiratory issues rather than from cardiac ones, given their young age. Chest compression to breathing ratios is set at 30 to 2 in adults.

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Injuries from CPR vary. 87% of patients are not injured by CPR. Overall, injuries are caused in 13% (2009–12 data) of patients, including broken sternum or ribs (9%), lung injuries (3%), and internal bleeding (3%). The internal injuries counted here can include heart contusion,

389:. Therefore, in general CPR is effective only if performed within seven minutes of the stoppage of blood flow. The heart also rapidly loses the ability to maintain a normal rhythm. Low body temperatures, as sometimes seen in near-drownings, prolong the time the brain survives. 10228:"Hands-only (compression-only) cardiopulmonary resuscitation: a call to action for bystander response to adults who experience out-of-hospital sudden cardiac arrest: a science advisory for the public from the American Heart Association Emergency Cardiovascular Care Committee" 827:

that guide to the user along the defibrillation process. It also checks the victim's condition to automatically apply electric shocks at the correct level, if they are needed. Other models are semi-automatic and require the user to push a button before an electric shock.

1315:. In a 2010 prospective study of cardiac arrest in children (age 1–17) for arrests with a non-cardiac cause, provision by bystanders of conventional CPR with rescue breathing yielded a favorable neurological outcome at one month more often than did compression-only CPR ( 551:

when the victim is already unconscious. The common model of defibrillator (the AED) is an automatic portable machine that guides to the user with recorded voice instructions along the process, and analyzes the victim, and applies the correct shocks if they are needed.

9227:"Increasing cardiopulmonary resuscitation provision in communities with low bystander cardiopulmonary resuscitation rates: a science advisory from the American Heart Association for healthcare providers, policymakers, public health departments, and community leaders" 918:

Audible and visual prompting may improve the quality of CPR and prevent the decrease of compression rate and depth that naturally occurs with fatigue, and to address this potential improvement, a number of devices have been developed to help improve CPR technique.

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CPR involves chest compressions for adults between 5 cm (2.0 in) and 6 cm (2.4 in) deep and at a rate of at least 100 to 120 per minute. The rescuer may also provide artificial ventilation by either exhaling air into the subject's mouth or nose

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There is also a clear relation between the cause of arrest and the likelihood of a bystander initiating CPR. Laypersons are most likely to give CPR to younger people in cardiac arrest in a public place when it has a medical cause; those in arrest from trauma,

302: 290:, which usually requires the treatment of underlying conditions to restore cardiac function. Early shock, when appropriate, is recommended. CPR may succeed in inducing a heart rhythm that may be shockable. In general, CPR is continued until the person has a 559:

A normal cardiopulmonary resuscitation has a recommended order named 'CAB': first 'Chest' (chest compressions), followed by 'Airway' (attempt to open the airway by performing a head tilt and a chin lift), and 'Breathing' (rescue breaths). As of 2010, the

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The portrayal of CPR technique on television and film often is purposely incorrect. Actors simulating the performance of CPR may bend their elbows while appearing to compress, to prevent force from reaching the chest of the actor portraying the patient.

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Less than 1/3 of those people who experience a cardiac arrest at home, work or in a public location have CPR performed on them. Most bystanders are worried that they might do something wrong. On October 28, 2009, the American Heart Association and the

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As well as its use during actual CPR on a cardiac arrest victim, which relies on the rescuer carrying the device with them, these devices can also be used as part of training programs to improve basic skills in performing correct chest compressions.

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Abbo ED, Yuen TC, Buhrmester L, Geocadin R, Volandes AE, Siddique J, et al. (January 2013). "Cardiopulmonary resuscitation outcomes in hospitalized community-dwelling individuals and nursing home residents based on activities of daily living".

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receiving conventional CPR that included breathing. Because people tend to be reluctant to do mouth-to-mouth resuscitation, chest-only CPR nearly doubles the chances of survival overall, by increasing the odds of receiving CPR in the first place.

246:). Current recommendations place emphasis on early and high-quality chest compressions over artificial ventilation; a simplified CPR method involving only chest compressions is recommended for untrained rescuers. With children, however, 2015 1310:

In adults compression-only CPR by bystanders appears to be better than chest compressions with rescue breathing. Compression-only CPR may be less effective in children than in adults, as cardiac arrest in children is more likely to have a

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Katz DI, Polyak M, Coughlan D, Nichols M, Roche A (2009-01-01). "Natural history of recovery from brain injury after prolonged disorders of consciousness: outcome of patients admitted to inpatient rehabilitation with 1–4 year follow-up".

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Cancer was also studied by Champigneulle et al.in Paris. In 2015 they reported survival after patients entered ICUs, not overall. Cancer ICU patients had the same ICU mortality and 6-month mortality as matched non-cancer ICU patients.

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When the patient cannot be placed in the supine position, it may be reasonable for rescuers to provide CPR with the patient in the prone position, particularly in hospitalized patients with an advanced airway in place (Class IIb, LOE

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without those advantages, the survival rate is only 5 percent for witnessed shockable arrest. Similarly, in-hospital CPR is more successful when arrests are witnessed, occur in the ICU, or occur in patients wearing heart monitors.

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result, the Red Cross updated and endorsed its emergency preparedness application, which uses pictures, text and videos to assist the user.The UK Resuscitation Council has an app, called Lifesaver, which shows how to perform CPR.

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the rescuer would call to emergency medical services, and then it could be tried a search for a defibrillator nearby (the CPR maneuvers are supposed to be the priority for the drowned and most of the already collapsed children).

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found the risk of rib fractures rose with age, though they did not say how much. Children and infants have a low risk of rib fractures during CPR, with an incidence less than 2%, although, when they do occur, they are usually

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Mechanical chest compression devices have not been found to be better than standard manual compressions. Their use is reasonable in situations where manual compressions are not safe to perform, such as in a moving vehicle.

627:", which is 110 beats-per-minute and contains a repeating drum pattern. For those in cardiac arrest due to non-heart related causes and in people less than 20 years of age, standard CPR is superior to compression-only CPR. 7926: 1426:

A 2004 overview said, "Chest injury is a price worth paying to achieve optimal efficacy of chest compressions. Cautious or faint-hearted chest compression may save bones in the individual case but not the patient's life."

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ratio of compressions to breaths of 30:2 or 15:2 was found to have better results for children. Both children and adults should receive 100 chest compressions per minute. Other exceptions besides children include cases of

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Boland LL, Satterlee PA, Hokanson JS, Strauss CE, Yost D (January–March 2015). "Chest Compression Injuries Detected via Routine Post-arrest Care in Patients Who Survive to Admission after Out-of-hospital Cardiac Arrest".

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Oschatz E, Wunderbaldinger P, Sterz F, Holzer M, Kofler J, Slatin H, et al. (July 2001). "Cardiopulmonary resuscitation performed by bystanders does not increase adverse effects as assessed by chest radiography".

8764: 5142:"Outcomes of chest compression only CPR versus conventional CPR conducted by lay people in patients with out of hospital cardiopulmonary arrest witnessed by bystanders: nationwide population based observational study" 6326: 1326:

When done by trained responders, 30 compressions interrupted by two breaths appears to have a slightly better result than continuous chest compressions with breaths being delivered while compressions are ongoing.

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Champigneulle B, Merceron S, Lemiale V, Geri G, Mokart D, Bruneel F, et al. (July 2015). "What is the outcome of cancer patients admitted to the ICU after cardiac arrest? Results from a multicenter study".

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In US hospitals in 2017, 26% of patients who received CPR survived to hospital discharge. In 2017 in the US, outside hospitals, 16% of people whose cardiac arrest was witnessed survived to hospital discharge.

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The following is a summary of the evidence-based recommendations for the performance of basic life support: Rescuers begin CPR if the victim is unconscious, not moving, and not breathing (ignoring occasional

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There exist some plastic shields and respirators that can be used in the rescue breaths between the mouths of the rescuer and the victim, with the purposes of sealing a better vacuum and avoiding infections.

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updated their CPR guidelines. The importance of high quality CPR (sufficient rate and depth without excessively ventilating) was emphasized. The order of interventions was changed for all age groups except

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Brady WJ, Gurka KK, Mehring B, Peberdy MA, O'Connor RE (July 2011). "In-hospital cardiac arrest: impact of monitoring and witnessed event on patient survival and neurologic status at hospital discharge".

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discharge had broken ribs, and a study in the 1960s found 97% did; training and experience levels have improved. Lung injuries were caused in 3% of patients and other internal bleeding in 3% (2009–12).

856:(an item carried by many ambulance crews) to assist the rescuer in achieving the correct rate. Some units can also give timing reminders for performing compressions, ventilating and changing operators. 867: 5846:

Boyle AJ, Wilson AM, Connelly K, McGuigan L, Wilson J, Whitbourn R (July 2002). "Improvement in timing and effectiveness of external cardiac compressions with a new non-invasive device: the CPR-Ezy".

3745:"Part 11: Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" 3449:

processes, greatly decreasing the tissues' need for oxygen. There are cases where CPR, defibrillation, and advanced warming techniques have revived victims after substantial periods of hypothermia.

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professionals are responsible for more than half of out-of-hospital resuscitation attempts. People with no connection to the person are more likely to perform CPR than are a member of their family.

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Søholm H, Bro-Jeppesen J, Lippert FK, Køber L, Wanscher M, Kjaergaard J, et al. (March 2014). "Resuscitation of patients suffering from sudden cardiac arrests in nursing homes is not futile".

4402:"Cardiopulmonary resuscitation quality: [corrected] improving cardiac resuscitation outcomes both inside and outside the hospital: a consensus statement from the American Heart Association" 3681:

conscious animal would not require chest compressions. Animals, depending on species, may have a lower bone density than humans and so CPR can cause bones to become weakened after it is performed.

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Swor RA, Jackson RE, Cynar M, Sadler E, Basse E, Boji B, et al. (June 1995). "Bystander CPR, ventricular fibrillation, and survival in witnessed, unmonitored out-of-hospital cardiac arrest".

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Abella BS, Edelson DP, Kim S, Retzer E, Myklebust H, Barry AM, et al. (April 2007). "CPR quality improvement during in-hospital cardiac arrest using a real-time audiovisual feedback system".

987:(PEA) where defibrillation is not indicated, effective CPR is no less important. Used alone, CPR will result in few complete recoveries, though the outcome without CPR is almost uniformly fatal. 947:. Both use straps around the chest to secure the patient. The first generation of the LUCAS uses a gas-driven piston and motor-driven constricting band, while later version are battery operated. 9687:

Eich C, Bräuer A, Kettler D (October 2005). "Recovery of a hypothermic drowned child after resuscitation with cardiopulmonary bypass followed by prolonged extracorporeal membrane oxygenation".

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The most common side effect is vomiting, which necessitates clearing the mouth so patients do not breathe it in. It happened in 16 of 35 CPR efforts in a 1989 study in King County, Washington.

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Van Hoeyweghen RJ, Bossaert LL, Mullie A, Calle P, Martens P, Buylaert WA, et al. (August 1993). "Quality and efficiency of bystander CPR. Belgian Cerebral Resuscitation Study Group".

222:, or mouth to mouth in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person who is in 7355:

Orioles A, Morrison WE, Rossano JW, Shore PM, Hasz RD, Martiner AC, et al. (December 2013). "An under-recognized benefit of cardiopulmonary resuscitation: organ transplantation".

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In some cases, the problem is one of the failures in the rhythm of the heart (ventricular fibrillation and ventricular tachycardia) that can be corrected with the electric shock of a

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Steen S, Liao Q, Pierre L, Paskevicius A, Sjöberg T (December 2002). "Evaluation of LUCAS, a new device for automatic mechanical compression and active decompression resuscitation".

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is monitored continuously, and a physician is present." When coughing is used on trained and monitored patients in hospitals, it has been shown to be effective only for 90 seconds.

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For the untrained rescuers helping adult victims of cardiac arrest, it is recommended a compression-only CPR (chest compressions hands-only or cardiocerebral resuscitation, without

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ventilations could be omitted for untrained rescuers aiding adults who suffer a cardiac arrest (if it is not an asphyxial cardiac arrest, as by drowning, which needs ventilations).

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When Alone," which wrongly cited "ViaHealth Rochester General Hospital" as the source of the technique. Rochester General Hospital has denied any connection with the technique.

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after blood flow has been stopped for about four minutes and irreversible damage after about seven minutes. Typically if blood flow ceases for one to two hours, then body cells

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and website as a means to address this issue. In July 2011, new content was added to the website including a digital app that helps a user learn how to perform hands-only CPR.

651:, lying on the chest. This is achieved by turning the head to the side and compressing the back. Due to the head being turned, the risk of vomiting and complications caused by 8261:

Baubin M, Rabl W, Pfeiffer KP, Benzer A, Gilly H (December 1999). "Chest injuries after active compression-decompression cardiopulmonary resuscitation (ACD-CPR) in cadavers".

4089: 4059: 10013: 9048: 8803: 4825: 4708: 4677: 4631: 4575: 427:

would be placed later, as the last of those three possible reactions. But all these tasks can be distributed between many rescuers to make them simultaneously and save time.

6318: 536:

other), while in children one hand could be enough (or two, adapting the compressions to the child's constitution), and with babies the rescuer must use only two fingers.

1402:

complications − pneumothorax, hemothorax, lung contusions. Most injuries did not affect care; only 1% of those given CPR received life-threatening injuries from it.

9629:

Kondratiev TV, Flemming K, Myhre ES, Sovershaev MA, Tveita T (July 2006). "Is oxygen supply a limiting factor for survival during rewarming from profound hypothermia?".

374:

to the tissues. The physiology of CPR involves generating a pressure gradient between the arterial and venous vascular beds; CPR achieves this via multiple mechanisms.

3646:

Society meeting on September 16, 1960, in Ocean City, and gained widespread acceptance over the following decade, helped by the video and speaking tour they undertook.

9320:

Gallagher EJ, Lombardi G, Gennis P (December 1995). "Effectiveness of bystander cardiopulmonary resuscitation and survival following out-of-hospital cardiac arrest".

9548:

Cummins RO, Eisenberg MS, Hallstrom AP, Litwin PE (March 1985). "Survival of out-of-hospital cardiac arrest with early initiation of cardiopulmonary resuscitation".

7295:"Therapeutic hypothermia after cardiac arrest: an advisory statement by the advanced life support task force of the International Liaison Committee on Resuscitation" 3401:

It is believed that there is a higher chance that CPR will be performed if the bystander is told to perform only the chest compression element of the resuscitation.

802:

maneuvers of CPR) can be distributed between many rescuers who make them simultaneously. The defibrillator itself would indicate if more CPR maneuvers are required.

773:, in those cases a normal CPR would be used to oxygenate the brain until the heart function can be restored. Improperly given electrical shocks can cause dangerous 9615: 4361:"Part 1: Executive summary: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations" 841:

There are several devices for improving CPR, but only defibrillators (as of 2010) have been found better than standard CPR for an out-of-hospital cardiac arrest.

11152: 8296:

Maguire S, Mann M, John N, Ellaway B, Sibert JR, Kemp AM (July 2006). "Does cardiopulmonary resuscitation cause rib fractures in children? A systematic review".

556:

indicate asking for any emergency defibrillator (AED) near, to try an automatic defibrillation as soon as possible before considering that the patient has died.

9420:

Bossaert L, Van Hoeyweghen R (1989). "Bystander cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest. The Cerebral Resuscitation Study Group".

7334: 3994:"Part 12: cardiac arrest in special situations: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" 3462:

CPR is often severely misrepresented in movies and television as being highly effective in resuscitating a person who is not breathing and has no circulation.

7469: 10395:"Adult Basic Life Support: International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations" 6278:"Manual chest compression vs use of an automated chest compression device during resuscitation following out-of-hospital cardiac arrest: a randomized trial" 1423:

Where CPR is performed in error by a bystander, on a person not in cardiac arrest, around 2% have injury as a result (although 12% experienced discomfort).

440:

continue the CPR. The reason is that the phone call and the defibrillation are considered the most important actions when the problem has a cardiac origin.

9198: 8868:

Becker LJ, Yeargin K, Rea TD, Owens M, Eisenberg MS (July 2003). "Resuscitation of residents with do not resuscitate orders in long-term care facilities".

5362:

McAlvin SS, Carew-Lyons A (November 2014). "Family presence during resuscitation and invasive procedures in pediatric critical care: a systematic review".

5192: 3502:. If a patient is not breathing, these risks still exist but are dwarfed by the immediate threat to life. For this reason, training is always done with a 903: 592:

The CPR 'compressions only' procedure consists only of chest compressions that push on the lower half of the bone that is in the middle of the chest (the

3412:(NIH), and examined nearly 20,000 cases across the U.S. The study found that women are six percent less likely than men to receive bystander CPR when in 3621:

It was not until the middle of the 20th century that the wider medical community started to recognize and promote artificial ventilation in the form of

9156:

Wik L, Steen PA, Bircher NG (December 1994). "Quality of bystander cardiopulmonary resuscitation influences outcome after prehospital cardiac arrest".

8474: 6892:"Continuous chest compression versus interrupted chest compression for cardiopulmonary resuscitation of non-asphyxial out-of-hospital cardiac arrest" 6476: 4967: 4149: 6147:"Part 7: CPR techniques and devices: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" 5402:"Part 7: CPR techniques and devices: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" 5276:"Part 7: CPR techniques and devices: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" 532:, the artificial ventilation should occur without pauses in compressions at a rate of 1 breath every 6 to 8 seconds (8–10 ventilations per minute). 6098:"European Resuscitation Council Guidelines for Resuscitation 2010 Section 2. Adult basic life support and use of automated external defibrillators" 461: 3786:"Part 1: Executive Summary: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" 10939: 6002:

Liao, Q. (2011). LUCAS – Lund University Cardiopulmonary Assist System. Department of Cardiothoracic Surgery, Clinical Sciences, Lund University.

8990:

Davis R (July 28, 2003). "Special report: Many lives are lost across USA because emergency services fail (data for 2001, corrected 7/29/2003)".

7293:

Nolan JP, Morley PT, Vanden Hoek TL, Hickey RW, Kloeck WG, Billi J, et al. (International Liaison Committee on Resuscitation) (July 2003).

7024:"Partial pressure of end-tidal carbon dioxide successful predicts cardiopulmonary resuscitation in the field: a prospective observational study" 6196:"Manual vs. integrated automatic load-distributing band CPR with equal survival after out of hospital cardiac arrest. The randomized CIRC trial" 5573: 4595: 4330: 148: 10943: 9813: 5811:

Perkins GD, Augré C, Rogers H, Allan M, Thickett DR (January 2005). "CPREzy: an evaluation during simulated cardiac arrest on a hospital bed".

834:, so the patient would be placed lying in a face up position. Additionally, patient's head would be tilted back, except in the case of babies. 720:

Active compression-decompression methods using mechanical decompression of the chest have not been shown to improve outcome in cardiac arrest.

59: 1319:

5.54). For arrests with a cardiac cause in this cohort, there was no difference between the two techniques (OR 1.20). This is consistent with

703:

Interposed abdominal compressions may be beneficial in the hospital environment. There is no evidence of benefit pre-hospital or in children.

8207: 6237:"Mechanical versus manual chest compression for out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised controlled trial" 6082: 1333:

In a study of in-hospital CPR from 2000 to 2008, 59% of CPR survivors lived over a year after hospital discharge and 44% lived over 3 years.

11773: 10959: 10703: 9264: 3912:"Part 1: executive summary: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" 6399: 3555:. The AHA does recognize a limited legitimate use of the coughing technique: "This coughing technique to maintain blood flow during brief 274:, is usually needed to restore a viable, or "perfusing", heart rhythm. Defibrillation is effective only for certain heart rhythms, namely 11145: 11065: 10954: 9928: 7073:

Garnett AR, Ornato JP, Gonzalez ER, Johnson EB (1987-01-23). "End-tidal carbon dioxide monitoring during cardiopulmonary resuscitation".

1464: 412:

The best position for CPR maneuvers in the sequence of first aid reactions to a cardiac arrest is a question that has been long studied.

10078: 9963: 9492: 7001: 4907: 4033: 3952: 12482: 11808: 10349: 8014: 4282: 1490:

Table Showing How Well Groups with Different Illnesses Survive to Hospital Discharge after CPR (USA national data, except where noted)

9984: 11904: 10931: 5621: 4446:"Cardiopulmonary resuscitation (CPR) plus delayed defibrillation versus immediate defibrillation for out-of-hospital cardiac arrest" 4085: 4063: 10949: 10005: 9041: 4135: 3641:

and Joseph S. Redding had recently discovered the method of external chest compressions, whereas Safar had worked with Redding and

3608: 619:" provides an ideal rhythm in terms of beats per minute to use for hands-only CPR, which is 104 beats-per-minute. One can also hum 8830:

Shah MN, Fairbanks RJ, Lerner EB (March 2007). "Cardiac arrests in skilled nursing facilities: continuing room for improvement?".

6506: 4741: 1348:

Since 2003, widespread cooling of patients after CPR and other improvements have raised survival and reduced mental disabilities.

10969: 10639: 6450: 4945: 10448: 10179: 7400:"The rate of brain death and organ donation in patients resuscitated from cardiac arrest: a systematic review and meta-analysis" 5724:"Quality of out-of-hospital cardiopulmonary resuscitation with real time automated feedback: a prospective interventional study" 547:. So, if a victim is suffering a cardiac arrest, it is important that someone asks for a defibrillator nearby, to try with it a 12556: 12302: 11892: 11138: 10979: 10819: 10318: 5881: 4814: 4697: 4666: 4620: 4564: 12177: 10100: 9476: 7616: 5066: 3873: 3466:

rates, the proportion of patients over 60 years of age desiring CPR should they have a cardiac arrest drops from 41% to 22%.

7803: 4934:"Cardiocerebral Resuscitation: Could this new model of CPR hold promise for better rates of neurologically intact survival?" 4113: 810:

it, or continue the CPR (the phone call and the defibrillator are considered urgent when the problem has a cardiac origin).

608:; in both these cases, compressions and rescue breaths are recommended if the bystander is trained and is willing to do so. 423:, because it is easy to use) is also preferred to performing CPR (but only if the AED can be used in a few minutes). So the 10974: 10791: 5119: 873:

The ejection of blood from the heart is conditioned by the compression of the sternum by a third of the height of the chest

10268: 9867: 9219:

Comilla Sasson et al. on behalf of the American Heart Association Council on Quality of Care and Outcomes Research et al.

11502: 11059: 10989: 10964: 10481: 3544:

oneself is impossible because a prominent symptom of cardiac arrest is unconsciousness, which makes coughing impossible.

9584: 7448: 6350:"Smartphone apps for cardiopulmonary resuscitation training and real incident support: a mixed-methods evaluation study" 3482:

It is dangerous to perform CPR on a person who is breathing normally. These chest compressions create significant local

765:. Defibrillation is not indicated if the patient has a normal pulse or is still conscious. Also, it is not indicated in 12427: 12103: 12008: 10343: 254:

CPR alone is unlikely to restart the heart. Its main purpose is to restore the partial flow of oxygenated blood to the

71: 9516: 6427: 5604: 4968:"Effectiveness of different compression-to-ventilation methods for cardiopulmonary resuscitation: A systematic review" 12308: 10375: 5017: 1474:

from 40% in Wyoming to 20% in New York, so there is room for good practices to spread, raising the averages. For CPR

1357: 473:

to chest compressions, airway, breathing (CAB). An exception to this recommendation is for those believed to be in a

291: 279: 93: 8439:

McCormack AP, Damon SK, Eisenberg MS (March 1989). "Disagreeable physical characteristics affecting bystander CPR".

4790: 419:(if possible) before starting CPR. And, after making the call, asking for an AED defibrillator (to get it and try a 11766: 10814: 10756: 10696: 10547: 7482: 3704: 3404:

The first formal study into gender bias in receiving CPR from the public versus professionals was conducted by the

10006:"Arizona 9-year-old boy, Tristin Saghin, Saved Sister With CPR, Congratulated by Movie Producer Jerry Bruckheimer" 3551:(AHA) and other resuscitation bodies do not endorse "cough CPR", which it terms a misnomer as it is not a form of 12315: 12122: 11053: 10993: 10766: 6063:"The merits of mechanical CPR: Do mechanical devices improve compression consistency and resuscitation outcomes?" 4919:

is based on an international evidence evaluation process that involved 250 evidence reviewers from 39 countries."

4218:

Lurie KG, Nemergut EC, Yannopoulos D, Sweeney M (March 2016). "The Physiology of Cardiopulmonary Resuscitation".

9194: 3860:

Werman HA, Karren K, Mistovich J (2014). "Shock and Resuscitation". In Werman HA, Mistovich J, Karren K (eds.).

1412:

The costal cartilage also breaks in an unknown number of additional cases, which can sound like breaking bones.

762: 12415: 12112: 11280: 11041: 11035: 8500:"Patterns of Resuscitation Care and Survival After In-Hospital Cardiac Arrest in Patients With Advanced Cancer" 5204: 958:

Several studies have shown little or no improvement in survival rates but acknowledge the need for more study.

577:), as it is easier to perform and instructions are easier to give over a phone. In adults with out-of-hospital 9072:

Clark JD, Dudzinski DM (March 2013). "The culture of dysthanasia: attempting CPR in terminally ill children".

8122:

Hoke RS, Chamberlain D (December 2004). "Skeletal chest injuries secondary to cardiopulmonary resuscitation".

5449:

Dell'anna AM, Scolletta S, Donadello K, Taccone FS (June 2014). "Early neuroprotection after cardiac arrest".

844:

When a defibrillator has been used, it should remain attached to the patient until emergency services arrive.

12437: 11671: 11118: 11023: 3409: 984: 770: 287: 9382:

Jackson RE, Swor RA (June 1997). "Who gets bystander cardiopulmonary resuscitation in a witnessed arrest?".

4512:"A randomised controlled comparison of video versus instructor-based compression only life support training" 1330:

Measurement of end-tidal carbon dioxide during CPR reflects cardiac output and can predict chances of ROSC.

12422: 12410: 12291: 11938: 11666: 11312: 11047: 11029: 11012: 10761: 10634: 10056: 7477: 3699: 3622: 509: 239: 10200: 6480: 6014:"Compartment syndrome of the hand as a complication of prolonged mechanical cardiopulmonary resuscitation" 5327:

Flanders SA, Strasen JH (December 2014). "Review of evidence about family presence during resuscitation".

4153: 3437:

A notable exception is cardiac arrest that occurs in conjunction with exposure to very cold temperatures.

706:

Cooling during CPR is being studied as currently results are unclear whether or not it improves outcomes.

12537: 11759: 11106: 10689: 4174: 3596: 11130: 11656: 11512: 11507: 10731: 10531: 10519: 8554:

Hirlekar G, Karlsson T, Aune S, Ravn-Fischer A, Albertsson P, Herlitz J, et al. (September 2017).

6997: 5907:"Use of Mechanical Cardiopulmonary Resuscitation Devices for Out-of-Hospital Cardiac Arrest, 2010-2016" 3910:

Field JM, Hazinski MF, Sayre MR, Chameides L, Schexnayder SM, Hemphill R, et al. (November 2010).

3710: 3659: 3548: 3405: 1320: 794: 624: 561: 416: 401: 247: 67: 10034: 8660:"Chronic health conditions and survival after out-of-hospital ventricular fibrillation cardiac arrest" 5790: 5765: 3429:

therefore, cannot survive the reintroduction of oxygen in a traditional resuscitation. Research using

1463:

Nursing home residents' survival has been studied by several authors, and is measured annually by the

1307:\* AED data here exclude health facilities and nursing homes, where patients are sicker than average. 12369: 12259: 12062: 12013: 11803: 11374: 10629: 9355:

Carragher R, Johnson J, Harder M (2017). "Factors that influence bystander CPR: A narrative review".

8940:"Regional variation in the incidence and outcomes of in-hospital cardiac arrest in the United States" 7398:

Sandroni C, D'Arrigo S, Callaway CW, Cariou A, Dragancea I, Taccone FS, et al. (November 2016).

5722:

Kramer-Johansen J, Myklebust H, Wik L, Fellows B, Svensson L, Sørebø H, et al. (December 2006).

5583: 4599: 1356:

Organ donation is usually made possible by CPR, even if CPR does not save the patient. If there is a

684: 9809: 7160:

Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et al. (March 2019).

6655:

Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et al. (March 2019).

4338: 3992:

Vanden Hoek TL, Morrison LJ, Shuster M, Donnino M, Sinz E, Lavonas EJ, et al. (November 2010).

12448: 12432: 11899: 11882: 11736: 11563: 11530: 11522: 10290: 9042:"European Resuscitation Council Guidelines 2021: Ethics of resuscitation and end of life decisions" 8182: 1373:

patients, or 2 out of 419 survivors, 0.5%), and the study did not track how long the comas lasted.

991: 778: 758: 275: 155: 75: 10393:

Olasveengen TM, Mancini ME, Perkins GD, Avis S, Brooks S, Castrén M, et al. (November 2020).

8374:

White L, Rogers J, Bloomingdale M, Fahrenbruch C, Culley L, Subido C, et al. (January 2010).

8215: 8038:

Krischer JP, Fine EG, Davis JH, Nagel EL (August 1987). "Complications of cardiac resuscitation".

7201:

Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, et al. (March 2018).

6062: 4359:

Hazinski MF, Nolan JP, Billi JE, Böttiger BW, Bossaert L, de Caen AR, et al. (October 2010).

1312: 891: 12444: 12386: 12286: 12251: 12097: 11290: 11179: 10514: 10474: 7782: 6096:

Koster RW, Baubin MA, Bossaert LL, Caballero A, Cassan P, Castrén M, et al. (October 2010).

3654:

in 1957. In the U.S., it was first promoted as a technique for the public to learn in the 1970s.

3560: 1391: 9226: 9195:"Members of the public lack skills, confidence necessary to save lives with CPR, research shows" 8331:

Dolinak D (June 2007). "Rib fractures in infants due to cardiopulmonary resuscitation efforts".

6788:"Heart disease and stroke statistics--2014 update: a report from the American Heart Association" 5954: 4400:

Meaney PA, Bobrow BJ, Mancini ME, Christenson J, de Caen AR, Bhanji F, et al. (July 2013).

3629:. The combination was first seen in a 1962 training video called "The Pulse of Life" created by 695:

Evidence generally supports family being present during CPR. This includes in CPR for children.

12490: 11726: 11691: 11661: 11596: 11497: 10746: 10660: 9980: 8606:

Ehlenbach WJ, Barnato AE, Curtis JR, Kreuter W, Koepsell TD, Deyo RA, et al. (July 2009).

7203:"Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association" 7162:"Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association" 6747:"Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association" 6745:

Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. (January 2016).

6698:"Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association" 6657:"Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association" 3642: 3578: 3416:

in a public place, citing the disparity as "likely due to the fear of being falsely accused of

936: 709:

Internal cardiac massage is manual squeezing of the exposed heart itself carried out through a

581:, compression-only CPR by the lay public has an equal or higher success rate than standard CPR. 574: 338: 321:

CPR is indicated for any person unresponsive with no breathing or breathing only in occasional

266:

and to extend the brief window of opportunity for a successful resuscitation without permanent

243: 219: 9913: 3784:

Neumar RW, Shuster M, Callaway CW, Gent LM, Atkins DL, Bhanji F, et al. (November 2015).

990:

Studies have shown that immediate CPR followed by defibrillation within 3–5 minutes of sudden

12521: 12325: 12246: 11706: 11369: 11087: 10858: 10831: 10572: 10333: 10082: 9948: 9468: 9462: 8376:"Dispatcher-assisted cardiopulmonary resuscitation: risks for patients not in cardiac arrest" 7108:

Chan PS, Nallamothu BK, Krumholz HM, Spertus JA, Li Y, Hammill BG, et al. (March 2013).

6993: 6786:

Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al. (January 2014).

6276:

Hallstrom A, Rea TD, Sayre MR, Christenson J, Anton AR, Mosesso VN, et al. (June 2006).

3960: 3534: 980: 529: 363: 351: 227: 10368:

American Sirens: The Incredible Story of the Black Men Who Became America's First Paramedics

10064: 8763:

Pape M, Rajan S, Hansen SM, Mortensen RN, Riddersholm S, Folke F, et al. (April 2018).

7986: 7640:

Giacino JT, Katz DI, Schiff ND, Whyte J, Ashman EJ, Ashwal S, et al. (September 2018).

6145:

Cave DM, Gazmuri RJ, Otto CW, Nadkarni VM, Cheng A, Brooks SC, et al. (November 2010).

5400:

Cave DM, Gazmuri RJ, Otto CW, Nadkarni VM, Cheng A, Brooks SC, et al. (November 2010).

5274:

Cave DM, Gazmuri RJ, Otto CW, Nadkarni VM, Cheng A, Brooks SC, et al. (November 2010).

3743:

Atkins DL, Berger S, Duff JP, Gonzales JC, Hunt EA, Joyner BL, et al. (November 2015).

1369:

with daily activities. 5% more had moderate mental problems and could still be independent.

346:, CPR is considered futile but still recommended. Correcting the underlying cause such as a 12495: 12052: 11865: 11860: 11751: 11578: 11553: 11364: 10864: 10741: 10726: 10670: 10577: 939:; however, use in the prehospital setting is increasing. Devices on the market include the 652: 347: 31: 5617: 1961:

Nursing homes, Denmark, best case, 30 days (witnessed, bystander CPR, AED before hospital)

392:

Following cardiac arrest, effective CPR enables enough oxygen to reach the brain to delay

8: 12374: 12352: 12038: 11877: 11850: 11701: 11683: 11651: 11601: 11226: 10843: 10837: 10825: 10562: 6348:

Kalz M, Lenssen N, Felzen M, Rossaint R, Tabuenca B, Specht M, et al. (March 2014).

3638: 741:

A briefcase with a public defibrillator, at a station. Its universal symbol appears above

215: 17: 10410: 9700: 9603: 9585:"Sudden cardiac death: directing the scope of resuscitation towards the heart and brain" 9225:

Sasson C, Meischke H, Abella BS, Berg RA, Bobrow BJ, Chan PS, et al. (March 2013).

9019: 8783: 8572: 8555: 8157: 8135: 7573: 6609: 6212: 6195: 6113: 5824: 5739: 5700: 5091: 4986: 4131: 1546:

AED used by Bystander on Adult Outside Hospitals, not in health facility or nursing home

370:

to keep vital organs alive. Blood circulation and oxygenation are required to transport

12357: 12270: 12266: 12212: 12207: 12148: 12069: 11977: 11926: 11840: 11573: 11545: 11399: 11299: 11162: 11017: 10921: 10712: 10665: 10467: 10419: 10394: 9786: 9769: 9654: 9395: 9256: 9097: 8969: 8893: 8795: 8740: 8684: 8659: 8632: 8607: 8524: 8499: 8356: 8344: 8236: 8099: 8006: 7902: 7877: 7858: 7764: 7739: 7715: 7690: 7666: 7641: 7532: 7507: 7424: 7399: 7380: 7311: 7294: 7134: 7109: 7050: 7023: 6975: 6916: 6891: 6864: 6839: 6812: 6803: 6787: 6722: 6697: 6572: 6547: 6502: 6376: 6349: 6171: 6146: 6122: 6097: 6038: 6013: 5931: 5922: 5906: 5882:"Public Health Initiative Uses PocketCPR to Help Improve Cardiac Arrest Survival Rates" 5664: 5639: 5518: 5493: 5474: 5426: 5401: 5300: 5275: 5256: 4998: 4966:

Ashoor HM, Lillie E, Zarin W, Pham B, Khan PA, Nincic V, et al. (September 2017).

4871: 4847:"Chest-compression-only versus standard cardiopulmonary resuscitation: a meta-analysis" 4846: 4538: 4511: 4470: 4445: 4243: 3815: 3556: 679: 474: 334: 322: 231: 10244: 10227: 10096: 9892: 9131: 8956: 8939: 8938:

Kolte D, Khera S, Aronow WS, Palaniswamy C, Mujib M, Ahn C, et al. (April 2015).

8452: 8392: 8375: 8274: 7608: 6953: 6696:

Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, et al. (March 2017).

6454: 6253: 6236: 6235:

Perkins GD, Lall R, Quinn T, Deakin CD, Cooke MW, Horton J, et al. (March 2015).

6162: 5981: 5859: 5417: 5291: 5243: 5227:"Cardiopulmonary resuscitation in prone position: a simplified method for outpatients" 5226: 4901:"Highlights of the 2015 American Heart Association: Guidelines Update for CPR and ECC" 4862: 4377: 4360: 4010: 3993: 3928: 3911: 3718:, spontaneous autoresuscitation where attempts at artificial resuscitation have failed 400:

attempts. If an incorrect compression rate is used during CPR, going against standing

12400: 12346: 12276: 12184: 12172: 12033: 12023: 12018: 11921: 11872: 11783: 11731: 11721: 11234: 10916: 10751: 10736: 10509: 10504: 10424: 10381: 10371: 10339: 10249: 10175: 9871: 9791: 9750: 9704: 9646: 9607: 9565: 9561: 9524: 9472: 9457: 9437: 9433: 9399: 9337: 9302: 9298: 9248: 9173: 9169: 9135: 9089: 9023: 8973: 8961: 8885: 8847: 8799: 8787: 8765:"Survival after out-of-hospital cardiac arrest in nursing homes - A nationwide study" 8732: 8689: 8637: 8577: 8529: 8456: 8397: 8348: 8313: 8278: 8139: 8091: 8087: 8055: 8010: 7907: 7850: 7769: 7720: 7671: 7622: 7612: 7577: 7537: 7429: 7372: 7316: 7224: 7183: 7139: 7090: 7086: 7055: 6979: 6967: 6921: 6869: 6817: 6768: 6727: 6678: 6613: 6577: 6381: 6299: 6258: 6217: 6176: 6127: 6074: 6043: 5985: 5936: 5863: 5828: 5743: 5704: 5669: 5550: 5523: 5466: 5431: 5379: 5344: 5305: 5248: 5173: 5002: 4990: 4876: 4543: 4475: 4423: 4382: 4235: 4015: 3933: 3869: 3865: 3842: 3807: 3766: 3564: 710: 525: 343: 230:

for those who are unresponsive with no breathing or abnormal breathing, for example,

143: 131: 10314: 9101: 8897: 8744: 8360: 8103: 7691:"Functional Neurologic Outcomes Change Over the First 6 Months After Cardiac Arrest" 7523: 7506:

Chan PS, Spertus JA, Krumholz HM, Berg RA, Li Y, Sasson C, et al. (June 2012).

7384: 5888: 5478: 5260: 4247: 3819: 818: 658:

The American Heart Association's current guidelines recommend performing CPR in the

12500: 12405: 12143: 12073: 12056: 11988: 11961: 11956: 10414: 10406: 10239: 10161: 10157: 9781: 9740: 9696: 9658: 9638: 9599: 9557: 9429: 9391: 9364: 9329: 9294: 9260: 9238: 9165: 9127: 9081: 9015: 8951: 8877: 8839: 8779: 8724: 8679: 8671: 8627: 8619: 8567: 8556:"Survival and neurological outcome in the elderly after in-hospital cardiac arrest" 8519: 8511: 8448: 8387: 8340: 8305: 8270: 8131: 8083: 8047: 7998: 7897: 7889: 7862: 7842: 7759: 7755: 7751: 7710: 7702: 7661: 7653: 7604: 7569: 7527: 7519: 7419: 7411: 7364: 7306: 7214: 7173: 7129: 7121: 7082: 7045: 7035: 6957: 6949: 6911: 6907: 6903: 6859: 6851: 6807: 6799: 6758: 6717: 6709: 6668: 6605: 6567: 6559: 6371: 6361: 6289: 6248: 6207: 6194:

Wik L, Olsen JA, Persse D, Sterz F, Lozano M, Brouwer MA, et al. (June 2014).

6166: 6158: 6117: 6109: 6033: 6025: 5977: 5926: 5918: 5855: 5820: 5735: 5696: 5659: 5655: 5651: 5513: 5509: 5505: 5458: 5421: 5413: 5371: 5336: 5295: 5287: 5238: 5163: 5153: 4982: 4866: 4858: 4533: 4523: 4465: 4461: 4457: 4413: 4372: 4227: 4005: 3923: 3797: 3756: 3715: 3446: 1395: 616: 393: 309: 9667: 8002: 6838:

Girotra S, Nallamothu BK, Spertus JA, Li Y, Krumholz HM, Chan PS (November 2012).

187: 12472: 12394: 12241: 12231: 12217: 12108: 12078: 11984: 11813: 11798: 11484: 11456: 11359: 10603: 9243: 8608:"Epidemiologic study of in-hospital cardiopulmonary resuscitation in the elderly" 8415: 8309: 7846: 7706: 7657: 7508:"A validated prediction tool for initial survivors of in-hospital cardiac arrest" 7368: 7219: 7202: 7178: 7161: 6763: 6746: 6713: 6673: 6656: 5462: 4418: 4401: 4231: 4104: 3802: 3785: 3761: 3744: 1387: 659: 644: 161: 9745: 9728: 9642: 8843: 6546:

Merchant RM, Berg RA, Yang L, Becker LB, Groeneveld PW, Chan PS (January 2014).

5340: 5115: 4199: 1446: 12379: 12364: 12160: 12137: 11968: 11952: 11887: 11643: 11622: 11606: 11463: 11412: 11307: 11221: 10848: 10810: 10799: 10608: 10593: 10552: 10442: 9517:"Fear of touching women's chests may be barrier to giving CPR, researchers say" 5193:"Compression-Only CPR Is Less Effective Than Conventional CPR in Some Patients" 3626: 3615: 3417: 3413: 3395: 976: 822:

Defibrillation: position of the electrodes of a defibrillator on the human body

648: 635: 578: 470: 453: 397: 367: 326: 271: 223: 10385: 8911: 8881: 7415: 5140:

Ogawa T, Akahane M, Koike S, Tanabe S, Mizoguchi T, Imamura T (January 2011).

4815:"Highlights of the 2010 American Heart Association Guidelines for CPR and ECC" 4698:"Highlights of the 2010 American Heart Association Guidelines for CPR and ECC" 4667:"Highlights of the 2010 American Heart Association Guidelines for CPR and ECC" 4621:"Highlights of the 2010 American Heart Association Guidelines for CPR and ECC" 4565:"Highlights of the 2010 American Heart Association Guidelines for CPR and ECC" 4272:"Highlights of the 2015 American Heart Association Guidelines for CPR and ECC" 12550: 12516: 12236: 11855: 11492: 11420: 11384: 11349: 10776: 10567: 10122: 9827: 9528: 9333: 6294: 6277: 5042: 3495: 3491: 3474: 1470:

Geographically, there is wide variation state-to-state in survival after CPR

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Athanasuleas CL, Buckberg GD, Allen BS, Beyersdorf F, Kirsh MM (July 2006).

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CPR training: CPR is being administered while a second rescuer prepares for

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Institute of Medicine (2015-09-29). Graham R, McCoy MA, Schultz AM (eds.).

4019: 3937: 3846: 3811: 3770: 3530: 3507: 3483: 3430: 1485:

CPR success varies widely, so most places can learn from the best practices

940: 714: 620: 382: 267: 263: 9754: 9729:"Cardiopulmonary resuscitation on television. Miracles and misinformation" 9569: 9467:(5th ed.). Morris Book Publishing, LLC. & Falcon Guides. p. 9441: 9403: 9341: 9306: 9177: 9139: 8623: 8460: 8059: 7125: 7094: 6855: 5494:"Active chest compression-decompression for cardiopulmonary resuscitation" 3625:

combined with chest compressions as a key part of resuscitation following

12458: 12201: 12165: 11845: 11830: 11568: 11448: 11435: 11425: 11393: 11317: 11268: 11206: 11201: 11196: 11160: 10906: 10870: 9770:"Public expectations of survival following cardiopulmonary resuscitation" 7929:[Medical-legal implications in cardio-respiratory resuscitation] 5578: 4783: 3647: 3634: 3438: 3382:

Provide clearer information about legal implications for specific regions

3349: 662:, and limits prone CPR to situations where the patient cannot be turned. 378: 259: 255: 181: 8498:

Bruckel JT, Wong SL, Chan PS, Bradley SM, Nallamothu BK (October 2017).

6319:"Prove It: Mechanical chest compression devices vs. manual compressions" 5375: 4729:. St. John Ambulance; St. Andrew's First Aid; British Red Cross Society. 3662:'s acknowledgment of the effectiveness of chest compressions alone (see 2929:

Ventricular fibrillation (quiver) / ventricular tachycardia (rapid beat)

737: 12453: 12320: 12225: 11993: 11558: 11440: 11341: 11242: 11216: 11211: 11188: 11082: 10891: 10805: 7110:"Long-term outcomes in elderly survivors of in-hospital cardiac arrest" 6962: 6029: 3630: 3592: 3442: 1316: 774: 754: 136: 9368: 8728: 6366: 6012:

Lesser FD, Yakubi M, Rochester S, Evans J, Highgate J (January 2020).

5448: 5168: 5158: 5141: 4784:"Resuscitation Council UK Paediatric Advanced Life Support Guidelines" 197: 11716: 11354: 11273: 11001: 10886: 10853: 10681: 10613: 10490: 10226:

Sayre MR, Berg RA, Cave DM, Page RL, Potts J, White RD (April 2008).

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American Heart Association, Ad Council launch Hands-Only CPR campaign

9868:"ViaHealth Rochester General Hospital statement on 'Cough CPR' email" 8212:

Heartsaver (BLS Training Site) CPR/AED & First Aid (Bellevue, NE)

7689:

Tong JT, Eyngorn I, Mlynash M, Albers GW, Hirsch KG (December 2016).

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Focus on reducing the stigma and fears around providing bystander CPR

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Table Showing Survival Rate in Hospitals in Each US State, 2003-2011

1399: 944: 853: 671: 584: 493: 270:. Administration of an electric shock to the subject's heart, termed 123: 10146:

Brown RL (2013-04-01). "The Breath of Life—Artificial Respiration".

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vegetative state. Level 6 is brain dead or death from other causes.

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The central nervous system in pediatric critical illness and injury

10079:"Americans can learn Hands-Only CPR with a new digital application" 9853: 9582: 8183:"Fractured Ribs Still Painful After 2 Months? You May Need Surgery" 7040: 5723: 1417: 766: 612: 601: 466: 386: 283: 8373: 7878:"Myocardial contusion injury: redefining the diagnostic algorithm" 7397: 5721: 745: 448: 312:

training video of how to perform CPR on a person in cardiac arrest

117: 37:"Cpr" redirects here. For a common abbreviation of copyright, see 11535: 11170: 10557: 9628: 9284: 8072: 7200: 6548:"Hospital variation in survival after in-hospital cardiac arrest" 4434: 3991: 3373:

Target CPR training to family members of potential cardiac arrest

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