External Chest Compression Methods

Cardiac arrest may result from electric shock or asphyxia, or it can be caused by a combination of factors such as hypoxia, shock or embolism.  Absence of heart action can be recognized by the absence of pulse in the major vessels.  If the heart is interrupted for more than four minutes, irreversible damage to the brain and other vital organs will usually result due to lack of oxygen.

External chest compression (or closed-chest cardiac massage) is a method for artificially continuing the flow of blood to the central nervous system and vital organs and, hopefully, the compression will result in a spontaneous resumption of the heart beat.  If it does not, compression must be continued until effective spontaneous circulation and ventilation have been restored or a doctor assumes responsibility and directs the treatment to be stopped.

In external chest compression, pressure is applied on the patient's breastbone, which squeezes his heart and serves to simulate the normal pumping action.  At the same time, the patient's lungs must be ventilated using mouth-to-mouth resuscitation.

A methods for performing heart-lung resuscitation is:

  1. Check for pulse at either side of the windpipe on the neck.  If none is present, lift neck and extend head to open air passage
  2. Go into a kneeling position on either side of the patient.  Place the heel of one hand on the lower third of the breastbone with the fingers pointing toward the patient's armpit.  Place the other hand directly on top of the first
  3. Press downward, using your body weight, compressing the chest approximately 40-50 mm.  Release pressure immediately.  Compress the chest and release once every second, eight consecutive times.  After the eighth compression, ventilate the lungs once using the mouth-to-mouth technique
  4. This cycle should be maintained continuously, by alternating mouth-to-mouth ventilation with the chest compression.  Observe for return of spontaneous heart action every three minutes.

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