The European Resuscitation Council has produced updated ERC Guidelines 2021 on adult basic life support with the aim of increasing confidence and encouraging individuals to act immediately when witnessing a cardiac arrest. Unfortunately, to this day, failing to recognise a cardiac arrest earlier on remains a barrier to saving more lives.
The following are excerpts from the ERC Guidelines 2021 which may help save lives. Link to the original document will be provided at the bottom of the article for full document reference.
How to recognise cardiac arrest
– Start CPR in any unresponsive person with absent or abnormal
breathing.
- Slow, laboured breathing (agonal breathing) should be considered a sign of cardiac arrest.
– A short period of seizure-like movements can occur at the start of
cardiac arrest. Assess the person after the seizure has stopped: if
unresponsive and with absent or abnormal breathing, start CPR.
High quality chest compressions
– Start chest compressions as soon as possible.
- Deliver compressions on the lower half of the sternum (‘in the centre of the chest’).
- Compress to a depth of at least 5 cm but not more than 6 cm.
- Compress the chest at a rate of 100-120/min with as few interruptions as possible.
- Allow the chest to recoil completely after each compression; do not lean on the chest.
- Perform chest compressions on a firm surface whenever feasible.
– Continue CPR until an AED (or other defibrillator) arrives on site and is switched on and attached to the victim.
- Do not delay defibrillation to provide additional CPR once the defibrillator is ready.
Rescue breaths
– Alternate between providing 30 compressions and 2 rescue breaths.
- If you are unable to provide ventilations, give continuous chest compressions.
When and How to use an aed
– As soon as the AED arrives, or if one is already available at the site of the cardiac arrest, switch it on.
- Attach the electrode pads to the victim’s bare chest according to the position shown on the AED or on the pads.
- If more than one rescuer is present, continue CPR whilst the pads are being attached.
– Follow the spoken (and/or visual) prompts from the AED.
- Ensure that nobody is touching the victim whilst the AED is analysing the heart rhythm.
- If a shock is indicated, ensure that nobody is touching the victim.
– Push the shock button as prompted. Immediately restart CPR with 30 compressions.
- If no shock is indicated, immediately restart CPR with 30 compressions.
- In either case, continue with CPR as prompted by the AED. There will be a period of CPR (commonly 2 min) before the AED prompts for a further pause in CPR for rhythm analysis.
Foreign Body Airway Obstruction
– Suspect choking if someone is suddenly unable to speak or talk, particularly if eating.
- Encourage the victim to cough.
- If the cough becomes ineffective, give up to 5 back blows:
1. Lean the victim forwards.
2. Apply blows between the shoulder blades using the heel of one hand
- If back blows are ineffective, give up to 5 abdominal thrusts:
1. Stand behind the victim and put both your arms around the upper part of the victim’s abdomen.
2. Lean the victim forwards.
3. Clench your fist and place it between the umbilicus (navel) and the ribcage.
4. Grasp your fist with the other hand and pull sharply inwards and upwards.
– If choking has not been relieved after 5 abdominal thrusts, continue alternating 5 back blows with 5 abdominal thrusts until it is relieved, or the victim becomes unconscious.
- If the victim becomes unconscious, start CPR.
References
European Resuscitation Council Guidelines 2021: Basic Life Support (2021). Retrieved from https://cprguidelines.eu/assets/guidelines/European-Resuscitation-Council-Guidelines-2021-Ba.pdf on 6th September 2022
European Resuscitation Council Guidelines 2021: Executive summary (2021). Retrieved from https://cprguidelines.eu/assets/guidelines/European-Resuscitation-Council-Guidelines-2021-Ex.pdf on 6th September 2022
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