What is CPR?

Cardiopulmonary resuscitation (CPR) is an important lifesaving technique that involves chest compressions and giving breaths. This technique can help keep oxygenated blood circulating in the body, which can help prevent brain and organ damage.

When is CPR important?

CPR may be done when a person is showing signs of no breathing or does not respond when you tap them or ask if they are OK. If a person is not responding and has an advanced life-threatening illness (such as cancer) or is dying, CPR may not be the best option. It’s important for the person, family members, and their doctor to talk about this issue early, before the need arises.

What happens during CPR?

CPR consists of 2 stages: chest compressions (forceful pressing on the chest to stimulate the heart) and breathing technique (mouth-to-mouth rescue breathing). Pushing hard and fast on the chest is the most important part of CPR. It helps pump blood to the brain and heart. CPR must be done by someone who is healthy and able to complete the chest compressions and give breaths. If you have training, the current recommendation is 30 “pumps” (chest compressions) and two breaths. Repeat the cycle until the person shows signs of breathing. If you do not have training, the recommendation is to only do chest compressions.

Electric stimulation to the chest (called an automated external defibrillator or AED) is a device that helps start the heart. Special medicines are sometimes used to resuscitate a person whose heart has stopped beating. This is usually done for 15 to 30 minutes. A tube may also be put through the mouth or nose into the lung. This tube is then connected to a breathing machine and helps the person breathe. If using an AED, first, turn it on and follow the directions found on the machine.

What happens if CPR isn’t done?

A person may black out almost immediately and will die in five to 10 minutes.

What are the benefits of CPR?

CPR may extend life for a person who is in good health and suddenly stops breathing. The best time to start CPR is within five to 10 minutes of when a person’s breathing has stopped.

However, for a person who has an advanced life-threatening illness or who is dying, CPR does not provide any benefits.

What are the risks of CPR?

Pressing on the chest can cause a sore chest, broken ribs, or a collapsed lung. Some people who survive may need to be on a breathing machine in the intensive care unit (ICU) to help them breathe for a while after they receive CPR.

Someone who has more than one illness, may not survive after CPR. Someone with advanced cancer likely will not survive after CPR and some people may need to live on breathing machines for a long time, even after getting CPR. These risks are common and should not stop you from trying to give someone CPR, if needed.

If you are making a decision about your “do not resuscitate” (DNR) status, it is important to know that few people in the hospital who have had CPR will survive and are able to function the way they used to. Many people live for a short time after CPR, but still die in the hospital. CPR may also prolong the dying process.

How do I learn CPR?

CPR is a skill that you need to learn by taking an accredited first-aid training course. This course will teach you how to perform CPR and how to use an automatic external defibrillator (AED).

Citations

• Withholding and Withdrawing Life-Sustaining Treatment  by RJ Ackermann, M.D. (American Family Physician October 01, 2000,http://www.aafp.org/afp/20001001/1555.html  )

Some information in this handout comes from Education for Physicians on End-of-Life Care Trainer’s Guide, Module 11, withholding, withdrawing therapy. In: Emanuel LL, von Gunten CJ, Ferris FD. Education for physicians on end-of-life care/Institute for Ethics at the American Medical Association. Chicago, IL: EPEC Project, The Robert Wood Johnson Foundation, 1999.