CPR - adult and child after onset of puberty

Definition

CPR stands for cardiopulmonary resuscitation. It is a lifesaving procedure that is done when someone's breathing or heartbeat has stopped. This may happen after an electric shock, drowning, or heart attack. CPR involves:

Permanent brain damage or death can occur within 4 minutes if a person's blood flow stops. Therefore, you must continue CPR until the person's heartbeat and breathing return, or trained medical help arrives.

For the purposes of CPR, puberty is defined as breast development in females and the presence of axillary (armpit) hair in males.

Alternative Names

Cardiopulmonary resuscitation - adult; Rescue breathing and chest compressions - adult; Resuscitation - cardiopulmonary - adult; Cardiopulmonary resuscitation - child 9 years and older; Rescue breathing and chest compressions - child 9 years and older; Resuscitation - cardiopulmonary - child 9 years and older

Considerations

CPR is best done by someone trained in an accredited CPR course. The procedures described here are NOT a substitute for CPR training. The newest techniques emphasize compression over rescue breathing and airway management, reversing a long-standing practice. See cpr.heart.org/en/course-catalog-search for classes near you.

Time is very important when an unconscious person is not breathing. Permanent brain damage begins after only 4 minutes without oxygen, and death can occur as soon as 4 to 6 minutes later.

Machines called automated external defibrillators (AEDs) can be found in many public places, and are available for home use. These machines have pads or paddles to place on the chest during a life-threatening emergency. They automatically check the heart rhythm and give a sudden shock if, and only if, that shock is needed to get the heart back into the right rhythm. When using an AED, follow the instructions exactly.

Causes

In adults, major reasons that heartbeat and breathing stop include:

There are many things that cause an older child or teen's heartbeat and breathing to stop, including:

Symptoms

CPR should be done if a person has any of the following symptoms:

First Aid

1. Check for responsiveness. Shake or tap the person gently. See if the person moves or makes a noise. Shout, "Are you OK?"

2. Call 911 or the local emergency number if there is no response. Shout for help and send someone to call 911 or the local emergency number. If you are alone, call 911 or the local emergency number and retrieve an AED (if available), even if you have to leave the person.

3. Carefully place the person on their back. If there is a chance the person has a spinal injury, two people should move the person to prevent the head and neck from twisting.

4. Perform chest compressions:

5. Open the airway. Lift up the chin with 2 fingers. At the same time, tilt the head by pushing down on the forehead with the other hand.

6. Look, listen, and feel for breathing. Place your ear close to the person's mouth and nose. Watch for chest movement. Feel for breath on your cheek.

7. If the person is not breathing or has trouble breathing:

8. Repeat chest compressions and rescue breathing until the person recovers or help arrives. If an AED for adults is available, use it as soon as possible.

If the person starts breathing again, place them in the recovery position. Keep checking for breathing until help arrives.

Do Not

When to Contact a Medical Professional

Prevention

In adults, to avoid injuries and heart problems that can lead to the heart stopping beating:

Most children need CPR because of a preventable accident. The following tips may help prevent some accidents in children:

References

American Heart Association website. Highlights of the 2020 American Heart Association Guidelines for CPR and ECC. cpr.heart.org/-/media/cpr-files/cpr-guidelines-files/highlights/hghlghts_2020_ecc_guidelines_english.pdf. Accessed March 24, 2023.

Duff JP, Topjian A, Berg MD, et al. 2019 American Heart Association focused update on pediatric advanced life support: an update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2019;140(24):e904-e914. PMID: 31722551 pubmed.ncbi.nlm.nih.gov/31722551/.

Morley PT. Cardiopulmonary resuscitation (including defibrillation). In: Bersten AD, Handy JM, eds. Oh's Intensive Care Manual. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 21.

Panchal AR, Berg KM, Kudenchuk PJ, et al. 2018 American Heart Association focused update on advanced cardiovascular life support use of antiarrhythmic drugs during and immediately after cardiac arrest: an update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2018;138(23):e740-e749. PMID: 30571262 pubmed.ncbi.nlm.nih.gov/30571262/.



Review Date: 1/2/2023
Reviewed By: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
© 1997- adam.comAll rights reserved.
A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.