CPR — Cardiopulmonary Resuscitation

🔄 The Universal Sequence

1. Check safety — ensure the scene is safe before approaching the patient.
2. Check responsiveness — tap shoulders firmly, shout "Are you OK?"
3. Call for help — shout for a bystander to call emergency services. If alone, call yourself before starting. Exception: drowning or choking children — perform 2 minutes of CPR first, then call.
4. Open the airway — head-tilt chin-lift. If spinal injury is suspected, use jaw thrust instead.
5. Check for normal breathing — look for chest rise, listen, feel for no more than 10 seconds. Occasional gasps (agonal breathing) are not normal breathing — begin CPR immediately.

• Position: heel of dominant hand on the centre of the chest (lower half of sternum), other hand on top, fingers interlaced and lifted off the chest.
• Depth: 5–6 cm (2–2.4 inches). Allow full recoil between compressions — do not lean on the chest.
• Rate: 100–120 compressions per minute. Think of the beat of "Stayin' Alive" by the Bee Gees.
• Ratio: 30 compressions : 2 rescue breaths.
• Rescue breaths: pinch the nose closed, seal lips over the patient's mouth, give a 1-second breath while watching for chest rise. If the chest does not rise on the first attempt, re-tilt the head and try once more, then continue compressions regardless.
• Hands-only CPR: if untrained or unwilling to give rescue breaths, compression-only CPR is acceptable — maintain compressions at 100–120/min without stopping.
• Rotation: swap compressors every 2 minutes if a second rescuer is present, to maintain compression quality.

• Sequence and ratio: same universal sequence. 30:2 for a lone rescuer; 15:2 if two healthcare providers are present.
• Depth: approximately one-third of chest depth (~5 cm / 2 inches).
• Technique: one hand for smaller children, two hands for larger children — use whatever achieves adequate depth.
• Rescue breaths: use smaller breaths than for adults — only enough to see the chest rise. Over-inflation is harmful.
• Rate: same 100–120 compressions per minute.
• AED: use paediatric pads or paediatric key/mode if available. If only adult pads are available, place one pad on the chest (front) and one on the back — do not delay defibrillation if no paediatric option exists.

• Sequence: same universal sequence.
• Ratio: 30:2 for a lone rescuer; 15:2 for two healthcare providers.
• Technique: 2-finger compressions on the centre of the chest, just below the nipple line. If two rescuers are present, use the 2-thumb encircling technique — it is more effective.
• Depth: approximately one-third of chest depth (~4 cm / 1.5 inches).
• Rescue breaths: cover both the mouth AND nose with your mouth. Use small puffs only — just enough to see the chest rise.
• Head position: neutral — do not hyperextend as with adults. An infant's airway occludes if the head is tilted too far back.

⚡ AED — Automated External Defibrillator

1. Power on — open the lid or press the power button. The device will immediately begin giving spoken instructions.
2. Attach pads — right pad: right of sternum, below the right collarbone. Left pad: left side, below the armpit (axilla). Remove clothing and dry the chest. Shave if excessive chest hair is present — most AED kits include a razor. For children: use paediatric pads or paediatric key/mode if available.
3. Stop CPR, do not touch the patient — the AED will analyse the heart rhythm. This takes 5–15 seconds. Ensure no one is touching the patient during analysis.
4. Follow the AED's advice — if a shock is advised, ensure everyone stands clear ("I'm clear, you're clear, everybody's clear"), then press the shock button when prompted.
5. Resume CPR immediately — do not check for a pulse. Restart compressions immediately after the shock. The AED will prompt you to stop after 2 minutes for re-analysis.
6. Continue cycles — repeat analyse / shock / CPR cycles until EMS arrives, the patient shows obvious signs of life, or you are physically unable to continue.

🔃 Recovery Position

• Roll the patient onto their side (left side is preferred).
• Bend the upper knee to approximately 90° to prevent rolling forward.
• Extend the lower arm to prevent rolling backward.
• Tilt the head back slightly to maintain an open airway.
• Monitor breathing continuously — if breathing stops, return to supine position and begin CPR.
• Do not use the recovery position if spinal injury is suspected — maintain in-line stabilisation instead.

🛑 When to Stop CPR

• EMS or other trained personnel arrive and take over.
• A doctor or medical authority (by phone) advises you to stop.
• The patient shows obvious signs of life — purposeful movement, normal breathing, or coughing.
• The environment becomes unsafe for rescuers.
• You are physically exhausted and no rotation is possible.
• Signs of obvious death are present (rigor mortis, decapitation, dependent lividity).