Cardiopulmonary resuscitation is an emergency life-saving procedure performed when the heart stops beating. The primary goal is to maintain a flow of oxygenated blood to the brain and vital organs until advanced medical help arrives. Without immediate intervention, irreversible brain damage occurs within minutes. Effective CPR combines chest compressions and artificial ventilation to manually preserve circulatory and respiratory function.
The Chain of Survival represents the interconnected steps needed to maximize survival rates from cardiac arrest. Each link depends on the success of the previous one.
Before touching a collapsed individual, nurses must scan the environment for potential hazards such as live electrical wires, heavy traffic, or chemical spills to prevent becoming a casualty themselves. Once safety is established, approach the patient and tap their shoulders firmly while shouting, "Are you alright?" Simultaneously check for normal breathing by watching the chest for movement for no more than ten seconds. Gasping is not considered normal breathing and indicates the need to start CPR immediately.
Opening the airway is essential to prevent the tongue from blocking the pharynx in an unconscious person. Use the head-tilt, chin-lift maneuver unless a cervical spine injury is suspected, in which case the jaw-thrust maneuver is preferred. After opening the airway, deliver rescue breaths if trained, ensuring each breath makes the chest visibly rise over one second. Avoid excessive ventilation, as it increases intrathoracic pressure and reduces venous return to the heart.
High-quality chest compressions are the cornerstone of effective resuscitation. Place the heel of one hand on the center of the chest (lower half of the sternum) and put the other hand on top with fingers interlocked. Push hard and fast, maintaining a depth of at least 5 centimeters (2 inches) for adults at a rate of 100 to 120 compressions per minute. Allow full chest recoil between every compression to let the heart chambers refill with blood.
An AED analyzes the cardiac rhythm and delivers an electrical shock if a shockable rhythm like ventricular fibrillation is detected. As soon as the device arrives, turn it on and follow the visual and voice prompts. Apply the adhesive pads to the bare chest—one on the upper right chest below the collarbone and the other on the lower left side of the ribcage. Ensure nobody touches the patient during rhythm analysis and shock delivery.
Resuscitation efforts sometimes present unique challenges and physical complications. Rib fractures and sternal bruising are common during forceful chest compressions, especially in older adults, but should not stop the nurse from continuing life-saving compressions. For pregnant women in cardiac arrest, manual left uterine displacement is performed to relieve aortocaval compression by the gravid uterus and improve venous return.
Resuscitation continues until the patient shows signs of return of spontaneous circulation, a physician orders cessation, or the rescue team is physically exhausted and unable to continue. Comprehensive nursing documentation must record the exact time of collapse, time CPR started, shock deliveries, medications administered, and the time of handover to advanced medical personnel or time of death declaration.