17680 Cardiopulmonary Resuscitation Cpr

Overview

CPR stands for cardiopulmonary resuscitation (say: kar-dee-oh-PUL-muh-nair-ee ree-sus-ih-TAY-shun). It is a set of simple actions you can take when someone's heart has stopped beating and they have stopped breathing normally. The aim is to keep blood and oxygen moving around the body until trained help arrives. CPR is not a cure — it is a bridge. Every minute without CPR lowers a person's chance of survival, and doing something is almost always better than doing nothing.

Cardiac arrest — the emergency where CPR is needed — is common. Hundreds of thousands of people around the world have one each year, and many happen at home in front of family members. Most people who witness one have never done CPR before, which is exactly why short, simple training matters.

Anyone can need CPR — babies, children, healthy adults and older people. It is slightly more common in men and in people with existing heart disease, but it can happen to someone with no known health problems at all. Because it is unpredictable, the person most likely to need your help is someone you know, in your own home.

Symptoms

Common symptoms

• The person does not respond when you tap their shoulders and shout their name.
• They are not breathing at all, or they are making occasional gasps or snoring-like sounds (these are not normal breathing).
• They suddenly collapse and fall to the ground.
• Their skin may look pale, grey, bluish or blotchy, especially around the lips.
• Before collapsing, some people feel chest pain, feel very dizzy, have a racing or fluttering heartbeat, or feel breathless.

Symptoms in children

• Children often stop breathing before their heart stops, so breathing problems come first — choking, drowning, suffocation or a severe infection.
• They may be found limp and unresponsive, or may go quiet and still after struggling to breathe.
• Gasping or sighing sounds can happen and are easy to mistake for normal breathing.
• In babies under one year, CPR uses gentler compressions with two fingers or two thumbs — it is worth learning the difference.

Symptoms in older adults

• Collapse may be the very first sign, particularly in people with heart disease.
• There may be warning signs in the hours or days beforehand, such as chest discomfort, unusual breathlessness, fainting or extreme tiredness.
• Medicines, dehydration, infections and existing heart or lung conditions can raise the risk.
• Hearing loss, poor eyesight or being alone can make it harder for others to notice something is wrong — knowing CPR as a family helps.

Causes

Main causes

• A heart attack that damages the heart muscle and triggers a dangerous rhythm.
• An abnormal heart rhythm (arrhythmia) — the heart's electrical signals become chaotic.
• Drowning, choking, suffocation or smoke inhalation, which cut off oxygen first.
• Severe bleeding, major injury or a serious infection that has spread through the body.
• Electric shock or lightning strike.
• Taking too much of a medicine, or using illegal drugs.
• Very low body temperature (hypothermia) or, rarely, a severe allergic reaction.
• In children, breathing problems are the usual cause rather than heart problems.

Risk factors

• Existing heart disease, a previous heart attack, heart failure or an abnormal heart rhythm.
• A family history of sudden cardiac death, or an inherited heart condition.
• Smoking, high blood pressure, high cholesterol or diabetes.
• Being very overweight, drinking heavily, or using illegal drugs.
• Being very unwell with a severe infection, or having a serious eating disorder.
• Working or playing sport in extreme heat or cold, or swimming alone.
• Doing strenuous activity when you are not used to it and are unwell or dehydrated.

When to see a doctor

See a doctor urgently if:

• You have chest pain, pressure or tightness — call your local emergency number rather than waiting.
• You have fainted, or nearly fainted, particularly during exercise or with palpitations.
• You have a heartbeat that feels racing, fluttering or irregular and does not settle.
• You feel suddenly very breathless, or your ankles have swollen quickly.
• Someone in your family died suddenly under the age of 40 — ask your doctor about a heart check for the family.

Book a routine appointment if:

• You would like to learn CPR or refresh skills you learned a long time ago.
• You want to know where the nearest AED is at work, school or in your community.
• You have a heart condition, or a family member does, and want to plan what to do in an emergency.
• You witnessed or performed CPR and would like to talk it through with a doctor.
• You are returning to sport or strenuous work after a cardiac event and want advice.

Diagnosis

CPR is an action, not a diagnosis — the 'diagnosis' you need to make in the moment is simple: is the person responsive, and are they breathing normally? If the answer to both is no, treat it as a cardiac arrest and act. After the person reaches hospital, medical teams work out why their heart stopped. They do this with tests, by talking to family, and sometimes by looking at what happened in the minutes before the collapse.

Tests that may be done

• A heart tracing (ECG), which records the heart's electrical activity.
• Blood tests, including tests that show whether the heart muscle has been damaged.
• An ultrasound scan of the heart (echocardiogram) to check how well it is pumping.
• A test that uses dye and X-rays to look at the arteries of the heart (coronary angiogram).
• CT or MRI scans of the brain and body, especially if the cause is unclear.
• Genetic testing and family heart screening if an inherited heart condition is suspected.

What to expect at your appointment

If you performed CPR, someone from the ambulance or hospital team will usually ask you a few short questions about what you saw and did — your answers genuinely help the doctors. Survivors often spend time in intensive care, where they are kept warm, monitored closely and supported with breathing and circulation. Recovery is different for everyone, and the first few weeks are usually the hardest.

Treatment

Treatment has two parts. The first is what happens at the scene: calling for help, starting chest compressions, using an AED if there is one, and continuing until the ambulance crew takes over. The second is hospital care, which focuses on restarting the heart, protecting the brain and finding and fixing the underlying cause.

Self-care at home

• Learn CPR — a short course with a manikin is the best way, and many are free or low cost.
• Practise the basics in your head: check for a response, shout for help, call your local emergency number, then push hard and fast in the middle of the chest.
• Find out where the AEDs are at your workplace, gym, school and local shops.
• Keep your phone charged and, if you live remotely or alone, consider a personal alarm or a phone that can call for help.
• After performing CPR, give yourself time. Talk to someone about what happened, and see your doctor if you are not sleeping or cannot stop thinking about it.
• If you are a survivor, follow your rehabilitation plan, take your medicines as prescribed and build activity back gradually.

Medical treatments

Ambulance teams give oxygen, support breathing, use a defibrillator to try to restart the heart, and give medicines through a vein to support the heart's rhythm and blood pressure. In hospital, the team may use a breathing machine, careful temperature control to protect the brain, and monitoring in intensive care. They may also treat the underlying cause — for example, opening a blocked heart artery with a thin tube passed through the wrist or groin, or fitting a small implanted device that can correct a dangerous rhythm if it happens again. After recovery, a rehabilitation programme with exercise, education and support is a normal part of care.

When is surgery considered?

Most people who have a cardiac arrest do not need open surgery, but some do. This can include an emergency procedure to open a blocked heart artery, heart bypass surgery, or an operation to implant a small defibrillator device under the skin of the chest. Any of these would be discussed with you and your family by the hospital team.

Living with this condition

Recovery after a cardiac arrest takes weeks to months. Many people feel exhausted at first, and some notice changes in memory, concentration or mood — this usually improves over time, but it can be frustrating. Your team will advise you on when you can drive, fly, return to work and be left alone. It helps to write down questions before appointments and to take someone with you.

Lifestyle tips

• Stop smoking — ask your doctor or pharmacist for support, as this is the single biggest change most people can make.
• Keep blood pressure, cholesterol and blood sugar in the healthy range and attend your check-ups.
• Limit alcohol and avoid illegal drugs, especially stimulant drugs.
• Stay physically active within the plan your team gives you — build up slowly.
• Make sure the people you live with know CPR and where the nearest AED is.
• Wear any medical ID or carry information about your heart condition if your team advises it.

Diet and exercise

A heart-healthy eating pattern is a sensible long-term choice: plenty of vegetables, fruit, beans, wholegrains, nuts and oily fish, with less salt, sugar and processed food. Exercise is strongly encouraged after a cardiac arrest, but it should be gradual and guided by your cardiac rehabilitation team. Many people start with short walks and build up over weeks, and some will be given a target heart rate or advice about avoiding very strenuous activity on their own.

Mental health and emotional wellbeing

A cardiac arrest affects everyone involved, not just the patient. Survivors often describe anxiety, low mood, poor sleep, or vivid memories of the event. Partners, family members and bystanders can feel shaken, guilty or frightened for a long time, even when the outcome was good. These feelings are common and treatable — tell your doctor or cardiac rehab team, because talking therapy and support groups help a great deal. If you or someone you know is having thoughts of harming themselves, contact your local emergency number or a crisis line straight away; you deserve immediate support.

Prevention

You cannot always prevent a cardiac arrest, but you can lower the risk and hugely improve the chances of survival if one happens. Looking after your heart, taking prescribed medicines, attending check-ups and learning CPR all make a real difference. Communities that teach CPR widely and place AEDs in public places have noticeably better survival rates.

Vaccines

There is no vaccine for cardiac arrest itself, but staying up to date with routine vaccinations — including flu and pneumonia vaccines if your doctor recommends them — helps prevent severe infections that can occasionally lead to a cardiac arrest.

Screening programmes

If you have a heart condition, a strong family history of early heart disease or sudden death, or an inherited condition in the family, your doctor may offer heart tracing, ultrasound scans or genetic counselling. Routine NHS health checks and blood pressure checks are a good way to catch risk factors early. Talk to your doctor about what is right for you.

Complications

If left untreated

• Without CPR or a shock from a defibrillator, brain damage can begin within about four to six minutes.
• After about ten minutes without help, survival becomes very unlikely.
• Survivors may have memory problems, tiredness, difficulty concentrating, or emotional difficulties.
• Some people have ongoing heart rhythm problems and need long-term monitoring or a fitted device.
• Family members and bystanders can experience lasting distress after witnessing a cardiac arrest.

Long-term outlook

Survival after cardiac arrest has improved a lot over the past twenty years, mostly because more bystanders start CPR and more public places have defibrillators. Many people go back to work, driving, sport and family life. Every person's recovery is different, and the medical team will be honest with you about what to expect. Whichever side of the emergency you are on — patient or helper — the single most powerful thing you can do is learn CPR and be willing to try.

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