Prepare for "CPR"

No patient should undergo CPR, until the need for resuscitation has been established by appropriate assessment. Before providing CPR you must determine unresponsiveness and breathlessness.

Follow these steps:
1) Establish unresponsiveness. Ask the patient, “Are you okay?” ,“What is your name?” or shake/tap the patient. If unresponsive, position the patient properly (must be supine with arms along the body on a firm, flat surface, or blood flow will be compromised).
2) Activate the EMS system. (Ask someone else to activate when available or call 108 for emergency).
3) Perform C-A-B.(circulation - airway - breathing).

Circulation: Check pulselessness. On an adult and child, check the carotid pulse for not more than 10 seconds. On an infant, check brachial pulse. If you detect no pulse, begin CPR immediately with chest compressions.
Elimination of look, listen and feel for breathing (in 2015 AHA Guidelines for CPR). AHA recommends initiating chest compressions before giving rescue breaths (C-A-B rather than A-B-C).
Beginning CPR with 30 compressions than 2 ventilations leads to a shorter delay to first compression.
Airway: After the first set of chest compressions, open airway. Use appropriate method to open airway.
Breathing: The MFR delivers two ventilations. Use small puffs on infants.

CPR Chest Compressions for Adults- 
Chest compressions consist of rhythmic, repeated pressure over the lower half of the sternum. When combined with artificial ventilation, it provides enough blood circulation to sustain Life.

Follow these steps:
1) Position the patient. Must be supine on firm, flat surface, with arms along sides.
2) Expose the patient’s chest. Remove the patient’s clothes near chest for location of heart and for some fresh air, providing patient’s privacy as much as possible.
3) Get in position. Kneel close to the patient’s side, with your knees about as wide apart as your shoulders.
4) Locate the compression site. Place the heel of the dominant hand at the center of the patient’s chest (between the nipples, along the axis of the sternum).
5) Position your hands. Put your free hand on top of your first hand. Extend or interlace your fingers(do not rest them on the chest wall).
6) Position your shoulders. They should be directly over your hands.
7) Perform chest compressions. Keeping your arms straight and your elbows locked, thrust straight downward from your shoulders. Release pressure completely after each compression.
However, do not lift or move your hands, or you will lose proper position. Count as you perform compressions.

CPR Chest Compressions for Children and Infants
Cardiac arrest in infants is rarely caused by heart problems. Usually the cause is too little oxygen (hypoxia)due to injuries, suffocation, smoke inhalation, etc. For this reason, you should resuscitate an infant for two minute before activating the EMS system (if you are alone).
1) Position the patient. Must be supine on firm, flat surface, with arms along sides. If an infant, place him or her on your forearm, using your palm to support the head. If the infant is on his/her back, maintain head in a neutral position. It may be necessary to provide support under the shoulder with a folded blanket or towel.
2) Expose the patient’s chest. Remove the patient’s shirt or blouse.
3) Locate the compression site. In a child, use the same location as an adult. In infants, use two finger width below an imaginary line between the nipples.
4) Perform chest compressions. For an infant, use the flat part of your middle and ring fingers to compress the sternum. For a child, use the heel of one hand. Release pressure completely after each compression. However, do not lift or move your hands, or you will lose proper position. Count as you perform compressions.