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Emergency life support

Key points

  • Emergency life support can keep a person alive until professional help arrives.
  • If you have been trained, you should perform cardiopulmonary resuscitation (CPR).
  • If you can’t do mouth-to-mouth breathing, just do chest compressions.
  • Remember to push hard and fast in the centre of the person’s chest.

Video: how CPR is carried out

Emergency life support is a set of actions that you can do to keep a person alive until professional help arrives. Actions include performing cardiopulmonary resuscitation (CPR) on people who may have stopped breathing or whose heart has stopped.

This information will help you to learn how to carry out emergency life support. For simplicity, the injured person is referred to as a male throughout.

About emergency life support

A person's heart or breathing can stop as a result of a heart attack, drowning, an electric shock or other injuries. If this happens, their organs don't receive a supply of oxygen-rich blood and this will soon lead to irreversible damage.

CPR involves giving chest compressions and rescue breaths (mouth-to-mouth breathing) to a person who has stopped breathing or whose heart has stopped. In people whose heart has stopped, for example, after a heart attack, CPR circulates enough oxygen-rich blood around their body to slow down organ damage.

Emergency life support can make the difference between life and death. Giving CPR to someone whose heart has stopped can increase their chance of survival and buys time until a medical professional arrives. If you aren’t trained in emergency life support then giving chest compressions only can increase the chance of survival. This is better for the person than doing nothing.

You can learn basic life-saving skills, including CPR, at a local training centre.

Chain of survival

A rapid response is a crucial part of emergency life support. This is called the ‘chain of survival’ and involves:

  • early recognition of the emergency and calling for an ambulance – to prevent cardiac arrest
  • immediately performing CPR if the person isn’t breathing – to buy time
  • early defibrillation – to restart the heart
  • effective advanced life support – to maintain the heart rhythm
  • early post-resuscitation care – to restore quality of life
     

What to do in an emergency

Stay calm and remember you can only do your best. First, assess the situation and make sure the area is free of hazards, particularly anything that may have caused the injury to the person. These could include live overhead cables or traffic. You should never put yourself at risk and if no one else is there with you, then shout for help.

If you have had first aid training, let others know. Also, nominate someone to stand by in case you need to ask them to call for emergency help.

Once you have assessed the situation, it’s important to quickly check the person's responses by talking to him. Ask him to perform an action – such as opening his eyes – as he may not be able to talk to you.

If he responds, leave him in the position that you found him. If necessary, ask your nominated bystander to call the emergency services and inform them that you have a conscious adult male who is breathing. You should monitor his condition regularly until help arrives or he has recovered.

If you don’t get a response, gently tap his shoulders without moving his neck and continue to speak to him. Always speak loudly and clearly to the person. You will then need to check his airway and breathing.

Airway

The person can only breathe if his airway is clear. An airway can be blocked when a person is unconscious and their tongue falls to the back of their throat. To open the airway, complete the following actions.

  • Place two fingers under the point of his chin.
  • Put your other hand on his forehead.
  • Lift his jaw and tilt his head back slightly.
  • Remove any obvious debris that might be blocking his airway.
     

Animation: How to open the airways

Breathing

Next, keeping the airways open, check if the person is breathing normally in a continuous, rhythmical way.

  • Look to see if his chest is moving up and down.
  • Listen for his breathing by placing your ear next to his mouth.
  • Feel for his breath against your cheek.

You need to look, listen and feel for up to 10 seconds before deciding if the person is breathing normally.

If the person is breathing normally, then place him in the recovery position and frequently check his breathing before you get emergency help. If the person isn’t breathing or isn’t breathing normally (for example, if he takes infrequent gasps), call for emergency help and then begin CPR. See our frequently asked questions for more information about normal breathing. If the person is a baby (up to one year) or a child (aged one to puberty), you should carry out one minute of CPR before calling for emergency help.

Ask your nominated bystander to call for emergency help or, if you’re alone, then you should call. Only leave the person if there is no other way of getting help. If the person isn’t breathing, tell the bystander to bring an automated external defibrillator (AED) if one is available.

If you’re in any doubt as to whether or not the breathing is normal, act as if he isn’t breathing.

Recovery position

If you don’t suspect injury and the person is unconscious but breathing, you can place him in the recovery position. This will keep his airway clear and allow any fluid to drain from his mouth. For a child or adult lying on his back, take the actions shown in the illustration below.

An illustration showing the different stages of the recovery position

If the person is in the recovery position for more than 30 minutes, move him onto his other side to relieve pressure on his lower arm. Only do this if he has no injuries that prevent you moving him.

For babies less than one year old, a different recovery position is needed. If a baby is unconscious and breathing, hold him on his side in your arms, head tilted downward, with his head lower than his tummy. This helps to prevent him from choking on his tongue or vomit.

Cardiopulmonary resuscitation (CPR)

A person who isn’t breathing needs CPR, which is a combination of chest compressions and rescue breaths. There are a few differences in CPR for adults, children and babies. However, the adult CPR technique can be used on children. For a child or baby who isn’t breathing, initially perform five rescue breaths. If the child or baby still isn’t breathing normally, carry out 30 compressions followed by two rescue breaths until emergency help arrives. For an adult who isn’t breathing, start by performing 30 compressions followed by two rescue breaths and continue until help arrives. If you aren’t trained in emergency life support, then you should just perform chest compressions.

Compressions

  • Move the person so he is lying on his back on a firm surface.
  • Kneel beside the person's chest.
  • Place the heel of your hand on the centre of his chest
  • Place your other hand on top and interlock your fingers.
  • With your arms straight, press down 5 to 6cm (this is one compression).
  • After each compression, release the pressure on his chest, but keep your hands in contact.
  • Do compressions at a rate of 100 to 120 compressions per minute (the compress and release parts take about the same time). You will need to do 30 compressions for one cycle of CPR.

For children, you should place one or two hands on the centre of the chest (depending on the size of the child). With the heel of your hand, press down at least one-third of the depth of his chest. For babies, you should use two fingers in the middle of the chest and press down at least one-third of the depth of his chest.

Rescue breaths

At the end of the 30 chest compressions, you should perform two rescue breaths to deliver oxygen into the person's lungs if you’re trained in emergency life support. For children and adults, you should perform the following actions.

  • Place two fingers under his chin and gently lift it to open the airway.
  • Pinch his nose closed.
  • Take a normal breath.
  • Seal your mouth over the person's and breathe out steadily into his mouth for around one second.
  • Watch for his chest to rise and fall.
  • Repeat once more.

For babies, you should seal your lips around his mouth and nose. Blow gently into his lungs, watching for his chest to rise as you breathe into his mouth. See our frequently asked questions for more about carrying out CPR on children. Repeat the cycle in the ratio of 30 chest compressions to two rescue breaths until either:

  • professional help arrives
  • the person starts showing signs of regaining consciousness and breathing normally
  • you become exhausted
  • you have help from another person who can perform CPR and take over from you

Doing chest compressions is very tiring so if you have help, take turns doing CPR – swap every one to two minutes so neither of you gets too tired. This will increase the efficiency of your CPR, but it’s important to minimise any delay each time you swap over.

If you’re not able or willing to breathe into the person's mouth, you can just do the chest compressions without a pause for the rescue breaths. This is much better than doing nothing at all. Only stop to check the person if he begins to show signs of regaining consciousness, such as opening his eyes, speaking or coughing and starts to breathe normally. For more information about rescue breathing, see our frequently asked questions.

Animation: How cardiopulmonary resuscitation is carried out

Automated external defibrillators

Automatic external defibrillators (AEDs) are machines designed to be operated by members of the public. They are available in public places such as offices, shopping centres, railway stations and on aeroplanes. AEDs analyse a person's heart rhythm through pads connected to the chest area, and deliver an electric shock if needed. They give spoken instructions and are easy for people without training to use. If no shock is needed, then you should continue CPR.

You can use an AED safely and effectively without any previous training. You can also learn how to use an AED at a local training centre.

 

Produced by Natalie Heaton, Bupa Health Information Team, July 2013.

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For answers to frequently asked questions on this topic, see FAQs.

For sources and links to further information, see Resources.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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