Cardiopulmonary resuscitation (CPR) is a basic life-saving technique that is administered to people suffering from sudden cardiac arrest (SCA). An SCA victim’s heart is typically not regulating electric signals; thus, the heart fails to pump blood properly, leading to problematic heart rhythms. When the heart rhythms are irregular, the heart can’t pump blood properly to transport oxygenated blood throughout the body, therefore depriving other organs of oxygen. A heart rhythm abnormality that manifests itself suddenly, such as this one, is referred to as an arrhythmia. Arrhythmia may cause sudden cardiac arrest and death.

There are different causes of arrhythmia or irregular heartbeat. They are known as supraventricular arrhythmia and ventricular tachycardia primarily. Still, they are not predictable, and inconsistent heart rhythms can generate from both the upper and lower chambers of the heart. Cardiac arrests occur as the electrical signal that drives the heart to pump fails to do its job, and thus the heart problems often manifest themselves.  

Why Mouth-to-Mouth During CPR Is Not Necessary

Cardiopulmonary resuscitation (CPR) is a combination of compression and ventilation although in recent years the administering of breaths to CPR victims has become less popular.

The move to get away from mouth-to-mouth CPR in CPR training was a divisive issue. After many years, it took off; the American Heart Association now encourages untrained bystanders who witness a victim collapse in their presence to perform hands-only cardiopulmonary resuscitation (CPR).

The shift from traditional to mouth-to-mouth resuscitation was met with resistance by those who had been taught for years in conventional CPR. For decades, emergency care experts, from CPR certified to EMTs to ER doctors, have been taught the “ABCs of emergency care.”

1. Airway
2. Breathing
3. Circulation
4. in that order.

We’ve all been advised to start by ensuring that the patient has an airway and, if they are not breathing, to breathe air into them through their mouth. Then, if the patient didn’t have a pulse or indicators of circulation, we were taught to compress the chest and force blood through the body.

The conventional method of CPR was, in fact, wrong. This is demonstrated by how the body is designed and why the outdated technique of CPR was misguided.

Why is Breathing so Important?

Airway and breathing are critical. There’s no doubt about it. The brain is proof of it. The most basic of all human needs are focused in our brain stems, and the most fundamental of all is the desire to breathe. Even as the rest of the brain is harmed or destroyed by disease or trauma, one of the last functions to fail will be our desire to breathe.

Even the structures that aid breathing is designed to be safeguarded. Nerves that control the diaphragm, a muscle in the chest base responsible for breathing, are located near the top of the spinal cord, so they’ll be the last to be damaged if there is an injury to the spine.

Our emphasis on the airway is correct; we followed our lead from the body itself. We neglected to make a crucial distinction. The brain’s to-do list includes a lot of things, but pumping blood isn’t even on it. Pumping blood is carried out by the heart naturally and without instruction.

Is the Heart More Important Than the Brain

The only muscle tissue in the body that does not require an outside stimulus to contract is our heart muscle which occurs automatically. Even as the brain tries to concentrate on breathing, the heart may continue to pump blood. When the brain’s ability to control breathing is lost, so is its capacity to command circulation.

The brain controls air intake and output, while the heart controls blood circulation. They collaborate, yet they’re autonomous. The heart may continue to function even if the brain stops operating.

If the heart stops, so does the brain.

How to Perform CPR

Step-1: Chest Compressions 

The attendees must begin CPR immediately and give at least 100 to 120 compressions per minute until the paramedics arrive. Here they have to perform the compressions constantly along with the breaths. The attendee has to kneel beside the patient and put their hand in the middle of the patient’s chest. Put their hands in the midpoint of the rib joint, and then with locked elbows, they need to push. At least 2 inches of pressure on the rib is a must to perfect compression. Continuous pressure and compression are a must to save the patient.  

Step-2: Clear the Airway  

The rescuer needs to clear the airways by removing any blocking. Some patients tend to have vomit or foreign entities that need to be terminated. If the victim is biting their tongue, the head has to be tilted and use the other hand to open up their chin gently. 

Step-3: Mouth to Mouth 

After clearing the airways, the rescuer has to ultimately connect their mouth to the patient’s mouth and then respire into them. They have to breathe out until they see inflation on the victim’s chest. Two breaths in every one second are required.  

Step-4: check for life 

The patient has to be checked for rhythm and breathing every ten seconds. One can place their cheek near the patient’s mouth to check breathing and pulse until normal rhythm. 

For children and infant’s compression will be two inches and one and a half inches, respectively. Two rescuers are highly recommended for young ones as they are very delicate. Here one rescuer will perform compression, and the other will use a one-way valve to convey rescue breaths.  

Including an Automated External Defibrillator (AED) with CPR 

If an AED is available it is imperative to deploy defibrillation along with CPR to save the life of the SCA victim. A Defibrillator is used to reset an irregular or fast heart rhythm. They provide a systematic electrical shock and automatically calculate the heart rate. An AED does not always shock a suspected SCA victim. These amazing devices can recognize if the individual is suffering from a possible heart attack or other non-shockable cardiac issues like asystole.

Automatic External Defibrillator with CPR feedback  

The feedback feature of modern AED devices allows the machine to guide the rescuers even if they have no CPR or AED training. Modern AEDs improve the chances of survival and a full recovery. The audio and visual instructions can encourage the rescuer and guide them through what is typically a very stressful event. They are highly effective when treating a patient with sudden cardiac arrest.  

The feedback feature ensures that the patient is receiving the correct rate and depth of compressions.

Here are some of the CPR feedback technologies that are included  

• The real-time and constant analysis tracks the compression rate of the heart. This is included in the integrated adaptive metronome. 
• Visual feedback shows the rate of compression and the depth of compression. 
• Voice feedback directs the user with audio guides based on the actual live feedback data for rate and depth of compressions.
• The visual feedbacks can identify the null period in between the compressions. 
• The current heart rate is shown in the monitors. 
• Voice feedbacks can instruct when to start the CPR after each electric shock. 
• Evaluation of the CPR is done with event analysis.  

High-quality CPR and AED deployment success can be greatly enhanced by deploying an AED with CPR feedback. The visual and audible cues are a form of encouragement and assurance to the rescuer, allowing them to be certain of their efforts until the patient reaches the hospital. These features increase the survival rate of SCA victims, and thus it is regarded as the best type of AED to deploy.

AED and CPR in case of sudden cardiac arrest 

When the heart starts to pump erratically or very rapidly, it is known as Sudden Cardiac Arrest or SCA. These individuals tend to lose consciousness with severe chest pain. And all of these happen very quickly. In the event of a cardiac arrest, emergency responders must be contacted immediately.

The patient will require cardiopulmonary resuscitation (CPR) and an available AED before the paramedics can arrive in this case. Between 100 to 120 compressions per minute on the chest are required for CPR. CPR will be halted when the defibrillator is providing shocks or analyzing the heart rhythm of the individual with the exception of one very advanced Physio-Control CR2 AED. The CR2 is the first public access AED on the market that allows the responder to continue to perform life-saving CPR while the device analyzes the rhythm of the heart. This hands-on approach which allows for more CPR compressions can be the difference between life or death.

AEDs with CPR feedback  

AEDs that offer CPR feedback works with an event and real-time algorithms. They can detect the heart rate, compression depth, and compression speed. It provides precise information about how effective the compressions are and whether they require more pressure or not. The audible and visible signals assure that the rescuer is on the correct course to save the patient. We’ve compiled a list of some of the top AEDs with CPR feedback capabilities for you:

Physio-Control Lifepack CR2 AED

This AED can be fully or semi-automatic and does not require additional pads or hardware to provide CPR feedback. Lightweight and user-friendly, and it responds to the victim’s situation immediately. It has dual language capability with a clear audible voice. And there are features like WiFi connections and pediatric mode that change the AED over to pediatric mode without changing the AED pads. 

Zoll AED 3 

This AED comes in two sizes, and you can add a pack at an additional cost. This one provides audible feedback regarding the current situation of the patients and the instructions for CPR. The CPR Uni-Padz are dual-function electrode pads for use on adult and pediatric patients. The CPR feedback data is delivered through a compression pad that is connected to the pads and sits directly on the chest of the SCA victim.

Cardiac Science Powerheart G5

One of the first FDA-approved fully automated external defibrillators equipped with audible features. This one provides reflexive and less time-consuming electrical pulses. This one is designed for both a medical professional and an untrained user. The Powerheart G5 AED uses special electrode pads with CPR feedback built into the electrode pads with a feedback pad that sits directly on the chest of the SCA victim.

Zoll AED plus 

This Zoll Plus includes audio feedback and has information regarding the depth and speed of compression through a feedback pad attached to the electrodes that sit directly on the chest of the victim.

Zoll AED Pro 

The Zoll Pro is designed for first responders and BLS trained teams and delivers CPR feedback through a hardware feedback pad attached to the Zoll Pro electrode pads that sit directly on the chest of the SCA victim.

Heartsine Samaritan PAD

The Heartsine Samaritan 350P, 360P, and 450p AEDs share the same combination of electrode pads and battery pack that is small and easy to use. Even the most inexperienced rescuers can deliver CPR and electrical shocks with this device. This is also an AED that does not require additional hardware pads or pucks to read CPR feedback. This device uses impedance algorithms to estimate and coach the CPR depth and rate to the responder.

The algorithmic calculation used by two AEDs to estimate the impedance of an SCA victim 

The Physio-Control CR2 and Heartsine 350P, 360P, and 450P all use a complex algorithm to measure chest compressions depth. The process starts with raw data, which means pressure provided by the rescuer. Then, more steps include weighted smoothing, integration, and component emphasizing. There are multiple integration points after which peaks are detected and distinguished for positive and negative peaks, and then chest compression depth is measured. The chest compressions speed is also verified in a similar sequence with raw data and ends with a compression rate measurement. 

Conclusion  

If you or someone you know is experiencing heart attack symptoms, such as shortness of breath, chest discomfort, dizziness, tiredness, anxiety in breathing, please call 911 right away. Ambulances might take a long time to arrive, and reaching the hospital may be challenging. If the condition of the patient is critical, bystanders should begin CRP immediately and implement an AED as well for early defibrillation. This could be what saves the victim of SCA’s life.