![]() The risk of serious injury from chest compressions to patients who are not in cardiac arrest is negligible, while any delay in starting chest compressions has grave implications for outcome. If a patient is found unresponsive without a definite pulse or normal breathing then the responder should assume that this patient is in cardiac arrest, activate the emergency response system and immediately start chest compressions. ![]() This is based on implied patient consent for emergency treatment. Unlike other medical interventions, chest compressions can be initiated by any healthcare provider without a physician's order. Finally, it is important that family and patients' loved ones who witness chest compressions be treated with consideration and sensitivity.Ĭhest compressions are generally indicated for all patients in cardiac arrest. ![]() If there is no return of spontaneous circulation, then the decision to terminate chest compressions is based on the clinical judgment that the patient's cardiac arrest is unresponsive to treatment. Unconscious patients with normal breathing are placed in the recovery position. Chest compressions are terminated following return of spontaneous circulation. Aggressive rotation of compressors prevents decline of chest compression quality due to fatigue. The rate should be at least 100 compressions per minute and any interruptions should be minimized to achieve a minimum of 60 actually delivered compressions per minute. Optimal technique for adult chest compressions includes positioning the patient supine, and pushing hard and fast over the center of the chest with the outstretched arms perpendicular to the patient's chest. Contra-indications to starting chest compressions include a valid Do Not Attempt Resuscitation Order. Thus, the quality of the delivered chest compressions is a pivotal determinant of successful resuscitation. In order to optimize blood flow excellent chest compression technique is critical. This is achieved by direct cardiac massage as well as a thoracic pump mechanism. Chest compressions have saved the lives of countless patients in cardiac arrest as they generate a small but critical amount of blood flow to the heart and brain.
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