Adult CPR (Cardio-Pulmonary Resuscitation)
ACT Program (Advanced Coronary Treatment)
I) 4 R’s of CPR
A. Risk
B. Recognize
C. React
D. Resuscitate
A. Risk
 Risk factors for heart disease:
o Smoking, diet, lack of exercise, insufficient sleep, high blood pressure,
cholesterol, diabetes, stress, obesity, age, gender, hereditary history.
B. Recognize
 Recognize signals of heart attack.
o The 5 P’s – Pain, pale, puffing, pooped and puking.
o Often the casualty will resist that they are having a heart attack.
C. React
 The key is to act and reassure the casualty.
o PLT – Position, Loosen and Talk. Place the casualty in a comfortable
position, loosen any tight clothing and reassure the person.
o Check for hazards.
o Call 911
D. Resuscitate
One person CPR
II) What is …
A. Heart Attack
 The heart pumps blood to all organs in your body to deliver oxygen. The heart
also has its own blood vessels so it to gets oxygen. When one of these arteries
gets blocked by fat or cholesterol, that area of the heart is deprived of circulation,
therefore it is getting no oxygen. The result is chest pain. If the blockage is not
cleared that area of the heart begins to die.
B. Cardiac Arrest
 When the heart stops beating and is no longer pumping blood to the rest of your
body. Generally, the main muscles in the heart stop their rhythmic pumping
action because there is no oxygen, resulting in spasm – fibrillation.
C. CPR – Cardiopulmonary Resuscitation
 The act of pushing on the casualty’s chest to force blood to flow through the
body, it is not to try and restart the heart. Mouth to mouth breathing provides
oxygen.
D. Stroke
 This is when an artery to the brain is blocked by fat or cholesterol. That area of
the brain receives no oxygen and is damaged. Another type of stroke is when a
blood vessel in the brain bursts.
E. Shock
 This is a condition of inadequate circulation to body tissues. It results from
oxygen deprivation to the brain. Severe bleeding for example would lead to
shock.
F. First Aid
 This is emergency help given to an injured or ill person using readily available
resources. Your objectives are to preserve life, prevent further injury or the
illness from becoming worse, and to promote recovery. Anyone who acts to the
best of their ability and in good faith is protected by the “Good Samaritan Act”.
If the casualty is conscious tell them you are a first-aider and get permission to
assist, if they are unconscious you have implied consent.
III) Assess the Situation
1. Check for hazards
 Electric wires, traffic, fire, gas, etc.
2. Assess Responsiveness
 Shake shoulders, pinch earlobes, call out to person
3. Call 911- Send Someone, Don’t leave the casualty
IV) Resuscitate the Casualty
A, B, C’s of CPR
o Airway – Check that it is clear.
Breathing – Look, listen and feel. Breathe for them.
Circulation – Check pulse, begin compressions.
1. Open airway using Head-Tilt, Chin-Lift method (No Neck Injury)
 Use two fingers under the chin and the other hand on forehead. Tilt the head
back by pushing down on the forehead and gently lifting the chin up. Sweep
the mouth with your finger to check if there is anything lodged in the throat.
Do not use this method if you suspect a neck injury.
2. Check for breathing – up to 10 seconds
 Place your ear over their mouth and nose. Look at their chest for movement,
listen for sounds of breathing and feel for exhaled breath on your cheek.
3. Give 2 slow breaths if not breathing
 Maintain the head-tilt, chin-lift. Pinch the person’s nose and seal your mouth
over theirs. Give 2 slow breaths, about 2 seconds for each breath. Watch the
person’s chest to make sure it rises and falls. If your breaths do not go in,
check to see if anything is blocking it, reposition the head, seal your mouth to
theirs, pinch the nose and try again.
 If possible use a barrier device to breathe through. Your greatest concern is
Hepatitis.
 ABC’s again
4. If not breathing, landmark for chest compressions
 Trace your middle finger along the rib cage to the center of their chest. Place
your index finger next to your middle finger and the heel of your hand next to
your index finger so that the heel of your hand is on the lower half of the
breast bone just above the notch where the lower ribs meet the breastbone.
Cover the heel of that hand with your other hand.
 Next, position your shoulders directly above the heels of your hands. Keep
your arms straight with your elbows locked in position.
 Compress straight down on the breast bone compressing 4-5 cm or 1.5 to 2
inches. Compress at a rate of 100 compressions per minute (5 compressions
in 3 seconds). Compressions should be smooth without loosing contact with
the chest, and allowing the chest to return to its normal position between
compressions. Find your landmark with each new cycle of compressions.
 If you break ribs, check your landmark, depth of compressions and continue.
5. Give 30 compressions and 2 slow breaths
 Count aloud as follows; 1 and 2 and 3 and 4 and 5 and 6 and 7 and 8 and 9
and 10 and 1 and 2 and 3 and 4 and 5 and 6 and 7 and 8 and 9 and 15... Do 4
cycles of 30 compressions followed by 2 breaths after each cycle of 30 (30
and 2 is what you do). After 4 cycles of 30 compressions and 2 breaths
recheck for signs of breathing for up to 10 seconds (ABC’s). If there is no
response begin a second set of 4 cycles of 30 and 2.
 If there are no signs of breathing, continue CPR until Paramedics arrive, a
defibrillator is made available or the casualty recovers.
9. If casualty responds put in recovery position
 Roll the casualty towards you on their side so that their head is resting on their
bottom arm and their top leg is completely over their lower leg. Place their
top arm across their body, cover them and wait for medical help.