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Cardiopulmonary Resuscitation

Cardiopulmonary resuscitation (CPR) — restoring circulation and breathing after cardiac arrest.

Emergency intervention that includes basic and advanced life support practices, providing chest compressions and, when needed, respiratory support to restore circulation in a person with sudden cardiac arrest.

Indication

  • Loss of consciousness with no detectable pulse
  • Respiratory arrest or inadequate breathing (gasping)
  • Sudden cardiac arrest
  • Circulatory failure following drowning, electrocution, or poisoning
  • Respiratory and circulatory arrest in newborns or infants (special technique)
  • Loss of circulation following trauma or hypothermia

Preparation

  • The safety of the scene is assessed; if there is danger, the patient is moved to a safe area
  • 112 (emergency line) is called immediately, and an automated external defibrillator (AED) is requested if available
  • The patient is placed supine on a firm surface
  • For healthcare personnel: monitor, defibrillator, advanced airway, and medications are prepared

How it's performed

  1. For lay rescuers, basic life support (BLS): hands-only chest compressions can be applied at a rate of 100-120 per minute, 5-6 cm depth, without interruption
  2. For healthcare personnel, advanced cardiac life support (ACLS): 30 chest compressions plus 2 breaths are applied in sequence
  3. In a shockable rhythm (VF/pulseless VT), early defibrillation is delivered
  4. Intravenous access is obtained; medications such as adrenaline and amiodarone are given according to protocol
  5. Advanced airway (intubation, supraglottic device) is used when needed
  6. Resuscitation is continued until return of spontaneous circulation (ROSC) or until criteria to terminate resuscitation are met

Post-procedure

  • After ROSC, the patient is admitted to the intensive care unit
  • Targeted temperature management (32-36°C) may be applied
  • Neurological prognosis is evaluated (24-72 hours later)
  • The underlying cause (MI, arrhythmia, electrolyte disturbance) is investigated and treated
  • After discharge, cardiology and neurology follow-up is planned

Risks

  • Rib fracture or sternum injury during chest compressions (common, considered acceptable)
  • Aspiration of stomach contents into the lungs
  • Neurological injury or brain death after prolonged arrest
  • Risk of electrical contact during defibrillation (if rules are not followed)
  • Unsuccessful resuscitation — ROSC may not be achieved in every case

FAQ

I have no medical training; can I perform CPR?

Yes. For untrained people, hands-only CPR is recommended. Call 112 and follow the operator's guidance; even simple intervention saves lives.

What is the difference between BLS and ACLS?

BLS (basic life support) includes chest compressions, rescue breathing, and AED use; anyone can perform it. ACLS (advanced cardiac life support) includes medications, advanced airway, and rhythm analysis; it is performed by healthcare personnel.

Is the AED (automated external defibrillator) safe?

Yes. The device automatically analyzes the rhythm and recommends a shock only when needed. It guides the user with voice prompts; even untrained people can use it safely.

What if a rib breaks during CPR?

Rib fractures are common despite proper technique and considered an acceptable trade-off. Because saving a life is the priority, CPR should not be avoided due to this complication.