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Md.Mizanur Rahman
Social and Institional Expert
National Land Zoning Project
Ministry of Land
email: info.mmizan@gmail.com

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As we are well aware of that cardiac arrest become very common in all over the world which caused the heart attack and sudden death. Cardiac arrest is the abrupt loss of heart function in a person who may or may not have diagnosed heart disease. In another word, is a sudden stop in effective blood circulation due to the failure of the heart to contract effectively or at all. Cardiopulmonary resuscitation (CPR) is an important lifesaving technique that involves chest compressions and giving breaths. This technique can help keep oxygenated blood circulating in the body, which can help prevent brain and organ damage. CPR may be done when a person is showing signs of no breathing or does not respond when you tap them or ask if they are okay. If a person is not responding and has an advanced life-threatening illness (such as cancer) or is dying, CPR may not be the best option. It's important for the person, family members, and their doctor to talk about this issue early, before the need arises. When someone affected by cardiac arrest, he has nothing do by own but some general measure especially Cardiopulmonary resuscitation (CPR) by the people who are around him could save his life or reduce the severe damage of prime organ of the patient. Here are some CPR techniques are given:

How to apply CPR on an Adult

CPR for Adult could be divided into five parts.

· Taking Vitals

· Administering CPR

· Continuing the Process Until Help Arrives

· Using an AED

· Putting the Patient in Recovery Position

Part :1		Taking Vitals
	*1.1*	*Check the scene or immediate danger*

Make sure you're not putting yourself in harm's way by administering CPR to someone unconscious. Is there a fire? Is the person lying on a roadway? Do whatever is necessary to move yourself and the other person to safety.

If there is anything that could endanger you or the victim, see whether there is something you can do to counteract it. Open a window, turn off the stove, or put out the fire, if possible.

However, if there is nothing you can do to counteract the danger, move the victim. The best way to move the victim is by placing a blanket or coat underneath their back and dragging it

1.2

Assess the victim’s consciousness

Gently tap his or her shoulder and ask "Are you OK?" in a loud, clear voice. If he or she responds agreement "Yeah" or such, CPR is not required. Instead, undertake basic first aid and take measures to prevent or treat shock, and assess whether you need to contact emergency services. If the victim does not respond, continue with the following steps.

1.3

Send for help

The more people available for this step, the better. However, it can be done alone. Send someone to call for emergency medical services (EMS).

Give the dispatcher your location, and notify him or her that you're going to perform CPR

1.4

Do not check for a pulse

Unless you're a trained medical professional, odds are you'll spend too much valuable time looking for a pulse when you should be doing compressions.

1.5

Check for breathing

And, make sure that the airway is not blocked. If the mouth is closed, press with your thumb and forefinger on both cheeks at the end of the teeth and then look inside. Remove any visible obstacle that is in your reach but never push your fingers inside too far. Put your ear close to the victim's nose and mouth, and listen for slight breathing.

If the victim is coughing or breathing normally, do not perform CPR.

Part :2		Administering CPR
	*2.1*	*Place the victims on her or his back*

Make sure he or she is lying as flat as possible - this will prevent injury while you're doing chest compressions. Tilt their head back by using your palm against their forehead and a push against their chin.

2.2

Place the heel of one hand of victim’s breath bone

Make sure 2 finger-widths above the meeting area of the lower ribs, exactly between the nipples.

2.3

Place your second hand on the top of the first hand

Make sure palm-down, interlock the fingers of the second hand between the first.

2.5

Perform 30 chest compression

Press down with both hands directly over the breastbone to perform a compression, which helps the heart beat. Chest compressions are more critical for correcting abnormal heart rhythms (ventricular fibrillation or pulseless ventricular tachycardia, heart rapidly quivering instead of beating).

You should press down by about 2 inches (5 cm).

Do the compressions in a relatively fast rhythm. Some agencies recommend doing compressions to the beat of the chorus of "Stayin' Alive," a 1970s disco hit, or at roughly 100 beats per minute.

Part:3		Continuing the Process Until Help Arrives
	*3.1*	*Minimize pauses in chest compression*

Continuing the Chest compressions that occur when changing providers or preparing for a shock. Attempt to limit interruptions to less than 10 seconds.

3.2

Make sure the airway is open

Place your hand on the victim's forehead and two fingers on their chin and tilt the head back to open the airway.

If you suspect a neck injury, pull the jaw forward rather than lifting the chin. If jaw thrust fails to open the airway, do a careful head tilt and chin lift.

If there are no signs of life, place a breathing barrier (if available) over the victim's mouth.

3.3

Give two rescue breaths( optional)

As the chest compressions are more important. If you are trained in CPR and totally confident, give two rescue breaths after your 30 chest compressions. If you've never done CPR before, or you're trained but rusty, stick with only chest compressions

Keeping the airway open, take the fingers that were on the forehead and pinch the victim's nose closed. Make a seal with your mouth over the victim's mouth and breathe out for about one second. Make sure you breath slowly; as this will make sure the air goes in the lungs and not the stomach.

If the breath goes in, you should see the chest slightly rise and also feel it go in. Give a second rescue breath.

If the breath does not go in, re-position the head and try again. If it does not go in again, the victim may be choking. Do abdominal thrusts (the Heimlich maneuver) to remove the obstruction.

3.4

Repeat the cycle of 30 chest compressions

If you're also doing rescue breaths, keep doing a cycle of 30 chest compressions, and then 2 rescue breaths; repeat the 30 compressions and 2 more breaths.

You should do CPR for 2 minutes (5 cycles of compressions to breaths) before spend time checking for signs of life.

3.5

Continue the CPR

Please continue CPR until someone takes over for you, emergency personnel arrives, you are too exhausted to continue, an Automated External Defibrillator (AED) is available for immediate use, or signs of life return.

Part :4		Using an AED
	*4.1*	*Use an AED ( Automated External Definbrillator)*

If an AED is available in the immediate area, use it as soon as possible to jump-start the victim's heart.

Make sure there are no puddles or standing water in the immediate area.

Turn on the AED. It should have voice prompts that tell you what to do.

4.2

Fully expose the victim’s chest.

Remove any metal necklaces or underwire bras. Check for any body piercings, or evidence that the victim has a pacemaker or implantable cardioverter defibrillator (should be indicated by a medical bracelet) to avoid shocking too close to those spots.

Make sure the chest is absolutely dry and the victim is not in a puddle. Note that, if the person has a lot of chest hair, you may need to shave it, if possible. Some AED kits come with razors for this purpose.

4.3

Attach the sticky pads with electrodes the victim’s chest

Follow the instructions on the AED for placement. Move the pads at least 1 inch (2.5 cm) away from any metal piercings or implanted devices.

Make sure no one is touching the person, when you apply the shock.

Press analyze on the AED machine. If a shock is needed for the patient, the machine will notify you. If you do shock the victim, make sure no one is touching him or her.

4.4

Do not remove the Pads

Do not remove pads from the victim and resume CPR for another 5 cycles before using the AED again. Stick on adhesive electrode pads are intended to be left in place.

Part :5		Putting the patient in the recovery position
	*5.1*	*Position the patient ( Position 01)*

Please position the patient ONLY after the victim has been stabilized and is breathing on his/her own.

5.2

Flex and raise one knee joint

Flex and raise one knee joint, push the victim`s hand that's on the opposite side from the raised knee, partially under the hip with the straight leg. Then position the free hand onto the opposite shoulder, and roll the victim onto the side with the straight leg. The raised knee/bent leg is on top and helps stop the body from rolling over onto the abdomen. The arm with the hand tucked under the edge of the hip is kept from sticking out in the way when rolling the patient onto that side.

5.3

Use the recovery position to help the victim to breath more easily

This position keeps saliva (spit) from accumulating in the back of the mouth or throat, and helps the tongue to hang to the side without it falling/flopping into the back of the mouth and obstructing the airway.