During the CPR, what is the percentage of heart efficiency as a pump?

The best estimate of the heart efficiency during CPR is 10-30% of normal.

I heard that no matter what if a person is unconscious that you should perform CPR. Is this true? If not when should you not perform CPR?

It is true that sometimes a person may be unconscious and their heart is still beating and they may still be breathing. Such a situation, for example, may occur in someone who has just had a grand mal seizure. If you tried to do CPR on such a person he or she would probably groan and even try to push you away. This would be your clue that they did not need CPR. CPR is intended only for someone whose heart and breathing has stopped. If the victim moves or pushes you away, you should stop CPR.

How do I perform CPR on a person who has a trachea? Do I have to cover their mouth or just breath directly into the stoma?

There are two types of stomas, one which communicates to the nose and mouth and one which doesn't. Since you won't know which type you are dealing with, it is best to pinch the victim's nose closed, keep the victim's mouth closed and breathe directly into the stoma opening.

When you are giving mouth to mouth are you actually breathing oxygen into the victim's lungs or are you trying to stimulate breathing by breathing carbon dioxide into their lungs?

You are breathing oxygen into the lungs. Your exhaled breath contains 16% oxygen which is close to the 20% contained in the air you breathe in.

When performing CPR, how do I know if its working?

The only way to tell is to see if the chest rises with ventilation and if the chest compression results in a pulse. Someone has to feel the femoral artery while the other compresses the chest in order to see if the chest compression results in a pulse. If you are unsure whether you are doing CPR correctly during an emergency situation don't stop. Its better to perform CPR imperfectly than not at all.

If a person has had bypass surgery, and a situation occurs that they require CPR, are there any special considerations that need to be made?

No, CPR should be done in the regular fashion.

What is the victim has a pulse, but is not breathing?

Then continue with mouth to mouth respiration and continue to check the pulse every minute or so.

Is it easier to break an overweight persons ribs or a skinner persons ribs when performing cpr?

The weight of the victim has little to do with the chances of breaking a rib, instead the age of the victim seems to determine the fragility of the bones.

Can I kill someone if I do CPR incorrectly?

No. Remember the person in cardiac arrest is already clinically dead. CPR can only help. Even if it's not done "letter perfect" it will probably provide some benefit to the victim.

What if I crack a rib when I do CPR?

Frequently ribs are broken with the pressure CPR places on the sternum. Some studies quote up to 30% of cardiac arrest victims have broken ribs as a result of CPR. This happens more frequently the older the victim since the cartilage is less compliant and the bones more easily crackable. But remember, it's better to have a cracked rib then be dead.

Will CPR always save a life?

No, in fact, most instances of CPR for cardiac arrest are unsuccessful.

What is the recovery position?

Assuming the person has a pulse and is breathing, the recovery position means placing the person on his or her side. This allows for the person not to choke on saliva and helps keep the airway open.

What should you do for a person who has been accidentally shocked by electricity?

A person with electric shock (assuming the shock doesn't severely damage the body) often dies from the heart going into ventricular fibrillation. Such a person needs CPR and it should be performed in the regular fashion. If CPR begins quickly and if a defibrillator arrives quickly this person has an excellent chance of survival.

I want to know what the current teachings are on helping a choking victim. I have heard conflicting information on back blows for an adult. Is it still recommended, or discouraged?

The first action to take is the Heimlich maneuver. This should be done in adults instead of back blows since back blows may lodge the foreign body further down the windpipe. Back blows are the first thing to do only in infants who are conscious. In doing the back blows the infant should be in a face down position, ie the head is lower than the body.

What if the victim vomits?

Vomit is obviously unpleasant. If it happens (and it may in one out of 20 cardiac arrests) merely turn the head to the side and wipe out the vomit as best you can with your finger.

If someone has an asthma attack and collapses, what should a person do? Will CPR help?

If someone collapses from an asthma attack, it is because he or she is not getting enough oxygen. This is because all the lung's small airways have narrowed and are not allowing enough air to reach the air sacs. Mouth to mouth respiration may help a little. The real need is to get this person to an emergency department so that the patient can receive medications and emergency endotracheal intubation (a tube in the main airway).

What are some of the causes of CPR being used for in infants and children?

Usually CPR in infants and children is performed for respiratory arrest such as severe asthma. Ventricular fibrillation is rare in children but very common in older adults.

In regards to administering the Heimlich Maneuver to a victim while they are lying down. Should the head be facing up, as when administering CPR (in order to clear the airway), or to the side?

The victims head should be facing up with the victim on his/her back. Since the airway is blocked you shouldn't spend much time positioning the head. The Heimlich maneuver is the most important thing to do and should unblock the airway

What if the victim is wearing dentures?

Keep them in place if possible as they will allow for a better seal of your mouth on his/hers.

Can I get AIDS from doing CPR?

No. There has never been a documented case of AIDS transmitted by CPR.

Can I get sued if I perform CPR?

You theoretically could but there has never been a successful suit brought against someone performing CPR.

Does the Good Samaritan law protect me?

Yes, if you give assistance, including CPR, for a medical emergency Good Samaritan laws cover you.

What are agonal respirations?

When the heart stops beating in cardiac arrest the breathing center in the brain is still alive for a couple of minutes and will cause the victim to take a few abnormal breaths. These abnormal breaths associated in dying are called agonal respiration's. They may appear like snoring, gasping, or snorting and will disappear in a couple of minutes. Don't let abnormal breathing stop you from starting CPR.

In cardiopulmonary arrest occurring outside of a hospital what are statistics regarding successful uncomplicated recovery? Also in this situation how many patients are successfully resuscitated but are then in a vegetative state?

The statistics vary from locale to locale. In New York City or Chicago the survival rate (discharge alive from the hospital) is 2 or 3%. In Seattle the survival rate is 20% overall and 35% for ventricular fibrillation. Less than 5% of those discharged have severe neurologic damage. Over 60% return to their prior level of mental status. Persistent vegetative states (PVS)s are very unusual.

Can CPR be performed on dogs?

CPR can be performed on dogs. To give respiration you will need to keep the dogs mouth and lips closed and breathe through the nose. Cover the dogs nose completely with your mouth to prevent air from leaking out. You should see the chest rise if you are doing it properly. To give chest compression's you might need to press side to side instead of straight down on the chest. This is especially true for funnel chested dogs. The rates of respiration to chest compression are the same as for humans. In general, most instances of CPR for dogs will involve accidents of smoke inhalation or drowning. Respirations may indeed prove life saving especially if the dog has a heart beat. Once the dog's heart stops beating it is unlikely that CPR will be of benefit. By the way, the name gingy in my address is for my 13 year-old golden retriever.

What if I'm not sure whether I feel a pulse in the neck of the victim?

Go on to the next step of CPR and give chest compression's.

If a person moves when I do CPR should I stop?

Yes, if a person moves his arms or legs they probably don't need CPR.

When should I stop CPR?

When help arrives to take over, or the victim starts to move.

What chance does the person (on whom I perform CPR) have of surviving?

If you do CPR on a person whose heart has stopped beating there is a 30% chance the person will live if a defibrillator can arrive within several minutes to shock the heart.

What should I do if I'm alone and I do not know CPR?

If you are alone and don't know how to do CPR call 911 and ask the emergency dispatcher to give you instructions over the phone.

If a pregnant women chokes should I do the Heimlich Maneuver or can it harm the baby?

You should do the chest thrust in a very pregnant woman. This is like the Heimlich except you grab around the middle chest instead of the upper abdomen. Click here for more info.

What is the reason calling 911 occurs after 1 minute of CPR for infants and children whereas for adults, the call is made immediately?

It is because airway problems are the main cause of cardiac arrest in infants and trying to correct that problem takes precedent over calling 911.

if successful CPR is dependent on a defibrillator arriving, are there any portable defibrillators available?

Portable defibrillators which operate automatically (they are called automatic external defibrillators - AEDs) are available but they are expensive (around $3000) and require a doctor's prescription. The training is very simple and takes less than an hour. You should talk to your doctor as to whether one of these might be indicated in your situation. Probably in several years the cost will come down to about $1000 and one day they may be sold over the counter.

In a trekking guidebook I own it states that if there has been a trauma fall and the victim has no pulse, then CPR is futile, is this true?

Doing CPR in the wilderness is futile. I would, however, make an attempt to open the airway and perhaps give several ventilation's. You may be dealing with respiratory arrest and a little mouth to mouth could be lifesaving.

Is it true that if a victim "regains" a pulse after doing CPR he/she has probably had a pulse all along?

You are partially correct. The most common cause of cardiac arrest is VF and this cannot be converted with CPR alone. Electricity is required. However there are some instances when the heart is going very slowly and CPR can oxygenate the system enough to get the heart going again. Also there are instances when the person is really in respiratory arrest and the heartbeat is too faint to feel. In this situation CPR may be enough to get the heart beating stronger.