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In this short video, we're gonna have a little bit of a look at the introduction into CPR or cardiopulmonary resuscitation. In the UK between 90,000 and 120,000 people, a year die from sudden cardiac arrest, needlessly a lot of the time. The survival rate is as high 85% if we get it right, 85% is a good figure. In the UK currently, we are getting roughly 15%-17% survivals out of that 85% which is pretty poor really. And it's because a lot of people think cardiopulmonary resuscitation is difficult, they don't understand it properly, and they need to get to the basics. It's no good just doing chest compressions. We have got to understand what we are trying to achieve with the chest compression. There's no point just using a defib without chest compressions because the whole cycle is a team event, it's a chain of events that we need to keep as fluid and as fast and flexible as possible.

So first of all, we look at: What does CPR actually try to achieve? Well, when we do chest compressions on the chest, we need to be in the right place, roughly nipple line across the centre of the chest, your heart is roughly the size of the owner's clench fist and it sits slightly left side of the chest itself, right underneath the sternum. So when we do chest compressions we need to be the centre of the chest nipple line and we need to press five to six centimetres in-depth. The depth is really, really important. A lot of people worry about pressing too hard. Trust me you will never press too hard. Your own natural instincts won't allow you to press too hard, in actual fact the problem is your natural instincts will probably stop you pressing hard enough, so that's the first thing that needs to be understood, five to six centimetres is quite a long way. And what we're trying to do is to press the sternum against the spine on a hard surface.

So firstly, CPR will not work very efficiently or effectively on a bed, in a chair or in a car, because the seat will bounce, the mattress will absorb the compression, the compressions need to be five to six centimetres in depth on a hard surface, the floor, the bedroom floor out of the car onto the road surface. When we compress the chest, what we're actually trying to do is to manually squeeze blood from the heart, and pump that blood up to the brain. And we are roughly 30% efficient, so if we get it right, we are putting 30% of the normal blood flow to the brain, if we get it wrong, we don't press hard enough, or in the wrong place, or we panic, we become very inefficient.

The target organ for resuscitation is not the heart, believe it or not, it's the brain. The brain is one part of the body that we can't get back. I can get a heart started very easily, but I can never restart the brain, and the brain will probably be terminally dead after eight minutes, so we need to start resuscitation immediately without any interruptions whatsoever if we stop CPR, Cardiopulmonary resuscitation, it should be for no more than two seconds. And a rule of thumb is if we give breaths it should take two second, one second per breath and then we go straight back into CPR again. The only time we stop for longer than two seconds is when we apply the defib and wait for the defib to analyse.

So if we go back to understanding the compression itself, if we press the sternum five to six centimetre in-depth at 100-120 per minute we get decent blood flow from the heart to the brain. The other thing that a lot of people don't realize is when your heart stops beating, there is approximately 6-8 minutes with the blood oxygen in your bloodstream that's not going anywhere because the heart can't pump it. When you do CPR, what we are actually trying to do is imagine this is a heart and you press down on the sternum, what we do is we squeeze blood from the heart, the next really important part of CPR, is we allow the heart to fully refill, so it's critically important that relieving the pressure we take the pressure totally off the chest wall to allow the chest to expand back to its normal volume which will draw blood back to the heart. So every compression empties the heart and every time we come off the chest completely, we allow the heart to refill. If we go too fast, we become very inefficient, if we go too slow, we are very inefficient, and if we don't take the weight off the chest, we are inefficient.

So CPR, Cardiopulmonary resuscitation is critical that we understand what we are trying to achieve. Good blood flow to the brain from good CPR is the most crucial part of the resuscitation.