Cardiopulmonary resuscitation (eg, in cardiac arrest)
CPT4 code
Name of the Procedure:
Cardiopulmonary Resuscitation (CPR), also known as Basic Life Support (BLS), Cardiopulmonary Cerebral Resuscitation (CPCR).
Summary
Cardiopulmonary Resuscitation, or CPR, is an emergency procedure performed when the heart stops beating, typically due to cardiac arrest. It involves chest compressions and artificial ventilation to manually preserve brain function until further measures can restore spontaneous blood circulation and breathing.
Purpose
CPR addresses cardiac arrest, a life-threatening condition where the heart ceases to pump blood effectively. The goal is to maintain circulatory flow and oxygenation to vital organs, particularly the brain, to prevent tissue death and enhance survival chances and neurological outcomes until professional medical help arrives.
Indications
- Unresponsiveness and absence of normal breathing in a person.
- No detectable pulse.
- Cardiac arrest due to heart conditions, drowning, trauma, drug overdose, or other causes.
Preparation
Typically, there is no preparation time for CPR, as it is an emergency procedure. However, immediate recognition of cardiac arrest and prompt initiation of CPR are crucial for effectiveness.
Procedure Description
- Assess the Scene: Ensure the area is safe.
- Check Responsiveness: Tap the person and shout to see if they respond.
- Call for Help: If unresponsive, call emergency services or instruct someone nearby to do so.
- Open the Airway: Tilt the head back and lift the chin to open the airway.
- Check for Breathing: Look, listen, and feel for normal breathing.
- Chest Compressions: Place hands in the center of the chest and press hard and fast, about 2 inches deep, at a rate of 100-120 compressions per minute.
- Rescue Breaths: After 30 compressions, give 2 rescue breaths if trained to do so, ensuring the chest rises with each breath.
- Repeat cycles of 30 compressions and 2 breaths until emergency personnel arrive or the person shows signs of life.
No anesthesia or sedation is involved, and CPR can be performed with minimal equipment; however, having access to an Automated External Defibrillator (AED) can significantly enhance outcomes.
Duration
The procedure should continue until professional medical help arrives or the patient shows signs of life. Individual cycles of compressions and breaths last about two minutes or until the responder becomes fatigued.
Setting
CPR can be performed anywhere, from public spaces to home settings, as it is a lifesaving emergency intervention.
Personnel
While professional healthcare providers are well-trained in CPR, bystanders, including laypeople, can and should perform CPR if they are the first on the scene. Training courses are widely available and recommended.
Risks and Complications
- Rib fractures or sternum injury from chest compressions.
- Internal organ damage.
- Aspiration or gastric inflation from rescue breaths.
Despite these risks, the potential benefit of saving a life usually outweighs the risks.
Benefits
The primary benefit is the preservation of life during cardiac arrest. Early and effective CPR can significantly improve survival rates and neurological outcomes.
Recovery
Post-procedure care depends on the patient's condition after resuscitation. This usually involves advanced cardiac life support (ACLS) and hospital care. Recovery times and follow-up vary based on individual patient circumstances and the underlying cause of the cardiac arrest.
Alternatives
Other than CPR, advanced medical interventions like defibrillation and use of medications are available but typically require professional healthcare settings. For bystanders, initiating CPR is the primary and immediate response.
Patient Experience
During CPR, the patient is usually unconscious and unable to feel pain. Post-recovery, the patient may have chest soreness or bruising from compressions. Continuous monitoring and pain management will be managed by medical professionals in the hospital.