How to give CPR (in case of a heart attack) to an elderly person?

[Mr Virtual]

Hello everyone

I am asking this question because I haven't joined any CPR course yet. The normal procedure requires a lot of force to be applied on the chest. But isn't such a huge pressure harmful for extremely aged people, whose bones are fragile and who may develop other complications in the process (this is what I think). Since I did not take biology in school, I have no idea whether what I am saying is right or wrong. What is the correct procedure to administer CPR to an aged person?

Also, can we give CPR on a clothed chest, since pulling off the clothing may lead to wastage of precious time?

Expert Advice is requested.

Warm Regards
Mr V

 

[Moonbear]

First, you might want to read this thread:
https://www.physicsforums.com/showthread.php?t=225842

Second, yes, you need to apply enough force to get sufficient compression of the heart to keep blood circulating during CPR. If you don't push hard enough, you might as well do nothing. If you keep a person alive with CPR, the broken ribs will mend should you break one.

I don't know where you got the idea that one needs to remove clothing to perform CPR (perhaps this is the danger of watching shows like BayWatch...I dunno). This is completely unnecessary. The only exception might be if someone is wearing a heavy coat and you can't feel their sternum through it to be sure you're pressing in the right place.

I strongly suggest enrolling in a CPR course. They are often offered to the community through adult education programs, community recreation center activities, or sponsored by the local rescue squad or fire department. It doesn't take long to learn some of the basics, and is well worth the knowledge gained should you be the only person around able to help in an emergency situation (it also helps you to know WHEN to administer CPR...not everyone having a heart attack needs CPR, only someone who is not breathing and has no pulse).

Tsu, who is a technologist at a hospital, and berkeman who recently went through extensive EMT training, might chime in with more details and helpful tips.

 

[Mr Virtual]

I don't know where you got the idea that one needs to remove clothing to perform CPR (perhaps this is the danger of watching shows like BayWatch...I dunno).

Ha, Ha. No, it is not because I view Baywatch (I just searched in wiki to find out what it is: turned out it is a popular TV show).
I got this idea because I have a clip in which a person is performing CPR on a dummy, and he removes the shirt it is wearing before giving CPR.

Mr V

 

[Mr Virtual]

And you are right: being alive with a fractured rib is better than being dead. So, one should press as hard as he/she can.

But I am still confused. You are not taking into account the variable strengths that different people possess. I mean you can't instruct The Undertaker to press as hard as he can (OMG, he would squash anyone to a pulp). Not that I am as strong as him, just asking this out of curiosity.

 

[Tsu]

You DO need to compress the sternum to a depth of 1.5-2" for CPR to be effective. Yes, you may break a rib or two in an elderly patient, but you have two choices. A live person with a busted rib or two, or a dead person with all ribs intact. I'll take the former choice.

Do not waste time removing clothing. IF (and ONLY if) you have an AED (automatic electronic defibrillator), just push the coat away and rip the shirt/blouse open to attach the pads. These should only be used if you've been trained to use them.

In the clinical setting, we still use the 5:1 (compressions:respiration) for two-man CPR and 15:2 for one-man CPR, but out in public they just use the new "down and dirty" method of 100 compressions/minute and skip the respirations. They say that, technically, there is still enough O2 in the blood stream to keep the brain alive - but NOT if you don't do the fast compressions to get the blood to the brain.

Like Moonbear, I strongly recommend taking a full-blown CPR course. It could save the life of someone you love one day.

 

[Moonbear]

I got this idea because I have a clip in which a person is performing CPR on a dummy, and he removes the shirt it is wearing before giving CPR.

It might have been done simply for assist in demonstrating the correct placement of the hands for CPR. One thing you're taught in a proper CPR course is to feel for the xiphoid process at the bottom of the sternum and make sure you start compressions 2 finger widths above it so you aren't causing liver damage by doing compressions too low to be effective for the heart (the liver and diaphragm are just below the xiphoid process). I think for someone untrained, it's sufficient to recommend placing the palm of your hand centered between the breasts and press straight down.

As for pressing too hard, the problem is that most people don't press hard enough. They learn most of what they know from the movies, where obviously real CPR is not being performed, and are timid about breaking ribs. CPR is hard and tiring even for a big guy, so err on the side of too hard rather than not hard enough.

 

[jim mcnamara]

Anatomical Annie films do just that. The idea is to help learn where goodies like the sternum are. They still use AA womanikins to teach CPR around here. But we are at least 20 years behind on everything except teen pregnancy - we lead the nation there...
:yuk:

 

[Mr Virtual]

Thanks a million to you all for clearing my doubts.

Mr V