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JAMA Patient Page
January 19, 2005

Cardiopulmonary Resuscitation (CPR)

JAMA. 2005;293(3):388. doi:10.1001/jama.293.3.388

Cardiac arrest (sudden stopping of the pumping function of the heart) is an important cause of sudden death. Cardiopulmonary resuscitation (CPR), which involves performing chest compressions and rescue breathing (see below), is a temporary procedure that can be used to maintain some blood flow to the brain, heart, and other vital organs until trained medical personnel are available to provide more advanced treatment. Studies have found that CPR is most effective when started as soon as possible after cardiac arrest (ie, within minutes of the arrest) and when trained medical personnel arrive within 8 to 12 minutes of the arrest. Cardiopulmonary resuscitation should be performed only by persons trained in the technique because specific CPR recommendations vary depending on the patient's age and the cause of arrest. If performed incorrectly, CPR may be ineffective or harmful. Because most cardiac arrests occur outside the hospital, it is important for laypersons to be trained in CPR. The January 19, 2005, issue of JAMA contains 2 articles evaluating CPR performed by trained personnel in both in-hospital and out-of-hospital settings.

Major components of cpr

  • Activation of the local emergency medical service (EMS) system. In most areas of the United States and Canada this is done by dialing 9-1-1. Because CPR is only a temporary measure, it is always important to know how to activate your local EMS and to do so as soon as a cardiac arrest occurs.

  • Chest compressions are performed by applying downward pressure to the chest wall with the hands positioned in a specific way over the sternum (breast bone). When performed correctly, these compressions cause blood to be pumped from the heart to other vital organs.

  • Rescue breaths (mouth-to-mouth breathing) provide oxygen to the lungs when the individual is not breathing. Rescue breaths are alternated with chest compressions at a specific ratio, depending on the patient's age.

Associated components

  • The Heimlich maneuver is used for patients who are unable to breathe as a result of choking, which may lead to cardiac arrest. The Heimlich maneuver is therefore taught during most CPR classes and, like CPR, this technique is performed differently depending on the patient's age and size.

  • Automatic external defibrillators (AEDs) are computerized devices that can be used to detect and treat ventricular fibrillation, an irregular heart rhythm that is an important cause of sudden cardiac death. Automatic external defibrillators provide both visual and voice instructions and are used by some EMS personnel and by lay rescuers. These devices are now located in many public places, including airports, and have been found to improve survival for patients with ventricular fibrillation when used early. These devices can only be used on patients older than 8 years. Most CPR classes now include instruction on the proper use of AEDs.

For more information

Learn how to perform CPR. For information regarding classes in your area, please contact the organizations below.

Inform yourself

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. A Patient Page on CPR was published in the April 7, 1999, issue.

Sources: American Heart Association, American Red Cross

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. Any other print or online reproduction is subject to AMA approval. To purchase bulk reprints, call 718/946-7424.