Hands-only CPR is indicated in:

In many emergencies, like a cardiac attack or near drowning, where a person's breathing or heartbeat has stopped, cardiopulmonary resuscitation (CPR) proves to be a useful and lifesaving technique. By providing a proper CPR, the brain and other vital organs can receive a supply of oxygenated blood until medical treatment can restore the normal cardiac rhythm. Hands-only CPR (compression-only) reduces the time to initiate CPR and result in more chest compressions with fewer interruptions for the first few minutes of cardiac arrest. According to the AHA ECC Committee, the delivery of high-quality chest compressions (adequate rate and depth of compressions with minimal interruptions) will benefit all victims of cardiac arrest. In some cases like airway obstruction, acute respiratory diseases, trauma, a victim of drowning, pediatric victims and apnea (associated with drug overdose), additional interventions taught in a conventional CPR course are required. Hands-only CPR can adversely affect victims of asphyxial arrest and pediatric victims if incorrectly applied.

Prior to beginning compressions:

Cardiopulmonary resuscitation (CPR) includes a combination of techniques, designed to pump the heart to keep the blood circulating in the body and delivering oxygen to the brain until medical help arrives. CPR is most effective when provided as promptly as possible without delay. CPR should be immediately provided to the person who shows no signs of life, is unresponsive, or does not have normal breathing. It takes only 3 to 4 minutes for the person's brain to be dead due to the inadequate supply of oxygen if no CPR is provided. If a person is not breathing, gasping or having irregular breathing provide immediate CPR. It is not important to find the pulse in a person who is not showing any signs of life as it is sometimes difficult to find the pulse. CPR must be initiated without any delay to elevate the survival rate.


An AED checks the cardiac rhythm and if needed sends a shock to the heart to restore normal rhythm which helps in saving lives of people having a sudden cardiac arrest (SCA). The shock can restore normal rhythm after SCA and can possibly stop an abnormal heartbeat (arrhythmia). The device is a battery-operated, lightweight, portable and contains electrodes (i.e, sticky pads with sensors) which are attached to the chest of the patient witnessing cardiac arrest. The victim's cardiac rhythm is checked by a built-in computer through sticky electrodes. The computer then finds out whether defibrillation is needed or not. If defibrillation is needed then AED will charge automatically and a recorded voice prompts the rescuer to press the shock button on the device. This shock temporarily stops all activity and stuns the heart, giving the heart a chance to restore normal rhythm. Recorded instructions guide the user through the process.

Spinal injury following blunt force trauma:

Direct contact of a blunt object with the body causes blunt impact injury. An external or internal hemorrhage may be caused by blunt trauma depending upon its location and mechanism. Spinal cord injuries (SCI) are mostly caused by trauma to the vertebral column, thus affecting the spinal cord's ability to send and receive messages from the brain to the body's systems that control motor, sensory, and autonomic function below the level of injury. Though in acute early stages of treatment, doctors focus on preventing further spinal cord damage by immobilizing your neck.In this case, to begin CPR if the person shows no signs of circulation (coughing, breathing, or movement) and to open the airway, use fingers to grasp the jaw gently and lift it forward.

Cricoid pressure during ventilation:

Cricoid Pressure (CP) is a method used to prevent passive vomiting and gastric contents aspiration while inducing anesthesia in a patient with a full stomach, anesthesiologists use it as standard practice during rapid sequence intubation. It has been proved that during FMV at Paw less than 20 cmH2O cricoid pressure is effective in preventing gastric insufflation. The risk of gastric insufflation during FMV may increase due to high airway pressures. The lungs of all patients could be ventilated quite satisfactorily (i.e, without gas entering the stomach) by hand. When maximal inflation pressures are generated gas could be redirected to the stomach in half of the patients. However, when cricoid pressure is applied, it is not possible to cause the gas to enter the stomach of the patient with a patent airway. Studies conclude that CP can be safely and effectively used during FMV to reduce gastric insufflation, thus preventing the risk of regurgitation.

Mouth-to-mouth ventilation:

If the patient does not have normal breathing compressions should be initiated If you do not have a bag valve mask or barrier device, mouth-to-mouth ventilation should be provided. This is an effective, safe, and quick way to provide ventilation and oxygen to the victim. Oxygen in your exhaled breath is enough to fulfill the victim's needs. Because of the safety concerns about the transmission of infectious diseases some rescuers hesitate to perform mouth-to-mouth rescue breathing. However, studies show that infections after providing mouth-to-mouth ventilations are extremely rare as exposure of rescuers to victims is brief. If the patient is apneic and unresponsive, providing mouth-to-mouth rescue breathing proves to be life-saving in most cases. The chances of transmission of disease are extremely low and should nor prevent rescuers from providing mouth-to-mouth ventilation.


  1. https://www.mayoclinic.org/first-aid/first-aid-cpr/basics/art-20056600
  2. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/cardiopulmonary-resuscitation-cpr
  3. https://www.heart.org/-/media/data-import/downloadables/3/1/c/pe-abh-what-is-an-automated-external-defibrillator-ucm_300340.pdf
  4. https://www.nhlbi.nih.gov/health-topics/defibrillators
  5. https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Spinal-Cord-Injury
  6. https://www.mayoclinic.org/first-aid/first-aid-spinal-injury/basics/art-20056677
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6180674/
  8. https://www.semanticscholar.org/paper/44-%E2%80%93-Airway-Management-in-the-Adult-Artime/52ac0e3e364ea497192b137050a9bb28caa15edf
  9. https://www.ahajournals.org/doi/10.1161/circ.102.suppl_1.I-22
  10. https://www.ahajournals.org/doi/10.1161/circ.102.suppl_1.I-253