Interpersonal relationships are social associations, connections, or affiliations between two or more people.

They vary in differing

levels of intimacy and sharing, implying the discovery or establishment of common ground, and may be centered around
something(s) shared in common. The study of relationships is of concern to sociology, psychology and anthropology.

Types of interpersonal relationships

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Main article: Types of interpersonal relationships

Kinship relationships, including family relationships, being related to someone else by blood (consanguinity), e.g.
fatherhood, motherhood; or through marriage (affinity), e.g. father-in-law, mother-in-law, uncle by marriage, aunt by
marriage.

Formalized intimate relationships or long term relationships through law and public ceremony, e.g. marriage and civil
union.

Non-formalized intimate relationships or long term relationships such asloving relationships or romantic relationships with
or without living together; the other person is often calledlover, boyfriend or girlfriend (not to be confused with just a male or
female friend), or significant other. If the partners live together, the relationship may be similar to marriage, and the other
person may be calledhusband or wife. In Scottish law they are so regarded by common law after a time. Long term
relationships in other countries are often erroneously called common law marriages, although they have no special status in
law. Mistress is a somewhat old fashioned term for a female lover of a man who is married to another woman, or of an
unmarried man. She may even be an official mistress (in French matresse en titre); an example is Madame de Pompadour.

Soulmates, individuals who are intimately drawn to one another through a favorable meeting of the minds and who find
mutual acceptance and understanding with one another. Soulmates may feel themselves bonded together for a lifetime;
and, hence, they may be sexual partners but not necessarily.

Casual relationships, relationships extending beyond one night stands that exclusively consist of sexual behavior, the
participants of which may be known as friends with benefits when limited to considering sexual intercourse or sexual
partners in a wider sense.

Platonic love is an affectionate relationship into which the sexual element does not enter, especially in cases where one
might easily assume otherwise.

Friendship, which consists of mutual love, trust, respect, and unconditional acceptance, and usually implies the discovery
or establishment of common ground between the individuals involved; see also internet friendship and pen pal.

Brotherhood and sisterhood, individuals united in a common cause or having a common interest, which may involve formal
membership in a club, organization, association, society, lodge, fraternity or sorority. This type of interpersonal relationship
also includes the comradeship of fellow soldiers in peace or war.

Partners or coworkers in a profession, business, or a common workplace.

Participation in a community, for example, a community of interest or practice.
Association, simply being introduced to someone or knowing who they are by interaction.

Stages of formation

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1) Contact:
a) Uncertainty reduction - through eye contact, identification, opening disclosure, etc.
b) Perceptual - notice how a person looks at the other and their body language.
c) Interactional cues - nodding, maintaining eye contact, etc.
d) Invitational - encouraging the relationship (e.g. asking if they want to meet up later for coffee)
e) Avoidance strategies - if one person discloses and the other does not, minimal response, lack of eye contact, etc.
2) Involvement
a) Feelers - hints or questions (ex. asking about family)
b) Intensifying strategies - further the relationship (ex. meeting old friend, bringing the other to meet family, becoming
more affectionate, etc.)

c) Public - seen in public together often (ex. if in a romantic relationship, may be holding hands)
3) Intimacy -very close, may have exchanged some sort of personal belonging or something that represents further commitment.
(ex. may be a promise ring in a romantic relationship or a friendship necklace symbolizing two people are best friends)
4) Deterioration - things start to fall apart. In a romantic relationship, typically after approximately six months, people are out of what
is sometimes referred to as the "honeymoon stage", NRE, or limerance and start to notice flaws. The way this is dealt with
determines the fate of the relationship.

Development

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Interpersonal relationships are dynamic systems that change continuously during their existence. Like living organisms, relationships
have a beginning, a lifespan, and an end. They tend to grow and improve gradually, as people get to know each other and become
closer emotionally, or they gradually deteriorate as people drift apart, move on with their lives and form new relationships with others.
One of the most influential models of relationship development was proposed by psychologist George Levinger. [1] This model was
formulated to describe heterosexual, adult romantic relationships, but it has been applied to other kinds of interpersonal relations as
well. According to the model, the natural development of a relationship follows five stages:

1.

Acquaintance - Becoming acquainted depends on previous relationships, physical proximity, first impressions, and a
variety of other factors. If two people begin to like each other, continued interactions may lead to the next stage, but
acquaintance can continue indefinitely.

2.

Buildup - During this stage, people begin to trust and care about each other. The need for compatibility and such filtering
agents as common background and goals will influence whether or not interaction continues.

3.

Continuation - This stage follows a mutual commitment to a long term friendship, romantic relationship, or marriage. It is
generally a long, relative stable period. Nevertheless, continued growth and development will occur during this time. Mutual
trust is important for sustaining the relationship.

4.

Deterioration - Not all relationships deteriorate, but those that do, tend to show signs of trouble. Boredom, resentment, and
dissatisfaction may occur, and individuals may communicate less and avoid self-disclosure. Loss of trust and betrayals may
take place as the downward spiral continues.

5.

Termination - The final stage marks the end of the relationship, either by death in the case of a healthy relationship, or by
separation.

Friendships may involve some degree of transitivity. In other words, a person may become a friend of an existing friend's friend.
However, if two people have a sexual relationship with the same person, they may becomecompetitors rather than friends.
Accordingly, sexual behavior with the sexual partner of a friend may damage the friendship (see love triangle). Sexual
relations between two friends tend to alter that relationship, either by "taking it to the next level" or by severing it. Sexual
partners may also be classified as friends and the sexual relationship may either enhance or depreciate the friendship.
Legal sanction reinforces and regularizes marriages and civil unions as perceived "respectable" building-blocks ofsociety. In
the United States of America, for example, the de-criminalization of homosexual sexual relations in the Supreme Court
decision, Lawrence v. Texas (2003) facilitated the mainstreaming of gay long-term relationships, and broached the possibility of the
legalization of same-sex marriages in that country.

Factors

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The discovery or establishment of common ground between individuals is a fundamental component for enduring interpersonal
relationships. Loss of common ground, which may happen over time, may tend to end interpersonal relationships.
For each relationship type, essential skills are needed, and without these skills more advanced relationships are not possible.
Systemic coaching advocates a hierarchy of relationships, from friendship to global order. Expertise in each relationship type (in this
hierarchy) requires the skills of all previous relationship types. (For examplepartnership requires friendship and teamwork skills).
Interpersonal relationships through consanguinity and affinity can persist despite the absence of love, affection, or common ground.
When these relationships are in prohibited degrees, sexual intimacy in them would be the tabooof incest.

Marriage and civil union are relationships reinforced and regularized by their legal sanction to be "respectable" building blocks
of society. In the United States the de-criminalization of homosexual sexual relations in the landmark Supreme Court
decision, Lawrence v. Texas (2003) facilitated the "mainstreaming" of gay long term relationships, and broached the possibility of the
legalization of same-sex marriages in that country.
In intimate relationships there is often, but not always, an implicit or explicit agreement that the partners will not have sex with
someone else - monogamy. The extent to which physical intimacy with other people is accepted may vary. For example, a husband
may be more receptive to his wife being physically affectionate with her female friend if she has one, other than with her male friend
(see also jealousy).
In friendship there is some transitivity: one may become a friend of an existing friend's friend. However, if two people have a sexual
relationship with the same person, they may be competitors rather than friends. Accordingly, sexual behavior with the sexual partner
of a friend may damage the friendship. See love triangle.
Sexual relations between two friends may alter that relationship by either "taking it to the next level" or severing it.Sexual
partners may also be friends: the sexual relationship may either enhance or depreciate the friendship.
The rise of popular psychology has led to an explosion of concern about one's interpersonal relationships (often simply called:
"relationships"). Intimate relationships receive particular attention in this context, but Sociologyrecognises many other interpersonal
links of greater or less duration and/or significance.
Relationships are not necessarily healthy. Unhealthy examples include abusive relationships and codependence.
Sociologists recognize a hierarchy of forms of activity and interpersonal relations, which divides them into:behavior, action, social
behavior, social action, social contact, social interaction and finally social relation.

Theories

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Social psychology has several approaches to the subject of interpersonal relationships, among them closureand also trust,
as trust between parties can be mutual. This may lead to enduring relationships.

Social exchange theory interprets relationships in terms of exchanged benefits. The way people feel about relationships
will be influenced by the rewards of the relationship, as well as rewards they may potentially receive in alternate
relationships.

Systemic coaching analyzes relationships as expressions of our human need to love and be loved. Relationships can be
confused by transferences, entanglements and substitution. Systemic coaching offers solutions for many relationship
difficulties.

Equity theory is based on criticism of social exchange theory. Proponents argue that people care more than just
maximizing rewards, they also want fairness and equity in their relationships.

Relational dialectics is based on the idea that a relationship is not a static entity. Instead, a relationship is a continuing
process, always changing. There is constant tension as three main issues are negotiated: autonomy vs. connection, novelty
vs. predictability, and openness vs. closedness.

Attachment styles are a completely different way of analyzing relationships. Proponents of this view argue that attachment
styles developed in childhood continue to be influential throughout adulthood, influencing the roles people take on in
relationships.

Socionics and some other theories of psychological compatibility consider interpersonal relationships as at least partly
dependent on psychological types of partners.

TOPICS
Attraction/First Impression
Attachment theory
Love & Intimacy
Social Exchange Theories
Interdependence & Commitment
Communication

Sexuality
Jealousy & Betrayal
Power & Deception
Conflict & Divorce
Relationship Maintenance

ew CPR Guidelines from the American Heart

Association
Cardiopulmonary resuscitation, or CPR, was first demonstrated in 1954 by James Elam along with Dr. Peter Safar. Safar
wrote a book called ABC of Resuscitation in 1957. Since then the standard method of CPR has been A-B-C, as in A for
airway, B for breathing and C for compressions. This is the order for performing CPR. But recently the American Heart
Association (AHA) has come out with a slight variation.

The AHA suggests that the A-B-Cs of CPR be rearranged as C-A-B. In other words, the order of CPR should now be
compressions first, then airway and breathing. The new AHA guidelines apply to all forms of CPR, except when performed
on newborns.
Why chest compressions first? As a result of sanitary concerns some people hesitate to start with clearing the airway or
performing mouth-to-mouth. Dr. Michael Sayre of the American Heart Association asserts that chest compressions alone
can be lifesaving to many victims.

When you are performing CPR, the goal is to continue the circulation of blood. Under the original approach, there was a
delay in starting the chest compressions. Those extra minutes can be critical to saving a persons life. Dr. Sayre adds that
other CPR procedures such as mouth-to-mouth are difficult to perform correctly if you are not trained.
Chest compressions are generally easy to do and you can normally be performed on a person without doing any harm.
Most of the time a reserve of oxygen is left in a persons lungs and blood following the last breath. Chest compressions
performed immediately reduce the risk of a lack of oxygen flow.
The new CPR procedure is:

Call 9-1-1.

Roll victim on his or her back check for medical ID jewelry for possible medical condition.

Begin chest compressions place the heel of your hand in the center of the victims chest. Place your other hand
on top of the other one. Your fingers should be interlocked.

The chest should be compressed about 2 inches for adults and children and 1 1/2 inches for infants. 100
compressions every minute is the suggested rate. Counting from 1-100 can help you keep the rhythm.
Many organizations offer CPR training and certification courses. Taking precautions such as wearing medical ID jewelry can
help medical workers and even those performing CPR be aware of any medical conditions in situations where you cant
speak for yourself. American Medical ID offers a wide variety of stylish medical ID jewelry to help keep you or your loved
ones safe in an emergency medical situation.

CPR INSTRUCTIONS FOR BABY

return to index

FIRST Get somebody to call EMERGENCY immediately (911 in US) If you are alone do CPR for a full 2
minutes before calling.
No Longer Recommended:

Do not try to check pulse

Do not remove water from lungs if drowning Water in the lungs does not obstruct CPR and attempting to
remove it may cause damage.
Risk: No documentation that HIV or AIDS has ever been transmitted by CPR.
Additional steps on how to do CPR procedure for a baby
(if you are alone, read ALL of the following below and do the cycle for 2 full minutes before calling emergency, and
then continue CPR)
1. If baby does not respond to tapping on shoulder or a shout, lay baby on its back.
2. Open mouth with fingers and be sure that tongue is not blocking throat. Do not do this without looking. Use finger
sweep to remove any blockage.Do not do a blind finger sweep. Look at what you are doing.
3. If not possible neck injury, place hand on forehead and other hand under chin, and gently tilt head back
tongue so as not to block windpipe.

4. Cover mouth and nose with your mouth or hold nose shut and blow 2 times (chest should rise).
If air does not seem to be going through or chest does NOT rise when doing breaths, look inside mouth using finger sweep to remove any
blockage. Do not do a blind finger sweep. Look at what you are doing.

5. Put middle two fingers (3rd and 4th) in middle of chest just below level of nipples.
6. Gently press down 30 times about 1/3 of depth of chest at a rate of a little less than about 2 per second (100 per
minute)
7. CYCLE:
2 breaths (both mouth and nose covered) and then
30 chest presses (a little less than 2 per second) with middle fingers
8. If you feel pulse return, continue with breaths only.
9. Continue until there is movement or rescue team comes.
10. If baby vomits, turn the head to the side and try to sweep out or wipe off the vomit. Continue with CPR.
return

CPR instructions for CHILD (8 years old or under)

return to index

FIRST
Get somebody to call EMERGENCY immediately (911 in US)
If you are alone do CPR for 2 full minutes before calling.
No Longer Recommended:

Do not try to check pulse

Do not remove water from lungs if drowning Water in the lungs does not obstruct CPR and attempting to
remove it may cause damage.
Risk: No documentation that HIV or AIDS has ever been transmitted by CPR.

How to do CPR on a child

(If you are alone, do steps 1 thru 6 and do the cycle 2 full minutes before calling emergency, and then continue CPR)

1. Place on back
2. Look inside mouth using finger sweep to remove any blockage. Do not do a blind finger sweep. Look at what
you are doing.
3. If not possibility of neck injury, gently tilt head back to free tongue from blocking windpipe (hand on forehead
and other hand under chin)
4. Hold nose shut - cover mouth with your mouth and give 2 breaths (each 2 seconds and see chest rise)
If air does not seem to be going through or chest does NOT rise when doing breaths, look inside mouth using finger sweep to remove any
blockage. Do not do a blind finger sweep. Look at what you are doing.

5. Then put heel of one hand on the center of the chest (midway between nipples)
6. Press down about 1/3 of depth of chest 30 times at a rate of a little less than about 2 per second (100 per minute)
7. CYCLE: Repeat 2 breaths and 30 chest press
8. If you feel pulse return, continue with breaths only
9. Continue until there is movement or rescue team comes
10. If child vomits, turn the head to the side and try to sweep out or wipe off the vomit. Continue with CPR.
return

CPR instructions for ADULT (anyone over 8 years old)

return to index

Very IMPORTANT: CALL EMERGENCY FIRST for individuals over age 8 if at all possible and then do CPR
(the older the individual, the greater the possibility of a heart problem and the need for professional care as soon as
possible)
If other people, have someone call EMERGENCY immediately (911 in US)
Even if you are alone call EMERGENCY immediately (911 in US)
No Longer Recommended:

Do not try to check pulse

Do not remove water from lungs if drowning Water in the lungs does not obstruct CPR and attempting to
remove it may cause damage.
Risk: No documentation that HIV or AIDS has ever been transmitted by CPR.

CPR doubles a person's chance of survival from sudden cardiac arrest. [Eisenberg]
What are CPR procedures for an adult
IMPORTANT: CALL EMERGENCY FIRST if at all possible due to possibility of heart attack or other
emergency event.
1. Place on back
2. Open mouth with fingers and be sure that tongue or something else is not blocking throat. Do not do this without
looking. Use finger sweep to remove any blockage. Do not do a blind finger sweep. Look at what you are doing
3. If not possibility of neck injury, place hand on forehead and other hand under chin, and gently tilt head back to
free tongue so not blocking windpipe
4. Hold nose shut - cover mouth with your mouth and give 2 breaths (each 1.5-2 seconds and see chest rise)
If air does not seem to be going through or chest does NOT rise when doing breaths, look inside mouth using finger sweep to remove any
blockage. Do not do a blind finger sweep. Look at what you are doing.

5. Put heel of one hand midway between nipples and put other hand on top of first
6. Press down 30 times to a depth of about 1 1/2 to 2 inches at a rate of a little less than about 2 per second (100 per
minute)
7. CYCLE: Repeat 2 breaths followed by 30 chest presses
8. If you feel pulse return, continue with breaths only
9. Continue until movement or rescue team comes
10. If person vomits, turn the head to the side and try to sweep out or wipe off the vomit. Continue with CPR.
return

Extra procedure which may add to effectiveness of CPR

(procedure not yet approved by American Heart Association)
Studies indicate that if another person presses down gently on the stomach above naval, immediately after the chest
is pressed down, the recovery rate is greater. Must be done in rhythm. See discussion below. Source: See Purdue.edu
below.
*If person was drowning, do not attempt to remove water from person.
"There is no evidence that water acts as an obstructive foreign body, and time should not be wasted in attempting to
remove water from the victim. Such maneuvers can cause injury butmore importantlywill delay CPR,
particularly support of airway and ventilation." [AHA 001]
return

This page has been approved by Dr. Mickey Eisenberg

How to Do the Heimlich Maneuver
The Heimlich Maneuver for CHOKING ADULTS
A choking victim can't speak or breathe and needs your help immediately. Follow these steps to help a choking victim:
1.
2.

From behind, wrap your arms around the victim's waist.

Make a fist and place the thumb side of your fist against the victim's upper abdomen, below the ribcage and above the navel.

3.

Grasp your fist with your other hand and press into their upper abdomen with a quick upward thrust. Do not squeeze the ribcage;
confine the force of the thrust to your hands.

4.

Repeat until object is expelled.

UNCONSCIOUS VICTIM, OR WHEN RESCUER CAN'T REACH AROUND VICTIM:

Place the victim on back. Facing the victim, kneel astride the victim's hips. With one of your hands on top of the other, place the heel of your
bottom hand on the upper abdomen below the rib cage and above the navel. Use your body weight to press into the victim's upper abdomen
with a quick upward thrust. Repeat until object is expelled. If the Victim has not recovered, proceed with CPR.
The Victim should see a physician immediately after rescue.
Don't slap the victim's back. (This could make matters worse.)

The Heimlich Maneuver for CHOKING INFANTS

A choking victim can't speak or breathe and needs your help immediately.

Follow these steps to help a choking infant:

Lay the child down, face up, on a firm surface and kneel or stand at the victim's feet,
or hold infant on your lap facing away from you. Place the middle and index fingers of
both your hands below his rib cage and above his navel. Press into the victim's upper
abdomen with a quick upward thrust; do not squeeze the rib cage. Be very gentle.
Repeat until object is expelled.
If the Victim has not recovered, proceed with CPR. The Victim should see a physician
immediately after rescue.
Don't slap the victim's back. (This could make matters worse.

The Heimlich Maneuver for CHOKING (ONESELF)

When you choke, you can't speak or breathe and you need help immediately. Follow
these steps to save yourself from choking:
1.
2.

3.

Make a fist and place the thumb side of your fist against your upper
abdomen, below the ribcage and above the navel.
Grasp your fist with your other hand and press into your upper abdomen
with a quick upward thrust.
Repeat until object is expelled.

Alternatively, you can lean over a fixed horizontal object (table edge, chair, railing) and
press your upper abdomen against the edge to produce a quick upward thrust. Repeat
until object is expelled.
See a physician immediately after rescue.

The Importance of CPR

Heart disease is the number 1 killer in the United States. Each year, almost
330,000 Americans die from heart disease. Half of these will die suddenly, outside of the hospital, because their heart stops
beating.

The most common cause of death from a heart attack in adults is a disturbance in the electrical rhythm of the heart called
ventricular fibrillation.

Ventricular fibrillation can be treated, but it requires applying an electrical shockto

the chest calleddefibrillation.

If a defibrillator is not readily available, brain death will occur in less than 10 minutes.

One way of buying time until a defibrillator becomes available is to provide artificial breathing andcirculation by
performing cardiopulmonary resuscitation, or CPR.

The earlier you give CPR to a person in cardiopulmonary arrest (no breathing, no heartbeat), the greater the
chance of a successful resuscitation.

By performing CPR, you keep oxygenated blood flowing to the heart and brain until a defibrillator becomes
available.

Because up to 80% of all cardiac arrests occur in the home, you are most likely to perform CPR on a family member or
loved one.

CPR is one link in what the American Heart Association calls the "chain of survival." The chain of survival is a series of
actions that, when performed in sequence, will give a person having a heart attack the greatest chance of survival.

When an emergency situation is recognized, the first link in the chain of survival is early access. This means
activating the emergency medical services, or EMS, system by calling 911 (check your community plan, some communities
require dialing a different number).

The next link in the chain of survival is to perform CPR until a defibrillator becomes available.

In some areas of the country, simple, computerized defibrillators, known as automated external defibrillators,
or AEDs, may be available for use by the lay public or first person on the scene. If available, early defibrillation becomes the
next link in the chain of survival.

Once the EMS unit arrives, the next link in the chain of survival is early advanced life support care. This
involves administering medications, using special breathing devices, and providing additional defibrillation shocks if needed.

Cardiac Arrest
When a person develops cardiac arrest, the heart stops beating. There is no blood flow and no pulse. With no blood flowing to the
brain, the person becomes unresponsive and stops breathing normally.

When you discover a person whom you believe is experiencing a medical emergency, the first thing to do is check for
responsiveness. Gently shake the victim and shout, "Are you OK?"

If the person does not respond to your voice or touch, they are unresponsive. If the victim is unresponsive and you are
alone, leave the victim and immediately call 911. If someone is with you, tell him or her to call 911 and then return to help you.

If an AED is available, bring it back to the person's side. The moment an AED becomes available, IMMEDIATELY press
the "on" button. The AED will begin to speak to you. Follow its directions to use the AED.

Rescue Breathing
You now need to check to see if the person is breathing normally.

You do this by first opening the person'sairway. Tilt the victim's head back by lifting the chin gently with one hand, while
pushing down on the forehead with the other hand.

Next, place your ear next to the victim'smouth and nose and look, listen, and feel: Look to see if the chest is rising, listen
for any sounds of breathing, and feel for any air movement on your cheek. Taking no more than 5-10 seconds, if you do not see,
hear, or feel any signs of normal breathing, you must breathe for the victim.

While keeping the victim's head tilted back, place your mouth around the victim's mouth and pinch the victim's nose shut.
Give 2 slow breaths, making sure that the person's chest rises with each breath.

Chest Compressions
After giving 2 breaths immediately begin chest compressions.

Place the heel of one hand on the center of the chest, right between the nipples. Place the heel of your other hand on top
of the first hand. Lock your elbows and position your shoulders directly above your hands. Press down on the chest with enough
force to move the breastbone down about 2 inches. Compress the chest 30 times, at a rate of about 100 times per minute
(slightly faster than once every second).

After 30 compressions, stop, open the airway again, and provide the next 2 slow breaths. Then, position your hands in
the same spot as before and perform another 30 chest compressions. Continue the cycles of 30 compressions and 2 breaths
until an AED becomes available or until EMS providers arrive.

This technique of performing CPR may be used on anyone older than eight years of age.

CPR in Children
Sudden cardiac arrest is less common in children than it is in adults. It usually happens when there is a lack of oxygen caused by a
breathing problem such as choking, near-drowning, or respiratory infections. Because oxygen often corrects the problem in a child,
when an unresponsive, non-breathing child is found, CPR is performed for 1 minute before activating the EMS system. This may
reverse the lack of oxygen and revive the child.
In order to use an AED on a child from one year of age through eight years of age a specialpediatric cable is used to reduce the
amount of energy provided by the electrical shock.
Doing CPR on children aged one year to eight years is similar to doing CPR on adults. However, there are some minor differences.
Most are due to the child's smaller size.

When compressing the chest, the heel of only 1 hand is used instead of 2 hands, and the chest is pressed down about
of its depth.

Perform 5 cycles of 30 chest compressions followed by 2 breaths, then use an AED to evaluate the heart rhythm if
available.. If an AED is not available, and the child is still not breathing normally, coughing, or moving, continue cycles of 30
compressions to 2 breaths until help arrives.

CPR in Infants
An infant is defined as a child younger than one year of age. Because an infant is smaller than a child, the CPR technique for infants
contains further changes.

Even smaller breaths are given-enough to just get the chest to rise. Only 2 fingers are used to compress the chest down
about 1 inch.

Otherwise, the CPR sequence is the same as for the child.

There are no recommendations for the use of AEDs in children less than one year of age.

Cardio = HEART
Pulmonary = LUNGS
Resuscitate = REVIVE
Cardio-Pulmonary Resuscitation = Reviving the Heart and Lungs
Cardio = HEART

Your heart is a big, strong muscle that expands and contracts more than 60 times a minute without
you even thinking about it. It is automatically driven by electrical impulses and runs 24 hours a day, 7
days a week, with no vacation time. That's around 33 million beats a year!
Your heart has a simple, but important job. It pumps oxygen-rich blood from the lungs out to the rest
of your body. If your heart stops pumping, oxygen does not reach vital organs and they stop working.
That's when you get in trouble.

Pulmonary = LUNGS

You breathe about

lungs and gets rid
have to think about
Oxygen is

15 to 25 times each minute and every breath you take brings oxygen into your
of carbon dioxide. Your lungs function automatically just like your heart - you don't
breathing, it just happens.
important to your body because it gets combined with sugar to burn as fuel. There

is very little oxygen stored in your body's tissues so it needs to be replenished often. (There is a big supply of sugar so you
can go a long time without eating.)
If your body stops bringing air with oxygen in it into your lungs or your heart stops circulating the oxygen-rich blood to
your organs, then bad things start to have real fast. When the oxygen runs out, the body only has a few minutes in an
anaerobic state before cells start to die and brain damage results.
Typically, cells last 4 to 6 minutes before they begin to die and, after 10 minutes, the body is unrevivable.
Some things that might prevent oxygen from reaching the cells of your body:

Choking
- something blocks the path for air to reach the lungs.

Poisoning
- some other gas takes the place of oxygen, such as carbon monoxide.

Drowning or suffocation
- there is no air available to breathe in.

Electric shock
- an electric impulse disrupts the normal heart pattern and causes it to stop.

Heart attack
- the heart stops beating. Oxygen is available in the blood in the lungs, but the heart is not moving it around.

Ventricular Fibrillation (VF)

- the heart gets out of synch and quivers instead of pumps, causing cardiac arrest. This is the most common
cause of sudden cardiac arrest and is what Automated External Defibrillators (AEDs) are for.

CardioPulmonary Resuscitation (CPR)

is a combination of simulating the breathing of the lungs and the pumping of the heart. You should know that CPR is
effective less than 30% of the time. Does that mean it is futile? No way! The types of victims you will probably run into will
most likely be on the high end of the probability scale. Recovery rates for people already in the hospital are about half that
and less than 5% for elderly people with other medical problems. So, even though there's a good chance your efforts will
fail, that person has a 0% chance if you do nothing. Let's talk about what CPR is and how it works.
CPR is made up of two parts: Rescue Breathing and Chest Compresssions

Rescue Breathing
You exhale air from your lungs into the victim's lungs so they can absorb oxygen. This assumes that there is adequate
oxygen in your exhaled air.
Air contains approximately 20% oxygen at sea level, 16% at 5000 feet elevation, and 13% at 10000 feet. When we
breathe in air, our lungs absorb about 25% of whatever is available. So, at sea level, we exhale air with about 15%
oxygen which is more than exists at 5000 feet and is adequate.
When you breathe into a victim's mouth and have their nose closed, the air is forced into their lungs and you can see the
chest rise. You have successfully gotten some amount of oxygen into the system.

Chest Compressions

You manually compress the heart by pressing down on the chest. When you let up on the chest, the heart expands.
The hope is that by compressing and expanding the heart, the blood flows through it as designed. Unfortunately, you
don't have an easy way to tell if blood is flowing. You can't feel for a pulse or see results. You just need to believe in
your efforts.

CPR Effectiveness

When properly performed, CPR simulates from 20 to 40% of normal circulation. That is not enough to sustain life
indefinitely, but will be sufficient to put off the start of cell death in the hope that revival tools arrive soon. You should not
expect CPR to restart a heart and have the victim pop back to life like is shown on TV. Your job is to keep oxygenated
blood flowing until life support services arrive.
In communities with a thorough CPR training program and fast access to ACLS through an efficient Emergency Medical
Services program, CPR can be effective up to half the time. Other places where CPR training is not promoted or where
little ACLS support is available, the results are much less. Remember, your goal of administering CPR is to buy a little
time for an emergency rescue team to arrive and revive.
So, what does CPR stand for? It stands for saving a life.

CPR
is one of the simplest, and most important skills, you can ever learn. It's like insurance - you hope you never need it but
will be awfully glad you have it if you do.
The basics of CPR are the same for everyone, but there are a few specific differences for adult CPR, child CPR, and infant
CPR that you really should remember. Use these links to learn about each type of CPR.

Adult CPR - easy as

Child CPR - CPR for 1 to 12 yr olds
Infant CPR - CPR for under 1 yr olds
CPR Summary - Key points to remember
Free CPR Card - Keep in your wallet or purse

CPR guide

Please be sure to take a high quality CPR class for hands-on training to really make sure you know how to do CPR
correctly for adults, children, and infants.
Get CPR certified by the American Red Cross or American Heart Association every year to stay up with changes in CPR
guidelines.
Dude, you just never know....!
Just as important as knowing HOW to perform CPR is knowing WHEN to perform it - and when NOT to! Before forcing
air into someone's mouth and crushing their chest through cardiopulmonary resuscitation, there's a few quick but
important things to do...

Check the Scene

- make sure it is safe for you to help the person. Don't become a victim yourself by rushing to help someone
without being sure you will be safe. Some examples of this are victims in contact with electric wires, victims in
traffic, or victims in fires.

Check the Person

- make sure this person needs CPR.

If the person is conscious, they do not need CPR. They may needchoking help or first aid, but not
CPR.

If they appear to be unconscious, tap their shoulder and shout at them "Are you OK?"
They may have just been asleep or zoning out - that would have been embarrassing to start CPR!
If there is no response, then this is an emergency and 9-1-1 should be called.

Check for Breathing

- don't move the person, but look, listen, and feel for breathing.

If there is breathing, no CPR is needed. Other aid may be required.

Check Airway
- carefully roll the person onto their back, tilt the head back and lift the chin. This is to help open the airway and
may allow breathing to resume. Check for breathing again.

o
o

If there is breathing, no CPR is needed. Keep the airway open and check if other aid is required.
If there's no breathing, then CPR is needed.

It may seem like a lot of steps, but all that checking only takes about 15 seconds at the most and it makes you certain that
cardiopulmonary resuscitation is really needed by this person. Now that you know he or she needs CPR, you've got to
actually do the CPR.
These adult CPR steps are intended for victims over 12 years old.

Check the Scene

- make sure it is safe for you to help.
Don't become another victim.

Check the Victim

- tap and shout to get response.

Call for Help

- call 9-1-1, or tell someone to call.
If you are alone with an adult, call first then start CPR if needed.
Call for any unconscious victim, whether they are breathing or
not.

Circulation
- pump the chest 30 times.
Place the heel of one hand in the center of the chest and your
other hand on top of it. Press chest down 2 inches at a rate of
100 per minute (16 compressions in 10 seconds).

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Airway
- tilt head back, lift chin up to open airway.

Breathing
- Pinch nose closed, take a normal breath, cover victim's
mouth with yours and blow out your breath until you see the
chest rise. Give a second breath. Take about 1 second per
breath. If chest doesn't rise, open airway again.

Repeat C - A - B
until help arrives or the victim begins breathing.
If there are two rescuers, one does the breathing and one does the
compressions - CPR steps and ratios remain the same.

Just remember

to save a life!

Becoming familiar with these adult CPR instructions will help you in performing CPR steps using the correct procedures.
This is only a quick review of the skills needed and should not be used as training, but can be a useful refresher.
Notice that these child CPR steps for victims 1 to 12 years old are nearly identical to adult CPR steps with the following
key differences:

Perform 5 cycles of CPR (about 2 minutes) before calling 9-1-1 if you are alone.

Check the Scene

- make sure it is safe for you to help.
Don't become another victim.

Check the Victim

- tap and shout to get response.

Call for Help

- If no response, tell someone to call 9-1-1.
If you are alone, perform 5 cycles of CPR First, then call 9-1-1.
Even if the child is breathing, call 9-1-1 for any unconscious
victim.

Circulation
- pump the chest 30 times.
Place the heel of one hand in the center of the chest and your
other hand on top of it. Press chest down about 2 inches at a
rate of 100 per minute (16 in 10 seconds).

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Airway
- tilt head back, lift chin up to open airway.

Breathing
- Pinch nose closed, take a normal breath, cover victim's
mouth with yours and blow out your breath until you see the
chest rise. Give a second breath. Take about 1 second per
breath. If chest doesn't rise, open airway again.

Repeat C - A - B
until help arrives or the victim begins breathing.
If there are two rescuers, one does the breathing and one does the
compressions - CPR steps and ratios remain the same.

Remember

to save a child's life!

Becoming familiar with these child CPR instructions will help you in performing CPR correctly. This quick review of skills
should not be used as training, but can be a useful refresher.
Notice that these infant CPR steps for victims under 1 year old are nearly identical to adult CPR steps with the following
key differences:

Be careful not to tilt the head too far.

If you are alone, perform 5 cycles of CPR (about 2 minutes) then call 911

Cover mouth and nose with your mouth.

Use two fingertips instead of two hands for chest compressions.

Check the Scene

- make sure it is safe for you to help.
Don't become another victim.

Check the Victim

- tap and shout to get response.

Call for Help

- If no response, tell someone to call 9-1-1.
If you are alone, perform 5 cycles of CPR First, then call 9-1-1.
Call 9-1-1 for any unconscious victim, including an infant that is
breathing.

Circulation
- pump the chest 30 times.
Place two fingertips of one hand in the center of the chest.
Press chest down about 1 1/2 inches at a rate of 100 per minute
(16 in 10 seconds).

Airway
- tilt head back, lift chin up to open airway.

Breathing
- Take a normal breath, cover victim's mouth and nose with
your mouth, and give a breath until the chest rises.
Give a second breath. Take about 1 second per breath.
If chest doesn't rise, open airway again.

Repeat C - A - B
until help arrives or the victim begins breathing.
If there are two rescuers, one does the breathing and one does the
compressions - CPR steps and ratios remain the same.

Remember

to save an infant's life at any time!

Becoming familiar with these infant CPR instructions will help you in performing CPR correctly. This quick review of skills
should not be used as training, but can be a useful refresher.

Check the Scene

- make sure it is safe for you to help the choking victim.
become another victim yourself.

Don't

Check the Victim

- Ask if they are choking. If they can not cough, speak, or
breathe, then they need help.

Call for Help

- Tell someone to call 9-1-1.
If you are alone with an adult, skip this step until later - it's more
important to fix the choking.

Back Blows and Abdominal Thrusts

Give 5 back blows:

Stand slightly behind the victin.

Place one arm diagonally across the victim's chest

for support and lean him forward.

With the heel of your other hand, strike the victim

firmly between the shoulder blades.

Give 5 abdominal thrusts:

Place the thumb side of your fist just above the

victim's belly button.

Grab your fist with your free hand.

Pull quick, upward thrusts to dislodge the object.

Repeat Back Blows and Abdominal Thrusts

until the object is forced out, the victim can breathe, or the victim
becomes unconscious.

Check the Scene

- make sure it is safe for you to help the choking
victim. Don't become another victim yourself.

Check the Victim

- Ask if they are choking. If they can not cough,
speak, or breathe, then they need help.

Call for Help

- Tell someone to call 9-1-1.
If you are alone with an adult, skip this step until later
- it's more important to fix the choking.
Back Blows and Abdominal Thrusts

Give 5 back blows:

o Stand slightly behind the victin.

Place one arm diagonally across the

victim's chest for support and lean him
forward.

With the heel of your other hand, strike

the victim firmly between the shoulder
blades.

Give 5 abdominal thrusts:

Place the thumb side of your fist just

above the victim's belly button.

Grab your fist with your free hand.

Pull quick, upward thrusts to dislodge

the object.

Repeat Back Blows and Abdominal Thrusts

until the object is forced out, the victim can breathe,

or the victim becomes unconscious.

Check the Scene

- make sure it is safe for you to help the choking
victim. Don't become another victim yourself.

Check the Victim

- If the parent is there, identify yourself and ask if
you can help. If the infant cannot cough, cry, or
breathe, then they need help.

Call for Help

- Tell someone to call 9-1-1.
If you are alone with an infant, skip this step until
later - it's more important to fix the choking.

Blows and Thrusts

Carefully hold the infant face down on your forearm, your

hand supporting its head and neck

Strike the infant directly between the shoulder blades with

the heel of your other hand 5 times

Turn the infant over and position two fingers in the center
of the chest

Give 5 1/2 to 1 inch deep chest thrusts

Repeat Blows and Thrusts

until the object is forced out, the infant starts breathing, or the
infant becomes unconscious.

Automated External Defibrillators (AEDs)

are the latest, most important, advancement in sudden cardiac arrest response. They are amazing little gadgets that
pretty much anyone can operate with little aed training and they are popping up all over the place, from schools to
churches to health clubs to homes.

Ventricular Fibrillation (VF)

is an electrical abnormality where the heart stops pumping because the electrical impulses in the heart are out of synch,
causing it to quiver instead of beat. I like the analogy of this being like an hysterical person who is screaming and crying
and beyond reason - a rude slap in the face shocks them into gaining composure. If VF is treated quickly, the heart can get
back to work just fine - if not treated, VF degrades to something called 'asystole' which is generally fatal.

Importance of Rapid Response

If a VF victim gets his heart pattern restored immediately following a sudden cardiac arrest, he has about a 2/3rds chance
of recovery. Every minute that revival is delayed, the chances drop until there is little hope after 10 minutes.
CPR is not a means to revival. CPR is a temporary bandaid to keep oxygen flowing to the brain until a way to revive the
victim is ready. Not many years ago, that means of revival was only available in hospitals, operated by highly trained
medical personnel. Manual external defibrillators are used to apply an electric shock to victims in an attempt to restore a
useful pattern to the heart muscle. Doing CPR in the field while a means to revival is bolted to the floor in a hospital does
the victim no good.
The next step was to make the defibrillators portable. These portable defibrillators were installed in ambulances. With this
advancement, CPR in the field made sense. If a person could keep blood flowing until the ambulance arrived, there was a
chance of recovery. But, arrival times could be 15 minutes, 30 minutes, or longer.

AEDs Arrive
Around 1980, the AED (automated external defibrillator) debuted. The 'automated'
part is what is really exciting. Now people with only minimal training can successfully
revive VF victims in the field, even before Emergency Medical Services personnel
arrive. An AED can be down the hall, just 1 or 2 minutes away, so chances for revival
are way up. The AED can automatically analyze the victim and decide if a shock is
required or not. The operator just needs to follow simple commands from the AED and
push the shock button when/if told to push it.
AEDs are nearly error-free, weigh under 5 lbs, are simple to learn and operate, are
safe, can be stored anywhere, and they work! There are a few different types of AEDs
and improvements are being made all the time. Many people have home defibrillators
and there are personal aeds that are worn under clothing and automatically analyze
and apply shock as needed.

Using an AED
As soon as a victim is encountered and it is determined that they are unresponsive, three things need to happen:

Someone calls 9-1-1 if a phone is available

Someone checks for breathing and circulation and begins CPR if needed

Someone retrieves the AED if one is available

That works fine if you have at least 3 people on the scene.

If there are only 2 people, one calls 9-1-1 and gets the AED while the second begins CPR.
If you are all alone, you should do them all in the order listed even if it means leaving the victim - call 9-1-1, get the AED,
and then check for breathing.
If the victim is not breathing, follow these steps to perform CPR with an AED:

Position the victim on his back.

Tilt head back and lift chin. Check for breathing for no more than 10 seconds.

If the victim is not breathing, give 2 rescue breaths.

Check for signs of circulation. If there is no circulation, then the heart is not pumping.

Turn on the AED and follow audio commands.

Open the victim's shirt and wipe his chest dry of sweat or water.

Attach one pad to the victim's upper right chest and one to the lower left side. The pads will be labelled with a
picture of where they go.

Plug the wire from the pads into the AED if they are not already attached.

Make sure no one is touching the victim so the AED can analyze correctly.

Push the 'Analyze' button or let the AED automatically begin its analysis. Just wait for the analysis to complete.

If the AED determines a shock is required:

Keep everyone clear of the victim.

Press the 'shock' button.

Let the AED reanalyze.

If the AED determines no shock is needed:

Check for a pulse.

If you can not find a pulse and the victim is not breathing, perform CPR until the AED reanalyzes.

If there is a pulse but no breathing, then perform rescue breathing and make sure the breaths raise the
chest.

If there is a pulse and breathing, place the victim in a recover position and monitor them.

Once you have attached the AED to a victim, do not remove it. It will continue to analyze and if the victim lapses again,
the AED will recommend a shock if needed. When Emergency Medical Services personnel are on the scene, they can
remove it.

AED Q & A

Can I hurt someone by using an AED on them? No, the AED automatically
analyzes and determines if a shock is required. If you have determined to use
an AED, then the person is essentially dead already anyway. You should
participate in some aed training before using an AED.

Can I get sued for using an AED? Yes, you can get sued for any reason.
Chances of you losing a suit because you used CPR and an AED attempting to
revive someone are very close to zero. Finding 'Good Samaritans' at fault is
very rare.