There is no scientific basis for altering hand placement during chest compressions on a pregnant woman. If you are untrained, provide compression-only CPR by pushing hard and fast in the center of the chest.
CPR for a Pregnant Woman: Key Steps
When administering CPR to a pregnant woman, the priority remains the same: saving both her life and, potentially, the life of her unborn child. While the fundamental steps of CPR remain consistent, there are a few important considerations:
1. Assess the Situation and Call for Help
- Check for responsiveness: Gently tap or shake the woman and shout, "Are you okay?"
- Call 911 (or your local emergency number) immediately or ask someone else to do so. Clearly state that the person is pregnant. Early activation of emergency services is crucial.
- If possible, have someone locate an AED (Automated External Defibrillator).
2. Chest Compressions: The Core of CPR
- Hand Placement: As stated above, there is no specific guidance to change hand placement due to pregnancy. Place the heel of one hand in the center of the chest, on the lower half of the breastbone. Place the other hand on top of the first, interlacing your fingers.
- Compression Technique:
- Push hard and fast. Aim for a depth of at least 2 inches (5 cm) but no more than 2.4 inches (6 cm).
- Compress at a rate of 100-120 compressions per minute.
- Allow the chest to recoil completely after each compression.
- Continue compressions without interruption until help arrives or the person shows signs of life (e.g., breathing).
3. Airway and Breathing (If Trained)
- Open the airway: Use the head-tilt/chin-lift maneuver. Place one hand on the forehead and gently tilt the head back. Place the fingers of your other hand under the chin and lift it to open the airway.
- Check for breathing: Look, listen, and feel for breathing for no more than 10 seconds.
- Give rescue breaths (if trained):
- Pinch the nose closed.
- Make a complete seal over the person's mouth with yours.
- Give two rescue breaths, each lasting about one second. Watch for the chest to rise.
- Compression-to-Ventilation Ratio (if trained): Continue chest compressions and rescue breaths in a cycle of 30 compressions followed by 2 breaths (30:2).
4. Using an AED
- Turn on the AED and follow the voice prompts.
- Attach the AED pads as directed (usually one pad on the upper right chest and the other on the lower left side of the chest).
- Ensure no one is touching the person while the AED is analyzing the heart rhythm and delivering a shock (if advised).
- Immediately resume chest compressions after a shock, following the AED's prompts.
Additional Considerations for Pregnancy:
- Lateral Uterine Displacement: While performing CPR, if possible, a second rescuer can manually displace the uterus to the left. This helps to relieve pressure on the inferior vena cava, which can improve blood flow back to the heart. To do this, gently push the uterus towards the woman's left side. This is especially important in later stages of pregnancy. However, do not delay chest compressions to perform this maneuver. It is secondary to providing effective CPR.
- Focus on High-Quality CPR: The most critical aspect is providing high-quality chest compressions. Effective compressions are more likely to improve outcomes for both the mother and the fetus.
Important Notes:
- Prioritize Chest Compressions: In most scenarios, compression-only CPR is preferred, especially if you are not trained in rescue breaths.
- Don't Be Afraid to Act: Performing CPR, even if imperfectly, is better than doing nothing.
- Stay Calm and Follow Instructions: Listen carefully to the dispatcher or AED prompts.
- Consider Attending a CPR Training Course: Knowing how to properly perform CPR is a valuable skill that can save lives.
By following these guidelines, you can provide effective CPR to a pregnant woman and increase her chances of survival. Remember, early recognition, calling for help, and providing high-quality chest compressions are key to a positive outcome.
