What is closed cardiac massage?
The pumping of blood throughout the body by intermittent thrusts upon the breastbone (sternum) overlying the heart. By pushing down every second against the breastbone, it is possible to expel blood from the heart so that it will circulate throughout the body. Closed cardiac massage is an essential part of Cardiopulmonary Resuscitation.

How hard should one press against the breastbone while performing CPR?
Sufficiently enough to depress the breastbone about one to two inches.

What steps should be carried out after it has been definitely determined that cardiac arrest exists?

• The first–aider kneels alongside the head on the victim.
• The left hand is place under the victim’s neck, thus raising his chin and opening the air passage.
• The right hand pinches off the victim’s nostrils.
• The first–aider then places his mouth firmly against the victim’s mouth and artificial respiration is begun. The first–aider blows hard into the victim’s mouth twice.
• The first–aider then locates the lowest extent of the sternum (the xiphoid process), measures up about one–and–a–half inches, places the heel of one hand on the breastbone and his other hand over it, and begins the intermittent thrusts in a downward direction. The thrusts are continued for fifteen strokes, after which the first–aider again pinches off the nostrils and blows hard once into the victim’s mouth.
• Cardiac massage is resumed for fifteen more strokes and then mouth–to–mouth respiration is given again.
• These maneuvers are continued indefinitely until the first-aider notes the resumption of heartbeat and spontaneous respirations.

Is CPR best carried out with two first-aiders?
Definitely, yes! One will concentrate on the cardiac massage, the other on mouth–to–mouth artificial respiration. The cardiac massage should consist of a downward thrust upon the breastbone every second. The person giving artificial respiration should employ it after every five thrusts of the person performing the cardiac massage.

Should the two first–aiders change places when doing CPR?
Yes. Usually the person performing the cardiac massage tires first. He should then exchange duties with the one performing the mouth–to–mouth breathing.

How long should Cardiopulmonary Resuscitation be continued?
At least a half an hour. By this time, some kind of heartbeat should be restored if the first aid is going to be successful.

Should CPR be continued indefinitely if the slightest evidence of an occasional heartbeat is noted?
Yes. Occasional heartbeats often signify that a rhythmic beat can be restored.

Does regular breathing come back before a heart beat is restored?
No. Heart actions come before resumption of breathing.

How long does it take to learn CPR?
The average intelligent individual can learn the technique in several hours of instruction.

Where can one get instruction in Cardiopulmonary Resuscitation?
Call your local Red Cross.