A Minute by Minute Guide to What Happens During CPR

ProTrainings What Happens During CPR

Every minute counts for someone experiencing cardiac arrest. It is a matter of life and death, and there is not a second to waste. But do you know what happens during CPR at each crucial stage?

According to the American Heart Association (AHA), a person’s chances of surviving cardiac arrest fall seven to 10 percent for every minute of delay in starting CPR. This means that it is crucial to know not only what happens during CPR, but also how to properly administer it, as well as the warning signs of when CPR might be needed.

This minute-by-minute guide explains exactly what happens during CPR and how the body is affected in the first few minutes after experiencing cardiac arrest.

What Happens in the Minutes Before Someone Needs CPR?

The first sign of cardiac arrest is loss of consciousness. While loss of consciousness is not always caused by cardiac arrest, signs indicating that a cardiac arrest could be taking place in the moments before the victim loses consciousness include:

  • A racing heartbeat
  • Feeling dizzy or lightheaded 
  • Chest pain
  • Shortness of breath
  • Nausea or vomiting

These symptoms can occur in the hour before a victim experiences cardiac arrest. But what happens during CPR to reverse the ill effects of cardiac arrest? Below is a minute-by-minute rundown.

What Happens in the First Minute of CPR?

In the event of a cardiac arrest, blood is not circulating well enough to get oxygen to the organs. Without the oxygen and sugars the brain needs to function, it fails at delivering the signals required to keep the body’s organs working. Proper CPR administration helps the blood to regain circulation when the body is unable to do it on its own.

The first minute of CPR is crucial. For every minute the organs are not receiving oxygen, more of these organs’ cells start to die.

What Happens After Two Minutes of CPR?

If CPR is being performed correctly, blood should still be flowing through a person’s arteries and oxygen will be getting through to these vital organs.

It is best to begin CPR within the first two minutes of cardiac arrest. If CPR is delayed by longer than three minutes, irreversible brain injuries start to occur. 

What Happens After Four Minutes of CPR? 

By now, without CPR, the patient has almost certainly suffered brain injury. This is called cerebral ischemia

Of course, CPR can drastically alter this narrative. This is because the person performing the CPR is manually pumping the patient’s heart, which is delivering blood around the body and feeding those vital organs their beloved oxygen. 

If CPR is initiated within four minutes or less, the patient is less likely to have developed a serious brain injury by this point. Unfortunately, without CPR, even if the person is resuscitated at this time, the risk of brain injury is high.

What Happens After Six Minutes of CPR?

Six may be the magic number when it comes to cardiac arrest. The time of brain death after cardiac arrest has been widely researched, and the consensus is that without CPR, the brain can only survive for six short minutes following the point of cardiac arrest.

With CPR in the scenario, this turns into a possibility of brain damage. This could still be catastrophic for the patient, but the CPR administrator has prevented total brain death in these six minutes.

What Happens After 10 Minutes of CPR?

After 10 minutes of cardiac arrest with no CPR, total brain death is the most likely outcome. Even with CPR, the chances of resuscitation and recovery are extremely low.

While the chances of survival after 10 minutes low, with CPR they are much higher than if the person had not received CPR at all. The advice is to keep going until medical help arrives. You never know how a person might react to CPR when it is given properly.

What Happens During CPR: 20 Minutes and Counting

After 20 minutes, the survival rate drops to just 4.6% according to the AHA. Of this number, only 1.6% will survive without a catastrophically injured brain.

That being said, CPR – even after 20 minutes of resuscitation – can still be beneficial. In fact, there have been several examples of successful resuscitation after the 20 minute mark.

Have People Survived After Receiving an Hour or More of CPR? 

It is incredibly rare for a patient to survive after an hour or more of CPR. However, there are, of course, some exceptions to these rules. These medical marvels appear to defy all odds and make full recoveries after receiving CPR for sometimes hours at a time. A study in 2019 raised the case of a 52-year-old Italian mountaineer who had survived cardiac arrest with complete organ recovery after receiving CPR for 5 hours and 44 minutes. 

Another story, reported by the Sudden Cardiac Arrest Foundation, is that of 29-year-old North Carolina man John Letterman, who survived after 210 minutes – or three and a half hours – of CPR.

Many of these stories are anecdotal and should be treated as exceptions to the patterns laid out above. A 2018 review by the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine found there were many gaps in the knowledge of researchers. It called for further research into the factors leading to brain damage in cardiac arrest.

However, according to statistics from real life case studies in medical journals across the world, it is undeniable that what happens during CPR drastically raises the chances of survival.
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