The sternum plays a critical role in CPR, as it serves as the primary site for chest compressions, which help maintain circulation during cardiac arrest. Below is a detailed breakdown of its significance in CPR:
1. Location and Function in CPR
- The sternum is a flat bone located in the center of the chest, making it the ideal compression point.
- It provides a rigid yet flexible surface to transfer force effectively to the heart.
- Compressions on the sternum help create artificial circulation, maintaining oxygen delivery to the brain and vital organs.
2. Ideal Hand Placement for Effective CPR
- Hands should be placed on the lower half of the sternum, avoiding the xiphoid process (lower tip) to prevent injury.
- Proper hand placement ensures maximum pressure on the heart, improving blood flow.
- Incorrect positioning may lead to fractured ribs or ineffective compressions.
3. Compression Technique and Depth
- Chest compressions should be performed at a depth of 2-2.4 inches (5-6 cm) for adults.
- Compressions must be strong and rhythmic, at a rate of 100-120 compressions per minute.
- Allowing the chest to fully recoil between compressions ensures effective blood circulation.
4. Role of the Sternum in Blood Flow Maintenance
- The sternum acts as a mechanical lever, pressing the heart against the spine during compressions.
- This mimics the natural pumping action of the heart, pushing blood to the brain and other vital organs.
- Continuous compressions keep the aortic and pulmonary valves open, preventing blood stagnation.
5. Impact on Oxygenation and Brain Function
- Effective sternal compressions ensure oxygenated blood reaches the brain, preventing brain damage.
- If CPR is not started within 4-6 minutes of cardiac arrest, brain cells begin to die.
- The sternum’s central location allows for consistent blood flow until advanced medical help arrives.
6. Role in Automated External Defibrillator (AED) Use
- AED pads are placed on the chest, near the sternum, to deliver controlled shocks.
- The sternum serves as a clear landmark for AED pad placement, ensuring optimal electrical conduction.
- Combining sternal compressions with defibrillation increases survival chances in cardiac arrest.
7. Risks and Injuries Associated with Sternal Compressions
- Fractured ribs or sternum can occur if excessive force is applied.
- Improper hand placement can damage the xiphoid process, leading to internal injuries.
- Despite risks, effective CPR significantly improves survival rates compared to inaction.
8. Importance in Pediatric and Infant CPR
- For infants, CPR is performed with two fingers on the sternum, reducing injury risk.
- In children, one-handed compressions ensure effective circulation with minimal trauma.
- The sternum's flexible nature in children allows for gentle yet effective chest compressions.
9. CPR in Special Conditions (Obese or Elderly Patients)
- In obese individuals, sternal compressions require increased force to be effective.
- Elderly patients have brittle bones, making fractures more likely but still necessary for survival.
- The sternum remains the key landmark in all age groups for CPR administration.
10. Conclusion: Life-Saving Role of the Sternum in CPR
- The sternum provides the ideal compression site for restoring blood flow during cardiac arrest.
- Effective CPR on the sternum increases survival chances by maintaining circulation until medical help arrives.
- Knowledge of proper hand placement, depth, and technique ensures the best outcomes in emergency situations.
