Cardiac Massage – An Overview and Techniques

Table of Contents:

• Introduction
• What is a Cardiac Massage?
• Types of Cardiac Massage
• How Is Cardiac Massage Different From CPR?
• Step-by-Step Guide to Perform Closed Chest Cardiac Massage
• How To Perform Open-Chest Cardiac Massage?
• The Role of Cardiac Massage in CPR

Did you know that 90% of people who suffer an out-of-hospital cardiac arrest die if they don’t get immediate help? When the heart stops pumping, blood flow to the brain and other organs stops too. Without quick action, a person can lose their life in minutes. Cardiac massage is a life-saving technique used to keep blood flowing when the heart stops working. This guide will explain both techniques, when to use them, and how they can help save lives.

What is a Cardiac Massage?

Cardiac massage is a manual technique used to maintain blood flow when the heart stops beating effectively. It is often performed during cardiac arrest, a condition where the heart suddenly stops pumping blood. Without immediate intervention, a person’s organs, including the brain, can suffer damage due to the lack of oxygen-rich blood.

Cardiac massage mimics the natural pumping action of the heart, helping circulate blood to critical areas such as the brain, lungs, and other vital organs. Timely and proper cardiac massage can reduce brain damage and other complications associated with prolonged oxygen deprivation. Cardiac massage is typically indicated in situations where the heart fails to pump effectively, such as:

• Cardiac arrest caused by trauma, heart attack, or electrical shock
• Severe chest injuries leading to cardiac dysfunction
• Cases during surgery when the heart stops
• Ineffective response to standard CPR

Read More: An Ultimate Guide to Cardiac Conduction System

Types of Cardiac Massage

Cardiac massage can be performed using two primary techniques: open-chest cardiac massage and closed-chest cardiac massage. Each approach has its specific uses and is selected based on the patient’s condition and the environment in which care is provided. 

• Open Chest Cardiac Massage

Open-chest cardiac massage involves gaining direct access to the heart by opening the chest cavity. In this technique, a surgeon or a trained medical professional manually squeezes the heart between their hands to pump blood throughout the body. Compared to external compressions, this method provides greater control and effectiveness in generating blood flow.

Open-chest cardiac massage is typically performed during heart surgery when there is severe trauma to the chest or in rare situations where closed-chest compressions are ineffective. It is often considered a last resort in life-threatening cases where immediate action is necessary to maintain blood circulation. It is more risky due to surgical complications such as infection and damage to nearby organs.

• Closed Chest Cardiac Massage

Closed-chest cardiac massage, also known as chest compressions, is the more commonly used technique in emergency settings. This method involves applying forceful compressions to the chest wall to stimulate the heart and maintain blood circulation.

Compressions are the main component of CPR (cardiopulmonary resuscitation) and are often performed by healthcare professionals or trained bystanders during cardiac arrest. The rescuer places their hands on the center of the patient’s chest and delivers compressions at a depth of about 2 inches (5 cm) and a rate of 100 to 120 compressions per minute. This technique is the first line of response in most out-of-hospital emergencies. While there is a risk of broken ribs or chest injuries, compressions are generally less invasive.

How Is Cardiac Massage Different From CPR?

Cardiac massage and CPR share the same goals, i.e. to restore blood circulation and save a life. However, there are distinct differences between the two. The differences between cardiac massage and cardiopulmonary resuscitation are:

Read More: How Long To Perform CPR?

Step-by-Step Guide to Perform Closed Chest Cardiac Massage

Closed chest cardiac massage is important when someone experiences a life-threatening emergency. It can be performed by anyone who is trained in CPR. The steps to perform a closed-chest cardiac massage are as follows: 

1. Assess the Situation

Before starting cardiac massage, check the person’s condition to determine if they need help. Gently tap their shoulder and ask loudly, “Are you okay?” If there is no response and the person is not breathing or is only gasping for air (agonal breathing), they may be in cardiac arrest. Call emergency medical services (EMS) immediately or ask someone nearby to do so. 

2. Position the Patient

Place the person flat on their back on a hard, stable surface, such as the ground or a sturdy table. Ensure their body is straight and aligned. Kneel next to them, close enough to position your hands effectively over their chest. Being in the right position helps you deliver strong and effective compressions.

3. Perform Chest Compressions

To begin chest compressions:

• Place the heel of one hand in the center of the chest, just above the lower part of the sternum.
• Place your other hand on top and interlock your fingers.
• Keep your arms straight and position your shoulders directly over your hands.
• Use your upper body weight to press down hard and fast. Compress the chest about 2 inches (5 cm) deep at a rate of 100–120 compressions per minute.

4. Allow Full Chest Recoil

After each compression, let the chest rise back to its original position. This allows the heart to refill with blood between compressions, making the procedure more effective. Avoid leaning on the chest between compressions.

5. Continue Until Help Arrives

Keep performing compressions without stopping. If trained, add rescue breaths by delivering 30 compressions followed by 2 breaths. Continue until EMS arrives or the person shows signs of recovery, such as movement or breathing.

How To Perform Open-Chest Cardiac Massage?

In case someone experiences severe trauma or has a cardiac arrest during surgery, then an open-chest cardiac massage is done. It is performed only by a trained surgeon or medical professional. The steps to perform an open-chest cardiac massage are as follows:

1. Prepare for the Procedure

Open chest cardiac massage is only performed in controlled environments, such as an operating room or during emergencies where immediate access to the heart is necessary. Begin by sterilizing the chest area and ensuring the patient is under anesthesia or already unresponsive.

2. Make an Incision

A surgical incision is made on the left side of the chest, typically between the fourth or fifth rib. This area allows direct access to the heart while avoiding critical structures. To provide clear visibility of the heart, the ribs may need to be spread apart using surgical instruments.

3. Locate the Heart

Once the chest cavity is open, carefully locate the heart. It will be positioned slightly to the left within the chest cavity. Ensure that any surrounding tissue or obstructions are cleared for effective manual access.

4. Perform Manual Compression

Gently but firmly hold the heart between both hands or with one hand if the space is limited. Apply rhythmic compressions by gently squeezing and releasing the heart at a steady pace, typically 60 to 80 times per minute. Be careful to avoid excessive pressure that might damage the heart tissue.

5. Monitor and Continue Until Stabilized

Continue compressions until the heart regains effective contractions or until advanced medical interventions are available. Throughout the process, monitor the patient’s vital signs and blood flow for signs of recovery. Once stabilized, the chest is closed and sutured to complete the procedure.

The Role of Cardiac Massage in CPR

Cardiac massage helps save a life during cardiac arrest by maintaining blood flow. It can be performed externally through chest compressions or internally by manually compressing the heart during surgery. Closed-chest cardiac massage is the most common and essential part of CPR in emergencies, while open-chest cardiac massage is reserved for specific situations requiring direct heart access. Quick and proper intervention can improve survival rates and reduce complications caused by a lack of blood flow to vital organs.

CPR is necessary to be prepared to help during cardiac emergencies. Enroll in a certified BLS course today to gain the knowledge and skills to save lives.

References:

• https://cprcare.com/blog/what-is-cardiac-massage-and-types-of-cardiac-massage-techniques/#:~:text=Cardiac%20massage%20involves%20rhythmic%20chest,oxygen%20delivery%20to%20the%20brain
• https://www.onlinecprcertification.net/blog/what-is-cardiac-massage-and-what-are-some-of-the-cardiac-massage-techniques/
• https://cprcertificationnow.com/blogs/mycpr-now-blog/essential-guide-to-cardiac-massage-techniques

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