The procedure used to restart the action of the heart if it is suddenly arrested. In many cases the arrested heart can be made to start beating again by rhythmic compression of the chest wall. This is done by placing the patient on a hard surface – a table or the ﬂoor – and then placing the heel of the hand over the lower part of the sternum and compressing the chest wall ﬁrmly, but not too forcibly, at the rate of 60–80 times a minute. At the same time artiﬁcial respiration must be started by the mouth-tomouth method. (See APPENDIX 1: BASIC FIRST AID.) Open heart massage is sometimes undertaken if an arrest occurs during a chest operation – the heart being directly handled by the resuscitator.
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