ADULT CPR BODY POSITIONING

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1 ADULT CPR CPR - Cardio Pulmonary Resuscitation, Cardio means HEART Pulmonary means LUNGS or breathing and Resuscitation means to REVIVE. If you come upon a victim, you are concerned if they are BREATHING and if their HEART is beating. The easiest way to find this out is to see if they are conscious. You can do this by shouting at them and gently shaking them. Say, Hey, are you OK. this is called SHAKE & SHOUT. If they respond, then you know that their HEART & BREATHING are functioning, so you do not need to do CPR. Call 911 and then see if perhaps they need First Aid to be administered. If you do the shake and shout and they do not respond, then you need to physically check their pulse to find out what is going on with their HEART. If they are on their back already then put them in the log roll. BODY POSITIONING IF THEY ARE ON THEIR STOMACH, straighten out their legs and put them together. Then put their foot that is furthest away from you over their other foot. Then raise the arm nearest you, straight up against their ear. You now have them in a log roll position that will allow you to roll them over on their back with ease. Reach your hand to the far side of their head and cradle it with your one hand and with the other hand you hold onto their belt or waist. You then pull both hands towards you making sure that their head rolls up onto their outstretched arm. Even if they out weigh you this position will make it easy to roll them over on their back. This procedure will protect their head and neck from further trauma. You then gently lay them on their back. They need to be on their back, on a hard flat surface for optimum results for any of these procedures. IF THEY ARE ON THEIR BACK all you need to do is put them in the same log roll so in case they vomit you will be able to roll them on their side and prevent the vomit from entering their lungs. These are the ONLY TWO TIMES that you need to roll the victim. All of the other procedures can be preformed while they are flat on their backside. Now that you know how to correctly and safely position a body we can return to Rescue Breathing. RESCUE BREATHING (Pulmonary Resuscitation) Once they are positioned correctly you will put yours fingers on their carotid artery on the side of their neck to see if they have a pulse. You also, need to check to see if they are breathing. You do this by putting your ear over their mouth and look towards their chest. You will LOOK to see if their chest is moving, you will LISTEN with your ear for breath and you will try to FEEL breath on your cheek. It is called LOOK, LISTEN & FEEL. If you feel a HEART beat and also detect BREATHING, then do not move them, call 911, continue to monitor them and stay with them until 911 arrives. They do not need CPR. Perhaps First Aid needs to be rendered. If you feel their Heart beating but you can t feel their breath then you would need to start Pulmonary Resuscitation (Rescue Breathing). Pulse/Breathing Yes/No combo One possibility would be: They have a pulse, but they are not breathing? This tells you that all you need to do is blow some air into their lungs. 1

2 You do this by making sure that their chin is straight up towards the sky. Keep your 2 fingers on their pulse to ensure that their Heart is still beating. ** With your other hand you pinch their nose, and then put your mouth over theirs, turn your head toward their chest and blow (their bare chest needs to be exposed in order for you to accurately assess chest movement). If you see their chest expand, then you know that their airway is OPEN and that you have blown in enough air into their lungs to do them some good. You give one breath, turn your head toward their chest and count to five seconds. You keep doing this until: 1. The victim revives 2. You blow air into their mouth but it doesn t go into their lungs and you see no chest expansion, then you need to reposition their head and if the air still does not go into their lungs then do the Mouth Sweep\ Bellybutton Thrust proceed. Mouth Sweep\Bellybutton Thrust (unconscious victim) (see illustration Online) You tilt their chin down and look into their mouth. If you see something then just use your finger to sweep it out. If you can t get it this way, then you will need to straddle the victim at the waist, put either the palm of your one hand or use two hands stacked on their bellybutton, lock your elbows and push down at a 45 degree angle. (This will put a little pressure from the stomach up towards the obstruction and when you push against the diaphragm it will put a lot of pressure on the lungs up towards the obstruction that will push it off of the airway, allowing air to go into the lungs) You then return to the mouth, look in and pick out the blockage. If the victim has a pulse and you push up the obstruction the victim should respond by breathing or coughing. If they don t start to breath, then you return to the rescue breathing procedures above** You keep doing it until one of the following happens: the victim is revived, persons responding to 911 relieve you, you become physically exhausted, or the victim is pronounced dead by an MD. (These 4 criteria are to protect you legally) The second possibility would be: They don t have a pulse and they are not breathing? This tells you that you need to give them some air. You do this by making sure that their chin is straight up towards the sky. You keep your 2 fingers on their pulse to ensure that their Heart is still beating. With your other hand you pinch their nose, and then put your mouth over theirs, turn your head toward their chest and blow (their bare chest needs to be exposed in order for you to accurately assess chest movement). If you see their chest expand, then you know that their airway is OPEN and that you have blown in enough air to their lungs to do them some good. But if you blow air into their lungs but it doesn't go in and you see no chest expansion, then you need to do the Mouth Sweep\ Bellybutton Thrust procedure above. Once you are able to blow air into the victim s lungs you must then do chest compressions. Chest Compressions (see illustrations Online) With the victim perpendicular to your knees, trace up their rib cage with both of your hands, until your fingers meet. At this point you will feel a bony structure at the bottom of their sternum (you don t want to compress on that bone) then place the heel of the palm of your hand next to where your fingers meet, perpendicular to the victim s body. This will put you about 2 finger widths above that bony structure. You are now ready to start chest compressions. Facing the victim, place the palm of one hand on the spot you just found, lock your elbow, and use your upper body weight to compress the chest. If one hand feels insufficient, then stack your two hands together in the same spot and fashion. You do 30 compressions, (push down 1.5 to 2 deep). Your rate of compressions are 100 per minute all of this information will be on the back of your cert card and then return to their head to check their pulse and breathing. You put 2

3 your two fingers on their neck pulse and your ear over their mouth/nose area. While you are listening and looking for air your two fingers are feeling for a pulse. I f the victim has no pulse and is not breathing then you blow once into there mouth while your looking at their chest to determine any movement. When you see movement you blow again into their mouth while watching for chest movement. During this time you have been monitoring their pulse and have determined they still don t have one. You return to the chest area, put your body in the proper position perpendicular to theirs, find their compression spot, stack your hands, lock your elbows and start your 30 compressions. After you finish your compressions you return to their head and check their pulse and breathing. If they are the same give 2 breaths and return to the chest and start your 30 compressions and then back to their head etc. Let s say that when you returned to their head and was checking their pulse and breathing you felt a pulse, but no breathing. Then you would just do rescue breathing. One blow and count to 5 seconds. (You don t need to do chest compressions, because their Heart is going on it s own and if you compress on a beating heart you risk injury or even stopping it.) Remember: When your at the victim s head you will get all the information you need concerning pulse and breathing to make the right decision. They have a pulse but no breathing: You just blow twice, count to 5 and monitor pulse. No pulse and no breathing you breath twice and then do 30 compressions. Your air won t go in: Do a mouth sweep and or Bellybutton thrust to clear airway. Continue until the victim revives, you become physically exhausted, your relieved by 911, or they're pronounced dead by an MD. Bellybutton Thrust (conscious person) There are two types of chocking: 1. A partial obstructed airway. This is identifiable by a gasping noise or coughing. For this talk to the victim and encourage them to calm down and cough it out. 2. A totally obstructed airway. This is identifiable by a lack of noise. What you do is talk to them and let them know you can help them. Ask them, Can you speak? Can you cough? If they cannot, then get behind them and put your leg between their legs and brace yourself with your other leg. You then reach around to their front side to find their bellybutton. Once you have done this, you put your fist in their bellybutton, reach your other hand around them and place it on your fist and give a firm thrust upwards. If they cough, then stop and encourage them to cough it out. If they are still obstructed keep doing the procedure until it is removed. If they happen to pass out you can use your body to slide them down on the floor and then continue to work on them using the Mouth Sweep\ Bellybutton Thrust (unconscious victim) THE INFANT (Up to 1 year old) (see illustration Online) Just as with the adult and the child you want to find out if they breathing and do they have a heartbeat. The easiest way to find this out is to see if they are conscious. On an infant you can pinch their inner thigh of flick their foot with your fingers. If there is no response then you need to check for pulse and breathing. When you are checking the pulse on an infant it is best to use the brachial artery in their arm. Most infants do not have a defined neck so it is hard to locate a pulse on their neck. To check for breathing you put your ear over the infant s mouth and LOOK-LISTEN and FEEL for breath. BREATHING (see illustration Online) If there is no breath but they have a pulse then you will give Pulmonary Resuscitation. Put your mouth over the infant s nose and mouth and give 1 breath every 5 seconds, keeping your fingers on their pulse. If there is no pulse and no breathing then they need CPR. 3

4 COMPRESSIONS (see illustration Online) To landmark on an infant you use the nipple method. Take two fingers and put one finger on the infant s nipples, lift that finger and the other finger will be one finger width below the nipple line. You compress 30 times at a rate of at least 100, and then give a 2 puffs of air and 30 compressions. Because they are so small you can keep your fingers on their pulse the entire time and keep your head close to the infant s mouth. Just swivel your head from side to side. Breath twice, look at the chest, and do 30 compressions. If the infant vomits just roll them on their side so the vomit does not go into their lungs. Clean up their mouth, check for pulse and breathing and if none continue with 2 breaths and 30 compressions. CHOKING (see illustration Online) If the infant is coughing then let him work it out. However if the infant has a totally obstructed airway put one finger in his mouth to push down on the tongue and cradle his head in the same hand. Roll him on his stomach with his head down and give him 5 back blows right in the middle of the shoulder blades (be careful not to hit too low because the kidneys are below the shoulder blades and you do not want to do back blows on the kidneys). If the object is still lodged roll the infant over on your other arm with his face up, support the back of his head and find his belly button. Put three fingers right above his belly button and give 5 pushes. Then go to baby s head and you can talk with 911. You would then stretch the baby s arms upright alongside their head, place. You can now look in baby s mouth. If you see it pull it out. However, if you do not see it do not do a blind finger sweep. (Repeat this procedure back taps & bellybutton thrusts until object is dislodged and airway is clear.) Remember to call 911. DROWNING (see illustration Online) Once you get the infant of the water by supporting it s head and body, you can then put the infant on their back on a hard surface, maybe next to a phone where one of your hands on the babies head to keep the chin vertical. Place two fingers of your other hand on the babies arm artery. Put your ear on baby s mouth to feel/listen for breath, while feeling for a pulse. If you feel a pulse, but no breath then you give baby a blow of air. If air does not go in you know the water is obstructing the airway. To get the water out of baby you roll the infant over on your other arm with his face up, support the back of his head and find his belly button. Put three fingers right above his belly button and give pushes until water is pumped out of baby s mouth. This will open airway and allow air in. You can now continue with rescue breathing(1 breath, count to 5). If baby loses their Heart Beat or pulse you would then administer CPR(2 breaths and 30 compressions). CHILD CPR CPR - Cardio Pulmonary Resuscitation, Cardio means HEART. Pulmonary means LUNGS or breathing and Resuscitation means to REVIVE. If you come upon a victim, you are concerned if they are BREATHING and their HEART is beating. The easiest way to find this out is to see if they are conscious. You can do this by shouting at them and gently shaking them. Say, Hey, are you OK. this is called SHAKE & SHOUT. If they 4

5 respond, then you know that their HEART & BREATHING are functioning, so you do not need to do CPR. Call 911 and then see if perhaps they need First Aid to be administered. If you do the shake and shout and they do not respond, then you need to physically check their pulse to find out what is going on with their HEART. If they are on their back already then put them in the log roll. BODY POSITIONING (see illustration Online) IF THEY ARE ON THEIR STOMACH, straighten out their legs and put them together. Then put their foot that is furthest away from you over their other foot. Then raise the arm nearest you, straight up against their ear. You now have them in a log roll position that will allow you to roll them over on their back with ease. Reach your hand to the far side of their head and cradle it with your one hand and with the other RESCUE BREATHING (Pulmonary Resuscitation) (see illustration Online) Once they are positioned correctly you will put yours fingers on their carotid artery on the side of their neck to see if they have a pulse. You also, need to check to see if they are breathing. You do this by putting your ear over their mouth and look towards their chest. You will LOOK to see if their chest is moving, you will LISTEN with your ear for breath and you will try to FEEL breath on your cheek. It is called LOOK, LISTEN & FEEL. If you feel a HEART beat and also detect BREATHING, then do not move them, call 911, continue to monitor them and stay with them until 911 arrives. They do not need CPR. Perhaps First Aid needs to be rendered. If you feel their Heart beating but you can t feel their breath then you would need to start Pulmonary Resuscitation (Rescue Breathing, 1 breath count to 5). One possibility would be: They have a pulse, but they are not breathing? This tells you that all you need to do is blow some air into their lungs. You do this by making sure that their chin is straight up towards the sky. Keep your 2 fingers on their pulse to ensure that their Heart is still beating. ** With your other hand you pinch their nose, and then put your mouth over theirs, turn your head toward their chest and blow (their bare chest needs to be exposed in order for you to accurately assess chest movement). If you see their chest expand, then you know that their airway is OPEN and that you have blown in enough air into their lungs to do them some good. You give one breath, turn your head toward their chest and count to five seconds. You keep doing this until: 1. The victim revives 2. You blow air into their mouth but it doesn t go into their lungs and you see no chest expansion, then you need to reposition their head and if the air still does not go into their lungs then do the Mouth Sweep\ Bellybutton Thrust procedure. Mouth Sweep\ Bellybutton Thrust (unconscious victim) You tilt their chin down and look into their mouth. If you see something then just use your finger to sweep it out. If you can t get it this way, then you will need to straddle the victim at the waist, put either the palm of your one hand or use two hands stacked on their bellybutton, lock your elbows and push down at a 45 degree angle. (This will put a little pressure from the stomach up towards the obstruction and when you push against the diaphragm it will put a lot of pressure on the lungs up towards the obstruction that will push it off of the airway, allowing air to go into the lungs) You then return to the mouth, look in and pick out the blockage. If the victim has a pulse and you push up the obstruction the victim should respond by breathing or coughing. If they don t start to breath, then you return to the rescue breathing procedures above** You keep doing it until the victim is revived, you are relieved by 911, you become physically exhausted, or the victim is pronounced dead by an MD. (These 4 criteria are to protect you legally) 5

6 The second possibility would be: They don t have a pulse and they are not breathing? This tells you that you need to give them some air. You do this by making sure that their chin is straight up towards the sky. You keep your 2 fingers on their pulse to ensure that their Heart is still beating. With your other hand you pinch their nose, and then put your mouth over theirs, turn your head toward their chest and blow (their bare chest needs to be exposed in order for you to accurately assess chest movement). If you see their chest expand, then you know that their airway is OPEN and that you have blown in enough air to their lungs to do them some good. But if you blow air into their lungs but it doesn't go in and you see no chest expansion, then you need to do the Mouth Sweep\ Bellybutton Thrust procedure above. Once you are able to blow air into the victim s lungs you must then do chest compressions. Chest Compressions With the victim perpendicular to your knees, trace up their rib cage with both of your hands, until your fingers meet. At this point you will feel a bony structure at the bottom of their sternum (you don t want to compress on that bone) then place the heel of the palm of your hand next to where your fingers meet, perpendicular to the victim s body. This will put you about 2 finger widths above that bony structure. You are now ready to start chest compressions. Facing the victim, place the palm of one hand on the spot you just found, lock your elbow, and use your upper body weight to compress the chest. If one hand feels insufficient, then stack your two hands together in the same spot and fashion. You do 30 compressions, (push down 1 to 1.5 deep). Your rate of compressions are 100 per minute (all of this information will be on the back of your cert card) and then return to their head to check their pulse and breathing. You put your two fingers on their neck pulse and your ear over their mouth/nose area. While you are listening and looking for air your two fingers are feeling for a pulse. I f the victim has no pulse and is not breathing then you blow once into there mouth while your looking at their chest to determine any movement. When you see movement you blow again into their mouth while watching for chest movement. During this time you have been monitoring their pulse and have determined they still don t have one. You return to the chest area, put your body in the proper position perpendicular to theirs, find their compression spot, put one hand on it, lock your elbow and start your 30 compressions. After you finish your compressions you return to their head and check their pulse and breathing. If they are the same, blow twice return to the chest and start your 30 compressions and then back to their head etc. Let s say that when you returned to their head and was checking their pulse and breathing you felt a pulse, but no breathing. Then you would just do rescue breathing. One blow and count to 5 seconds. (You don t need to do chest compressions, because their Heart is going on it s own and if you compress on a beating heart you risk injury or even stopping it.) Remember: When your at the victim s head you will get all the information you need concerning pulse and breathing to make the right decision. They have a pulse but no breathing: You just blow and monitor pulse. No pulse and no breathing you give 2 breaths and then do 30 compressions. Your air won t go in: Do a mouth sweep and or Bellybutton thrust to clear airway. Continue until the victim revives, you become physically exhausted, your relieved by 911, or their pronounced dead by an MD. Bellybutton Thrust (conscious person) (see illustration Online) There are two types of chocking: 1. A partial obstructed airway. This is identifiable by a gasping noise or coughing. For this talk to the victim and encourage them to calm down and cough it out. 2. A totally obstructed airway. This is identifiable by a lack of noise. What you do is talk to them and let them know you can help them. Ask them, Can you speak? Can you cough? If they cannot, then get behind them and put your leg between their legs and brace yourself with your 6

7 other leg. You then reach around to their front side to find their bellybutton. Once you have done this, you put your fist in their bellybutton, reach your other hand around them and place it on your fist and give a firm thrust upwards. If they cough, then stop and encourage them to cough it out. If they are still obstructed keep doing the procedure until it is removed. If they happen to pass out you can use your body to slide them down on the floor and then continue to work on them using the Mouth Sweep\ Bellybutton Thrust (unconscious victim) DROWNING (see illustration Online) Once you get the victim out of the water and on to a dry surface you place them on their back and properly position their body. You then check for pulse and breathing. If you feel a pulse, but no breathing then you know that the water is their obstruction. You then straddle their legs, put the palm of your hand on their bellybutton, lock your elbow and push at a 45-degree angle inward. This will pump the water out of their mouth, opening their airway and allowing air in to their lungs. If they don t start to breathe on their own then you give them 1 breath and count to 5 seconds, while your other hand is monitoring their pulse. If they loose their pulse then you start the 30 chest compressions. Remember to call 911 so the person gets to a medical facility to be checked out and any problems can be corrected. TWO PERSON CPR This is when you have one victim and 2 rescuers. (Use the Body Positioning procedure to correctly position body, initially and then again incase of vomit). One rescuer is at the victims head to check pulse and breathing AND to tell the chest compressor whether to compress or not, depending on the victims pulse. GO if they do not have a pulse and the compressor will do 30 compressions. STOP if the victim has a pulse and the compressor will stop. If the victim has a pulse and is not breathing then you breath twice into their mouth, while looking at their chest and count to 5 seconds. If the pulse quits then you resume with the 30 compressions. If air won t go into lungs then you do the Mouth Sweep\Bellybutton Thrust procedure until obstruction is removed and continue with CPR/PR. (You keep this up until the victim is Revived, pronounced dead by a MD, the rescuer becomes physically exhausted, or your relieved by 911.) 7

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