First Aid CPR Summary

Check the Area

  • Look for hazards. Hazards include split electrical wires, fire, unstable building structure or anything else that could present a risk to the responder.  Make sure that you do not put yourself in danger
  • Put on gloves if you have them.
  • Use Pocket Mask or Face Shield if you have access to them and need to give rescue breaths

Check Level of Consciousness

  • If YES, check the victim for other conditions and call for help if necessary.
  • If NO, call EMS-911

DO not give CPR to conscious victims

Note: 2010 AHA guide lines call for compressions first and compression only if unwilling to give mouth-to mouth breaths.

Compressions

Correct position for CPR. The arms are fully extended and the thrusts are given from the hips.

Airway

Open the airway- Tilt head back lift chin up

After opening the victim’s airway, check to see if the victim is breathing.

  1. You may Feel the victim’s breath against your cheek.
  2. You may Hear the air entering or escaping your victim’s lungs.
  3. You may See the chest rise and fall with each breath.
  4. You may Smell the breath of the victim as they exhale.

Search for these signs for 10 seconds. If there is no breathing , you must perform rescue breathing.

Breathing

  • If victim is breathing place the victim in the Recovery position and call for help unless a spinal injury is suspected in which it is crucial to not move the patient.
  • If victim is Not breathing, No pulse, give 30 cheats compressions, then 2 rescue breaths (1Rescuer). Repeat cycle until EMS arrive

Compressions-Ventilation-Ratio Table

CPR Table
Age Group Adult Child Infant
Single-Person 30-2 30-2 30-2
Two-Person 30-2 15-2 15-2
Technique Both hands One hand Two fingers
  • Compressions are at a rate of 100 per minute.
  • Hand/finger placement is just below the nipple line and above the bottom of the breast bone.

Automated External Defibrillation-AED

An Automated External Defibrillator (AED) is a small, lightweight device used to assess a person’s heart rhythm. If necessary, it administers an electric shock to restore a normal rhythm in victims of sudden cardiac arrest. Built-in computers assess the patient’s heart rhythm, judge whether defibrillation is needed, and administer an appropriate level of shock. Audible and/or visual prompts guide the user through the process.

How Does an AED Work?

A microprocessor inside the defibrillator analyzes the victim’s heart rhythm through adhesive electrodes (some AED models require the operator to press an ANALYZE button). The computer then advises the operator whether a shock is needed. When the operator responds to the prompt to give a shock, an electric current is delivered through the victim’s chest wall through adhesive electrode pads.

Why Are AEDs Important?

When a person suffers a sudden cardiac arrest, the chances of survival are reduced by 7 to 10 percent with every minute that passes without CPR and defibrillation. The American Red Cross estimates that 50,000 lives could be saved each year if AEDs were widely used.

Who Can Use an AED?

Anyone trained to use cardiopulmonary resuscitation (CPR) can  use an AED. Most AEDs are designed to be used by people without medical backgrounds, such as police, firefighters, flight attendants, security guards and lay rescuers. The AED delivers electric current to the heart muscle,this gives the heart an opportunity to resume beating effectively.

Will an AED Always Resuscitate Someone in Cardiac Arrest?

No. The victim also requires breathing support. AEDs are less successful when the victim has been in cardiac arrest for more than a few minutes, especially if no CPR was administered.

Don’t do this!
Do not shock if:

  • The victim is close to explosive or flammable material.
  • The victim is wet (dry the victim off with a towel).
  • The victim has a medicine patch on them.
  • The victim is touching an object that could conduct the charge to others. (A metal bench)
  • If necessary, protect the victim from water and dry them. Cell phones and other electronic devices can disrupt the analyzing phase of the AED. Check for a cell phone on the patient and remove it to a distance of 6 feet or more.  Remember, life over limb (or possessions, in this case.)

Electrode placement is crucial,the AED machine will clearly talk you through all steps of the process.

CPR must be stopped while the defibrillator is monitoring the victim’s heart activity. In all cases, defibrillator has priority over CPR. Do not touch the victim or the AED.

Calling For Help

If a bystander has not already summoned assistance (known as EMS, Ambulance Service, Rescue Squad, or Paramedics depending on the region) call immediately. . Ideally, someone else will be able to make the call while you continue aid. If you’re alone, you must stop and call yourself.

You will need to give the emergency services:

  • Your exact location
  • The illness or injury that the victim is having (to the best of your knowledge).
  • A telephone number you can be contacted back.

C for Circulation principles

Chest compressions help squeeze the heart from outside the victim’s chest, helping to circulate blood around. When performing chest compressions during CPR, you are helping move the oxygen you delivered through rescue breathing where it is needed.

Chest compressions are often started before any other intervention in an emergency setting, because even blood that has already passed through the body has oxygen remaining to be used. Using compressions to pump that existing blood around can help buy the victim more time. This is the reason that CPR can be done “compression only”, or without rescue breathing. Once compressions start, they must continue for as long as possible.

Technique

The goal is always to compress in the center of the chest. This means that compressions are to performed on the sternum or breastbone of the victim, in line with the victim’s armpits or nipple line.

  • For adults (12 years and older) – place the heel of one hand in the center of the chest, bring your other hand to rest on top of the first hand, and interlock your fingers. Bring your shoulders directly above your hands, keeping your arms straight. You should then push down firmly onto the heel of the lower hand, depressing the chest to about one third (1/3) of its depth.
  • For children (1-12 years) – place the heel of one hand in the center of the chest. Bring your shoulder directly above your hand, with your arm straight, and perform compressions to one third (1/3) the depth of the chest with one arm only.
  • For infants (Younger then 12 months) – Use your forefinger and middle finger only. Compressing the chest about one third (1/3) of it’s depth.

Give 30 compressions in a row, and then two (2) rescue breaths ( one rescuer). Then restart your next cycle of compressions.

Making Compressions Effective

You MUST allow the ribs to come all the way back out after each compression. This allows the heart’s chambers to refill.

You are aiming for a rate of 100 compressions per minute, which includes the time to give rescue breaths. In practice, you should get just over 2 cycles of 30 compressions in along with breaths per minute.

  • The victim should be on a hard surface.
  • Keep your arms straight.
  • If you lose count, don’t stop, just estimate.
  • Chest compressions are tiring, rotate between rescuer.

If you are with someone else trained in CPR, rotate between compressions and rescue breaths.

When to Stop CPR

  • The victim starts breathing spontaneously.
  • The victim vomits- If the victim vomits, roll them in recovery position, clear the airway and reassess ABCs.
  • If you are without barrier device and feel uncomfortable giving rescue breaths, give chest compressions only.
  • Qualified help arrives
  • DO NOT STOP until instructed to. By continuing CPR, you are keeping the medical personnel free to perform other tasks.
  • You are unable to continue. Try to change places frequently with another trained rescuer to lessen the chance of exhaustion.
  • You put yourself in danger by continuing – If your life is endangered by a new hazard, you should stop CPR. If possible, remove the victim from the hazardous situation as well, but never at the risk of your own life or health.

Good Samaritan Laws

Best Practice
All rescuers should not be afraid of liability affecting them whilst performing their duties. In many cases, it is often best to provide care and to do so to the best of your ability without worry of legal implications.

Good Samaritan laws in the United States and Canada are laws that reduce the liability to those who choose to aid others who are injured or ill, though it does not protect you from being sued; it just significantly reduces your liability.. They are intended to reduce bystanders’ hesitation to assist, for fear of being prosecuted for unintentional injury or wrongful death. In other countries good samaritan laws describe a legal requirement for citizens to assist people in distress, unless doing so would put themselves in harm’s way. Citizens are often required to, at minimum, call the local emergency number.  Check with your local government for applicable legislation in your area. Typically, the Good Samaritan legislation does not cover an individual who exceeds their training level or scope of practice; nor would you be protected against gross negligence.

General guidelines

  1. Unless a caretaker relationship (such as a parent-child or doctor-patient relationship) exists prior to the illness or injury, or the “Good Samaritan” is responsible for the existence of the illness or injury, no person is required to give aid of any sort to a victim.
  2. Any first aid provided must not be in exchange.
  3. The responder is not legally liable for the death, disfigurement or disability of the victim as long as the responder acted rationally, in good faith, and in accordance with their level of training.

Negligence

Negligence requires few elements to be proven:

  1. Duty of care.
  2. Often, if you begin first aid, then a duty of care exists.
  3. You didn’t perform first aid properly, or went beyond your level of training.

Assisting with Medications

Assisting with medications can be a vital in a medical emergency. Assisting with medications includes helping the victim locate the medication, taking the cap off of a bottle of pills, and reading the label to ensure that the victim is going to take the right medication. Assisting, however, does not imply actually administering the medication. If done, may open you up to liability from going beyond your level of training. However, by assisting, you may be able to help the victim find their medications more quickly.

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