Airway A. AIRWAY: If you find a collapsed person, discover if he is conscious by shaking the shoulders and shouting "are you all right?" If no response, send someone to call 999 or 112 or your local emergency telephone number and say cardiac emergency. If the person is not lying flat on his back, roll him over, moving the entire body at one time, as a total unit. Then open the airway. To open the airway, lift the chin gently with one hand, while pushing down on the forehead with the other to tilt the head back. Once the airway is open, place your ear close to the casualty's mouth: * LOOK - at the chest and stomach for movement. * LISTEN - for sounds of breathing. * FEEL - for breath on your cheek. If none of these signs is present, the person is not breathing. If opening the airway does not cause the person to begin to breathe spontaneously, you must provide rescue breathing. Breathing B. BREATHING: The best way to provide rescue breathing is by using the mouth-to-mouth technique. Take your hand that is on the person's forehead and turn it so that you can pinch the nose shut, while keeping the heel of the hand in place to maintain head tilt. Your other hand should remain under his chin, lifting up. Immediately give two slow full breaths, using the mouth-to-mouth method. After giving two slow breaths, locate the person's carotid pulse to see if the heart is beating. To find the carotid artery, take your hand that is under his chin, and locate the voice box. Slide the tips of your index and middle fingers into the groove beside the voice box. Feel for the pulse for five seconds. Cardiac arrest can be recognized by absence of breathing, and an absent pulse in the carotid artery in the neck. If there is no pulse, you must provide artificial circulation in addition to rescue breathing. Circulation C. CIRCULATION: Artificial circulation is provided by external chest compression. In effect, when you apply rhythmic pressure on the lower half of the victim's breast-bone, you are forcing his heart to pump blood. To perform external chest compression properly, kneel at his side near his chest. Place the heel of one hand approximately two inches above the lower end of the breast bone. Place your other hand on top of the one in position. Be sure to keep your fingers off the chest wall. You may find it easier to do this if you interlock your fingers. Bring your shoulders directly over the breastbone as you press downward, keeping your arms straight. Depress the breastbone about 1½ to 2 inches for an adult victim. Then relax pressure on the breastbone completely. However, do not remove your hands from the victim's breastbone but do allow the chest to return to its normal position between compression's. Relaxation and compression should be of equal duration. If you are the only rescuer, you must provide both rescue breathing and external chest compression. The proper ratio is 15 chest compressions to 2 slow breaths. You must compress at the rate of 80-100 times per minute when you are working alone since you will stop compressions when you take time to breathe. Where there is another rescuer to help you, position yourselves on opposite sides of the patient if possible. One of you should be responsible for interposing a breath during the relaxation after each fifth compression. The other rescuer who compresses the chest should use a rate of 80-100 compressions per minute. Unconscious casualties who are breathing and whose hearts are beating should be placed in the Recovery position. ------------------ These files may be accessed through the web at http://firstaid.ie.eu.org/ I would like to thank the IEASR for allowing me to convert their pages over to the Pilot. Mary Jo Sminkey maryjo@dogpatch.org http://www.dogpatch.org ------------------ DISCLAIMER: Information in these files is presented in order to impart general information relating to first aid of various injuries and conditions. Such information is not complete and should not be used as a substitute for a consultation or visit with your physician or other health care provider, or as a substiture for actual training in first aid and/or CPR. While all reasonable care has been taken in compiling this information, Mary Jo Sminkey and Irish Emergency Ambulance Services Resource (IEASR) make no warranty as to the information's completeness, reliability or accuracy. Access to and use of the information contained herein is entirely at the risk of the user, Mary Jo Sminkey and IEASR shall not be liable, directly or indirectly to the user or any third party for any damage resulting from the use of the information contained or implied in the Pilot First Aid files.