Performing CPR on Adults WARNING:This is not a replacement for a CPR course, improper CPR or CPR performed on a person whose heart is still beating can cause serious injury. Never perform CPR unless: * The person has stopped breathing . * The person has no heartbeat (Pulseless). * No one with more training in CPR is present at the incident. You should take a CPR course with the American Red Cross or one of the volunteer first aid organizations in your area, bring a friend! 1. Establish unresponsiveness and call for help. Shake the person gently on the shoulder and shout, "Hello can you hear me, are you okay?" Be careful not to flex or twist the neck, as the victim may have a spinal injury. Move the victim only if necessary. If the victim doesn't respond, call for help. When help comes, send that person to call 911 or your local emergency telephone number and ask for an ambulance. If the victim is lying on his stomach, gently support his neck and roll him over onto his back. Roll head, neck, and shoulders together as a unit. 2. Check for breathing. Kneel at right angles to the victim's shoulder, and looking toward the victim's chest, put your cheek next to his mouth to feel air passing through the lips. Watch the chest and abdomen to see if either is moving. In other words, look, listen, and feel for signs of breathing. This should take 3 to 5 seconds. If these signs aren't present, the victim is not breathing and you should open the airway. 3. Open the airway. Open the airway by returning the victim's head face up and tilting the forehead back with one hand while lifting up on the chin with the other hand (head tilt/chin lift). In an unconscious person the tongue relaxes and falls against the back of the throat, blocking air to the lungs. Sometimes, just opening the airway is enough to get the victim breathing again. Again, look, listen, and feel for signs of breathing (3 to 5 seconds). If the victim does not promptly begin breathing on his own, begin rescue breathing immediately. 4. Begin basic rescue breathing. Pinch the victim's nostrils shut with your hand still on the forehead. With your other hand still holding the chin, place your mouth over the victim's mouth, making a tight seal. Slowly blow air into the victim's lungs until the chest rises. Each breath should last 1½ to 2 seconds. Remove your mouth and allow time for the victim to exhale normally before delivering the second breath. Once you deliver 2 breaths and see a good chest rise, check the victim's pulse. 5. Check for pulse. Locate the carotid artery in the neck. Place the tips of your index and middle fingers on the victim's Adam's apple. Slide your fingers down the side of the victim's neck that is facing you, into the groove under the Adam's apple. Hold your fingers in place for 5 to 10 seconds. 6. If pulse is present-rescue breathe only. If there is a pulse, continue rescue breathing only. You must never do chest compression's on someone who has a pulse. Blow into the lungs once every 5 seconds. Check the pulse once per minute (every 12 breaths). Continue rescue breathing until the victim breathes on his own or until medical help arrives. A revived victim still needs to be seen by a Doctor. This is important because a person can easily go into shock after breathing has stopped. 7. If pulse is absent-perform chest compressions. Place the heel of one hand over the lower third of the sternum (breastbone) 1 to 2 finger widths above the notch where the sternum and ribs meet. Place your other hand on top of the one that is in position. To avoid undue damage to the ribs, don't let your fingers touch the chest. Straighten your arms and lock your elbows. Position your shoulders directly over your hands to make sure the thrust of each compression goes straight down on the sternum. Using a steady, firm thrust, push down hard enough to press the lower end of the sternum 1½ to 2 inches with each compression. Lift your weight from the victim without lifting you hands from the chest. Repeat the compression. Use a rate of 80 to 100 compressions per minute. To get the proper speed and rhythm, count out loud as you do the compressions: 1 and 2 and 3 and 4 and 5 and. After each 15 compressions (counting to 5 three times), give 2 breaths. Take your hands off the chest, open the airway as before (head tilt/chin lift), pinch the nostrils, seal the mouth, and give 2 strong breaths. Looking out the corner of your eye, check for the chest to rise. Remember, the chest must deflate after each breath. Go back to the chest, find the correct hand position again, and do 15 more compressions, followed by 2 breaths. Repeat this compression/breath ratio of 15:2 approximately 1 minute (4 cycles of 15:2). Then check again for pulse and breathing (3 to 5 seconds). If neither has returned, you must continue compressions and breathing until the person revives, qualified help comes, or you become exhausted. Recheck pulse every few minutes. WARNING: This is not a replacement for a CPR course, improper CPR or CPR performed on a person whose heart is still beating can cause serious injury. Never perform CPR on a person with a pulse. Take a CPR course now! ------------------ 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.