SPECIAL CONSIDERATIONS FOR CPR
How to CPR is There are circumstances when it may be more difficult to deliver CPR; for example, a casualty may have a chemical around the mouth, in which case you can give rescue breaths through the nose [opposite].
Occasionally, a casualty may breathe through a hole in the front of the neck – a stoma -[opposite]. You can also use a pocket mask or face shield when giving rescue breaths.
If you have help, one person can perform full cycles of CPR for two minutes, then a second person can take over. Continue to swap every two minutes.
PROBLEMS WITH RESCUE BREATHING
If a casualty’s chest does not rise when giving rescue breaths:
- Recheck the head tilt and chin lift;
- Recheck the casualty’s mouth. Remove any obvious obstructions, but do not do a finger sweep of the mouth.
Make no more than two attempts to achieve rescue breaths before repeating chest compressions. rolled-up clothing under her right hip. or, if you have helpers, they can place their knees under her back.
WHEN THE AMBULANCE ARRIVES
The ambulance service may initially send a solo responder in a fast response vehicle, who will be followed by an ambulance.
Tell the personnel that you are a first aider and give a full report of what has happened. However, do not stop CPR while you are doing this unless they tell you to do so. Listen carefully to what they ask you to do and follow their instructions.
- Defibrillation If you had access to an AED and are trained to use it, you may have already attached it to the casualty’s chest. If not, the ambulance personnel will bring one and attach it. You may be asked to continue with chest compressions while they do this. You will be asked to stand clear of the machine while it analyses the casualty’s heart rhythm. Do not approach the casualty again until asked to do so.
- Airway and breathing The ambulance personnel will usually try to improve the casualty’s air supply by administering oxygen from a cylinder via a mask or tube.
- Circulation Resuscitation drugs may be required, which are administered via a needle into the casualty’s arm or hand. Chest compressions may be given at the same time as they help the drugs circulate through the body.
- Transfer to hospital The ambulance personnel will make a decision whether to transfer the casualty to the hospital immediately or continue treatment at the scene. Any decision to stop resuscitation can only be made by a health care professional.
PREGNANT CASUALTIES:- In the late stages of pregnancy, when a woman lies flat on her back, the uterus presses on the veins that return blood to the heart, reducing the flow of blood.
If resuscitation is required, tilt the woman onto her left side in order to relieve the pressure on the veins and assist the return of blood to the heart when giving chest compressions This can be done by placing It is important to remember that if you are unwilling or unable to give rescue breaths, you can give chest compressions only.
MOUTH-TO-NOSE RESCUE BREATHING
If a casualty has been rescued from the water, or injuries to the mouth make it impossible to achieve a good seal, you can use the mouth-to-nose method for giving rescue breaths. With the casualty’s mouth closed, form a tight seal with your lips around the nose and blow steadily into the casualty’s nose. Then allow the mouth to fall open to let the air escape.
MOUTH-TO-STOMA RESCUE BREATHING
A casualty who has had his voice-box surgically removed breathes through an opening in the front of the neck [a stomal, rather than through the mouth and nose.
Always check for a stoma before giving rescue breaths. If you find a stoma, close off the mouth and nose with one hand and then breathe into the stoma.
A casualty who has had his voice-box surgically removed breathes through an opening in the front of the neck [a stomal, rather than through the mouth and nose.
Always check for a stoma before giving rescue breaths. If you find a stoma, close off the mouth and nose with one hand and then breathe into the stoma.
FACE SHIELDS AND POCKET MASKS
First aiders may use these aids for hygienic purposes. Face shields are plastic barriers with a filter that is placed over the casualty’s mouth. A pocket mask is more substantial and has a mouthpiece through which breaths are given.
If you know how to use one of these aids, you should carry it with you and use it if you need to resuscitate a casualty. However, if you do not have a pocket mask or face shield with you and need to resuscitate a casualty, do not hesitate to give rescue breaths without them.
USING A FACE SHIELD
Tilt the casualty’s head back to open the airway. Place the shield over the casualty’s face so that the filter is over the mouth and pinch the nostrils shut. Deliver rescue breaths through the filter.
USING A POCKET MASK
Kneel behind the casualty’s head. Open the airway and place the mask, narrow end towards you, over the casualty’s mouth and nose. Deliver rescue breaths through the mouthpiece.
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