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- Now we're gonna cover adult CPR for the single rescuer for healthcare professionals. We've ensured that our scene is safe, our gloves are on, and our rescue mask is available with a one-way valve. And we're gonna call out to the victim to see if they're responsive. Sir, can you hear me? Are you okay? They don't respond. So I place a hand on the forehead, and I tap on the collarbone. Sir, sir, can you hear me? They didn't respond to my taps and shouts, so I'm gonna activate EMS, call 911 or call a code. If I have a bystander, I can tell them, Hey you in the plaid shirt, go call 911 and come back, and if you can find an AED, bring it with you. I might need your help. If I have a cellphone, I could whip that out too, and actually call 911 and put it on speakerphone and allow for some help that way as well, or just access it through that technology. Now that I've gone ahead and done that, I can continue my assessment. I'm gonna look for signs of normal breathing as I check for a carotid pulse. How do we find that carotid pulse? It's located between the trachea and the sternocleidomastoid muscle, in the valley between those two structures. We're gonna use the flat part of our two fingers and press moderately in that valley. I check for no more than 10 seconds, and I note that the patient is not breathing normally, and they do not have a pulse. Now you might say also, well, what do you mean, breathing normally, what does that mean? Breathing normally is someone who is breathing and oxygenating. Agonal respirations, which is basically like a fish out of water who's gulping or gasping for a breath, does not equal regular breathing or normal breathing. So, to me, agonal respirations are no respirations, and there's no pulse, and they're unresponsive. So we're gonna go right into CPR. Now let's talk about the technique of CPR. Right between the breasts, on the sternum, lower third of the sternum. We wanna do a 2 to 2.4 inch deep compression, and we wanna compress at a rate between 100 and 120 compressions per minute. That's about two per second. The other thing to note is that, as you see me sitting on this bench, I would not stay here to do these compressions. It's, A, gonna be very difficult and exhausting for me, and B, I'm gonna end up rolling over their chest, which does not adequately compress this hollow organ we call the heart. We want to compress that heart which is sandwiched between the sternum and the spine, so that we can maximize that cardiac output. The second feature of that is that, once we do our 2 to 2.4 inch deep compression, we want to allow for what we call full recoil. That full recoil means we come right back up to the neutral position before we do our next compression. And then, lastly, as we stand over our patient, I want to come directly over the top of them with my elbows locked, and using my upper body weight to do my full 2 to 2.4 inch deep compression, 100 to 120 times per minute. So here we go. One and two and three and four and five and six and seven and eight and nine and 10, 11 and 12, 13, 14, 15, 16 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30. I grab my rescue mask, seal it over the patient's face and nose, give them a full aggressive head-tilt/chin-lift, and try two breaths. (breathes) first breath goes in, chest rise and fall, (breathes) second breath goes in, chest rise and fall. Right back into the same location, and 30 more chest compressions. I'm gonna continue this 30 chest compressions to two rescue breaths, until help arrives, AED arrives, or until my patient begins responding and breathing normally.
A patient who is unconscious, not breathing normally, and has no pulse is in cardiac arrest and needs CPR.
CPR is a combination of chest compressions and ventilations that circulates blood and oxygen to the brain and other vital organs for a person whose heart and breathing have stopped.
Remember the five links in the Adult Cardiac Chain of Survival:
As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim to assess whether or not he or she is responsive.
Are you OK? Can you hear me?
If you don't get an initial response, place your hand on the victim's forehead and tap on his or her collarbone. If you still do not get a response, proceed with the following steps.
Pro Tip #1: Make sure you're directly over the victim's chest to maximize cardiac output, and not off to one side. If you're not directly over the chest, you may not adequately compress the heart.
Pro Tip #2: To maintain a steady rhythm, count out loud while performing chest compressions – one, as you press down, and, as you allow the chest to recoil. When you reach 13, drop the and to maintain a two-syllable cadence on the compressions and not disrupt the rhythm.
Warning: Once you perform a chest compression, make sure you allow for full recoil of the chest cavity. You want to allow the chest to come all the way back to the neutral position before performing another compression.
It's important to understand what constitutes high-quality CPR, as performing CPR correctly will give the victim the best chance of survival.
Warning: Once you begin CPR, it's important not to stop. If you must stop, do so for no more than 10 seconds. Reasons to discontinue CPR include more advanced medical personnel taking over for you, seeing obvious signs of life with the patient breathing normally again, an AED becomes available and ready to use or you getting too exhausted to continue.