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Now, we are going to cover Adult CPR for the single-rescuer for health care professionals. We have ensured that the scene is safe and our gloves are on and our rescue mask is available with a one way valve and we are going to call out to the victim to see if they are 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 shots. So I am going to activate EMS, call 911 or call a code. If I have a bystander, I can tell them, "hey you applied shirt, go call 911 and come back. and if you could find an AED, bring it with you, I might need your help." If I have a cell phone I can whip that out too and actually call 911 and put it on speakerphone and allow some help that way as well or just access it through that technology. Now that I have gone ahead and done that, I can continue my assessment. I am going to look for signs of normal breathing as I check for the carotid pulse. how we find the carotid pulse. it's located between the trachea and the sternocleidomastoid muscle in the valley between those two structures. We are going to use the flat point of our two fingers and then press moderately on the valley. I check 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, what do you mean breathing normally, I mean 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 is gulping or gasping for breath, does not equal regular breathing or normal breathing. So, to me, agonal respirations are no respirations and there is no pulse and they are unresponsive. So, we are going to go right into CPR. Now let's talk about the technique of CPR. Right between the breast and the sternum, lower third of the sternum. we want to do a 2 to 2.4-inch deep compression and we want to compress at a rate between 100 and 120 compressions per minute. That's about 2 per second. and the other thing to note as you see me sitting on this bench, I would not stay here to do the compressions. it's a) it's going to be difficult and exhausting for me and b) I am going to 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 the 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 the 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... ...thirty. I grab my rescue mask, seal it over the patient's face and nose, give it a full suction lip and try two breaths. first breath goes in, chest rise and fall. Second breath goes in, chest rise and fall. Right back into the same location and thirty more chest compressions. I am going to continue the thirty chest compressions to two rescue breaths until help arrives, AED arrives or until my patient begins responding and breathing normally.
In this lesson, we're going to cover adult CPR, including exactly how to provide care. A patient who is unconscious, not breathing normally, and has no pulse is in cardiac arrest and needs CPR. At the end of the lesson, we'll provide you with a Word on high-quality 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.
1. Locate the area over the heart to begin chest compressions – between the breasts and on the lower third of the sternum.2. Stand or kneel directly over the patient's chest. Lock your elbows and use only your upper body weight to supply the force for the chest compressions, and count as you perform them.
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.
3. Conduct compressions that go 2-2.4 inches deep (or 1/3 the depth of the victim's chest) and at a rate of between 100 and 120 compressions per minute, which amounts to two compressions per second.4. Perform 30 chest compressions.
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.
5. Grab the rescue mask and seal it over the victim's face and nose.6. Lift the victim's chin and tilt his or her head back slightly.7. Breathe into the rescue mask and wait for the chest to rise and fall before administering the next breath.8. Continue to perform 30 chest compressions to two rescue breaths until help arrives, an AED arrives, or the victim is responding positively and breathing normally.
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 and the patient breathing normally again, an AED being available and ready to use, or being too exhausted to continue.