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Push hardpush fast

Summary of CPR steps for adults, children and infants

With the 2010 CPR Guidelines

30:2

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Push hard, push fast

Essentials you need to know

In October 2010 the International Liaison Committee on Resuscitation (ILCOR) and the American Heart Association(AHA) released changes to the Guidelines or CPR & Emergency Cardiovascular Care (ECC). Te objective o the changesis to make it easier or rescuers and health care providers alike to learn, remember and perorm better CPR.

We have learned that a continued emphasis on good and eective CPR results in better outcomes and survival rates. Good,eective CPR means:

New CPR sequence for cardiac arrest victims: rescuers start with chest compres-

sions aer checking responsiveness, opening the airway and assessing or normalbreathing using visual cues such as chest rise.

Why? Cardiac arrest victims need immediate chest compressions. Look, Listen,Feel or 10 seconds has been removed rom the CPR sequence so chest compres-sions can begin as soon as possible.

No change in CPR sequence for drowning:aer assessing or breathing, rescuersdeliver two initial rescue breaths ollowed by 30 chest compressions.

Why? Drowning victims need urgent replenishment o oxygen starting with res-cue breaths as a result o severe asphyxia. Drowning victims may respond afer aew initial rescue breaths.

Compression-only CPR: all trained rescuers should perorm CPR with chestcompressions and rescue breaths using a mask and gloves. I an untrained rescueris unwilling or unable, compression-only CPR may be perormed.

Why? Studies have shown a combination o chest compressions and breaths ismost eective especially or children and inants who experience cardiac arrest asa result o hypoxia, or severe lack o oxygen. In addition, other underlying causeso cardiac arrest such as a drowning, trauma, drug overdose and other non-cardiac causes will benet rom breaths and compressions.

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Watch the YouTube Video Pushhard,pushfast: orceul, ast compressions provide bettercirculation o blood and oxygen. Fast means at least 100 compres-

sions/minute to a depth o 5 cm/2 in.

All owforfullchestrecoilaftereachcompression:

relaxing the pressure on the chest between compressions allows the

heart to rell and pump more blood.

Minimizeinterruptioninchestcompressions: blood fow

stops i compressions stop.

Ear lydebrillation: victims have a better chance o surviving when

CPR is perormed in combination with early debrillation.

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Minimum depth of chest compression: compression depth or adults is aminimum o 5 cm/2 in. Compression depth or a child is at least the deptho the chest size, or 5 cm or a child and 4 cm or an inant.

Why? Tere is a wide range o victim sizes or inants and children. Depthsmeasured in centimetres/inches may not refect the actual victim size orproper depth o compressions. Te descriptive term 5 cm/2 in. or the deptho the chest is more appropriate.

Choking procedures: conscious adults and children with a severe obstructionreceive alternating (5) back blows ollowed by (5) abdominal thrusts until theobstruction is dislodged or the victim becomes unconscious. o apply backblows, bend the victim over near-parallel to the ground and support with onearm across chest diagonally. Use your other hand to apply back blows aim-ing between the shoulder blades. For pregnant, obese and inant victims use acombination o back blows and chest thrusts.

Why? Evidence supports the use o chest thrusts, abdominal thrusts and backblows as eective and easible means o relieving an obstruction. In some casesmore than one technique may be required or severe-choking victims.

AED for children between 1 to 8 years of age: i available the rescuer shoulduse child pads. Some AED units may have a child key or switch on the AED. Ithe child is very small, you may need to put one pad on the centre o the chestand the other on the childs back to avoid having them touch. Use adult pads ichild pads are not available.

Why? Child pads lower the amount o energy delivered compared to adultpads. I no child pads are available, adult pads may be used since providing ashock is better than no shock.

EMS activation: most emergencies occur with several rescuers present whorespond as a team. Tis means activation o EMS may occur alongsideassessment or responsiveness and/or breathing. I the rescuer is alone and thevictim is a child or inant, activate EMS aer providing ve cycles o CPR. I alone rescuer is with an unresponsive adult he/she may check breathing beoreactivating EMS (i not already done).

Why? CPR has traditionally been presented as a sequence o distinct steps tohelp a single rescuer prioritize actions. However, many workplaces involveteams o rescuers perorming several actions simultaneously (e.g., one rescueractivates EMS while another begins CPR).

Jaw thrust: or spinal-injured victims NLS lieguards attempt a jaw thrust toopen the airway. Grasp the jaw on both sides o the ace where it orms anangle close to the ears. Using both hands, move the jaw orward (upward)without tilting the head back. I unsuccessul, lieguards should immediatelyuse the head-tilt/chin-li method.

Why? Te jaw thrust technique may minimize movement o the cervical spineand is appropriate or NLS lieguards who have received additional trainingbeyond liesavers.

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Jawthrust

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Summary of CPR steps for adults, children and infants

CPR Levels A, B, and C

CPR Adult Child Infant

(8 years of age and older) (1-8 years of age) (Less than one year)

400 Consumers Road, Toronto, Ontario, M2J 1P8

Tel: 416-490-8844 - Fax: 416-490-8766

Email: experts@lifeguarding.com

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Wake and shout - gently squeeze or tap shoulders - are you OK?

Check the scene

Establish

unresponsiveness

Check for breathing

Activate EMS

& get an AED

Start CPR

Compression

location

Compression

method

Compression

depth

Open airway using head-tilt/chin-lift, take no more than 5 seconds to look for normal

breathing using visual cues such as chest rise. Gasping is not normal breathing

Spinal victims: NLS lifeguards attempt jaw thrust to open the airway

Yell for help. If you are alone

phone EMS right away

Yell for help. If you are alone phone EMS

after giving 5 cycles of CPR

If victim is unresponsive and not breathing normally, immediately start CPR beginning

with chest compressions (30 compressions : 2 breaths)

Centre of chestJust below nipple

line on breastbone

5 cm or 2 in.

Immediatley start CPR (30 compressions: 2 breaths) if victim

is unresponsive and not breathing normally

2 hands: heel of 1 hand, other hand on top

(or 1 hand for children)

2 fngers:

middle and ring

1/3 depth of chest or about (5 cm child or 4 cm infant)

Compression

rate

Compression

ventilation ratio

100 per minute

30:2(1 or 2 rescuer CPR)

Drowning victims: start CPR sequence with 2 initial breaths before chest compressions

Is the scene safe to help?