I went to Thirsk for a Yorkshire Ambulance Turst training session. Although an ambulance call out delayed me (!) - Huby had a major incident so I had to get around the Leeds ring road I was only a little late.
I learnt and practised (on the mannequins!) CPR or CardioPulmonary Resuscitation, which is a first aid technique that is used if someone is not breathing properly or if their heart has stopped. The real reason for doing it is simply that chest compressions and rescue breaths keep blood and oxygen circulating in the body.
If someone is not breathing normally and is not moving or responding to you after an accident,
1. Check the area for hazards - electricity, falling debris or structures, slips, etc. Is it safe for you?
2. If safe get to the casualty - if possible - from the feet first so they are not suprised if conscious. Get down to them and reassure them by holding their shoulders and speaking to them clearly in both ears (in case one doesn't work!).
3. With little or no response if someone else id around call for them to help and
4. Tell them to call 999 for an ambulance. When you call for an ambulance, telephone systems now exist that can give basic life-saving instructions, including advice on CPR. These are now common and are easily accessible with mobile phones.
5. Tell them to tell the ambulance dispatcher that the person is not responding and that CPR is being administered ...
IF THERE IS NO ONE ELSE CALL 999 BEFORE DOING ANYTHING ELSE ... UNLESS THE CASUALTY IS SMALL ENOUGH TO CARRY _ then do 5 rescue breaths and administer CPR for a minute ... then carry them with you to dial 999.
6. start CPR straight away. Hands-only compression if there is any doubt given the high risk of mouth-to-mouth contamination. NOTE: The gold standard still is 30-2 CPR Mouth-To-Mouth.
7. To carry out a chest compression:
Place the heel of your hand on the breastbone at the centre of the person’s chest.
Place your other hand on top of your first hand and interlock your fingers.
Using your body weight (lock out your arms and lean over using your upper body) press straight down by 5–6cm on their chest. STAYING ALIVE is the right rhythm.
Repeat this until an ambulance arrives.
Try to give 100 chest compressions a minute.
CPR with rescue breaths
Adults
Place your hands on the centre of the person's chest and, with the heel of your hand, press down by 5–6cm at a steady rate, slightly faster than one compression a second.
After every 30 chest compressions, give two breaths but tilt the casualty's head gently and lift the chin up with two fingers. Pinch the person’s nose. Seal your mouth over their mouth and blow steadily and firmly into their mouth. Check that their chest rises. Give two rescue breaths, each over one second.
Continue with cycles of 30 chest compressions and two rescue breaths until they begin to recover or emergency help arrives.
Children over one year old
Open their airway by placing one hand on the child’s forehead and gently tilting their head back and lifting the chin.
Remove any visible obstructions from the mouth and nose.
Pinch their nose. Seal your mouth over their mouth and blow steadily and firmly into their mouth, checking that their chest rises. Give five initial rescue breaths. SAME FOR POSSIBLE DROWNING:
Place your hands on the centre of their chest and, with the heel of your hand, press down by one-third of the depth of the chest using one or two hands.
After every 30 chest compressions at a steady rate (slightly faster than one compression a second), give two breaths.
Continue with cycles of 30 chest compressions and two rescue breaths until they begin to recover or emergency help arrives.
Babies under one year old
Open the baby's airway by placing one hand on their forehead and gently tilting the head back and lifting the chin.
Remove any visible obstructions from the mouth and nose.
Place your mouth over the mouth and nose of the infant and blow steadily and firmly into their mouth, checking that their chest rises. Give five initial rescue breaths.
Place two fingers in the middle of the chest (or hands around the trunk leaving the two thumbs over the sternum to press) and press down by one-third of the depth of the chest. After 30 chest compressions at a steady rate (slightly faster than one compression a second), give two breaths.
Continue with cycles of 30 chest compressions and two rescue breaths until they begin to recover or emergency help arrives.
Choking:
Clearing a blocked airway in conscious adults and children over the age of one follows;
it is not meant to be used for choking infants under age one. See later
First, ask the person if he/she can speak. If he/she can speak, it means he/she still has good air exchange and might be able to get the object out of his/her throat on their own with some coughing. Ask them to try to cough the object out.
If the person can’t speak, makes high-pitched sounds when he/she talks or coughs, or it looks like their not breathing, it’s time to intervene.
If the casualty is conscious and choking .... the first is to slap them - quite hard - on the back 5 times - between the shoulder blades - with the casualty leaning forward but supported (so they cannot fall!). Warn them!
If this fails then - with them still leaning forward but supported by your arms - stand behind them and hold them in your two arms do that your hands interlock and one of the thumb joints is at a sharp angle inwards towards the casualty. A fist width with the thumb bent locates the right part of the diaphragm to thrust into.
The act of abdominal thrust lifts the diaphragm and forces air from the lungs, similar to a coughing action, so that the foreign body in an airway may be moved and expelled.
Stand behind the person, wrap your arms around the waist, and tip the person slightly forward.
Make a fist with one hand and place it slightly above the navel.
Grasp your fist with your other hand and press forcefully into the abdomen with quick, upward thrusts, using force as if you were attempting to lift the person up.
Continue the back slaps / thrusts - 5 each - until the foreign body is dislodged OR if the casualty loses consciousness go to CPR. When a choking person is unconscious, lower the person on her back onto the floor. Clear the airway using the head-tilt method. If you can see the blockage, reach a finger into the mouth and sweep it out (finger sweep), using caution not to push the object deeper into the airway. If you are unable to remove the obstructing object and the person doesn't respond, you must begin CPR. In this case, there is a chance that the chest compressions used in CPR will free the object so recheck the mouth at regular intervals.
To clear an airway obstruction of a pregnant woman or obese person, place your fists closer to the chest, right above the joining of the ribs at the base of the breastbone, and follow chest thrusts.
In the case of a choking infant younger than age one, sit with the infant face down on your forearm, positioned securely on your thigh. Thump the infant firmly and gently five times with the heel of your hand in the middle of the back. The back blows and the gravity will most likely free the obstruction.
If it doesn't work, turn the infant face up on your forearm, head lower than body, and use two fingers positioned over the center of the breastbone just below the nipples and give five quick chest compressions. Continue to repeat the back blows and chest thrusts and if the infant doesn't start breathing, call 999.
If you have cleared the obstruction and the infant doesn't start breathing, begin CPR.
