First Aid & CPR InformationWelcome to FirstAidReference.com. First Aid Reference is an online blog containing information on anything and everything First Aid and CPR related. Our online first aid guides provide generalized information on how to handle everyday first aid emergencies commonly seen at home and in the workplace based upon current nationally accepted guidelines.
First Aid Guide & CPR Guidelines
Cardiopulmonary resuscitation (CPR) is an emergency procedure for a victim in cardiac arrest. Cardiac arrest is when a persons heart quits beating.
CPR involves rescuer provided physical interventions to create artificial circulation for a victim who is unconscious/non responsive, not breathing, and does not have a pulse.
The main purpose of CPR is to maintain a flow of oxygenated blood to the brain and the heart. Effective CPR helps by delaying tissue death and provides an opportunity for a successful resuscitation without permanent brain damage if initiated quickly and effectively. Permanent cellular damage and death start to occur within 3 to 5 minutes of collapse.
The sooner we initiate the steps of CPR – the higher chances of survivability. Roughly 300,000 individuals suffer cardiac arrest outside of a hospital each year in the United States. Only an estimated 6% of that 300,000 survive. Knowing how to perform CPR may make the difference between life and death for someone else.
Scene Size Up / Ensure Personal Safety
Assess Victim (Tap and Shout)
Call 911 / Get Additional Resources
Circulation: Rib Fracture
Ciculation: Compression Only / Hands Only CPR
Airway: Open the Victims Airway
Breathing: Assess / Provide Breathing
Breathing: Mouth to Mouth
Breathing: Mouth to Mask
– Child CPR & Infant CPR –
When to call 911 or get help in Infant CPR & Child CPR
Steps of Infant CPR / Steps of Child CPR
–Healthcare Provider CPR –
Healthcare Provider BLS CPR Considerations
– Automated External Defibrillators –
How to use an AED
Automated External Defibrillator’s (or AED’s) are devices that treat the most common cause of sudden cardiac arrest by delivering a electrical shock to a persons body.
What an AED treats is an abnormal heart rhythm called Ventricular Fibrillation (or V-Fib) that causes the heart to stop circulating blood. V-Fib is a heart condition in which the heart quivers instead of mechanically pumping the blood throughout the body. The most effective treatment for V-Fib is CPR and use of a defibrillator. The longer it takes for CPR and an AED to be used, the less likely a person is to survive V-Fib. CPR should be stopped and an AED applied and used as soon as it is available.
Automated External Defibrillators are designed to allow anyone to use them regardless if they have been formally trained on their operations. AED’s accomplish this through use of voice instructions, pictures, and prompts. An AED will only deliver a shock if indicated and is safe when used correctly.
Quick Guide to Using an AED:
Open AED and Turn Unit On.
Attach AED Pads to victims bare chest.
Ensure AED Pads are attached to AED.
Follow Prompts of the AED.
Clear the Victim when Analyzing and Deliver Shocks.
Continue CPR starting with Chest Compressions for 2 minutes.
Follow AED instructions until emergency personnel arrive.
AED’s function by taking an EKG of the victims heart to analyze the electrical activity in an attempt to determine if the victim is in V-Fib or another heart rhythm. If the AED analysis indicated V-Fib a shock will be indicated and may be delivered by the rescuer and AED according to the device’s operating instructions. If the AED analysis finds any other rhythm than V-Fib a “No shock” instruction will be issued and the AED will not allow a shock to be delivered.
Pad Placement: AED pads typically go around the heart and are placed on the upper right side of the chest below the collar bone and on the lower left side below the nipple line near the armpit. The electricity delivered by an AED will travel in both directions between these two pads.
Rescuers using an AED must always listen to the instructions of an AED. The AED will advise not to touch the patient while it is analyzing the victims heart and again if a shock is indicated. If the victim is touched or moved during analysis the AED may interrupt those movements and cause a potential false positive for V-Fib. If any person is touching the victim when a shock is actually delivered, they may receive some of the shock which may cause injury or even death. If you are operating an AED verbally yell and physically look head to toe to make sure no person is touching when the victim when the AED advises not to touch the victim.
The electricity delivered by an AED during a shock stuns the heart in an attempt to stop the abnormal rhythm. Think of an AED as a TASER for the heart. It temporarily stuns it, stops what the heart is doing, and allows it to potentially recover.
An AED does NOT restart the heart or fix a “flat line” as often shown on television. A flat line represents that there is no heart electrical activity at all. A flat line usually represents clinical death as it is rare to recover from a flat line rhythm. Recognize an AED attempts to correct electrical system of the heart that is malfunction – not jump start it. If an AED recognizes a “flat line” it will indicate “No Shock Advised” and instruct you to resume CPR. Shocking a flat line will NOT benefit the patient.
If a shock is indicated and delivered, the heart may take up to 10 minutes to recover from the cardiac arrest. Therefore, immediately after delivering a shock (or a “No Shock” indication) the rescuers must resume CPR with compressions to help mechanically get the heart beating again. Effectiveness of a shock is greatly affected by how well CPR is performed immediately thereafter. Do 5 sets of 30:2 or 2 minutes of CPR. The AED will automatically stop and give instructions exactly every 2 minutes. Repeat the process of operation and perform the tasks indicated by the AED. Remember when resuming CPR after AED usage to always being CPR with chest compressions.
When a shock is delivered the victim will often convulse. You may always witness an arch of electricity travel across the victims body, smell burning hair or skin, or see smoke. This is normal as a large amount of electricity is entering the victims body. Continue with CPR and AED usage as indicated.
Once an AED is placed, never remove the pads from the victims chest or turn the AED off until instructed to by trained healthcare professionals. If the victim wakes up or recovers they may suffer from V-Fib again and require additional AED treatment.
Choking is a common medical occurrence and typically does not require emergency intervention. Rescuers should initiate care in cases of severe choking such as when a person is unable speak, makes the universal choking sign, or is turning blue. When witnessing someone believed to be in severe choking you should ask them if they are okay. If they are unable to respond, initiate care without delay.
In adults the most effective way to relieve severe choking is to deliver abdominal thrusts by performing the Heimlich maneuver.
The Heimlich maneuver uses abdominal thrusts to place pressure on the diaphragm simulating a coughing reflex in the choking victim to help expel the object. To perform the Heimlich maneuver stand behind the victim and wrap your arms around their abdomen. Create a fist with one hand and place the thumb side against the victim’s stomach above the belly button but below the rib cage. Place your other hand over the fist and thrust inward, hard and fast, until the victim begins breathing or goes unconscious.
IF the victim goes unconscious and falls to ground, begin the steps of CPR with one exception. When opening the airway, look and see if you see an object inside the victims airway. If you see an object and you feel comfortable you may perform a finger sweep to attempt to remove the object. If you do not see something, are uncomfortable, or think you are unable to sweep the object out – do not attempt a finger sweep. Continue CPR until professional help arrives.
The Heimlich maneuver can be applied to any person or child who is unable to stand. For children you should kneel down to perform abdominal thrusts.
Choking Relief for Infants: Choking relief for infants must be modified from the methods used on adults due to their small size. To relieve severe choking in an infant, place the child face down on your arm while supporting the head with the palm of the hand. Perform 5 back slaps, striking the infant between the shoulder blades, with sufficient force to attempt to dislodge the object. Turn the child over and perform 5 chest compressions with the two finger chest compression technique. Repeat 5 back slaps and 5 chest compressions until the infant begins breathing normally or goes unconscious.
If the infant become unconscious, begin the steps of CPR with one exception. When opening the airway, look and see if you see an object inside the victims airway. If you see an object and you feel comfortable you may perform a finger sweep to attempt to remove the object. If you do not see something, are uncomfortable, or think you are unable to sweep the object out – do not attempt a finger sweep. Continue CPR until professional help arrives.
Pregnant & Large Adults: For persons who are pregnant or of large size, choking relief may have to be modified. Chest thrusts may be used instead of abdominal thrusts when faced with these situations. Hand technique should be the same with placement being moved to the middle of the chest on top of the sternum.
New CPR Guidelines – 2010
The AHA today previewed the new CPR guidelines 2010. The new cpr guidelines put a preference on compressions first over the traditional ABC’s or Airway, Breathing, and Circulation.
The new guidelines now use the C-A-B approach. Persons finding a person in suspected cardiac arrest should:
1. Assess the victim
2. Call for help
3. Being Chest Compressions.
- Push Hard and Push Fast
- Perform Compressions at the rate of 100 CPM
- If trained in CPR, after 30 compressions, open the airway and give 2 breaths.
- If not trained or if you do not feel comfortable, continue compressions without interruption until other help arrives.
We will have more information on the new cpr guidelines later today.
If a patient begins to move, wake up, or show signs of life while performing CPR, you should immediately stop compressions and reevaluate the patients Airway, Breathing, and Circulation. You should continue treat as indicated. Be prepared to resume compressions if needed. Do not remove an AED if in place as the patient may go back into a shockable rhythm.