First Aid - CHOKING and CARDIAC ARREST

This page contains fast First Aid info for ADULTS, CHILDREN & INFANTS
Covered here is the Heimlich Maneuver for choking and CPR for cardiac resuscitation
READ IT ALL THE WAY THROUGH NOW SO YOU'LL KNOW WHAT TO DO
IN THE EVENT OF AN EMERGENCY. BOOKMARK THE PAGE.

FIRST AID

CHOKING:
HEIMLICH MANEUVER FOR A CONSCIOUS SITTING OR STANDING
ADULT VICTIM

Without oxygen the brain can begin to die within 4 to 6 minutes.

Rapid first aid for choking can save a life.

The Heimlich Maneuver is the best known method of removing an object from the airway of a person who is choking. You can use it on yourself or someone else.

If you choke on something and your airway becomes blocked, you will not be able to speak. Signal people that are nearby that you are choking: do this right away, before you pass out. Use the "Universal Sign for Choking".

If the airway is almost completely blocked, there may be high-pitched noises when the person inhales, great difficulty breathing, and a very weak, ineffective cough.

If the person cannot speak, cough, or breath, then the person may have a completely blocked airway. Emergency care for a person with a completely blocked airway, or a person with an airway almost completely blocked is the same.

If YOU are alone and YOU are choking, you can do the Heimlich maneuver on yourself.

Position your fist slightly above your navel and give yourself quick, inward and upward thrusts, or lean forward and press your abdomen quickly over any firm object, such as the back of a chair or a porch railing.

If you think another person is choking because of an almost or completely blocked airway, CALL FOR HELP, and immediately prepare to do abdominal thrusts (the Heimlich Maneuver).

Tell the victim what you are going to do, then
Stand behind the victim with the front of your body pressed against the victim's back.

These are the steps:

1.Wrap your arms around his or her waist. Bend the person slightly forward.

Grasp the choking victim from behind. Place your fist, thumb side in, just below the victim's breast bone and above the belly button, and with the other hand placed firmly over the fist.

Then pull your fist firmly and abruptly into the top of the stomach in order to force the object up the windpipe.

You should try not to squeeze the ribs with your forearms. Each thrust should be distinct and delivered as if it will be the only thrust needed to free the obstruction. Repeat the thrusts as described above until the obstructions comes free or the victim becomes unconscious.

Abdominal thrust (Heimlich Maneuver)
with victim standing

Following the expulsion of the object that caused the choking, keep the victim still and get medical help. All choking victims should have a medical examination, since complications can arise not only from the incident but also from the first aid measures that were taken. Occasionally an object will enter the lung instead of being expelled. While the victim may appear to improve and breathe normally, in a few days signs and symptoms of a foreign body in the lung will appear such as, wheezing, persistent cough, and pneumonia. If this happens, get medical help immediately.

DO NOT begin the chest compressions of CPR (if heartbeat has stopped) until the airway is cleared.

UNCONSCIOUS ADULT VICTIM:

Call immediately for emergency medical assistance if: a person is found unconscious.

If you are not alone, have one person call the local emergency number while another person begins CPR.

If you are alone, shout for help.
If you are trained in CPR, call the local emergency number and then administer CPR.

1. Roll the victim onto his back on a hard surface, keeping his back in a straight line, firmly supporting his head and neck. Expose the victim's chest.

Check for a pulse

2. Open the victim's mouth with your thumb and index finger, placing your thumb over his tongue and your index finger under his chin.

DO NOT try to grasp an object that is lodged in the victim's throat, because
this might push it farther down the airway.

If the object is visible and loose, CAREFULLY remove it.

CHECK FOR BREATHING
3. Lift the victim's chin while tilting the head back to move the tongue away from the windpipe. If a spinal injury is suspected, pull the jaw forward without moving the head or neck. Don't let the mouth close.

4. Place your ear close to the victim's mouth and watch for chest movement. Count to five while you, look, listen, and feel for breathing.

5. If the victim is breathing but remains unconscious, give first aid for unconsciousness. (Put a pillow or wadded up coat or whatever is handy under the victims FEET to elevate the feet about 12 inches.)

Do NOT place a pillow under the victims head. Next, wipe the victim's forehead with a cool cloth.) CALL FOR HELP.

6. If the victim is not breathing, begin rescue breathing.

Maintain the head position, close the victim's nostrils by pinching them with your thumb and index finger, and cover the victim's mouth tightly with your mouth. Give 2 slow, full breaths, with a pause in between.

7. If the victim's chest does not rise, reposition the head and give 2 more breaths.

8. If the victim's chest still doesn't rise, and it appears there is still a breathing obstruction, begin abdominal thrusts, as follows.

Kneel at the victim's feet or astride the thighs (or to the side if the victim is obese or pregnant).

Place the heel of your hand in the middle of the abdomen just above the navel, well below the tip of their breastbone. (If the victim is obese or pregnant, place the heel of your hand in the middle of the victim's breastbone.

Do not place your hand on the ribs or on the tip of the breastbone.) Place your other hand on top of the first hand.

9. Give 6 to 10 quick thrusts compressing the victim's chest about 2 inches, pressing your hands inward and upward. Do not press to either side.

Each thrust is a separate attempt to clear the victim's airway by forcing air out through the windpipe.

10. Again, open the victim's mouth with your thumb and index finger. If the object is visible and loose, remove it. Observe the victim's breathing.

If the victim's chest does rise, place 2 fingers on the victim's Adam's apple. Slide your fingers into the groove between the Adam's apple and the muscle on the side of their neck to feel for a pulse for 5 to 10 seconds.

If the victim has a pulse, give 1 breath every 5 seconds. Check the pulse after every 12 breaths.

Be sure the local emergency number has been called. Have someone else make the call if possible. Continue giving breaths and checking the pulse.

If the victim stops breathing, begin CPR.

CPR - ON ADULT

DO NOT give chest compressions if there is a heartbeat; doing so may cause the heart to stop beating.

CPR for TRAUMA VICTIM:
DO NOT move the victim's head or neck to check for breathing if a spinal injury is suspected.

When rolling the victim over, take care that broken bones are not further complicated by improper handling. Roll the victim as a unit so that the head, shoulders, and torso move simultaneously with no twisting.
Kneel beside the victim, a few inches to the side.
The arm nearest the rescuer should be raised above the victim's head.
The rescuer's hand closest to the victim's head should be placed on the victim's head and neck to prevent them from twisting.
The rescuer should use the other hand to grasp under the victim's arm furthest from rescuer. This will be the point at which the rescuer exerts the pull in rolling the body over.
Pull carefully under the arm, and the hips and torso will follow the shoulders with minimal twisting.
Be sure to watch the neck and keep it in line with the rest of the body.
The victim should now be flat on his/her back.

Press gently to check the victim's carotid artery pulse for at least five seconds but no more than ten seconds.

If a pulse is present, continue administering artificial ventilation once every 5 seconds or 12 times a minute. If not, make arrangements to send for trained medical assistance and begin CPR.

11.If the victim has no pulse, begin chest compressions. Maintain the head position and place the heel of your hand 2 finger-widths above the lowest notch of the victim's breastbone (where the lower edge of the ribcage meets in the middle). Place the heel of your other hand directly over the heel of the first hand. Interlock your fingers; don't let them touch the victim's chest. Lock your elbows straight. Lean your shoulders over your hands, and firmly press down about 2 inches into the victim's chest. Repeat the compressions 15 times. Give the compressions in a smooth, rhythmic manner, keeping your hands on the victim's chest. Don't rock back and forth - push straight down. Don't pause between
compressions.

12. Give the victim 2 breaths, followed by 15 chest compressions. Repeat this sequence 4 times. Count aloud as you pump in a regular rhythm. You should pump at a rate of about 80 to 100 times a minute. Count a 1 and 2 and 3 and 4 and...up to 15 and then give another 2 breaths, (breathe, breathe).

13. After the fourth cycle, recheck the carotid pulse in the neck for a heartbeat (5 to 10 seconds).

If breathing and heartbeat are absent, resume CPR (15 compressions and 2 ventilations).
Stop and check for heartbeat every few minutes thereafter.
Never interrupt CPR for more than five seconds, except to check the carotid pulse or to move the victim. KEEP GOING UNTIL HELP ARRIVES!!

Place the heel of the other hand on the sternum next to the index finger in the notch in the rib cage
Place the hand used to locate the notch at the rib cage on top and parallel to the hand which is on the sternum.
Keep the fingers off the chest, by either extending or interlocking them

Keep the elbows in a straight and locked position.
Position your shoulders directly over the hands so that pressure is exerted straight downward

Exerting pressure downward on an adult.

Exert enough downward pressure to depress the sternum of an adult 1 1/2 to 2 inches.
Each compression should squeeze the heart between the sternum and spine to pump blood through the body.
Totally release pressure in order to allow the heart to refill completely with blood.
Keep the heel of your hand in contact with the victim's chest at all times
Make compressions down and up in a smooth manner.

CPR is performed for times when the breathing or the heartbeat has stopped, such as for electric shock and drowning. Permanent damage to the brain can occur if oxygen flow is not restored within about 4 minutes. Therefore, it is critical that blood flow and breathing be continued until trained medical help arrives.

1. Check for consciousness. Shake or tap the child gently. See if the child moves or makes a noise. Shout, "Are you OK?"

3. Roll the child onto their back on a hard surface, keeping the back in a straight line, firmly supporting the head and neck. Expose the chest.

4. Kneel next to the child with your knees against the child's side. Lift the child's chin while tilting the head back to move the tongue away from the windpipe. If a spinal injury is suspected, pull the jaw forward without moving the head or neck. Don't let the mouth close.

5. Place your ear close to the child's mouth and watch for chest movement. For 5 seconds, look, listen, and feel for breathing.

6. If the child is not breathing, begin rescue breathing. Maintain the head position, close the child's nostrils by pinching them with your thumb and index finger, and cover the child's mouth tightly with your mouth. Give 2 slow, full breaths, with a pause in between.

7. If the chest does not rise, reposition the head and give 2 more breaths. If the chest still doesn't rise, the child's airway is blocked. Follow above instructions for choking (for unconscious adult or child over 1 year).

8. If the child's chest does rise, place 2 fingers on the child's Adam's apple. Slide your fingers into the groove between the Adam's apple and the muscle on the side of their neck to feel for a pulse for 5 to 10 seconds.

9. If the child has a pulse, give 1 breath every 4 seconds. Check the pulse after every 15 breaths.

10. Call the local emergency number or have someone else make the call if possible. Begin giving breaths and checking the pulse.

11. If the child has no pulse, begin chest compressions. Maintain the head position and place the heel of your hand 2 finger-widths above the lowest notch of the child's breastbone. Lean your shoulder over your hand, and quickly press about 1 inch into the child's chest 5 times. Give the compressions in a smooth, rhythmic manner, keeping your hand on the child's chest. Don't rock back and forth - push straight down. Don't pause between compressions.

12. Give the child 1 breath, followed by 5 chest compressions. Repeat this sequence 10 times. Count aloud as you pump in a fairly rapid rhythm. You should pump about 80 to 100 times a minute (Count 1 and 2 and 3...).

14. Repeat steps 12 and 13 until the child's pulse resumes or help arrives. If the pulse resumes, go to step 9

YOU HAVE MERE MINUTES TO TAKE ACTION. SHOUT FOR HELP IF PEOPLE ARE NEARBY!! IF NOT, DIAL 911 say INFANT NOT BREATHING, give them the address and GET BACK TO THE CHILD. IF THE PHONE CAN REACH THE CHILD, KEEP IT WITH YOU. THE 911 OPERATOR CAN HELP GUIDE YOU THROUGH CPR.

1. Quickly look, listen and feel for breathing and pulse. If breathing or pulse is absent, open the airway.

2. Tilt the baby's head back and give one firm but gentle puff of breath through the mouth and nose. Check the pulse and breathing. if there is no pulse or breathing, start CPR.

3. Start chest compression. Use 2 fingers over the breastbone. Give 5 (gentle!) chest compressions, then one puff of breath. Repeat.

This page is a very fast, very general look at what to do in the event of an emergency.There's no substitute for a formal CPR or First Aid course. Call your local hospital or fire department and ask where the next CPR course is going to be given in your neighborhood. Knowing what to do could save a life. Got kids in the Scouts? Make sure this is one of the things they're taught. Learn it together.