Easy instructions guide CPR

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October 21, 2010 - 12:00 AM

(Editor’s note: I attended a CPR class geared for The Family Physicians on Tuesday evening. I found the information worth sharing.)

To get best results, push hard, deep and often, participants learned Tuesday night at a class in CPR basics.
So hard, ribs can break. So deep, the chest is pushed down 2 inches. So often, it’s at a rate of 100 times a minute.
This all-out approach is what it takes to get blood circulating in unresponsive victims, said Lisa Griffith, director of Emergency Services at Allen County Hospital.
Griffith instructed employees of The Family Physicians in cardio pulmonary resuscitation. She used guidelines set forth by the American Heart Association specifically for those in the field of health care. Those guidelines include mouth-to-mouth resuscitation, which the AHA no longer prescribes for the layman.
In either case, the initial actions are the same: Look, listen and feel.
If you see someone unresponsive, the first thing to do is to call for help.
The second step is to put your ear to their mouth to listen for any sound of breathing or to feel their breath on your cheek.
The third step is to feel for a pulse.
If no response, then begin chest compressions with two hands. Some prefer to lace fingers, with one hand atop the other, and press down with the heel of the hand. Others wrap one hand around the other wrist, stabilizing the pushing hand, and pressing down with a straight arm. The hand should be positioned on a bare chest, between the nipples.
The compressions, followed by the chest’s re-expansion each time, simulate a heart’s beating, and carry oxygen to the body’s organs, keeping them alive.
For those who use mouth-to-mouth, a cycle of 30 chest compressions is interrupted by two breaths.
Proper mouth-to-mouth is done with the patient’s head tilted back so the air passage is clear. The breaths are neither long nor hard. One second of breath is enough to make the victim’s chest rise. After two, go back to chest compressions. Repeat five times.
For infants, the procedure is much the same, but without as much force. Instead of 30 compressions, it’s 15, followed by two breaths, which are more shallow. You need give only enough air to make a child’s chest rise. And just two fingers, not the heel of the hand, are sufficient to depress an infant’s chest one-third to one-half the depth of its chest.
The best place to feel for the pulse on an infant is the inside of its upper arm. And a child’s foot is the first thing to respond to stimulation.

IF CHOKING is suspected, don’t use a finger to try to clear the passageway, Griffith said. “That may push the food further down.”
Instead, on adults perform the Heimlich maneuver.
Fortunately, “our bodies are made for the Heimlich,” Griffith said as she positioned her fists below her sternum. A simple thrust up can cause a reflex that helps dislodge food stuck in the esophagus.
Usually the procedure is performed on others by coming from behind and wrapping your arms around their waist. Make a fist with one hand and place it, with the thumb facing down, slightly above their navel. Grasp that fist and press into the victim’s abdomen with a quick upward thrust. Repeat until the object is expelled from the airway.
Griffith warned that with obese people it’s best to have them sit on a chair or on the floor so they do not collapse on those assisting them. Also with the obese or pregnant, grasp them across the chest, not the abdomen.
For infants who are choking, hold them face down in your lap while giving five sharp thumps between the shoulder blades, and with your other hand keep the head in a level position. The slaps should be hard enough to dislodge food.
Then turn the infant over, all the while supporting the head but keeping it lower than its body, and give five downward chest thrusts about a second apart to make the child “cough” to dislodge the object.
Again, look for food, but don’t do a blind “finger sweep,” in case it is pushed down the throat.
If a person cannot talk, it’s a good sign he’s choking, Griffith said. People should grasp their throats to indicate their predicament.

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