Pre-med learning Adult CPR, need help of those who are experts...

[Raihan Mirza]

Greeting Fellow SDN members. I am calling all CPR experts a fellow SDN brother is in need of your expertise. I am taking a CPR course and I was wondering if I had mastered what I had learned. So far I had learned what to do if an adult person needs cpr, what to do when an adult person is consciously choking and unconsciously choking. Well I know for sure I mastered conscious choking with the Abdominal Thrust and chest thrusts. I think I may be a little rusty on the adult CPR and Adult Unconscious Airway Obstruction. I have listed down the steps I woud take if either situation had occured and included all the scenarios possible and the actions I woul take. Can some tell me if I am making a mistake or missing something? This will be greatly appreciated. I tried looking up videos on youtube and boy were they outdated.

Adult CPR
1) Put Gloves on
2) Check to see if the scene is safe.
3) Look for a response in the adult by tapping him on the shoulder and speaking loudly towards him for a response.
4) If there is no response, tell someone nearby to call 911. (If no one is near by, you have to do 2 minutes of CPR and then call 911)
5) After telling someone to call 911, start CPR. The first step is to open the air way by doing head tilt chin lift.
6) After doing head tilt chin lift, put your ear one inch above the patients and feel for breathing. At the same time look at the patients chest and see if its rising. Also at the same time listen to see if the patient is breathing. This is called the look, listen and feel technique.
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Side note- If the patient uncoconscious, but breathing adequately, put the patient in the recovery position and make sure the airway is still open.
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7) If the patient is not breathing, give the patient two initial breaths each lasting for about one second.
8) After that check the pulse. You check the pulse locating the carotid artery, which is on the side of the larynx or the adam’s apple in men. You should check the pulse for no less than 5 seconds and no more than 4 seconds.
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Side Note- If there is a pulse you perform rescue breathing for two minutes. One breath every 5-6 seconds or about 24 breaths. After that remove your mouth and allow the patient to breathe passive and you check for movement of the patient’s chest.
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9) If there is no pulse, you will begin chest compressions. You will do 30 chest compressions. The time it takes you to do 30 chest compressions should be about 20 seconds. The compressions should push down on the sternum about 1.5 to 2 inches.
10) Now open airway by the head tilt chin lift method. Give two breaths of air to the patient. Each breath should last about 1 second.
11) Do the cycle of breaths or ventilations and chest compression as described in 7 and 9 for 5 cycles. (You don’t need to check the pulse after 2 ventilations after the first cycle.)
12) After the 5 cycles check for a pulse. If there is a pulse and breathing, put the patient in the recovery position and make sure the airway is still open.
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Side Note- If there is a pulse and no breathing, start doing rescue breaths for 2 minutes. One breath every 5-6 seconds or about 24 breaths.

Side Note- If there is no pulse begin CPR by doing first 2 ventilations each about 1 second long, followed by 30 chest compressions for 5 cycles as before. After the 5 cycles check pulse. If no pulse continue CPR until you get a pulse.


Airway Obstruction in Unconscious Adult

1) Put on gloves.
2) Check to see if the scene is safe.
3) Check the response of the adult patient.
4) If the adult patient is unresponsive, get someone to call 911.(If you are alone, do 2 minutes of what you need to do and then go call 911.
5) Begin assessment of the patient by opening the patient’s airway by doing the head tilt chin lift method.
6) Once the airway is open, look, listen and feel for breathing by putting your ear 1 inch above the patient’s mouth.
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Side Note- If patient is breathing, then put the patient in the recovery position and make sure the air way is open.
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7) If the patient is not breathing, give the patient 2 initial breaths or ventilations each lasting for about 1 second.
8) If both ventilations fail to go in, or chest does not rise, reposition head again through the head tilt chin lift method and do 2 more ventilation.
9) If ventilations again fail to go into the patient, it is a sign of airway obstruction. Thus the next step would be to do 30 chest compressions.
10) After the 30 chest compressions, do the head tilt chin lift method and check the patients mouth to se f there is anything visible obstruction to take out.
11) If no obstruction is found, continue with 2 more ventilations. If the ventilations fail, reposition head and do 2 more ventilations. Each ventilation should be about second long. If the ventilations fail again, then do 30 more chest compressions. After the compressions check the mouth for visible obstruction by using the head tilt chin lift method.
12) Repeat step 11, until obstruction is visible.
13) After the obstruction is visible take the foreign obstruction out using your pinky.
14) Reassess the patient by checking for breathing using the head tilt chin lift method and looking listening and feeling.
15) If the patient is breathing, put the patient in the recovery position and make sure the air way is open and check for breathing.
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Side Note- If the patient is not breathing follow steps 7 onward in the Adult CPR section.

Side Note- Unconscious Airway obstruction is exactly the same is CPR except you have to remember to check the mouth using had tilt chin lift for visible obstruction after 30 compressions.

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[funklab]

I was a CPR instructor with Red Cross years ago, and I am pretty sure they changed the numbers on me. 30 compressions 2 breaths? It could be, but it was 15 and 2 when I learned. I know at least the red cross changed their numbers just a couple years ago, and I havent had any classes in a while. So 30 and 2 could be right, it seems a bit off to me.

There is one problem that I see in your list here though.


On the very last section with the obstructed airway you wrote

"9) If ventilations again fail to go into the patient, it is a sign of airway obstruction. Thus the next step would be to do 30 chest compressions.
10) After the 30 chest compressions, do the head tilt chin lift method and check the patients mouth to se f there is anything visible obstruction to take out.
11) If no obstruction is found, continue with 2 more ventilations. If the ventilations fail, reposition head and do 2 more ventilations. Each ventilation should be about second long. If the ventilations fail again, then do 30 more chest compressions. After the compressions check the mouth for visible obstruction by using the head tilt chin lift method."

I am pretty sure you just forgot what you were talking about and substituted 30 chest compresssions where you should have abdominal thrusts (although I know its not 30, gotta be less than that). It would do you no good to do chest compressions (pumping the heart hopefully) if you havent got any air in the lungs yet. You need to do abdominal thrusts instead of chest compressions. Since they changed the numbers on me a couple years ago I cant swear to the number of ab compresssions you should do, but it used to be 5 or so.

Other than that it looks pretty solid.

 

[LilHouse]

If there is no response, tell someone nearby to call 911. (If no one is near by, you have to do 2 minutes of CPR and then call 911)

You should do that for children, but it's not necessary for adults. For unconscious adults, call 911 then initiate CPR if nobody else is present.

Children die much quicker than adults when in cardiac arrest, so they need immediate circulation to oxygenate their delicate organs.

Other than that, it sounds right.

 

[LilHouse]

I am pretty sure they changed the numbers on me

They did. It used to be 15:2 and they changed it to 30:2. More compressions = high likelihood of survival

There is talk that they are going to totally eliminate rescue breaths. Ventilation is important, but the time it takes for one rescuer to stop compressions and manually ventilate lowers the likelihood of survival.

Sorry for the double post, but I've apparently been outsmarted by the bulletin board software...

 

[Raihan Mirza]

I am pretty sure you just forgot what you were talking about and substituted 30 chest compresssions where you should have abdominal thrusts (although I know its not 30, gotta be less than that). It would do you no good to do chest compressions (pumping the heart hopefully) if you havent got any air in the lungs yet.

No I am sure its chest compressions and not abdominal thrusts. The reason is because first the adult is unconscious and on the floor and the chest compression are not for pumping the heart, but for getting the foreign object out of the patients airway. Abdominal thrusts are for the conscious patient that has foreign air way obstruction.

 

[funklab]

No I am sure its chest compressions and not abdominal thrusts. The reason is because first the adult is unconscious and on the floor and the chest compression are not for pumping the heart, but for getting the foreign object out of the patients airway. Abdominal thrusts are for the conscious patient that has foreign air way obstruction.

I guess they changed more than I thought! I need to go back an re certify I guess. When I did it we did abdominal thrusts (same principle as heimlich maneuver) for the unconscious patient lying down. Thanks for reminding me that I need to learn it all over again!🙂

I did some reading real quick online, and it mentioned chest thrusts (not compressions) for the obese and pregnant women, but I bet that info is outdated too.

 

[funklab]

But wait, are you sure about the number??? 30??? that seems a bit extreme if your just trying to dislodge something.

 

[Jacobian78]

Not vital information, but in the case of telling a random onlooker to call 911 in the case of the person being unconcious, you should always add something along the lines of "...get back to me." after telling them. I lifegaurd at a water park, and this is something they have somewhat drilled into us. Never want to tell someone to call 911 and than find out 45 minutes later they thought you were talking to someone else so they proceeded to get back in their inner tube and float around.

 

[SoyMilk]

30:2 - Chest compressions: Breaths [adult, child, infant]

For the conscious choking adult: 5 backblows, 5 abdominal thrusts rinse and repeat

for the unconscious choking adult: its 30 chest compressions, check the mouth, then 2 rescue breaths, if the breaths go in recheck vitals if they do not 30 compressions.

BTW you are way too into CPR. Oh and it differs depending on whether you took Lay person CPR vs BLS.

 

[SoyMilk]

No I am sure its chest compressions and not abdominal thrusts. The reason is because first the adult is unconscious and on the floor and the chest compression are not for pumping the heart, but for getting the foreign object out of the patients airway. Abdominal thrusts are for the conscious patient that has foreign air way obstruction.

This is correct, sounds like you took Lay Person CPR.

I'm a CPR instructor for RC.

 

[Captain Fantastic]

For the conscious choking adult: 5 backblows, 5 abdominal thrusts rinse and repeat

With infants you alternate between backblows and abdominal thrusts, adults not so much.

 

[Ashers]

Your book has to have the information you're looking for. Look at the book that you typically use with CPR certification. It's really not that difficult. My mom made me get certified in CPR when I was a freshman or sophomore high school.

And, 30:2 does sound right to what I relearned last year. I think some recommendations have even been changed since, like don't give breaths by one of the major CPR certification groups.

 

[Bacchus]

As with any lifesaving or medical training, you should consult with someone in person that is certified in that field. Even though advice in this thread is correct, its best to consult with someone face to face, not screen to screen.

 

[Jolie South]

I realize many people on SDN are certified in CPR, but don't want anyone to receive poor advice for something this serious. I'm closing this thread.

OP-I suggest that you ask a certified instructor if you're not sure of the proper CPR steps.