BLS notes

1. scene is safe
2. Try to get person to wake up
3. Check for breathing and pulse (carotid)
4. Ensure help is on way
5. start chest compressions (30:2 for adults)must work with bare chests. straight down on breast bone. Must be on a
firm surface. Recoil is impt. Need rate 100-120 and depth of 2 inches
6. Breaths: hand on forehead till head back, two fingers on jaw to lift chin forward. Seal mask with C method, other
thumb at the base. Use bridge of nose as guide for correct position. Each breath delivered over 1 second, enough to
make victims chest rise. Pause 1 sec in between each breath
7. When AED arrives, check rhythm. Is rhythm shockable
1. Yes: give 1 shock, resume CPR for 2 min, follow AED prompts
2. No: resume CPR immediately for 2 min and follow AED prompts
Using AED:
Turn it on before placing on chest
Attach to BARE CHEST! Upper right below collarbone, and side left below L nipple and few inches below armpit. OR do
anteroposterior
Clear victim to analyze rhythm-nobody touches the person!!
If need to shock, clear victim! if dont shock, resume chest compressions. After shock, immediately resume chest compressions
With implanted defib, dont put pad directly over it, dont put medicine patch directly over defibrillator pad-take patch off,
wipe down, then put pad on. If wet, wipe chest quickly (doesnt need to be completely dry). Move pt if they are in water

Bag mask device

-Use C/E configuration to hold mask and lift chin, pump bag w/ other hand

Child life support

Single rescuer: 30:2
Double rescuer: 15:2
If witnessed: Immediately activate ERS and leave to get AED then start compressions
If not witnessed: start CPR and if still alone in 2 min then go get AED and activate emergency response
If no breathing but yes pulse, provide rescue breathing 12-20 breaths/min, add compressions if HR is <60 BPM or signs of poor
perfusion

Infants (<1 yr old, but not new borns)

If witnessed: Immediately activate ERS and leave to get AED then start compressions
If not witnessed: start CPR and if still alone in 2 min then go get AED and activate emergency response
Check BRACHIAL pulse
For 1 rescuer: 2 fingers on center of infants chest just below nipple line. DOnt press the tip of the sternum. Only do 1.5 inches
(not 2 like everyone else). 30:2
for 2 rescuer: one person activates response; do 15:2 once second rescuer arrives. 2 thumb encircling hands technique

Mouth to Mouth
-Head tilt chin lift, pinch nose w/ thumb and index finger using hand on victims forehead. Give 1 breath over 1 sec, look for
chest rise. 2 breaths.

Rescue breathing
-Person isnt breathing but has strong pulse
1 breath every 5 sec for adults
1 breath every 3-5 sec for infants and children

Advanced airway
continuous compressions, give 1 breath every 6 sec

If suspected 2/2 opiod abuse, dont delay rescue breaths to give naloxone!!

Perform abdominal thrusts if someone is choking

1. stand or kneel behind victim, wrap arms around, locate the navel
 2. make first just above navel and below breast bone
3. quick, forceful upward trust
If cant wrap arms around them, then do chest thrusts

Severe airway obstruction: clutch throat w/ thumb and fingers, inability to speak/cry, poor or no air exchange, weak ineffective
cough or no cough at all, high-pitched noise while inhaling or no noise at all, inc resp difficulty, possible cyanosis

Choking infant
-sit or kneel w/ infant in lab, hold infant facedown and resting on your forearm w/ head slightly lower than chest
-support head and jaw w/ hand. Avoid compressing soft tissues of throat
-5 Back slaps-heel of hand, forceful, between shoulder blades
-FLip baby over, 5 chest slaps. Same place where you give chest compressions (lower half of breastbone)
-If infant becomes unresponsive, then do CPR, also look for object!! but never do blind finger sweep