<div class="lesson-title">The CABs of CPR</div>
<h3>Understanding the CABs of CPR</h3>
<p>Cardiopulmonary Resuscitation (CPR) is a life-saving technique used when someone's heart has stopped beating (cardiac arrest). It involves a specific sequence of actions known as the CABs, which stands for:</p>
<ul>
<li><strong>C - Circulation (Chest Compressions):</strong> Focuses on restoring blood flow to the vital organs through chest compressions.</li>
<li><strong>A - Airway (Opening the Airway):</strong> Ensures a clear pathway for air to enter and exit the lungs.</li>
<li><strong>B - Breathing (Rescue Breaths):</strong> Provides oxygen to the victim's lungs.</li>
</ul>
<h3>Why CAB Instead of ABC?</h3>
<p>Traditional CPR teaching emphasized the ABC sequence (Airway, Breathing, Circulation). However, modern CPR guidelines prioritize <strong>Circulation (chest compressions)</strong> as the first step. This change is based on research demonstrating that starting with chest compressions is more effective in improving survival rates, especially in cases of sudden cardiac arrest. By prioritizing circulation, we ensure that any existing oxygen in the bloodstream is circulated to the vital organs as quickly as possible.</p>
<h3>The Importance of the CAB Sequence</h3>
<p>The CAB sequence is the foundation of effective CPR. Prioritizing chest compressions first maximizes the delivery of oxygen already present in the bloodstream to the vital organs. Opening the airway and providing breaths then replenishes the oxygen supply.</p>
<h3>Age-Specific Modifications</h3>
<p>While the CAB sequence remains the same for all age groups (excluding newborns), the techniques for performing chest compressions and rescue breaths are modified based on the victim's age (adult, child, or infant). Subsequent lessons will provide detailed instructions for each age group.</p>
<p>[[Next: Adult CPR|Adult CPR]]<br>
[[Previous: Welcome|Welcome]]</p><div class="lesson-title">Welcome to Your Healthcare Provider BLS Certification Course!</div>
<h3>Introduction to Basic Life Support (BLS)</h3>
<p>Welcome to the beginning of your journey to becoming a certified provider of Basic Life Support (BLS). This comprehensive course will equip you with the essential skills and knowledge necessary to respond effectively to life-threatening emergencies, such as cardiac arrest, choking, and respiratory distress. By the end of this course, you will confidently know how to perform life-saving techniques effectively and be prepared to act quickly and decisively in critical situations.</p>
<h3>The Importance of BLS</h3>
<p>Basic Life Support is a set of critical interventions designed to maintain circulation and oxygenation until advanced medical care arrives. Every year, sudden cardiac arrest affects thousands of individuals, often without warning. In these situations, every second counts. Prompt and effective BLS, including CPR (Cardiopulmonary Resuscitation), can significantly increase the chances of survival and improve patient outcomes. Similarly, knowing how to assist someone who is choking can prevent a potentially fatal outcome.</p>
<h3>What You Will Learn in This Course</h3>
<p>This course is designed to guide you step-by-step through the essential BLS skills and knowledge. You will learn:</p>
<ul>
<li><strong>The Critical Importance of CPR:</strong> You will understand why CPR is crucial in cardiac arrest and how it can significantly improve survival rates.</li>
<li><strong>How to Master Chest Compressions:</strong> You will learn the proper technique for performing effective chest compressions on adults, children, and infants, including correct hand placement, depth, and rate.</li>
<li><strong>How to Open Airways:</strong> You will learn various methods for opening and maintaining a patent airway, including the head-tilt/chin-lift and jaw-thrust maneuvers.</li>
<li><strong>How to Give Rescue Breaths:</strong> You will learn how to provide effective rescue breaths, ensuring adequate oxygen delivery to the victim's lungs.</li>
<li><strong>How to Use an AED (Automated External Defibrillator):</strong> You will learn how to operate an AED safely and effectively, including recognizing when it is appropriate to use an AED and following the device's prompts.</li>
</ul>
<h3>Course Content and Scope</h3>
<p>Moreover, we’ll cover techniques tailored for assisting adults, children, and infants, ensuring you are equipped to handle a wide range of emergencies across different age groups. This course emphasizes the importance of early recognition of emergencies, rapid activation of the emergency response system (calling 911 or your local emergency number), and the critical role of teamwork and effective communication during a resuscitation effort.</p>
<h3>Let's Begin Your Life-Saving Journey!</h3>
<p><strong>Let’s dive in and take the first step toward becoming a life-saver!</strong></p>
[[Next: The CABs of CPR|The CABs of CPR]]<div class="lesson-title">Using an AED</div>
<h3>Introduction to Automated External Defibrillators (AEDs)</h3>
<p>An <strong>Automated External Defibrillator (AED)</strong> is a portable electronic device that analyzes the heart rhythm and delivers an electric shock (defibrillation) if necessary to restore a normal heartbeat. AEDs are designed to be used by lay rescuers and are a crucial part of the chain of survival for sudden cardiac arrest. If an AED is available, use it as soon as possible while continuing CPR. Early defibrillation is the most effective way to restore a normal heart rhythm in many cases of sudden cardiac arrest.</p>
<h3>Operating an AED: Step-by-Step</h3>
<p>Most AEDs are designed to be user-friendly and provide clear <strong>step-by-step voice prompts</strong> to guide the user through the process. Here are the general steps for using an AED:</p>
<ol>
<li><strong>Power On the AED:</strong> Press the power button to turn on the AED. The device will begin providing voice prompts.</li>
<li><strong>Expose the Chest:</strong> Quickly expose the victim's chest to apply the AED pads. If the chest is wet, quickly wipe it dry. If there is excessive chest hair that prevents the pads from sticking, quickly shave the area if a razor is available in the AED kit.</li>
<li><strong>Apply the AED Pads:</strong> The AED will provide instructions on pad placement, typically with diagrams on the pads themselves. For adults and children over 8 years old:
<ul>
<li>Place one pad on the victim’s <strong>upper right side</strong> of the chest, just below the collarbone.</li>
<li>Place the other pad on the victim’s <strong>lower left side</strong> of the chest, a few inches below the armpit.</li>
</ul>
For children younger than 8 years old or smaller children (check AED instructions for specific guidance):
<ul>
<li>Use pediatric pads if available. These are smaller and deliver a lower dose of electricity.</li>
<li>If pediatric pads are not available, place one adult pad on the center of the chest and the other on the back, between the shoulder blades. This is called anterior-posterior placement.</li>
</ul>
</li>
<li><strong>Analyze the Heart Rhythm:</strong> Once the pads are in place, the AED will automatically <strong>analyze the victim's heart rhythm</strong>. The AED will instruct you to ensure no one is touching the victim during the analysis.</li>
<li><strong>Deliver a Shock (If Advised):</strong> If the AED determines that a shock is needed, it will instruct you to ensure everyone is clear of the victim before pressing the shock button. Verbally announce “Clear!” before pressing the button to avoid accidental contact.</li>
<li><strong>Resume CPR Immediately:</strong> After a shock is delivered (or if no shock is advised), the AED will instruct you to <strong>immediately resume chest compressions</strong>. Follow the AED’s prompts for further action, which will usually involve continuing cycles of chest compressions and rescue breaths. The AED will periodically reanalyze the heart rhythm and may advise further shocks.</li>
</ol>
<h3>Key Considerations for AED Use</h3>
<ul>
<li><strong>Wet Surfaces:</strong> Avoid using an AED on a wet surface if possible. If the victim is lying in water, move them to a dry area before using the AED.</li>
<li><strong>Implanted Medical Devices:</strong> If the victim has an implanted pacemaker or defibrillator (you will see a bump under the skin on the chest), avoid placing the AED pads directly over the device. Adjust pad placement slightly to the side.</li>
<li><strong>Hairy Chests:</strong> Excessive chest hair can prevent the AED pads from adhering properly. If available, use a razor from the AED kit to quickly shave the area where the pads will be placed.</li>
</ul>
<h3>The Importance of Prompt AED Use</h3>
<p>Using an AED promptly and correctly, in conjunction with high-quality CPR, can significantly improve a victim’s chance of survival in sudden cardiac arrest situations. Remember to continue CPR until trained medical professionals arrive and take over care.</p>
<p>[[Next: Signs of Effective CPR|Signs of Effective CPR]]<br>
[[Previous: CPR for Pregnant Women|CPR for Pregnant Women]]</p><div class="lesson-title">Common CPR Mistakes</div>
<h3>Avoiding Common Errors in CPR</h3>
<p>Performing high-quality CPR is essential for maximizing the victim's chances of survival. Avoiding common mistakes can significantly improve the effectiveness of your efforts. Here are some of the most frequent errors made during CPR and how to prevent them:</p>
<h3>Mistakes Related to Chest Compressions</h3>
<ul>
<li><strong>Inadequate Compression Depth:</strong> Shallow compressions fail to circulate blood effectively. For adults, compress the chest at least <strong>2 inches (5 cm)</strong> but no more than 2.4 inches (6 cm). For children, compress approximately one-third the anterior-posterior (front-to-back) diameter of the chest. For infants, compress about 1.5 inches (4 cm). Ensuring adequate depth is critical for generating sufficient blood flow.</li>
<li><strong>Leaning on the Chest (Incomplete Chest Recoil):</strong> Failing to allow full chest recoil between compressions prevents the heart from refilling with blood. After each compression, completely release pressure on the chest, allowing it to return to its normal position. Avoid leaning on the chest between compressions.</li>
<li><strong>Incorrect Hand Placement:</strong> Incorrect hand placement can reduce compression efficiency and potentially cause injury. For adults, place the heel of one hand on the center of the chest, on the lower half of the sternum (breastbone), between the nipples. Place the heel of your other hand on top of the first. Ensure your fingers are interlocked and raised off the chest.</li>
<li><strong>Incorrect Compression Rate (Too Slow or Too Fast):</strong> Compressing too slowly or too quickly reduces blood flow. Maintain a consistent rhythm of <strong>100–120 compressions per minute</strong>. Using a metronome, a CPR metronome app, or timing your compressions to a song with a similar tempo (like “Stayin’ Alive”) can help maintain the correct rate.</li>
</ul>
<h3>Mistakes Related to Rescue Breaths</h3>
<ul>
<li><strong>Giving Breaths That Are Too Forceful (Over-Inflation):</strong> Giving breaths that are too forceful or too large can cause air to enter the stomach (gastric distention), increasing the risk of vomiting and aspiration. Deliver breaths gently over one second, giving just enough air to produce visible chest rise.</li>
<li><strong>Interruptions in Compressions for Breaths:</strong> Minimizing interruptions in chest compressions is crucial. Do not interrupt compressions for more than 10 seconds to give breaths.</li>
</ul>
<h3>Other Common Mistakes</h3>
<ul>
<li><strong>Hesitation Due to Fear of Injury:</strong> Many people hesitate to act out of fear of causing harm, such as breaking ribs. While rib fractures are a common occurrence during effective CPR, they are far less critical than the need to save a life. Remember, performing CPR is the victim's best chance for survival.</li>
<li><strong>Not Recognizing the Need for CPR:</strong> Failing to recognize the signs of cardiac arrest (unresponsiveness and no normal breathing) can delay the initiation of CPR, significantly reducing the victim's chances of survival.</li>
<li><strong>Not Calling for Help (or Not Delegating):</strong> Not activating the emergency response system (calling 911 or your local emergency number) promptly can delay the arrival of advanced medical care. If other bystanders are present, delegate this task immediately.</li>
</ul>
<h3>The Importance of Proper Technique and Training</h3>
<p>Being aware of these common mistakes and focusing on proper technique through regular training and practice ensures your CPR efforts are as effective as possible. Hands-on training with a qualified instructor is highly recommended to develop the necessary skills and confidence to perform CPR effectively in a real-life emergency.</p>
<p>[[Next: Choking Emergencies|Choking Emergencies]]<br>
[[Previous: Signs of Effective CPR|Signs of Effective CPR]]</p><div class="lesson-title">Drowning Victims</div>
<h3>Resuscitation of Drowning Victims</h3>
<p>Drowning is a unique emergency that often requires a modified approach to CPR, prioritizing oxygen delivery before chest compressions. The primary issue in drowning is oxygen deprivation (hypoxia), so addressing this immediately is crucial. This lesson outlines the specific steps for resuscitating a drowning victim.</p>
<h3>Initial Actions Upon Rescuing a Drowning Victim</h3>
<p>Immediately after removing a drowning victim from the water:</p>
<ul>
<li><strong>Ensure Scene Safety:</strong> As always, ensure the scene is safe for both you and the victim.</li>
<li><strong>Check for Responsiveness and Breathing:</strong> Quickly assess the victim's responsiveness by tapping their shoulder and shouting, "Are you okay?" If there is no response, check for normal breathing by looking for chest rise and fall for no more than 10 seconds. Gasping is not considered normal breathing.</li>
</ul>
<h3>Prioritizing Rescue Breaths (Initial Ventilation)</h3>
<p>If the victim is unresponsive and not breathing normally (or only gasping), prioritize rescue breaths before beginning chest compressions. This is a key difference from standard CPR for other causes of cardiac arrest:</p>
<ul>
<li><strong>Deliver Two Initial Breaths:</strong> Deliver <strong>two initial breaths</strong> to introduce oxygen into the victim's lungs. Each breath should last about one second and produce visible chest rise.</li>
<li><strong>Clearing the Airway (If Necessary):</strong> If you encounter resistance when giving the initial breaths or suspect water or debris in the airway, quickly roll the victim onto their side (recovery position) to allow any fluids to drain. Then, return the victim to their back and attempt the rescue breaths again. You can also perform a finger sweep if you see an object in the mouth.</li>
</ul>
<h3>Continuing with CPR (CAB Sequence)</h3>
<p>If the victim remains unresponsive and is not breathing normally after the initial two breaths, begin the standard CPR sequence (CAB):</p>
<ul>
<li><strong>C - Compressions:</strong> Perform 30 chest compressions at a rate of 100-120 per minute and a depth of at least 2 inches (5 cm) for adults, adjusting for children and infants as previously described.</li>
<li><strong>A - Airway:</strong> Open the airway using the head-tilt/chin-lift or jaw-thrust maneuver.</li>
<li><strong>B - Breathing:</strong> Deliver 2 rescue breaths, each lasting about one second and producing visible chest rise.</li>
</ul>
<p>Continue cycles of 30 compressions and 2 breaths until:</p>
<ul>
<li>The victim shows signs of life (e.g., normal breathing, coughing, movement).</li>
<li>Trained medical professionals (EMS personnel) arrive and take over.</li>
<li>You become physically exhausted and are unable to continue.</li>
</ul>
<h3>Key Considerations for Drowning Victims</h3>
<ul>
<li><strong>Water in the Lungs:</strong> It's important to understand that significant amounts of water are rarely inhaled into the lungs during drowning. The primary issue is laryngospasm (a spasm of the vocal cords that closes off the airway) and subsequent oxygen deprivation. Therefore, focusing on effective ventilation (rescue breaths) is crucial.</li>
<li><strong>Vomiting:</strong> Drowning victims may vomit. If this occurs, quickly turn the victim onto their side to clear the airway and then return them to their back to continue CPR.</li>
</ul>
<p>Rescue breathing is especially important for drowning cases, as oxygen deprivation is the primary issue. Continue CPR until emergency responders take over or the victim regains consciousness.</p>
<p>[[Next: CPR for Overdose|CPR for Overdose]]<br>
[[Previous: Choking Emergencies|Choking Emergencies]]</p><div class="lesson-title">CPR for Overdose</div>
<h3>Resuscitation for Suspected Overdose</h3>
<p>When dealing with a suspected overdose, prompt action is crucial. The primary concern in many overdoses, particularly opioid overdoses, is respiratory depression or arrest (cessation of breathing). Therefore, ensuring adequate oxygenation through rescue breaths is paramount. This lesson outlines the steps for responding to a suspected overdose.</p>
<h3>Initial Assessment and Activating EMS</h3>
<p>Begin by quickly assessing the victim and activating the emergency response system:</p>
<ul>
<li><strong>Check for Responsiveness and Breathing:</strong> Assess the victim’s responsiveness by tapping their shoulder and shouting, “Are you okay?” If there is no response, immediately check for normal breathing (looking for chest rise and fall for no more than 10 seconds). Gasping is not considered normal breathing.</li>
<li><strong>Look for Clues of Overdose:</strong> While checking for responsiveness and breathing, quickly look for telltale signs of drug use, such as needle marks (track marks), empty pill bottles, or drug paraphernalia. These clues can help indicate a possible overdose, particularly an opioid overdose.</li>
<li><strong>Call 9-1-1 (or your local emergency number) immediately.</strong> Provide the dispatcher with your location and the nature of the emergency (e.g., “unresponsive person, possible overdose”).</li>
</ul>
<h3>Administering Naloxone (If Available)</h3>
<p>If naloxone (Narcan, Evzio) is available, administer it as soon as possible. Naloxone is an opioid antagonist that can temporarily reverse the effects of an opioid overdose, restoring breathing. Follow the instructions provided with the naloxone product. However, it's crucial to understand that:</p>
<ul>
<li><strong>Naloxone is not a substitute for CPR.</strong> Even if naloxone is administered, you *must* continue performing CPR if the victim is not breathing normally or has no pulse.</li>
<li><strong>Naloxone may not work immediately or may wear off.</strong> The effects of naloxone are temporary, and the victim may relapse into respiratory depression. Therefore, continued monitoring and CPR are essential.</li>
</ul>
<h3>Performing CPR (Prioritizing Rescue Breaths)</h3>
<p>If the victim is unresponsive and not breathing normally (or only gasping), begin CPR immediately, prioritizing rescue breaths:</p>
<ul>
<li><strong>Open the Airway:</strong> Open the airway using the head-tilt/chin-lift or jaw-thrust maneuver.</li>
<li><strong>Deliver Rescue Breaths:</strong> Deliver two initial rescue breaths, each lasting about one second and producing visible chest rise.</li>
<li><strong>Begin Chest Compressions:</strong> If the victim does not begin breathing normally after the initial breaths, begin chest compressions (30 compressions followed by 2 breaths).</li>
<li><strong>Continue CPR:</strong> Continue cycles of 30 compressions and 2 breaths until:
<ul>
<li>The victim begins to breathe normally and has a pulse.</li>
<li>Trained medical professionals (EMS personnel) arrive and take over.</li>
<li>You become physically exhausted and are unable to continue.</li>
</ul>
</li>
</ul>
<h3>Post-Resuscitation Care and Monitoring</h3>
<p>Be prepared for the victim to be disoriented, agitated, or confused upon regaining consciousness. This is a common side effect of overdose and the effects of naloxone. Provide the following care:</p>
<ul>
<li><strong>Reassurance:</strong> Offer reassurance and speak calmly to the victim.</li>
<li><strong>Monitoring:</strong> Continue to monitor their breathing and level of consciousness until EMS personnel arrive.</li>
<li><strong>Recovery Position (If Breathing Normally):</strong> If the victim is breathing normally but still unconscious, place them in the recovery position to maintain a patent airway.</li>
</ul>
<p>It is important to emphasize that even if naloxone is administered and appears to be effective, the victim needs further medical evaluation. The effects of the overdose may return, or other complications may arise.</p>
<p>[[Next: The Recovery Position|The Recovery Position]]<br>
[[Previous: Drowning Victims|Drowning Victims]]</p><div class="lesson-title">Post-Resuscitation Care</div>
<h3>The Importance of Post-Resuscitation Care</h3>
<p>After successfully reviving a victim (meaning they have regained a pulse and are breathing), your role as a rescuer continues. <strong>Post-resuscitation care</strong> is essential to ensure their continued recovery and stability until advanced medical care arrives. This phase focuses on monitoring the victim, maintaining a patent airway, and providing critical information to arriving emergency medical services (EMS) personnel.</p>
<h3>Monitoring Vital Signs</h3>
<p>Continuously monitor the victim's <strong>vital signs</strong>, including:</p>
<ul>
<li><strong>Breathing:</strong> Observe the victim's chest for regular rise and fall. Ensure their breathing is adequate and not labored or shallow.</li>
<li><strong>Pulse:</strong> Check for a pulse. If you cannot find a pulse, and the victim is not breathing, you must resume CPR.</li>
<li><strong>Level of Consciousness:</strong> Observe the victim's level of consciousness. Are they fully awake, responsive to verbal stimuli, responsive to pain, or unresponsive? Note any changes in their level of consciousness.</li>
</ul>
<h3>Placing the Victim in the Recovery Position (If Unconscious but Breathing)</h3>
<p>If the victim is unconscious but breathing normally, place them in the <strong>recovery position</strong>. This position helps to maintain a patent airway and prevents aspiration if the victim vomits:</p>
<ul>
<li><strong>Steps to place an adult in the recovery position:</strong>
<ol>
<li>Extend the arm nearest you above their head.</li>
<li>Bring the arm furthest from you across their chest.</li>
<li>Bend the leg furthest from you at the knee.</li>
<li>Gently roll the person towards you by pulling on their bent knee.</li>
<li>Adjust the top leg so the hip and knee are bent at right angles.</li>
<li>Tilt their head back slightly to keep the airway open.</li>
</ol>
</li>
<li><strong>Modifications for children and infants:</strong> The recovery position can be modified for children and infants to provide adequate support and prevent them from rolling too far. The key principle is to keep the airway open and prevent aspiration.</li>
</ul>
<h3>Providing Information to EMS Personnel</h3>
<p>Stay with the victim until emergency responders arrive. When they arrive, provide them with a clear and concise report of the following:</p>
<ul>
<li><strong>The events leading up to the incident.</strong></li>
<li><strong>The actions you took,</strong> including when you started CPR, whether you used an AED, and how many shocks were delivered.</li>
<li><strong>The victim’s condition,</strong> including their level of consciousness, breathing pattern, and pulse (if present).</li>
<li><strong>How long the victim was unresponsive</strong> before you began CPR.</li>
<li><strong>Any other relevant observations</strong>, such as any obvious injuries or medical conditions.</li>
</ul>
<p>Providing this information can greatly assist medical professionals in providing the most appropriate and effective care.</p>
<h3>Reassurance and Comfort</h3>
<p>Continue to reassure the victim and keep them as comfortable as possible. Even if they are unconscious, they may still be able to hear you. Speak calmly and reassuringly. Encourage them to stay still and avoid sudden movements to prevent further injury, especially if a spinal injury is suspected.</p>
<p>
[[Previous: The Recovery Position|The Recovery Position]]</p><div class="lesson-title">Signs of Effective CPR</div>
<h3>Recognizing Signs of Effective CPR</h3>
<p>Performing high-quality CPR is crucial for maximizing the victim's chances of survival. While only advanced medical personnel can definitively determine the effectiveness of CPR, there are several signs you can observe that suggest your efforts are having a positive impact. Recognizing these signs can provide reassurance and motivate you to continue providing care until professional help arrives.</p>
<h3>Visible Chest Rise During Rescue Breaths</h3>
<p>The most direct indication that your rescue breaths are effective is <strong>visible chest rise</strong>. This confirms that air is entering the victim's lungs. Observe the chest carefully during each rescue breath to ensure it rises and falls. If the chest does not rise, recheck the airway and seal as discussed in the "Airway Deep Dive" and "Rescue Breaths" lessons.</p>
<h3>Changes in Skin Color</h3>
<p>Changes in the victim's <strong>skin color</strong> can also provide clues about the effectiveness of your CPR efforts. A reduction in bluish or pale tones (cyanosis or pallor) suggests that oxygenated blood is beginning to circulate. However, it's important to note that changes in skin color may not always be immediately apparent, especially in poorly lit environments or individuals with darker skin tones. This sign should be considered in conjunction with other indicators.</p>
<h3>Gasping or Spontaneous Movements</h3>
<p><strong>Gasping</strong> (agonal respirations) or slight movements from the victim can be another positive sign. These may indicate that the victim is regaining spontaneous breathing or some level of consciousness. However, gasping is not considered normal breathing and should not cause you to stop CPR. Continue chest compressions and rescue breaths until the victim is breathing normally or advanced medical personnel advise otherwise.</p>
<h3>Using an AED and Feedback Devices</h3>
<p>If an <strong>AED (Automated External Defibrillator)</strong> is available, use it as soon as possible. AEDs analyze the heart rhythm and deliver an electric shock if needed. Many modern AEDs provide <strong>real-time feedback</strong> on compression rate and depth, which can be invaluable in helping you adjust your technique and ensure you are providing high-quality compressions. Pay close attention to the AED's prompts and feedback.</p>
<h3>The Importance of Continuous CPR</h3>
<p>It's crucial to remember that even if you observe some of these positive signs, you must <strong>continue CPR without interruption</strong> until one of the following occurs:</p>
<ul>
<li>Trained medical professionals arrive and take over (EMS personnel).</li>
<li>The victim begins to breathe normally and has a pulse.</li>
<li>You become physically exhausted and are unable to continue.</li>
</ul>
<p>The victim's condition can be unstable, and stopping CPR prematurely can have devastating consequences. Continued CPR provides the best chance of survival.</p>
<p>[[Next: Common CPR Mistakes|Common CPR Mistakes]]<br>
[[Previous: Using an AED|Using an AED]]</p><div class="lesson-title">Child CPR - Part 1: Getting Started</div>
<h3>Performing CPR on Children (Ages 1-Puberty)</h3>
<p>This lesson covers the modifications needed when performing CPR on children (defined as ages 1 year to the onset of puberty). For the basic principles of CPR, including the CAB sequence, please refer to the <a href="Adult CPR">Adult CPR</a> lesson.</p>
<h3>Ensuring Scene Safety and Activating EMS</h3>
<p>As with adult CPR, your safety and the safety of the child are paramount. Before approaching the child, ensure the scene is safe. Then:</p>
<ul>
<li>Call 9-1-1 (or your local emergency number) or ask someone else to do so immediately. Provide the dispatcher with your location and the nature of the emergency. If possible, have someone locate an AED and bring it to the scene.</li>
</ul>
<h3>Assessing Responsiveness and Breathing</h3>
<p>Assess the child's responsiveness and breathing:</p>
<ul>
<li><strong>Check for Responsiveness:</strong> Gently tap the child's shoulder and ask loudly, “Are you okay?”</li>
<li><strong>Check for Normal Breathing:</strong> If the child does not respond, immediately check for normal breathing. Look for chest rise and fall for no more than 10 seconds. Gasping is not considered normal breathing.</li>
</ul>
<h3>Initiating Chest Compressions (Modifications for Children)</h3>
<p>If the child is unresponsive and not breathing normally (or only gasping), begin CPR immediately, starting with chest compressions. Here are the modifications for children:</p>
<ul>
<li><strong>Hand Placement:</strong>
<ul>
<li>For smaller children, use the heel of <strong>one hand</strong> in the center of the chest, on the lower half of the sternum (breastbone), between the nipples.</li>
<li>For larger children (approaching adult size), you may need to use <strong>both hands</strong>, with one hand placed on top of the other, as described in the <a href="Adult CPR">Adult CPR</a> lesson.</li>
</ul>
</li>
<li><strong>Compression Depth:</strong> Compress the chest to a depth of approximately <strong>2 inches (5 cm)</strong>, or about one-third the anterior-posterior (front-to-back) diameter of the chest.</li>
<li><strong>Compression Rate:</strong> Maintain a compression rate of 100-120 compressions per minute, the same as for adults (see <a href="Adult CPR">Adult CPR</a>).</li>
</ul>
<p>[[Next: Child CPR - Part 2: Breathing and Rhythm|Child CPR - Part 2: Breathing and Rhythm]]<br>
[[Previous: Adult CPR|Adult CPR]]</p><div class="lesson-title">Child CPR - Part 2: Breathing and Rhythm</div>
<h3>Providing Rescue Breaths for Children (Modifications)</h3>
<p>This lesson covers the modifications needed for rescue breaths in child CPR. For the basic principles of opening the airway and delivering rescue breaths, please refer to the <a href="Adult CPR">Adult CPR</a> lesson.</p>
<h3>Opening the Airway (Head-Tilt/Chin-Lift - Modification)</h3>
<p>Use the head-tilt/chin-lift maneuver, but avoid excessive head tilt, especially in younger children. The head should be in a neutral or slightly sniffing position.</p>
<h3>Creating a Seal and Delivering Rescue Breaths (Modifications)</h3>
<ul>
<li><strong>Seal:</strong> Create a tight seal over the child’s mouth with your mouth, pinching their nostrils closed. For smaller children, you may need to cover both their mouth and nose with your mouth.</li>
<li><strong>Breath Delivery:</strong> Deliver two gentle breaths, each lasting about one second and producing visible chest rise. Avoid forceful or rapid breaths.</li>
</ul>
<h3>Compression-to-Ventilation Ratio and Cycles</h3>
<p>The compression-to-ventilation ratio for children is the same as for adults: <strong>30 compressions and 2 rescue breaths</strong>. Continue these cycles until:</p>
<ul>
<li>The child shows signs of life.</li>
<li>An AED arrives and is ready to use.</li>
<li>Trained medical professionals arrive.</li>
<li>You become too exhausted to continue.</li>
</ul>
<p>[[Next: Infant CPR - Part 1: Preparation and Positioning|Infant CPR - Part 1: Preparation and Positioning]]<br>
[[Previous: Child CPR - Part 1: Getting Started|Child CPR - Part 1: Getting Started]]</p><div class="lesson-title">Infant CPR - Part 2: Breathing and Cycles</div>
<h3>Providing Rescue Breaths for Infants (Modifications)</h3>
<p>This lesson covers the modifications needed for rescue breaths in infant CPR. For the basic principles of opening the airway and delivering rescue breaths, please refer to the <a href="Adult CPR">Adult CPR</a> lesson.</p>
<h3>Opening the Airway (Head-Tilt/Chin-Lift - Modification)</h3>
<p>Use a gentle head-tilt/chin-lift maneuver. Avoid excessive head tilt, as this can obstruct the infant's airway. The head should be in a neutral or slightly sniffing position.</p>
<h3>Creating a Seal and Delivering Rescue Breaths (Modifications)</h3>
<ul>
<li><strong>Seal:</strong> Create a seal over the infant’s <strong>mouth and nose</strong> with your mouth.</li>
<li><strong>Breath Delivery:</strong> Deliver two gentle breaths, each lasting about one second and producing visible chest rise. Avoid forceful or rapid breaths.</li>
</ul>
<h3>Compression-to-Ventilation Ratio and Cycles</h3>
<p>The compression-to-ventilation ratio for infants is the same as for adults and children: <strong>30 compressions and 2 rescue breaths</strong> (when one rescuer is present). If two rescuers are present, the preferred ratio is 15 compressions to 2 breaths. Continue these cycles until:</p>
<ul>
<li>The infant shows signs of life.</li>
<li>Trained medical professionals arrive.</li>
<li>You become too exhausted to continue.</li>
</ul>
<h3>Calling 9-1-1 (If Alone)</h3>
<p>If you are alone and have not already done so, remember to pause after approximately 2 minutes of CPR to call 9-1-1 (or your local emergency number), unless an AED is immediately available. If an AED is available, use it as soon as possible after assessing the infant.</p>
<p>[[Next: CPR for Pregnant Women|CPR for Pregnant Women]]<br>
[[Previous: Infant CPR - Part 2: Breathing and Cycles|Infant CPR - Part 1: Preparation and Positioning]]</p><div class="lesson-title">Choking Emergencies</div>
<h3>Recognizing and Responding to Choking</h3>
<p>Choking is a common emergency that requires immediate intervention to prevent severe injury or death. The appropriate response varies depending on the age of the victim. This lesson will cover the appropriate techniques for adults, children, and infants.</p>
<h3>Choking in Adults and Children</h3>
<p>For adults and children (older than 1 year):</p>
<ul>
<li><strong>Recognizing Choking:</strong> The universal sign of choking is clutching at the throat. The person may also be unable to speak, cough, or breathe.</li>
<li><strong>Heimlich Maneuver (Abdominal Thrusts):</strong> If the person is conscious and choking, perform the <strong>Heimlich maneuver</strong> (abdominal thrusts):
<ol>
<li>Stand behind the person and wrap your arms around their waist.</li>
<li>Make a fist with one hand and place the thumb side just above their navel (belly button).</li>
<li>Grasp your fist with your other hand.</li>
<li>Perform quick, upward abdominal thrusts, pulling inward and upward.</li>
<li>Repeat the thrusts until the object is dislodged or the person becomes unresponsive.</li>
</ol>
</li>
<li><strong>If the Person Becomes Unresponsive:</strong> If the person becomes unresponsive, carefully lower them to the ground and begin <strong>CPR</strong> immediately.
<ol>
<li>After each set of chest compressions, before giving rescue breaths, open the victim's mouth and look for the obstructing object.</li>
<li>If you see the object, carefully remove it with a finger sweep (only if the object is visible).</li>
<li>Continue cycles of chest compressions and rescue breaths until help arrives or the object is cleared and the victim begins to breathe on their own.</li>
</ol>
</li>
</ul>
<h3>Choking in Infants (Under 1 Year)</h3>
<p>For infants (under 1 year):</p>
<ul>
<li><strong>Recognizing Choking:</strong> An infant who is choking may be unable to cry or cough effectively, may have high-pitched noises while inhaling (stridor), or may have bluish skin (cyanosis).</li>
<li><strong>Back Blows and Chest Thrusts:</strong> Use a combination of back blows and chest thrusts:
<ol>
<li><strong>Back Blows:</strong> Hold the infant <strong>face-down</strong> along your forearm, supporting their head and neck with your hand on their jaw. Rest your forearm on your thigh for support. Deliver <strong>5 firm back blows</strong> between their shoulder blades using the heel of your other hand.</li>
<li><strong>Chest Thrusts:</strong> If the object does not dislodge after the back blows, turn the infant face-up onto your other forearm, supporting their head and neck. Place two fingers in the center of the infant’s chest, just below the nipple line, and deliver <strong>5 chest thrusts</strong>, compressing about 1.5 inches (4 cm).</li>
<li>Repeat the cycle of 5 back blows and 5 chest thrusts until the object is removed or the infant becomes unresponsive.</li>
</ol>
</li>
<li><strong>If the Infant Becomes Unresponsive:</strong> If the infant becomes unresponsive, begin <strong>CPR</strong> immediately.
<ol>
<li>After each set of chest compressions, before giving rescue breaths, open the infant's mouth and look for the obstructing object.</li>
<li>If you see the object, carefully remove it with a finger sweep (only if the object is visible).</li>
<li>Continue cycles of chest compressions and rescue breaths until help arrives or the object is cleared and the infant begins to breathe on their own.</li>
</ol>
</li>
</ul>
<h3>Importance of Practice</h3>
<p>Quick, confident action is essential in a choking emergency. Practice these techniques regularly with a certified instructor or using a training manikin to develop the muscle memory and confidence needed to act effectively in a real-life situation. This training will help you stay prepared and potentially save a life.</p>
<p>[[Next: Drowning Victims|Drowning Victims]]<br>
[[Previous: Common CPR Mistakes|Common CPR Mistakes]]</p><div class="lesson-title">Adult CPR</div>
<h3>Performing CPR on Adults</h3>
<p>This lesson provides detailed instructions for performing CPR on adults (defined as anyone from puberty onward). Remember the CAB sequence: Compressions, Airway, Breathing.</p>
<h3>Chest Compressions (Adults)</h3>
<p>Chest compressions are the most critical component of CPR, as they artificially circulate blood to the vital organs. To perform compressions correctly:</p>
<ul>
<li><strong>Position your hands:</strong> Place the heel of one hand on the center of the chest, on the lower half of the sternum (breastbone), between the nipples. Place the heel of your other hand on top of the first hand. Interlock your fingers and keep them raised off the chest to avoid applying pressure to the ribs.</li>
<li><strong>Body Position:</strong> Keep your arms straight and position your shoulders directly above your hands. This allows you to use your body weight for maximum force.</li>
<li><strong>Compression Depth:</strong> Compress at a depth of at least <strong>2 inches (5 cm)</strong> but no more than 2.4 inches (6 cm) for adults, ensuring each compression is firm and rapid.</li>
<li><strong>Compression Rate:</strong> Maintain a rhythm of <strong>100–120 compressions per minute</strong>. Songs like <em>"Stayin' Alive"</em> can help you keep the pace.</li>
<li><strong>Chest Recoil:</strong> Allow the chest to <strong>fully recoil</strong> after each compression to let blood flow back into the heart.</li>
</ul>
<h3>Opening the Airway (Adults)</h3>
<p>Opening the airway is a critical step in CPR that ensures oxygen can reach the lungs. To effectively open the airway:</p>
<ul>
<li><strong>Head-Tilt/Chin-Lift Technique:</strong> Place one hand on the victim’s forehead and gently tilt the head back while using the fingers of your other hand to lift the chin. This movement moves the tongue away from the back of the throat, where it could otherwise block airflow. Be gentle, especially if a neck injury is possible, but prioritize opening the airway.</li>
<li><strong>Checking for Obstructions:</strong> Check for any visible obstructions in the mouth. Remove them only if you can see and safely access them. <strong>Never perform a blind finger sweep</strong>, as this can push an unseen object further into the throat.</li>
</ul>
<h3>Rescue Breaths (Adults)</h3>
<p>Rescue breaths are critical for supplying oxygen to the victim’s lungs. With the airway open:</p>
<ul>
<li><strong>Seal:</strong> Seal your lips tightly around the victim’s mouth, pinching their nose shut.</li>
<li><strong>Breath Delivery:</strong> Give <strong>two slow, steady breaths</strong>. Each breath should last about <strong>one second</strong>, just enough to see the chest rise. Avoid over-inflating the lungs by blowing too forcefully, as this can push air into the stomach. If the chest does not rise, recheck the head tilt and look for blockages.</li>
</ul>
<h3>Compression-to-Ventilation Ratio (Adults)</h3>
<p>Continue alternating <strong>30 compressions with 2 rescue breaths</strong> until:</p>
<ul>
<li>The victim begins breathing on their own.</li>
<li>An AED is available and ready to use.</li>
<li>Professional help arrives.</li>
<li>You become too exhausted to continue.</li>
</ul>
<p>[[Next: Child CPR - Part 1: Getting Started|Child CPR - Part 1: Getting Started]]<br>
[[Previous: The CABs of CPR|The CABs of CPR]]</p><div class="lesson-title">Infant CPR - Part 1: Preparation and Positioning</div>
<h3>Performing CPR on Infants (Under 1 Year)</h3>
<p>This lesson covers the modifications needed when performing CPR on infants (under 1 year old). For the basic principles of CPR, including the CAB sequence, please refer to the <a href="Adult CPR">Adult CPR</a> lesson.</p>
<h3>Ensuring Scene Safety and Activating EMS</h3>
<p>As with adult and child CPR, ensure the scene is safe. Then:</p>
<ul>
<li>Call 9-1-1 (or your local emergency number) or shout for help immediately. If you are alone and no one responds to your shouts, perform CPR for approximately 2 minutes before leaving the infant to call for help, *unless* an AED is immediately available. If an AED is available, use it as soon as possible after assessing the infant.</li>
</ul>
<h3>Assessing Responsiveness and Breathing</h3>
<p>Assess the infant's responsiveness and breathing:</p>
<ul>
<li><strong>Check for Responsiveness:</strong> Gently tap the bottom of the infant’s foot and call their name (if known). Avoid shaking the infant.</li>
<li><strong>Check for Normal Breathing:</strong> If the infant does not respond, immediately check for normal breathing. Look for chest rise and fall for no more than 10 seconds. Gasping is not considered normal breathing. Place your ear close to the infant's mouth and nose to listen for breath sounds and feel for air movement on your cheek.</li>
</ul>
<h3>Initiating Chest Compressions (Modifications for Infants)</h3>
<p>If the infant is unresponsive and not breathing normally (or only gasping), begin CPR immediately, starting with chest compressions. Here are the modifications for infants:</p>
<ul>
<li><strong>Hand Placement:</strong>
<ul>
<li><strong>Two-Finger Technique:</strong> Place two fingers (typically the index and middle fingers) on the center of the infant’s chest, just below the nipple line, on the lower half of the sternum (breastbone).</li>
<li><strong>Two-Thumb Encircling Hands Technique (Preferred for Two Rescuers):</strong> If there are two rescuers, the preferred technique is the two-thumb encircling hands technique. Place both thumbs side-by-side on the lower half of the sternum, with your fingers encircling the infant’s chest and supporting their back.</li>
</ul>
</li>
<li><strong>Compression Depth:</strong> Compress the chest to a depth of about <strong>1.5 inches (4 cm)</strong>, or about one-third the anterior-posterior (front-to-back) diameter of the chest.</li>
<li><strong>Compression Rate:</strong> Maintain a compression rate of 100-120 compressions per minute, the same as for adults (see <a href="Adult CPR">Adult CPR</a>).</li>
</ul>
<p>[[Next: Infant CPR - Part 2: Breathing and Cycles|Infant CPR - Part 2: Breathing and Cycles]]<br>
[[Previous: Child CPR - Part 2: Breathing and Rhythm|Child CPR - Part 2: Breathing and Rhythm]]</p><div class="lesson-title">CPR for Pregnant Women</div>
<h3>Modifications for CPR on Pregnant Women</h3>
<p>Performing CPR on pregnant women requires some specific modifications due to the physiological changes that occur during pregnancy. These changes primarily affect the circulatory and respiratory systems. It's crucial to remember that the primary goal is to save the mother's life, as this also gives the fetus the best chance of survival. For the basic principles of adult CPR, including the CAB sequence, please refer to the <a href="Adult CPR">Adult CPR</a> lesson.</p>
<h3>Physiological Changes During Pregnancy</h3>
<p>Several physiological changes during pregnancy are relevant to CPR:</p>
<ul>
<li><strong>Enlarged Uterus:</strong> The enlarging uterus can compress the inferior vena cava (IVC), a major vein that returns blood from the lower body to the heart. This compression can significantly reduce venous return and cardiac output, making chest compressions less effective.</li>
<li><strong>Increased Blood Volume:</strong> Pregnant women have an increased blood volume, which can affect the distribution of blood during CPR.</li>
<li><strong>Increased Oxygen Consumption:</strong> Pregnant women have increased oxygen consumption, making effective ventilation even more critical.</li>
</ul>
<h3>Modifications for Chest Compressions (Manual Left Uterine Displacement)</h3>
<p>The most important modification for chest compressions on a pregnant woman is <strong>manual left uterine displacement (LUD)</strong>. This technique helps to relieve pressure on the IVC:</p>
<ul>
<li><strong>Performing LUD:</strong>
<ul>
<li>If possible, have a second rescuer perform LUD. The rescuer should stand on the woman's right side and manually displace the uterus to the woman's left side. This is done by placing one hand on the woman's lower abdomen and gently pulling or pushing the uterus to her left.</li>
<li>If you are the only rescuer, you can attempt to perform LUD yourself by leaning slightly to the woman's left side while performing compressions. However, this is less effective than having a second rescuer perform LUD.</li>
</ul>
</li>
<li><strong>Hand Placement and Compression Technique:</strong> Hand placement and compression technique are the same as for standard adult CPR (see <a href="Adult CPR">Adult CPR</a>). However, because of the LUD, you may need to adjust your position slightly to maintain effective compressions.</li>
</ul>
<h3>Other Considerations</h3>
<ul>
<li><strong>Advanced Care:</strong> If resuscitation efforts are unsuccessful and advanced medical care is available, emergency delivery (perimortem cesarean section) may be considered. This is a complex decision that should be made by medical professionals.</li>
<li><strong>Focus on High-Quality CPR:</strong> The most important factor in improving the outcome for both the mother and the fetus is performing high-quality CPR with minimal interruptions.</li>
</ul>
<p>[[Next: Using an AED|Using an AED]]<br>
[[Previous: Infant CPR - Part 2: Breathing and Cycles|Infant CPR - Part 2: Breathing and Cycles]]</p><div class="lesson-title">The Recovery Position</div>
<h3>Using the Recovery Position</h3>
<p>The recovery position is a side-lying position used for unconscious but breathing individuals. It helps to maintain an open airway and prevents aspiration (inhaling vomit or other fluids into the lungs). It is only used if the person is breathing normally.</p>
<h3>When to Use the Recovery Position</h3>
<p>Use the recovery position if the person is:</p>
<ul>
<li>Unconscious.</li>
<li>Breathing normally.</li>
<li>Has a pulse.</li>
</ul>
<h3>When *Not* to Use the Recovery Position</h3>
<p>Do *not* use the recovery position if the person:</p>
<ul>
<li>Has a suspected spinal injury. In this case, keep the person still and wait for emergency medical personnel.</li>
<li>Has other serious injuries that would make moving them dangerous.</li>
</ul>
<h3>Steps for Placing an Adult in the Recovery Position</h3>
<p>Here are the steps for placing an adult in the recovery position:</p>
<ol>
<li>Extend the arm nearest you above their head.</li>
<li>Bring the arm furthest from you across their chest and place the back of their hand against their cheek nearest you.</li>
<li>Bend the leg furthest from you at the knee, keeping their foot flat on the ground.</li>
<li>Gently pull on the bent knee to roll the person towards you onto their side.</li>
<li>Adjust the top leg so that both the hip and knee are bent at right angles.</li>
<li>Tilt their head back slightly to keep the airway open and ensure that no pressure is placed on the chest that would inhibit breathing.</li>
</ol>
<h3>Modifications for Children and Infants</h3>
<p>The recovery position can be modified for children and infants. The key principle is to maintain an open airway and prevent aspiration. For infants, holding them face down along your forearm while supporting their head and neck can serve a similar function. For small children, a less extreme side-lying position with appropriate support may be necessary.</p>
<p>[[Next: Post-Resuscitation Care|Post-Resuscitation Care]]<br>
[[Previous: CPR for Overdose|CPR for Overdose]]</p>