![]() ![]() If an AED arrives, its pads should be applied to the front and back of the patient, taking care to minimize any delay in restarting chest compressions. The cycle of 30 chest compressions alternated with two rescue breaths is continued until an AED becomes available or until additional help arrives. If extenuating circumstances prohibit a healthcare provider in the out-of-hospital setting from performing rescue breathing without a barrier device, compression-only CPR should be performed until EMS arrives. Compression-only CPR has been accepted as appropriate for untrained lay rescuers. This is a decision that healthcare providers must make for themselves. Mouth-to-mouth rescue breaths have been the alternative, which many untrained rescuers are hesitant to perform, especially on an unknown victim. ![]() Ideally, a healthcare provider inclined to intervene as an out-of-hospital rescuer should have ready access to a barrier device such as a rescue mask. The process is repeated for a second rescue breath prior to resuming chest compressions. Two rescue breaths are administered: the rescuer takes a "regular" breath (not deep or excessive) and delivers a rescue breath lasting approximately one second, which should be enough just to allow the chest to rise. If a cervical spine injury is suspected, the airway is opened using the jaw-thrust maneuver without extending the head. Īfter 30 chest compressions, the rescuer performs a head tilt/chin lift maneuver to open the airway (assuming there is no suspicion of a cervical spinal injury). Because of the critical contribution of chest compressions to coronary artery perfusion, interruptions in chest compressions should be minimized, and any interruptions should be as short as possible when needed. Thirty compressions are performed, followed by a brief pause for two rescue breaths. The chest wall should be allowed to recoil fully on the upstroke to maintain coronary artery perfusion pressure. The goal is to depress the sternum to a depth of at least two inches while avoiding excessive depth of compressions. The hands are placed on the lower half of the sternum, and chest compressions are begun at a rate of 100 to 120 compressions per minute. Simultaneously, begin CPR by first performing chest compressions (C), followed by opening the airway (A) and delivering rescue breaths (B) (the CAB sequence as compared to the former ABC sequence). Make sure that the scene is safe, then call for help. In this era of universal mobile phone availability, it is now possible to call 911 while remaining with the victim. The immediate recognition of cardiac arrest is essential to initiate the emergency medical services (EMS) response and begin CPR as soon as possible. These recommendations are current as of the 2015 American Heart Association's Guidelines Update for CPR and Emergency Cardiac Care. ![]() The modifications for children, infants, and in-hospital CPR are listed below. Note: The technique described here is intended for a healthcare provider performing one-rescuer CPR on an adult victim in the out-of-hospital setting. ![]()
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