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CPR: The NEW way: What Every Parent Needs To Know!!!

josierm by josierm Walking(June 26th) (rank 348th)

CPR: The NEW way: What every parent should know!!

The recommendations for CPR changes frequently.  It seems that every year I do my CPR updates, there is a new way to do it.  As parents, we should ALL know how to do CPR.  Here is an overview of

the latest recommendations (current JUNE 09).  I highly recommend all parents attend a first aid course and practice how to do this properly.  It could save your child’s life one day!!  You may have read other articles about CPR….these may be out of date.  The ratios have changed, response methods have changed, airway checking has changed, pulse checking has been replaced with “signs of life”, EAR (expired air resuscitation) is being phased out…all based on best practice and best outcome.

DANGER

You see a person possibly unconscious.  The first thing you need to do is make sure that you are not going to get hurt by trying to help them.  Check for danger, remove objects that may be in your way and if it is unsafe DO NOT PROCEED.

RESPONSE

The recommendations for checking a response includes:

1- stand away from the person and shout (whatever comes to your head first: “are you OK”, “can you wake up”, “can you hear me”).  If no response to voice, then

2-proceed to the person and do a trapezius squeeze (shoulder muscle) and assess for response to pain.  Do not shake, do not use a sternal rub.  This recommendation comes from the number of helper injuries resulting from unconscious people suddenly waking in a confused state and hitting out at the helper.  If the person wakes….great, if not CALL OUT FOR HELP, take note of the time….proceed to check the airway…..

AIRWAY

If the person is unconscious (if pregnant, tilt pelvis on the left side to move the baby off vital organs and aid in circulation), proceed to checking the airway.  There is no need to roll the person to check the airway.  Open the mouth, look inside, scoop in 2 fingers if necessary and remove any foreign object if able to.  If the person vomits, turn onto the side.  Once the airway is clear, check for breathing……..

BREATHING

Do this by facing the chest and put the ear next to the mouth.  Place your hand on the chest.  Feel for breath on your face, feel and look at the chest for rise and fall, and listen for signs of breathing.  If the person is breathing, place on his/her side in the coma/recovery position wait for help and continue to monitor.  If the person is not breathing, administer 2 breaths.  Close the nose and keep a tight seal around the mouth.  Babies (under 1) heads should be in a neutral position, children and adults heads should be hyperextended (ie, tilt the head back to open the airway).  Watch the chest for rise and fall to see if your breaths are successful.  Next check circulation……

CIRCULATION

Do not check for a pulse.  Pulses can be hard to find at the best of times, but in an adrenaline fuelled situation it can be even harder.  Sometimes a person may have a very slow or very weak pulse that is still present but may still require circulatory resuscitation.  No harm will be done by giving compressions to a person with a heart beat. The recommendation is now to look for SIGNS OF LIFE.  Signs of life include any movement, colour (no signs will probably be pale or blue/grey/purple).

If there are no sings of life, begin CPR.  Measure one finger width up from the xyphoid process (the tip of the sternum) and commence compressions.  Use 2 hands for adults (and children above 12 years), the heel of 1 hand (rest the other on the active arm) for children under 12 years, and 2 fingers for babies.  You should press down to 1/3 of the depth of the chest for effective compressions.

The ratio of compressions to breathing for         adults is 30:2

                                                                        Children (under 12) 30:2

                                                                        Neonates (under 28 days) 3:1

The ratios are now the same for 2 person and 1 person CPR.

The rate of compressions should be around 100 per minute for adults and children and 120 per minute for babies.

**A tip given to me by the CPR instructor was to keep to the timing of the song “stay’n alive” by the Bee Gees.  The tempo is approximately 100 beats per minute**

Do 4 cycles of compressions and breaths before rechecking for breathing and circulation.  Continue if there is still no signs of life.

ANY ASSISANCE IS BETTER THAN NO ASSISTANCE AT ALL.

But if you can learn this process and practice, you improve the chances of a good outcome.

AGE SUMMARY

Adults:

30:2

2 hands

1/3 depth of chest

Hyperextend neck with breaths

100 compressions per minute

Children (under 1-12):

30:2

1 hand

1/3 depth of chest

Moderately hyperextend neck with breaths

100 compressions per minute

Babies (28 days to 1 year):

30:2

2 fingers

1/3 depth of the chest

head in neutral position

120 compressions per minute

Neonates:

3:1

2 fingers

1/3 depth of chest

Head in neutral position with breaths

120 compressions per minute

NEVER SHAKE A BABY!!!!

** this information is based on a mandatory CPR update done on 24/6/9 by an accredited CPR instructor and registered nurse, as written by a practicing registered nurse**

More info: http://www.resus.org.au/faq_guidelines.pdf

 

Any contributed content above is the subjective opinion of that member or external author, and not of Minti.com Pty Ltd. If you are searching for health related advice we strongly suggest you seek professional medical support. View our Terms of Service for more details.
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llmunchkin
July 26th | llmunchkin
Re: CPR: The NEW way: What Every Parent Needs To Know!!!

That's great Josie, I keep meaning to get my first aid certificate; this is a good reminder!  I think I'd like to print it out if that is ok with you?



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      josierm
July 26th | josierm
Re: CPR: The NEW way: What Every Parent Needs To Know!!!

You're quite welcome to print it out.

I would love to know who I have annoyed to get marked down!  I think the rating just before yours dropped me from a 5 to a 3 star (either high expectations that were not met, or a grudge about something perhaps!)  Its a shame that person could not enlighten me as to how I could improve my article. (although grudge ratings are not usually associated with constructive criticism).

thats just my whinge for the day (sorry you were on the other end of it Lui)

xx josie



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           blue-raven
July 26th | blue-raven
Re: CPR: The NEW way: What Every Parent Needs To Know!!!

Don't you just hate that! I wrote an article that was disabled before it was posted and someone reported it before admin approved it!!!!!!! I'm still laughing! If I give low score I usually say why.

Don't worry, I'm sure that certain 15yr old will be gunning for me seeings I was one that let her inner bitch out for a walk and gave her a proverbially cup of coffee!!!!!

Cheers Raven!!!!!



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           mystikal
July 26th | mystikal
Re: CPR: The NEW way: What Every Parent Needs To Know!!!

I was just thinking the same thing what the hell? There's nothing to be marked down about and your style of writing is very clear so even the most anal person wouldn't have any pointers there. Maybe it was an angry certain 15 year old?



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           llmunchkin
July 26th | llmunchkin
Re: CPR: The NEW way: What Every Parent Needs To Know!!!

I know, I saw that & thought that someone would have added some useful comment that had different information; yet there was nothing... Nevermind, we all get it and the cream rises to the top anyway ; )



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                josierm
July 28th | josierm
Re: CPR: The NEW way, UPDATED and edited.

Its OK guys.  I have received a minti mail and I am aware of who the low rater was (its not who you might think).  I have been asked to delete this advice, presumably because it is not what the community teaches (ie. the ratios for children differ).  I have had this discussion with mand already, as she had brought up the same issue- see below, but the person who mailed me is so concerned that she feels my advice should not be here.

Having had issues in the past with trying to delete advice with comments on already, I will update this advice to what the community is taught, rather than what I was taught as a paediatric health professional.

For those who have printed this advice already, please reprint, you will notice that the paediatric value will change from 15:2 to 30:2.  I do not want to be accused of writing misleading information that may endanger the community.



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                     mand
July 28th | mand
Re: CPR: The NEW way, UPDATED and edited.

I just read this on my email its great advice don't delete it so sorry someone disagrees.



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                          mystikal
August 4th | mystikal
Re: CPR: The NEW way, UPDATED and edited.

I thought you wrote 30:2? And don't delete your article it only needs a simple edit. The person who contacted you should have left a comment for everyone to read if they were so concerned that your article needed to be deleted. By being aware and failing to warn others of the difference in compressions, they were contributing to the risk.



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mystikal
June 28th | mystikal
Re: CPR: The NEW way: What Every Parent Needs To Know!!!

Just a thought but you may want to add how to roll the person on to their side if needed (ie lifting the leg to a 90 degree angle etc) and also explain what the "coma position" is to parents who aren't aware of first aid. If I were a parent unaware of first aid I would be confused.

xx mel



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      josierm
June 28th | josierm
Re: CPR: The NEW way: What Every Parent Needs To Know!!!

Thanks Mel.  I've just added a link to describe the coma/recovery position that included diagrams.  I am not sure that its the best link available, but my computer is being REALLY slow today, so it took a long time just to link this one.  I'll see if I can find something better when my computer is a bit faster.  I am about to put the computer in a situation where it requires CPR itself, PMSL.



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mystikal
June 28th | mystikal
Re: CPR: The NEW way: What Every Parent Needs To Know!!!

Nice article I was taught by a retired fire officer (many awards for his bravery and work - much deserved he even volunteered for the bush fires). He was great. He also taught me to squeeze both hands or both feet because someone who may have had a stroke on one side of their body may not respond to a shoulder squeeze or one particular side of the body. The other thing he taught me was if you were alone in the car having a heart attack the best way to prepare yourself is to start coughing.



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      llmunchkin
July 26th | llmunchkin
Re: CPR: The NEW way: What Every Parent Needs To Know!!!

Mel if you are going to write that, you need to tell us how the coughing will help... It has made me very curious! 



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           mystikal
August 4th | mystikal
Re: CPR: The NEW way: What Every Parent Needs To Know!!!

The coughing acts as immediate CPR to yourself



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blue-raven
June 28th | blue-raven
Re: CPR: The NEW way: What Every Parent Needs To Know!!!

Thanks this is really helpful. I'm gonna write it down and stick it somewhere to use in the event of a emergency!

Cheers Raven



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      josierm
June 28th | josierm
Re: CPR: The NEW way: What Every Parent Needs To Know!!!

Thanks.  I hope you never have to use it!!

xx josie



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janicepovey
June 27th | janicepovey
Re: CPR: The NEW way: What Every Parent Needs To Know!!!

 An excellent article Josie, especially the updates to the changes.

I have done a couple of courses over the years to keep my hand in and up to date with  any changes but unless your in the know, it is easy to lose track of updates.

A fantastic article for all to read.

Thanks for sharing.

Cheers Janice



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      josierm
June 28th | josierm
Re: CPR: The NEW way: What Every Parent Needs To Know!!!

Thanks Janince

This is a partner article to my "out of control" article I am STILL working on!

xx josie



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           josierm
June 28th | josierm
Re: CPR: The NEW way: What Every Parent Needs To Know!!!

sorry Janice- little typo there!



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mand
June 26th | mand
Re: CPR: The NEW way: What Every Parent Needs To Know!!!

Great info I remember the staying alive advice the last one i went to and use the breath in your cheeks for a small baby and mouth over their nose and mouth!!  



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      josierm
June 27th | josierm
Re: CPR: The NEW way: What Every Parent Needs To Know!!!

Thanks for adding that mand.  I knew I was going to forget something!!



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           mand
June 27th | mand
Re: CPR: The NEW way: What Every Parent Needs To Know!!!

No you covered everything just wondered if still teach this?

For the safety of children and people we love it is so important to do CPR training by the time an ambulance gets to your house it could be to late sorry that is negative but unfortunately true, great advice glad you are encouraging this I feel strongly on this one too!!!!

Just wondering do you know why they changed the compressions because last one I went to they said 30 for all so people don't get mixed up have they found 30 to much compression for young children? I have to update mine this year!!!! Thanks Josie



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                josierm
June 28th | josierm
Re: CPR: The NEW way: What Every Parent Needs To Know!!!

Hi mand,

We are both right.

 In the community the ratio of 30:2 is taught for both adults and children to prevent confusion and only require one ratio to remember.  I have included in this article what has been found to be best practice, and what is taught to health professionals.  The 30:2 and 15:2 are taught to health professionals because it is expected that they would have a higher exposure to resus situations and should be able to remember the 2 ratios.

The link I provided (if it works, you might need to copy and paste) included the reasons for the different ratios in FAQ 10.  in summary: the ratio of 15:2 has been found to be best practice for children because -children require higher ventilation rates than adults (breaths are more important for children than adults), Its not a case of TOO MUCh compressions for kids, more TOO LITTLE ventilation.  It fits better with the normal variables of heart rates and breathing rates in children, a large proportion of adults have a store of oxygen in the lungs and make ventilation less of a priority, Children have more resp arrests than cardiac arrest, children maintain their cardiac output for much longer than adults when under stress situations (i.e a blood pressure change in a child is close to pre-terminal, yet this may be an early sign in adults), this is why most paediatric hospital patients wont have routine BP’s done.

Any assistance you can offer is better than none at all, which is why the community ratios are different, but I decided to include in my article the best way that has been found so far.  I am sure with more studies a new best way will be discovered, LOL.

I also forgot to add that pregnant women should be tilted on their left side to improve circulation to the vital organs.

 



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                     mand
July 16th | mand
Re: CPR: The NEW way: What Every Parent Needs To Know!!!

Sorry havent been on here for a while been in and out of hospital getting there now. I thought that might be while they taught us that you are very good a your job. Lately I have meet a lot of nurses in the hospital and you have a very demanding stress ful job espically at night were they only have two nurses on staff in a section they are run of their feet this is quite scarry to see when you are in pain in hospital.



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