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 You may have read other articles about CPR….these may be out of date.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