Chapter 5 CPR Precautions, Complications, and Special Situations

CPR Performance Mistakes Rescue breathing mistakes Failing to ensure adequate head tilt-chin lift Failing to pinch the nose shut Failing to give slow breaths Providing breaths that are too fast or too forceful Failing to watch the person’s chest rise and fall Failing to maintain a tight seal around the mouth or barrier device

CPR Performance Mistakes Chest compression mistakes Pivoting at knees instead of hips Using wrong compression site Bending elbows Failing to place shoulders above the sternum Touching your fingers to the chest Providing quick, stabbing compressions Failing to allow the chest to fully recoil Failing to keep your hands in contact with the chest

Precautions During Training Practice the following on a manikin: Mouth-to-mouth resuscitation Chest compressions Abdominal or chest thrusts Wash your hands before and after class. Clean the manikin before using it. Do not put anything in your mouth when using a manikin.

Disease Precautions During CPR Training DO NOT use a manikin if you have the following: Sores on the hands, lips, or face An upper respiratory infection Hepatitis infection HIV or AIDS infection An infection or recent exposure to an infectious source Clean the manikin between use.

Disease Precautions During Actual CPR Use a mouth-to-barrier device. If you refuse to give rescue breaths, active EMS and give chest compressions until another provider arrives.

Dangerous Complications Dangerous complications include: Vomiting Stomach distention Inhalation of foreign substances Chest compression-related injuries Dentures, loose or broken teeth, or dental appliances

Special Resuscitation Situations: Stroke Call 9-1-1. Monitor breathing; if not breathing, begin CPR. Loosen tight or constricting clothing. Be prepared to turn the person onto his or her side. If the person is unresponsive but breathing, place the person on his or her side.

Special Resuscitation Situations: Hypothermia DO NOT start CPR in the following situations: The person has been submerged in cold water for more than 1 hour. The person has obvious fatal injuries. The person is frozen. The person’s chest is stiff or compressions are not possible. Rescuers are exhausted or in danger.

Special Resuscitation Situations: Person in an Avalanche If the person is unresponsive and not breathing, begin CPR. Use an AED as soon as available. DO NOT attempt resuscitation in a person buried for 35 minutes or longer with an airway obstructed by snow or ice.

Special Resuscitation Situations: Drowning Person Give CPR as soon as an unresponsive person is removed from the water. Rescue breathing can begin in shallow water. If vomiting occurs during CPR, turn the person onto his or her side. Stop CPR after 30 minutes unless the person is hypothermic.

Special Resuscitation Situations: Person Struck by Lightning When multiple people are struck at the same time, rescuers should give highest priority to people who are unresponsive and not breathing. Use an AED as soon as available.