1. CPR
Chapter 2

2. CPR Breathing Barriers
The chance of getting a disease from giving rescue breaths is extremely small.
Examples: Face shields and resuscitation masks
Barrier helps protect you from contact with blood and other body fluids.
These devices also protect you from breathing the air that the person exhales.
Do not delay rescue breathes while waiting for a CPR barrier.

3. Special Breathing Situations
Air in Stomach: When you are giving rescue breaths, be careful to avoid forcing air into the person’s stomach instead of the lungs. This may happen if you breathe too long, breathe too hard or do not open the airway far enough.
Vomiting: Even when you are giving rescue breaths properly, the person may vomit. If this happens roll the person onto one side and wipe the mouth clean.
Mouth-to-Nose Breathing: If you are unable to make a tight enough seal over the person’s mouth, you can blow into the nose.
Mouth-to-Stoma Breathing: Check the person’s neck to see if he or she breathes through a stoma.
Head, Neck and Spinal Injuries: Minimize movement of the head and neck when opening the airway. Carefully tilt the head and lift the chin just enough to open the airway.

4. Cardiac Chain of Survival
CPR alone may not be enough to help someone survive cardiac arrest.
A person in cardiac arrest will have the greatest chance of survival if you follow the four links in the Cardiac Chain of Survival.
1. Early recognition and early access to the EMS system.
2. Early CPR
3. Early defibrillation (AED)
4. Early advanced medical early (EMS transport to hospital)
For each minute that CPR and defibrillation are delayed, the chance for survival is reduced by about 10 %.

5. What to Look For…
The main signals of cardiac arrest in an adult, a child and an infant are unconsciousness and no breathing.
The presence of these signals means that no blood and oxygen are reaching the person’s brain and other vital organs.

6. When to call 9-1-1…
Call or local emergency number IMMEDIATELY if you suspect that a person is in cardiac arrest or you witness someone suddenly collapse.

7. What to Do Until Help Arrives…
Perform CPR until an AED is available and ready to use or advanced medical personnel take over.

8. ADULT CPR CHECK-CALL-CARE
The person should be on his or her back on a firm, flat surface.
Performing CPR:
Position your body correctly by kneeling beside the person’s upper chest, placing your hands in the correct position, and keep your arms and elbows as straight as possible so that your shoulders are directly over your hands.
Locate the correct hand position by placing the heel of one hand on the person’s sternum at the center of his or her chest.
Place your other hand directly on top of the first hand and try to keep your fingers off of the chest by interlacing them or holding them upward.
Give 30 chest compressions, push hard and fast 2 inches deep
Give compressions per minute
After each compression release the pressure without removing your hands or changing hand position.
Head tilt, chin lift- open the airway and give 2 rescue breathes
Continue cycles and minimize interruption

10. Cardiac Emergencies in Children and Infants
It is rare for a child or an infant to initially suffer a cardiac emergency.
Usually, a child or an infant has a respiratory emergency first and then a cardiac emergency develops.
Causes:
1. Airway and breathing problems
2. Traumatic injury or an accident
A hard blow to the chest
Congenital hear disease
Sudden infant death syndrome (SIDS)

11. CHILD CPR CHECK-CALL-CARE
The person should be on his or her back on a firm, flat surface.
Performing CPR:
Position your body correctly (same as Adult CPR)
Locate the correct hand position (same as Adult CPR)
Depending on child’s size and weight, decide to use one or two hand position as long as you are able to give CPR 2 inches.
Give 30 chest compressions, push hard and fast 2 inches deep
compressions per minute
After each compression release the pressure without removing your hands or changing hand position.
Head tilt, chin lift- open the airway and give 2 rescue breathes
Continue cycles and minimize interruption

12. INFANT CPR CHECK-CALL-CARE
The infant should be on his or her back on a
firm, flat surface.
Performing CPR:
Finding the correct location for compressions.
Keep one hand on the infant’s forehead to maintain an open airway.
Use the pads of 2 or 3 fingers of your other hand to give chest compressions on the center of the chest, just below the nipple line.
Give 30 compressions 1 ½ inches deep.
When your fingers are coming up, release pressure on the infant’s chest completely but do not let your fingers lose contact with the chest.
100 compressions per minute
Head tilt-chin lift, give 2 rescue breaths

13. If Chest Does not Rise with Rescue Breaths
If the chest does not rise with the initial rescue breath, re-tilt the head before giving the second breath.
If the second breath does not make the chest rise, the person may be choking.
After each set of chest compressions, check for an object, remove it and continue CPR.