1. Medical Emergencies: CPR and Choking Coconuts Beach Bar and Grill Restaurant 15208 Red Hollow Road Gravois Mills, MO 65247 Cassie Wilhelm Manager Cell: 573-789-5030 1

2. Table of Contents  Introduction………………………………………3  Emergency Numbers…………………………...4  Safety Warnings………………………………….5  Local Resources………………………………….6  Procedure #1-CPR………………………………7  CPR on Adults…………………..……………...8-9  Supporting Information for CPR……………..10  Procedure #2-Choking…………..……...........11  Choking for Adults………………………….11-13  Supporting Information for Choking………..14  Additional Resources………………….……....15  References………………………………………16 2

3. Introduction  In this procedure manual, the employees of Coconuts Beach Bar and Grill will learn the proper techniques of how to perform CPR and dealing with a choking victim within the restaurant. The employees will be able to demonstrate the skills, and the proper steps to follow in a medical emergency. This manual will discuss how to perform CPR, when CPR is needed, and what to do after CPR. Also, the manual will discuss the signs on choking, how to help one who is choking, and what to do after a choking victim has recovered. The purpose of this manual is to prepare the Coconut’s employees of a potential medical emergency. 3

4. Emergency Numbers  911 - Medical Emergencies  573-378-5481 Sheriff’s Department  573-378-5438 Morgan County Health Center

5. SAFETY WARNINGS 1.BEFORE PERFORMING CPR CALL 911 OR HAVE SOMEONE ELSE CALL 911. 2. DO NOT PERFORM CPR IF A SPINAL INJURY IS SUSPECTED. 3.CPR IS EXHAUSTING: IF YOU ARE NOT TRAINED IN CPR OR ARE NOT COMFORTABLE GIVING BREATHS, CONTINUE COMPRESSIONS ONLY

6. Local Resources Gift Shop Main Rest. First Aid Kit, land line and CPR Manual locations: Pool Bar

7. CPR The purpose of this procedure is to teach employees when to perform CPR, how to perform CPR and what to do after CPR. January 2013  Cardiopulmonary Resuscitation is an emergency procedure; performed in an effort to manually reserve intact brain function until further measures are taken to restore natural blood circulation and breathing in a person. It is indicated in those who are unresponsive with no breathing or abnormal breathing. 7

8. CPR on an Adult (ages 8+)  Check the scene to make sure it is safe.  Shake or tap the adult and shout, “Are you okay?”  Watch chest and nostrils for signs of breathing.  Have another person call 911, and place the victim flat on their back. (Do not leave the victim until CPR has been performed for at least 2 minutes.  IF not breathing then begin…….  GIVE 30 CHEST COMPRESSIONS: Place hands on top of each other, palm down. Then push hard and push fast in the middle of the chest at least 2 inches deep between the separation of the ribs and below the nipples thirty times. Let the chest fully rise between each compression. 8

9. CPR on an Adult Continued…  Look, listen, and feel for any breathing. Place your ear over the mouth and nose, watch for chest movement, feel for breath on your cheek.  GIVE 2 RESCUE BREATHS: Tilt the head back and lift the chin up. (As to open the airway.)  Pinch the nose shut, then make a complete seal over the person’s mouth with ones own mouth.  Blow in for about 1 second to make the chest clearly rise. (Give rescue breaths, one after the other.)  Return back to chest compressions and repeat this cycle until the victim begins breathing again or help arrives.  If the victim begins breathing again, place him or her in the recovery position: Laying on their left side with their head resting on their left arm. 9

10. CPR-Supporting Information  To become CPR certified: Visit your local health center to see when classes are offered or go www.redcross.org/CPR- Training  CPR Video: http://www.youtube.com/watch?v=1wj- zixnz2s 10

11. Choking The purpose of this procedure is to teach employees the signs of choking and how to care for someone who is choking. January 2013  Choking is the severe difficulty of breathing caused by compression or obstruction of the larynx or trachea. This is a medical emergency and can be treated by forcefully coughing, back blows, or doing the Heimlich Maneuver. 11

12. Choking: Adult The same techniques can be used on a choking adult and child.  Look for signs of distress: The person cannot speak or cry out, breathing is labored-gasps or wheezes, person violently coughs or gurgles, the person clutches their throat or mouth, or tries to induce vomiting. The person’s face may turn blue if breathing is not restored within a certain time.  Ask the person, “Are you choking?”  Encourage them to cough as hard as possible, if this does not help:  Bend the victim over at the waist and PERFORM 5 HARD BLOWS with the heel of the hand to the upper back of the victim between the shoulder blades. 12

13. Choking: Adult Continued…  GIVE 5 ABDOMINAL THRUSTS: Heimlich Maneuver  Standing behind the victim: Place a fist with the thumb side against the middle of the person’s abdomen, just above the navel; and cover your fist with your other hand.  Give 5 quick, upward abdominal thrusts.  Continue care by giving sets of 5 back blows and 5 abdominal thrusts until the object is forced out, or the person can cough forcefully or breathe.  Attached is a link that demonstrates the proper techniques to care for a choking adult or child. http://www.youtube.com/watch?v=SwJlZnu05 Cw 13

14. Choking-Supporting Information  Choking is a serious medical emergency and that is why it is important to be prepared and know what to do if a situation like this arises. The information presented in this section is found online at on any secure medical site, and the information is update.  The video links provided are demonstration videos that aid in the learning process of assisting choking victims.  Contact or visit www.redcross.org to learn more.www.redcross.org 14

15. Quiz Questions  What is the first thing you do when you come upon this scene? A: Make sure scene is safe, ask person if ok.  Why do you tilt the head back, chin up? A: Open the airway  What is the proper CPR performance? A: 30 compressions to 2 breaths  Where do you place your hands? A: On-top of each other below the breast plate and between the rib cage.  How long do you perform CPR? A: Until victim breaths on their own or help arrives.  What do you do after the victim begins to breath? A: Lay victim on their left side with left arm under head. 15

16. Suggested Resources  To Learn more visit: www.redcross.org www.babycenter.com OR visit your local health center and obtain pamphlets, instructions, and video demonstrations on CPR and Choking.  For questions or concerns regarding this procedure manual: Contact the Manager at Coconuts: 573-372-6500 16

17. References  Ignatavicius, D. and Workman, M.L. (2010) 6 th Ed. Medical-Surgical Nursing. Patient- Centered Collaborative Care. 1(1). Ignatavicius, D. and Workman, M.L. (2010) 6 th Ed. Medical-Surgical Nursing. Patient- Centered Collaborative Care. 1(1).  http://www.mayoclinic.com/health/first-aid- choking/FA00025 http://www.mayoclinic.com/health/first-aid- choking/FA00025  www.redcross.org/CPR-Training www.redcross.org/CPR-Training  YouTube: http://www.youtube.com/watch?v=SwJlZnu05 Cw http://www.youtube.com/watch?v=1wj-zixnz2s 17