Resuscitation
The information supplied on this page is based on the guidelines issued by the Resuscitation Council UK and applies to adults and children over the age of 8 years.
We run resuscitation courses for relatives of heart attack victims, with the help of Annie our resuscitation mannequin (right). |
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Check the victim and see if he responds:
A. If he responds by answering or moving:
B. If he does not respond:
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- Shout for help
- Unless you can assess him fully in the position you find him, turn the victim on to his back and then open the airway:
- Place your hand on his forehead and gently tilt his head back keeping your thumb and index finger free to close his nose if rescue breathing is required
- Remove any visible obstruction from the victim’s mouth, including dislodged dentures, but leave well fitting dentures in place
- With your fingertips under the point of the victim’s chin, lift the chin to open the airway (left)
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Try to avoid head tilt if you suspect that there is an injury to the neck
Keeping the airway open, look, listen and feel for breathing (more than an occasional gasp or weak attempts at breathing). Do this by:
- Looking for chest movement
- Listening at the victim’s mouth for breath sounds
- Feeling for air on your cheek
Look, listen and feel for no more than 10 seconds to determine if the victim is breathing normally
A. If he is breathing normally:
- Turn him into the recovery position
- Send or go for help
- Check for continued breathing
B. If he is not breathing or is only making occasional gasps or weak attempts at breathing:
- Send someone for help or, if you are on your own, leave the victim and go for help; return and start rescue breathing as below
- Turn the victim onto his back if he is not already in this position
- Give 2 slow, effective rescue breaths, each of which makes the chest rise and fall:
- Ensure head tilt and chin lift
- Pinch the soft part of his nose closed with the index finger and thumb of your hand on his forehead
- Open his mouth a little, but maintain chin lift
- Take a deep breath to fill your lungs with oxygen, and place your lips around his mouth, making sure that you have a good seal
- Blow steadily into his mouth whilst watching his chest; take about 2 seconds to make his chest rise as in normal breathing
- Maintaining head tilt and chin lift, take your mouth away from the victim and watch for his chest to fall as air comes out
- Take another breath and repeat the sequence as above to give 2 effective rescue breaths in all
- If you have difficulty achieving an effective breath:
- Recheck the victim’s mouth and remove any obstruction
- Recheck that there is adequate head tilt and chin lift
- Make up to 5 attempts in all to achieve 2 effective breaths
- Even if unsuccessful, move on to assessment of the circulation
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This is the part of resuscitation that most of us find difficult – try not to worry – just go ahead and do what appears to be correct.
Assess the victim for signs of a circulation:
- Look, listen and feel for normal breathing, coughing or movement by the victim
- Only if you have been trained to do so, check the carotid pulse (the pulse in the neck)
- Take no more than 10 seconds to do this
A. If you are confident that you have detected signs of a circulation:
- Continue rescue breathing until the victim starts breathing on his own
- About every 10 breaths (or about every minute) recheck for signs of a circulation; take no more than 10 seconds each time
- If the victim starts to breathe normally on his own but remains unconscious, turn him into the recovery position. Be ready to turn him on to his back and re-start rescue breathing if he stops breathing
B. If there are no signs of a circulation, or you are at all unsure, start chest compressions:
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- With your hand that is nearest the victim’s feet, locate the lower half of the sternum (breastbone):
- Using your index and middle fingers, identify the lower rib edge nearest to you. Keeping your fingers together, slide them upwards to the point where the ribs join the sternum. With your middle finger on this point, place your index finger on the sternum itself
- Slide the heel of your other hand down the sternum until it reaches your index finger; this should be the middle of the lower half of the sternum
- Place the heel of the other hand on top of the first
- Extend or interlock the fingers of both hands and lift them to ensure that pressure is not applied over the victim’s ribs. Do not apply any pressure over the upper abdomen or bottom tip of the sternum
- Position yourself vertically above the victim’s chest and, with your arms straight, press down on the sternum to depress it between 4-5cms.
- Release all the pressure without losing contact between the hand and sternum, then repeat at a rate of about 100 times a minute (a little less than 2 compressions a second); it may be helpful to count aloud. Compression and release should take an equal amount of time
- Combine rescue breathing and chest compression:
- After 15 compressions tilt the head, lift the chin, and give 2 effective breaths
- Return your hands without delay to the correct position on the sternum and give 15 further compressions, continuing compressions and breaths in a ratio of 15:2
- Only stop to recheck for signs of a circulation if the victim makes a movement or takes a spontaneous breath; otherwise resuscitation should not be interrupted
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Continue resuscitation until:
- Qualified help arrives and takes over;
- The victim shows signs of life;
- You become exhausted
When to go for help:
It is vital for rescuers to get help as quickly as possible.
- When more than one rescuer is available, one should start resuscitation while another rescuer goes for help immediately it has been established that the victim is not breathing
- A single rescuer will have to decide whether to start resuscitation or to go for help first. If the victim is an adult, the single rescuer should normally assume that he has a heart problem and go for help immediately it has been established that he is not breathing. This decision may be influenced by the availability of emergency medical services. However, if the likely cause of unconsciousness is a breathing problem, as in:
- trauma (injury)
- drowning
- choking
- drug or alcohol intoxication
- or if the victim is an infant or a child the rescuer should perform resuscitation for about 1 minute before going for help.
PHEW!
If all of that appears complicated, below is the summary as shown on the Resus Council site
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