CPR and First Aid for Shock and Choking

Vocabulary: chain of survival, defibrillator, cardiopulmonary resuscitation (CPR) rescue breathing, shock

Main Idea: In a medical emergency, a victim’s life depends on a specific series of actions called the chain of survival.

The most urgent medical emergencies are often those in which the victim is unresponsive, or unable to speak or react to his or her surroundings. This condition can result from a heart attack, a stroke, or cardiac arrest. In this type of emer- gency, you need to act quickly, because the first few minutes after a medical crisis are usually the most critical. The key is to know what to do, remain calm, and take action.

An unresponsive victim is in immediate danger. Her or his best hope lies in the chain of survival, a sequence of actions that maximize the victim’s chances of survival.

The links in the chain of survival include the following:

A call to emergency medical services. This first step is important for all victims. The 911 operator will ask you questions about the victim’s condition and instruct you on what to do next. If the victim’s heart has stopped, you will be instructed to move on to the next link in the chain of survival.
CPR, or cardiopulmonary resuscitation. CPR gives the victim a chance to survive until medical help arrives.
Defibrillation. A defibrillator is a device that delivers an electric shock to the heart to restore its normal rhythm. An increasing number of public places now provide automated external defibrillators (AEDs).
Advanced care. Paramedics and other trained medical personnel can provide the care needed to keep the victim alive on the way to the hospital.

CPR
Main Idea: CPR can save the life of a person whose heartbeat or breathing has stopped.

The second link in the chain of survival is to perform CPR on the victim. CPR, or cardiopulmonary resuscitation, is a first-aid procedure that combines rescue breathing and chest compressions to supply oxygen to the body until normal body functions can resume. It takes training from a certified professional to learn how to perform CPR correctly. However, if no trained person is present, it’s better to have CPR done by an untrained person than to wait for paramedics to arrive. Giving CPR as soon as possible is a crucial link in the chain of survival. In some parts of the country, 911 dispatchers are taught how to talk an untrained person through the steps of CPR.

CPR for Adults

Before performing CPR on an adult, check to see if the person is conscious. Tap the victim on the shoulder while shouting, “Are you okay?” I f the victim doesn’t respond, start the chain of survival by calling 911. Then begin performing the steps for CPR shown in Figure 27.4.

CPR for Infants and Children

If the victim is an infant or a young child (under eight years old), the cycle of CPR is still 30 chest compressions for every two rescue breaths. However, the procedure is different in several ways:

Check to see if the child is breathing before calling 911. If the child is not breathing, give five cycles of CPR-about two minutes’ worth-before making the call.

When performing rescue breathing on a baby, place your mouth over the baby’s nose and mouth at the same time-not the mouth only, as for an adult.
Do not use a face mask designed for adult CPR when performing CPR on an infant.

To perform chest compressions on an infant, position your fingers on the baby’s sternum. Press the sternum down about one-third to one-half the depth of the baby’s chest.
To perform chest compressions on a child between one and eight years old, you can either use the heel ofone hand or use both hands as in adult CPR. Position your hands about two finger widths above the end of the sternum, and press the sternum down about one-third to one-half the depth of the child’s chest.

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Figure 27.5 illustrates how to position your hands when performing CPR on an infant or a child.

Other Emergencies
Main Idea: Choking and shock are life-threatening medical emergencies that require immediate attention.

The chain of survival does not apply to every medical emergency. If a person is choking, for example, rescue breathing will not help because the airway is blocked. Knowing the specific first-aid procedures for choking and shock can save lives in a medical emergency.

First Aid for Choking

Choking occurs when an object, such as a piece of food, becomes stuck in a person’s windpipe, cutting off the flow of air. Clutching the throat is the universal sign for choking. Other signs of choking include an inability to speak, difficulty breathing, an inability to cough forcefully, turning blue in the face or lips, and loss of consciousness.

If you see these signs in an adult, help the person immediately by performing abdominal thrusts. If someone else is nearby, ask that person to call 911 while you help the victim. For a choking infant, perform back blows and chest thrusts to dislodge the object. Figure 27.6 illustrates these procedures. If the choking victim is unconscious, lower the person to the floor and try to clear the airway. Reach into the mouth and sweep the object out with one finger. Be careful not to push the obstruction deeper into the throat. If the obstruc- tion cannot be dislodged, begin performing CPR. The chest compressions may dislodge the object.

If you begin to choke when you’re alone, you can perform abdominal thrusts on yourself by covering your fist with the other hand and pushing upward and inward. Another method is to bend over and position your abdomen over a rigid structure, such as a countertop or the back of a chair. Press it to thrust your abdomen upward and inward.

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First Aid for Shock

Shock is a life-threatening condition which the heart is not delivering an adequate supply of blood to the body. Symptoms of shock include:

cold, clammy skin, which may appear pale or grayish.
weak, rapid pulse and altered breathing.
dull, staring eyes, which may have dilated pupils.
faintness, weakness, confusion, or loss of consciousness.

If someone displays these symptoms, call 911 right away. Get the victim to lie down and raise his legs about 12 inches if he is conscious and doesn’t have an injury to the head neck, legs, or spine. If the victim has any wounds or othe; injuries, give first aid for these while you wait for help. Some shock victims become anxious or agitated, so try to keep the person calm. Monitor the victim’s breathing, and be prepared to start CPR immediately ifbreathing stops. Loosen the vic- tim’s clothing and try to keep him warm and comfortable. Don’t give the victim anything to eat or drink. If the victim vomits, drools, or starts bleeding from the mouth, roll him into the recovery position.