Scenario An unconscious individual near some sort of electrical hazard. There’s no one in the vicinity but there is a house nearby which has a telephone. You do not have a mobile. What do you do? Checking that the individual is unconscious - 4marks Examining breathing – 5 marks CPR technique – 11 marks
What to do… Give student ID to examiner Speak through the procedure
Danger Talk your way through the initial part about DANGER Assess the scene “I see an unconscious man lying on his back” Assess the danger “I ensure the safety for myself and victim” “I can’t see any danger – there are no wires touching the individual, no broken glass…”
Response “I check for victim’s response” Shake the victim and rock shoulders Pinch ear or sternal rub (providing different stimuli) Ask loudly in both ears (incase they are deaf in one ear) “Sir! Sir! Can you hear me?” Response – Leave them in the same position and get help No Response – SHOUT “Help” 3 times Now make sure the victim is in Supine Position (head facing the sky, on their back looking up)
Airway “Check for any cervical spine injuries” Feel the cervical spine region “No signs of injury” Head tilt, Chin Lift Tilt the head back Raise the victim’s chin Check for airway potency Open the mouth using two fingers “There are no airway obstructions of foreign material”
Breathing Keep the airway open “I will now check for signs of normal breathing” Put your cheek next to the victim’s mouth Look – for chest rise Listen – for breath sounds Feel – air on the cheek Do this for 10 seconds – count out loud
Breathing (cont’d) If the victim is breathing normally Put them in the recovery position Then call an ambulance Keep checking for breathing If the victim isn’t breathing Call an ambulance “Since there is no bystander around and both the victim and I do not have a phone – I would try the house near by” “Once I have called the ambulance, I will return to the victim and commence CPR” Then start the CPR procedure
CPR Procedure Technique Kneel by the side of the victim Place the heel of one palm on the middle of the victim’s chest with the other hand interlocked above. Find the middle of the chest (you can do it 2 ways): 2 fingers on either side of the nipple Put the heel of your palm, 2 fingers above the xiphoid process Keep your arms completely straight Tower over the chest on your knees If your arms aren’t straight you WILL LOOSE MARKS
30 Compressions Press down on the sternum 4-5 cm (1/3 of chest height) right under the inter-nipple (horizontal) line. If you push down too hard you will hear clicking and you WILL LOOSE MARKS Rate of compressions 2 per second (about 100-120 a minute) Rhythm – ‘1 and, 2 and, 3 and…) or Nelly the elephant song Do 30 compressions… ….followed by 2 rescue breaths
2 Rescue Breaths To give the rescue breaths: pinch the nose shut using your index finger and thumb Keep your palm on his forehead. Chin lift with the other hand opens the airway. Take a deep breath in Form a tight seal around the victim’s mouth with your own Exhale air fully and at a steady rate In such a way that you can see the chest rise See if the chest moves up and down as you breathe.
Finish Keep doing and repeating: 30 chest compressions at 100/min followed by 2 rescue breaths Until: The ambulance or help arrives The individual starts breathing Put them in the recovery position I am completely exhausted
Extra bits and bobs In case of a toddler or drowned individual Initially, 5 rescue breaths 30 compressions Followed by 2 rescue breaths In case of a baby Use two fingers for compressions In a situation when not able to give rescue breaths – give compressions only
Ace the Station Be calm! A relaxed station Student takes full command Not asked any medical questions Memorise CPR procedure that is in your red practical books - those are the guidelines the examiner DON’T USE ANY OTHER GUIDELINES FROM THE NET! Speak out loud the CPR procedure Practice!