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CPR If you do not know it, LEARN IT!!!


1586 Jeff
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45 minutes ago, MTO said:

My 5 yr old gson was choking on steak on our deck yrs back.

His mother , a RN, stood screaming into her hands.

Got my fist under his ribs and that chunk of steak shot out into the yard.

Our golden retriever ran over and ate it.

Josh then returned to his steak.

First heimlich  for me

I then had a couple long necks and shook.

 

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I took it when I got my scuba certification back in 1986. I guess I need a refresher now.

I have a friend whose daughter took it at school on a Thursday about 2 years ago. That night she taught her mother how to do it. The next morning my friend hit the floor with a Widowmaker heart attack. His wife saved him with cpr. The doctor said if she had been there he'd have been up goner.  He is fine now, but has a pacemaker.  Sometimes things are just too coincidental to be coincidence.

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2 hours ago, lightninboy said:

A Heimlich is not usually that big a deal except infants and small children need special attention.

It was obvious I was all he had.

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I've researched a few years ago and made a document, but I don't review it enough to remember it. I figured I wouldn't do hands-only CPR when I was capable of giving breaths.

 

CPR

Have someone call for help if practical.

Six minutes until death, so start right away!

Place victim on his back.

Be on victim’s right side.

Establish open airway.

Check inside mouth with fingers for food, dentures, obstructions.

Use Heimlich Maneuver or give blows between the shoulder blades if necessary.

If victim vomits but still needs breaths, clean him out and keep giving him breaths.

 

Use head tilt – chin lift (push down on forehead and pull up chin or push up on back of victim’s neck) to position victim’s head for open airway or use jaw-thrust to keep airway open if victim has spinal injury. You want to use left arm on forehead pinching nose shut and right hand on victim’s chin to keep victim’s mouth open for mouth-to-mouth. It is possible to give mouth-to-nose.

 

To perform the jaw-thrust maneuver, approach the patient so that you are facing the top of their head. Place each hand on either side of their face so that your thumbs are on the cheek bone and fingers are underneath the jaw bone. Then pull the lower jaw forward by lifting your fingers while pushing slightly down with the thumbs. Alternatively, for more force, you can use your palms to push down on the cheeks as you lift the jawbone.

If you are not trained in the jaw-thrust maneuver, it is better to stick with using head-tilt/chin-lift.

 

To tell if victim is breathing after establishing open airway, turn your head and listen for exhalation and see if the chest falls.

 

Infants are treated similarly to older people but are treated more gently and more rapidly.

 

Check carotid pulse. Is on victim’s right side of neck. Takes 5-10 seconds. Baby has upper arm pulse.

 

Artificial respiration for when there is a pulse but no breathing should be 12 big slow breaths given per minute for adults and 20 small puffs given per minute for infants. Breaths should take 1.5 to 2 seconds for adults. Allow for exhalation. Breaths should take 1 to 1.5 seconds for ages 1-8 and infants. Allow for exhalation.

 

Give breaths mouth-to-mouth or mouth-to-nose. Shut the nose or mouth you aren’t giving breaths into. Victim’s exhalation should be through his mouth.

 

After giving breaths, turn your head and listen for exhalation and see if the chest falls.

 

Give a laryngectomee air through his stoma hole or breathing tube. Don’t tilt his head or pinch shut his mouth or nose.

 

A laryngectomee can’t give air but can perform hands only CPR and can raise and lower the victim’s arms to get some air into victim by the Silvester Method. Put something under victim’s shoulders. Turn victim’s head to the side. Kneel looking down victim’s body from his head end. Put both of the victim’s hands into his chest and compress. Pull both of the victim’s hands and arms upward and outward and downward so they end up stretched out flat on the floor. The compressing expels air. The stretching out of the arms lets air in.

 

Compressions should be given to the lower half of the sternum. Keep your arms stiff and give compressions with your body.

 

Chest compressions for adults 1.5” to 2” or 1/3 to ½ of chest depth about two fingers from the bottom of the chest using your two hands.

 

Chest compressions for ages 1-7 1” to 1.5” 1/3 to ½ of chest depth about one finger from the bottom of the chest using your right hand and using your left hand on victim’s forehead to hold head in position for open airway.

 

Chest compressions for infants .5” to 1” 1/3 to ½ of chest depth about ½ finger from the bottom of the chest using two finders of your right hand and using your left hand on victim’s forehead to hold head in position for open airway.

 

Give compressions at rate of at least 100 compressions per minute to “Stayin’ Alive” or “Another One Bites the Dust”. Adults can take slower and young children can take faster, but then adults are heavier to compress and young children are lighter to compress.

 

Old guidelines: Adults take ratio of compressions to breaths 15:2 one-man, 5:1 two-man, ages 1day-7 take 5:1 and newborn infants take 3:1.

 

New guidelines: 30:2 for everyone one-man and two-man except 15:2 for ages 1-7 and infants two-man.

 

Check for pulse every two minutes or every 4 cycles.

 

Use recovery position for victim with pulse and breathing and no spinal injury. Put victim’s right arm on floor bent at a right angle. Hold the victim’s left hand to his right cheek. Pick up victim’s left knee. Roll him toward you onto his right side. Position his left hand under his right cheek. Place his left leg on floor bent at a right angle. Place victim on his/her side (right or left) extending the lower arm above the head so the head rests on that arm and the opposite hand. Side-lying positions help prevent any blood or vomit from getting into the victim's lungs. Victims left alone should be in this position. Do not put victim in recovery position if spinal injury is suspected. Infant recovery position is cradled in your arms on their side with their head lower than the rest of their body. Make sure they still have breathing and pulse and alertness.

 

If victim is okay and conscious, use shock prevention position. With victim lying flat on his back, have his feet elevated 1’ and have him covered with a blanket.

 

Using an AED is just a matter of following its instructions and sticking two electrodes to the victim’s chest.

 

Never stop resuscitating victim until advanced life support takes over. Even after AED, keep doing CPR until it is established that victim has a pulse.

 

When an infant is choking, support the baby's face, head, and neck, and tilt the baby so the head is lower than the torso. Perform 5 back slaps between the shoulder blades. Flip the infant over and perform 5 CPR chest thrusts. If the object is not out, repeat the back slaps and CPR chest thrusts until the object is removed or the baby becomes unconscious. If an infant becomes unconscious while choking, make sure EMS has been activated. Perform 30 chest compressions, check for the object, and sweep it out if possible. Attempt a breath. If there is no chest rise and fall, attempt another breath. If air still does not go in, perform 30 chest compressions, check for the object again, and sweep it out if possible. Attempt a breath. If there is no chest rise and fall, reposition the airway and attempt another breath. Continue this process until the airway is open and air goes into the lungs. Then check for an upper arm pulse for 10 seconds max. If present without breathing, continue rescue breathing. If no pulse or breathing, begin CPR.

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On 5/10/2021 at 11:11 AM, 1586 Jeff said:

Who has scheduled CPR training/refreshers?

Do it today.

Thanks Jeff, for bringing this up.

I'm due for the 12 month recurrent and it's going to be a ZOOM training. They are sending Annie, the CPR dummy and (I think) the Heimlich pouch via FedEx and I get to have my laptop on the floor with me and Annie. I'm not sure how the Heimlich thing is going to work, perhaps I'll strap it on my wife and give her the hug. The usual training nurse is a 260 pound guy who collapses on you while he's choking! It's good training as you learn how to lower that weight without loosing control. He's a flight nurse and I've often wondered how the helicopter likes the extra weight. Of course they go over other first aid stuff as well.

Another thing we have due the fact we're on our own over the ocean and hours from help is the Tempus device which connects via satellite and does audio, video, EKG, BP,  pulse oximeter, etc., directly to the on duty MD. The med kit on the plane has all sorts of drugs that the doc can prescribe all located so a layman can find them. It's pretty cool as we have done test calls and had one of the guy's EKG read.  It's a popular device on yachts as well that can also be hours or even days from a medical facility.

So far the only thing we've ever had to use for a passenger was an antibiotic and he was ok to continue when we landed in Sicily for fuel and a new crew.

An AED can certainly be operated by following the directions but if you've never used one it would sure be nice to know what to expect and to know that if there's a sweaty or wet chest you will have to dry it or if it's a gorilla guy you might have to shave it. Here's a video:

 

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Accountability check; have you made arrangements for CPR training?

 My fire department is getting a refresher for the EMTs and making arrangements for the other members to get trained.

I have asked my local Extension Agent to get training for the area farmers.

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