CPR Training 101 Guide

I recently took a CPR certification training through the Rescue Training Institute set up via Meetup.com. I found it extremely informative and empowering to feel a bit more capable of dealing with an emergency. The class lasted 4 hours and our instructor worked as an EMT. The certification expires within a year and arrived in less than a week via USPS postal mail.

As part of the training, we were able to get hands on training using both adult and infant dummies for practice. We were also given our own face masks which we practiced using on the dummies. The face mask kit contained a face mask, gloves and alcohol wipes. There’s also a more portable mask available that is a plastic barrier with a filter. This type of mask is less safe but much more convenient.

I’ve included a CPR training video that I found. It is in line with what I learned during training.  I highly recommend taking the training course as it will familiarize you with the actions required in such an emergency. With this training you will be able to take better care of your loved ones. I also found the American Red Cross Adult CPR printout guide here via Dr. Oz.

Here are the notes that I took from the training.

CPR routine is to be done if the person is unconscious and not breathing.

Basic CPR Routine (for age 1 and older):

  1. Tap person to check reaction and check if the chest is moving
  2. If no reaction, call 911
  3. If the chest is not moving (the person is not breathing), start chest compressions 30 times, moving the chest 2 inches.
    1. Compressions should be done quickly at the speed of 100 times in 1 minute.
    2. Compressions are to be done on the center of the chest line (noted to where the nipples are)
    3. Strength should be coming from the shoulders and not from the back to prevent back fatigue and pain.
    4. Ribs may break in this process but can be healed later on. The most important thing is to get the person breathing again. If done correctly, no other injury should occur.
      i.    Breaking ribs is most common in the elderly or people with frail bones.
    5. Adjust pressure depending on the person’s build. More pressure will be required for a larger person, while less pressure will be needed for a smaller person such as a child.
    6. Put the mouth mask or filter onto the person, tilt head all the way back and provide 2 breaths
      1. If you hear a whistling sound, that means air is not going into the chest. Make sure to tilt the head back to allow air flow to reach the chest. Pressure is needed on the mask to force air in. If using a filter, the nose need to be pinched and the mouth needs to be completely covered.
      2. If there are no barriers available, it is your decision whether to provide the breaths. Without the barrier, it is possible for diseases to be transmitted. If you decide not to provide the breaths, continue with the chest compressions.
      3. Repeat steps 3-4 until the ambulance arrives

Basic CPR Routine (for baby younger than 1 year old):

  1. Tap and tickle the baby for a reaction and check if the chest is moving.
  2. If no reaction, call 911.
  3. If the chest is not moving, start chest compressions 30 times, moving the chest 1-1.5 inches.
    1. Compressions should be done quickly at the speed of 100 times in 1 minute.
    2. Compressions are to be done on the center of the chest line (noted to where the nipples are).
    3. Compressions are to be done with 2 fingers instead of the palm of the hand. If your nails are too long, use 2 knuckles instead.
  4. Put a filter over the baby’s mouth and nose as the mouth mask is too large for the baby. Raise the baby’s head so that it is facing straight to the ceiling. Your mouth needs to cover both the baby’s mouth and nose.
    1. If there are no barriers available, it is your decision whether to provide the breaths. Without the barrier, it is possible for diseases to be transmitted. If you decide not to provide the breaths, continue with the chest compressions.
    2. Repeat steps 3-4 until the ambulance arrives.

Choking (for age 1 and older):

  1. In a braced stance with one leg between the other person’s feet, stand behind the choking individual and using a fist, push into the person’s stomach where the belly button is located. The push motion is in the shape of the J, where the top of the J is where the belly button is located. Idea is to push air out to force the food to become dislodged and come out. This will be done 5 times.
    1. An alternative to this motion is for the choking person to lean against a wall and instead chest compressions will be used. This applies to:
      1. Obese individuals: when it is hard to get your arms around their waist
      2. Tall individuals: when it is hard to get the correct position
      3. Pregnant women: their organs have been shifted due to the pregnancy
  2. You can also do this on yourself by pushing your stomach at the belly button level into the bank of a chair or the side of a table. You will need to do it with as much force as you can.
  3. Keep repeating step 1 until the person’s throat has been dislodged or if they become unconscious.
  4. If the person becomes unconscious, gently slide the person onto the floor.
  5. Call 911.
  6. Check the person’s mouth for any signs of the object causing the blockage. If you see it, scoop it out with your pinky.
  7. Complete the basic CPR routine as this will push the air and hopefully dislodge the blockage. Check for the blockage before providing the breaths. The breaths will indicate if the blockage is clear (air will enter into the chest) and if not, will also aide in dislodging the blockage.
    1. The blockage will need to either go up or down. If the blockage goes down into a lung, the person will still be able to breathe with only one lunge. The blockage can be surgically removed in the hospital and the blocked lunge can heal. The important thing is to get the person breathing again.
    2. Since air is being shifted, the person may vomit. If vomiting occurs, move the person to their side to allow the vomit to drain to the side. Vomiting does not ensure the person is breathing.
    3. If the blockage is not cleared, do not tilt the person’s head back.
    4. Repeat steps 5-6 until the ambulance arrives.

Choking (for baby younger than 1 year old):

  1. Holding the baby’s mouth open by the side of the jaw and supporting the baby’s body with your arm, provide 5 strong pats on the center of the baby’s back. The baby should be facing down.
  2. Shift the baby onto your other arm supporting the head with your hand and the body with your arm. The baby should be facing up. Complete 5 chest compressions with 2 fingers.
  3. Repeat steps 1-2 until blockage has become dislodged or the baby becomes unconscious.
  4. If the baby becomes unconscious, lay the baby onto a flat surface on it’s back.
  5. Call 911.
  6. Check the baby’s mouth for any signs of the object causing the blockage. If you see it, scoop it out with your pinky.
  7. Start the basic CPR routine. Check for the blockage between when switching from chest compressions to providing breaths.
  8. Repeat steps 6-7 until the ambulance arrives.

AED (Automated Electrical Defibrillator):

The AED kit is required in large buildings and may contain a face mask, blunted scissors, towel and razors. The AED machine will increase the chance of saving someone from 30-35% to 80-85% success rate.

The AED machine will provide voice instructions once turned on. There will be 2 pads that need to be connected to the machine. The pads will be labeled and indicate where it needs to be attached to the person. One pad will be placed on the upper right side (on the chest closer to the shoulder), the other will be on the lower left side near the ribs. The machine will check for the person’s heart rate and will know whether the electric shock will be appropriate. If the person has any patches, on the chest, remove it completely. Use gloves and a towel to wipe down any residue left. It is possible that the patch is nitroglycerin which will cause the person’s skin to burn. If there is a hard plastic underneath the person’s skin, attach the pad somewhere else such as the shoulder or upper back. If needed, shave or trim the person’s chest hair to provide better skin contact with the pad.

Once the machine is ready to provide the shock, stay away from the person and make sure others are away as well before hitting the start button. Otherwise any person close by will become shocked as well. Once the shock is over and the person is not recovering, continue with the basic CPR routine. If there are other people available, ask them to fetch the AED. Only fetch it yourself if you know exactly where it is and if you are alone.

Heart Attack:
Signs: The person may be sweaty, pale and complain about chest pains.
Call 911, as nothing can be done.

Stroke:
Signs: The person may be week on one side and complain about a headache.
Call 911, as nothing can be done.

Other signs of issues can be the person is zoning out and does not have a reaction.
Ask them to sit down and call 911.

Diabetic emergency:

If the person is acting in an extreme (such as being abnormally quiet or shut down, or being extremely loud),

Seizures:
Signs: can be full body, part of a body, the person can be zoned out, or smell a specific odor. Symptoms depends on which part of the brain is triggered.

Asthma or Allergic Emergencies:
In cases where medication is required such as in an asthma or allergy emergency only assist the person with administrating any medication such as an inhaler or epi-pen. Do not provide any medications or administer it yourself as this is illegal. You are not a doctor and are not allowed to prescribe any medication.

Broken bones:
Apply a splinter using any hard item to prevent movement and further damage. Examples could be a ruler, branch or pencil.
If there is exposed bone and active bleeding, gently wrap the area to try and trap the blood.
Tourniquets are only last resort as this could lead to amputation.

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