perform the back pressure/arm lift method, do the
1. Place the victim on the stomach, face to one
side, neck hyper extend, with hands under the
2. Quickly clear the mouth of any foreign matter.
3. Kneel at the victims head and place your hands
on the victims back so that the heels of the
hands lie just below a line between the armpits,
with thumbs touching and fingers extending
downward and outward.
4. Rock forward, keeping your arms straight, and
exert pressure almost directly downward on the
victims back, forcing air out of the lungs.
5. Then rock backward, releasing the pressure and
grasping the arms just above the elbows.
6. Continue to rock backward, pulling the arms
upward and inward (toward the head) until
resistance and tension in the victims shoulders
are noted. That expands the chest, causing active
intake of air (inspiration).
7. Rock forward and release the victims arms.
That causes passive exiting of air (expiration).
Repeat the cycle of press, release, lift, and release
10 to 12 times a minute until the victim can breathe
CARDIAC ARREST AND
Learning Objective: When you finish this chapter, you
will be able to
Recall the procedures to administer
cardiopulmonary resuscitation (CPR).
Cardiac arrest is the complete stoppage of heart
function. If the victim is to live, action must be taken
immediately to restore heart function. The immediate
administration of cardiopulmonary resuscitation (CPR)
by a rescuer using correct procedures greatly increases
the chances of a victims survival. CPR consists of
external heart compression and artificial ventilation.
The compression is performed on the outside of the
chest, and the lungs are ventilated either by
mouth-to-mouth or mouth-to-nose techniques. To be
effective, CPR must be started within 4 minutes of
the onset of cardiac arrest. The victim should be lying
on a firm surface.
A rescuer who has not been properly trained
should not attempt CPR. (To learn CPR, you
should take an approved course from a
qualified CPR instructor.) Improperly done,
CPR can cause serious damage. Therefore, it is
never practiced on a healthy individual for
training purposes; a training aid is used instead.
In an unwitnessed cardiac arrest, dont assume that
an arrest has occurred solely because the victim is lying
on the floor and appears to be unconscious. Before
beginning CPR, you should
1. Try to arouse the victim (shake the victims
shoulders and shout to try to obtain a response).
2. Lie the unconscious victim on his/her back.
3. Kneel at the shoulders and establish an open
airway, using the procedures outlined
previously in artificial ventilations.
4. Check for breathing by looking, listening, and
a. Look to see if the chest is rising and falling.
b. Listen for air coming from the mouth.
c. Check close to the victims mouth and feel
for air coming out.
5. If the victim isnt breathing, seal the nose, take a
deep breath, and blow four quick breaths into
the victim without allowing time for the lungs to
6. Quickly remove your mouth and allow the
victim to exhale by himself/herself.
7. Check the carotid pulse as shown in figure 14-1.
If no pulse is present, start CPR immediately.