To start external cardiac compression—1. Place the victim on his/her back, establish anopen airway, and kneel at right angles to thevictim’s body.2. Then locate the victim’s sternum (breastbone)by—a. Baring the chest and locating the sternum bydrawing an imaginary line from one nippleto the other to identify the proper area of thesternum, which is darkened in figure 14-2.b. Locating the lower tip of the sternum withthe index and middle fingers, placing theheels of your hands above your fingers in thedarkened area.NOTEThere is a small piece of cartilage at thelower end of the sternum (fig. 14-2). Afracture of this area can damage the liver,causing hemorrhage (heavy bleeding)and death. When you place the heels ofyour hands on the victim’s chest, stayabove the tip of the sternum.3. Place the heel of one hand directly on thesternum, and the heel of the other on top of thefirst. Figure 14-3, view A, shows this technique.Interlock your fingers, and keep them off thevictim’s chest!4. Lean or rock forward with elbows locked, andapply vertical pressure to depress the sternum(adult) 1 ½ to 2 inches (fig. 14-3, view B).5. Then release the pressure, keeping the hands inplace.6. Administer 60 to 80 compressions per minute.You won’t get as tired if you use the propertechnique, and you will be more effective. Ineffectivecompression occurs when the elbows are not locked, therescuer is not directly over the sternum, or the hands areimproperly placed on the sternum.14-5Student Notes:Figure 14-1.—Feeling for the carotid pulse.Figure 14-2.—Locating the sternum.Figure 14-3.—Position for cardiac compression.
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