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Performance
Steps
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1. Roll the
casualty onto his back if necessary.
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WARNING:
The casualty should be carefully
rolled as a whole, so the body does
not twist.
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2. Open the airway.
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Note. If foreign
material or vomit is in the mouth, it
should be removed as quickly as
possible (see step 7).
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a.
Head-tilt/chin-lift
method.
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(1)
Kneel at the level of
the casualty’s shoulders.
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(2)
Place one hand on the
casualty’s forehead and apply
firm, backward pressure with the
palm to tilt the head back.
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(3)
Place the fingertips of
the other hand under the bony part
of the lower jaw and lift,
bringing the chin forward.
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Note. Do not use
the thumb to lift.
Note. Do not
press deeply into the soft tissue
under the chin with the fingers.
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b.
Jaw-thrust method.
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Note. This method
is usually used for casualties with a
neck or severe head injury.
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(1)
Kneel above the
casualty’s head (looking toward
the casualty’s feet).
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(2)
Rest your elbows on the
ground or floor.
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(3)
Place one hand on each
side of the casualty’s head and
place the tips of the index and
middle fingers under the angles of
the casualty’s lower jaw.
Place your thumbs on the
jaw just below the level of the
teeth.
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(4)
Raise your fingertips
to lift the jaw forward (upward).
This action will also cause
the casualty’s head to tilt
backward somewhat.
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Note. If the
casualty’s lips are still closed after
the jaw has been moved forward, use
your thumbs to retract the lower lip
and allow air to enter the casualty’s
mouth.
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3. Check for breathing.
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a.
Check for breathing
within 3 to 5 seconds by placing an
ear over the casualty’s mouth and
looking toward his chest.
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b.
Look for the chest to
rise and fall.
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c.
Listen for sounds of
breathing.
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d.
Feel for breath on your
cheek.
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Note. If the
casualty resumes breathing at any time
during this procedure, the airway
should be kept open and the casualty
should be monitored. If the casualty continues to breathe, he should be
transported to medical aid.
Otherwise, the procedure should
be continued.
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4. Give breaths to ensure an open airway.
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Note. When
mouth-to-mouth resuscitation breathing
cannot be performed because the
casualty has jaw injuries or spasms,
the mouth-to-nose method may be more
effective.
Note. Perform the mouth-to-nose method by blowing into the
nose while holding the lips closed.
Let air escape by removing your
mouth and, in some cases, removing
your mouth and separating the
casualty’s lips.
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a.
Maintain the airway and
gently pinch the nose closed, using
the hand on the casualty’s forehead.
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b.
Take a deep breath and
place your mouth, in an airtight
seal, around the casualty’s mouth.
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c.
Give two full breaths (1
½ to 2 seconds each), taking a
breath between them, while watching
for the chest to rise and fall and
listening and/or feeling for air to
escape during exhalation.
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Note. If chest
rises, go to step 8.
Note. If chest
does not rise, continue with step 5.
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5. Reposition the casualty’s head slightly farther
backward and repeat the breaths.
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Note. If chest
rises, go to step 8.
Note. If chest
does not rise, continue with step 6.
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6. Perform abdominal or chest thrusts.
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Note. Abdominal
thrusts should be used unless the
casualty is in the advanced stages of
pregnancy, is very obese, or has a
significant abdominal wound.
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a.
Abdominal thrusts.
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(1)
Kneel astride the
casualty’s thighs.
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(2)
Place the heel of one
hand against the casualty’s
abdomen, slightly above the navel
but well below the tip of the
breastbone, with the fingers
pointing toward the casualty’s
head.
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(3)
Place the other hand on
top of the first.
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(4)
Press into the abdomen
with a quick forward and upward
thrust.
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Note. Each thrust
should be a separate, distinct
movement.
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(5)
Give several thrusts
(up to five).
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b.
Chest thrusts.
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(1)
Kneel close to the side
of the casualty’s body.
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(2)
Locate the lower edge
of the casualty’s ribs and run the
fingers up along the rib cage to
the notch where the ribs meet the
breastbone.
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(3)
Place the middle finger
on the notch with the index finger
just above it on the lower end of
the breastbone.
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(4)
Place the heel of the
other hand on the lower half of
the breastbone next to the two
fingers.
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(5)
Remove the fingers from
the notch and place that hand on
top of the other hand, extending
or interlacing the fingers.
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(6)
Straighten and lock the
elbows with the shoulders directly
above the hands.
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(7)
Without bending the
elbows, rocking, or allowing the
shoulders to sag, apply enough
pressure to depress the breastbone
1 to 2 inches.
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Note. Each thrust
should be given slowly, distinctly,
and with the intent of relieving the
obstruction.
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(8)
Give several thrusts
(up to five).
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7. Perform a finger sweep and repeat breaths.
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a.
Open the mouth by
grasping the tongue and lower jaw to
lift the jaw open or crossing the
fingers and thumb to push the teeth
apart.
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b.
Insert the index finger
of the other hand down along the
cheek to the base of the tongue.
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c.
Use a hooking motion from
the side of the mouth toward the
center to dislodge the object.
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WARNING:
Take care not to force the object
deeper into the airway
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d.
Reopen the airway and
repeat the breaths.
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Note. If chest
rises, go to step 8.
Note. If chest
does not rise, repeat steps 6 and 7
until the airway is clear.
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8. Check for a pulse for 5 to 10 seconds.
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Note. Use the
first two fingers in the groove in the
casualty’s throat beside the Adam’s
apple.
Do not use the thumb.
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a.
If a pulse is found but
the casualty is not breathing,
continue with step 9.
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b.
If no pulse is found,
cardiopulmonary resuscitation (CPR)
must be performed by qualified
personnel.
Send for qualified medical
personnel.
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9. Continue mouth-to-mouth resuscitation, at the rate
of about 10 to 12 breaths per minute.
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10. Recheck for pulse and breathing for 3 to 5 seconds after every
12 breaths.
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Note. Once
breathing is restored, watch the
casualty closely, maintain an open
airway, and check for other injuries.
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