Assess the Scene

Check the scene for safety hazards BEFORE providing care.

  • You and the victim should be in a safe location, free of imminent danger or hazards.
  • Check the person for responsiveness
    • Tap on victim’s shoulder and shout “Are you okay?”
  • Call 911 or direct a bystander call 911
  • Apply personal protective equipment (PPE)
  • Check for pulse (about 10 seconds)
  • Request AED machine, if available

If you are alone:

Adults:
  • FIRST call 911
  • Retrieve AED, if available
  • Perform CPR cycle until EMS takes over or you are too tired to continue
Children and Infants:
  • FIRST complete five cycles (about 2 minutes) of CPR
  • Call 911
  • Perform CPR cycle until EMS takes over or you are too tired to continue

Always provide care first for unresponsive victims of hypoxic arrest (i.e. lack of oxygen to the brain due to drowning, injury, drug overdose, stroke, etc…).

Naloxone or Narcan, if available, may be administered by a bystander if suspected life-threatening opioid overdose has occurred. 

Assess the Victim

Assess the approximate age and size of the victim. Suggested guidelines for administering CPR are as follows:

  • Adult CPR: should be administered to victims who have reached the onset of puberty and older.
  • Child CPR: should be administered to victims who have not reached the onset of puberty and are not considered infants (approximately 1 year to the onset of puberty).
  • Infant CPR: should be administered to victims who are younger than toddler aged (approximately birth to 1 year).

Compressions - Airway - Breathing

C-A-B (Compressions-Airway-Breathing) Order

  • Begin Compressions
  • Open Airway with head tilt–chin lift method, check breathing, AT THE SAME TIME
  • Give 2 rescue Breaths

Head Tilt-Chin Lift Method

Use one hand on the forehead to tilt the victim’s head back. AT THE SAME TIME place the other hand under the victim’s chin, lift the chin to open the airway and displace the tongue. Look into the victim’s mouth for an obstruction. If you see an obstruction, remove it immediately.

Rescue Breaths

Keep airway open with head tilt-chin lift method. Administer one rescue breath (1 second). Observe chest for rise and fall. If breath does not go in, re-tilt head and administer second rescue breath (1 second). Observe chest for rise and fall AT THE SAME TIME as administering rescue breaths.

Use one of the following methods to administer rescue breaths:

  • Mouth-to-barrier
  • Mouth-to-nose
  • Mouth-to-stoma (an artificial opening in the neck, such as a breathing tube)

Chest compressions, which keep oxygen flowing to the brain, is the single most important factor in life saving procedures.

Chest Compressions

Chest compressions should be swift, hard and consistent, at a rate of 100-120 per minute.

Use

  • Adult: Two hands (heel of dominant hand)
  • Child: One hand (heel of dominant hand)
  • Infant: Two fingers

Depth

  • Adult: At least 2 inches, but no more than 2.4 inches
  • Child: At least 1/3 depth of the child’s body (or 2”)
  • Infant: At least 1/3 depth of the infant’s body (or 1 ½”)

Position

  • Adult and child: On the breastbone (sternum)
  • Infant: On the breastbone, just below nipple line

Rate

  • 100-120 compressions per minute

CPR Cycle

Perform 30 compressions then administer 2 rescue breaths

  • At a rate of 100-120 compressions per minute
  • Check for signs of breathing (rise/fall of chest)

Continue CPR cycles until:

  • AED becomes available
  • Victim shows signs of life
  • A second rescuer takes over
  • EMS takes over
  • You are too tired to continue

Identify Airway Obstruction

Partial air exchange

  • Mild: victim is able to produce forceful cough
  • Severe: victim is able to produce weak, ineffective cough
  • Complete blockage: victim is unable to breathe, cough or speak

Common causes for airway obstruction

  • Tongue, foreign object, vomit, allergic reaction, spasm, swelling

Caring for Airway Obstruction

Responsive adult or child: Heimlich Maneuver

  • Abdominal thrusts just above navel
  • Continue until object is removed or victim is unresponsive
  • Chest thrusts should be used for larger or pregnant victims

Responsive infant

  • Support infant’s head and lay face-down over your forearm
  • Support forearm with thigh
  • Give five back blows
  • Roll infant face up
  • Check for breathing
  • Continue until object is removed or victim is unresponsive

Unresponsive adult or child (if breath does NOT go in)

  • Re-tilt head
  • Reattempt breath
  • Begin CPR
  • Check airway
  • Remove object

Unresponsive infant (if breath does NOT go in)

  • Re-tilt head
  • Reattempt breath
  • Begin CPR
  • Check airway
  • Remove object