How To Save A Life

A requirement recently for one of my doula courses was to take an online CPR certification course and exam. It was my second time taking the course and yet I was refreshed in my knowledge.

It had me thinking that so many people don’t know even basic life saving measures. How to do the Heimlich is probably only what we have seen in movies.

While working on this blog I have had the song by The Fray, “How to Save A Life” in my head. In this song the singer laments that he himself was unable to save a friend because he did not know how.

Don’t let not knowing how keep you from saving a life.

Infant Choking:

Conscious and choking:

• If the infant is choking then place it on your lap.
• If the infant is unable to cough, then start back slaps and chest compressions
• Hold the infant in one of your forearms facing down. Support the head and the jaw with your hand. Head position needs to be lower than the chest.
• Give 5 back slaps in the middle of the back (between the shoulder blades) using the heel of your hand.
• Turn the infant while carefully supporting the head and the neck, with your other hand and the forearm.
• Hold the infant with its head lower than the trunk
• Give 5 chest compressions – compressing with two fingers just below the nipple line. Compress at the rate of 1 per second. (Pace of the “Staying Alive” chorus beat)
• Continue the sequence of 5 back slaps and 5 chest compressions, until the object is removed or the infant becomes unconscious.

Unconscious after choking:

1. If the infant collapses /becomes unconscious, then activate emergency medical services (Only if two rescuers/persons are present)
2. For one rescuer, immediately start CPR (without a pulse check)
3. Position two fingers in the center of the chest below the nipple line
4. Start compressions (1 1/2 inches or 1/3 the depth of the chest) at 100 per minute.
5. After 30 compressions, open airway – Head tilt-chin lift (push the forehead back with one hand and lift the chin to move the jaw forward with the other hand)
6. Check for an object in the mouth, and if you see an object then remove it.
7. Use mouth to mouth and nose technique i.e. cover infant’s entire mouth and nose with your mouth.
8. Give 2 breaths, each for a 1-second duration, and look for chest rise. If the first breath doesn’t make the chest rise and fall, then reposition the head i.e. head tilt-chin lift, and re administer the breaths. Give one breath, every 3-5 second intervals (12-20 breaths per minute).
9. Continue 30 compressions followed by 2 ventilations (check for an object in the mouth each time before the ventilation, and if you see an object then remove it) i.e. ratio of 30:2, until AED or EMS arrives.
10. Leave to activate emergency medical services after 5 cycles or after 2 minutes (only if one rescuer/person is present and EMS has not been activated)

Rescue Breathing:

• Check for response
• If no response i.e. unresponsive and lack of normal breathing i.e. no breathing or gasping
• Activate EMS (Emergency Medical Services or Emergency Response Team) (only if 2 rescuers/persons are present)
• Check for the brachial pulse (continue to check pulse every two minutes). Check the pulse for a MAXIMUM of 10 seconds
• If there is a pulse greater than 60 per minute, start rescue breathing.
• Open airway – head tilt-chin lift (push the forehead back with one hand and lift the chin to move the jaw forward with the other hand) or do a jaw thrust if cervical spinal injury is suspected.
• Using mouth to mouth technique or bag-mask for ventilation
• Give 2 breaths, each for a 1-second duration, and look for chest rise. If the first breath doesn’t make the chest rise and fall, then reposition the head i.e. head tilt-chin lift, and re administer the breaths.
• Continue rescue breathing every 3-5 second intervals (12-20 breaths per minute), each breath for 1 second.
• Check the brachial pulse every 2 minutes

Cardio Pulmonary Resuscitation: CPR

• Check for response
• If no response i.e. unresponsive and lack of normal breathing i.e. no breathing or gasping
• Activate EMS (Emergency Medical Services or Emergency Response Team)  (only if 2 rescuers/persons are present)
• Check for the brachial pulse. Check the pulse for a MAXIMUM of 10 seconds
• If no pulse or pulse less than 60 per minute and signs of poor perfusion then, start compressions
• For one rescuer: Position two fingers in the center of the chest below the nipple line
• Start compressions (1 1/2 inches or at least 1/3 the depth of the chest), doing at least 100 per minute.
• After 30 compressions, open airway – Head tilt-chin lift (push the forehead back with one hand and lift the chin to move the jaw forward with the other hand)
• Use mouth to mouth and nose technique i.e. cover infant’s entire mouth and nose with your mouth
• Give 2 breaths, each for a 1-second duration, and look for chest rise. If the first breath doesn’t make the chest rise and fall, then reposition the head i.e. head tilt-chin lift, and re administer the breaths. Give one breath, every 3-5 second intervals (12-20 breaths per minute).
• Continue 30 compressions followed by ventilations, i.e. ratio of 30:2, until an advanced airway (i.e., endotracheal tube) is placed, then start continuous chest compressions with ventilations at a rate of 1 breath every 6 to 8 seconds (8 to 10 ventilations per minute).
• Leave to activate emergency medical services after 5 cycles or after 2 minutes (only if 1 rescuer/person is present and the EMS has not been activated)

One Rescuer:

• 30:2 chest compression to ventilation (breaths)- using two finger technique below nipple line to compress on the chest

Two Rescuers:

• 15:2 compression to ventilation (breaths)
• For compression: use two thumb encircling hand technique i.e. Encircle the infant’s chest with both hands; spread your fingers around the chest, and place your thumbs together over the lower third of the sternum. Forcefully compress the sternum with your thumbs
• For two rescuers: change the compressor rescuer every 2 minutes i.e. every 5 cycle to avoid fatigue.

Summary:

• Recognition of cardiac arrest (no response and no breathing or only gasping breath )
• Activation of EMS
• Immediate CPR (Pulse check for maximum of 10 seconds then chest compressions followed by breaths)

This is a very heavy topic, so here is a fun video that might lighten your thoughts and might eve help you remember some important aspects of CPR!

Also here is the song by The Fray

And Staying Alive

Abbey is a Birth, Postpartum, Bereavement, and Sibling Doula, Breastfeeding Educator, Post Abortion Counselor, Photographer, and Artisan in Fort Worth Texas. Abbey strives to make services available to everyone through financial assistance, income based services, and more!