First Aid - Respiration & Recussitation

BREATHING STOPS & SURVIVAL CHANCES CHART:
1 min. 98% survive
5 min 25% survive
10 min. 1% survive

EMERGENCY PROCEDURE UPON ARRIVAL:
Take away the cause or move away the victim from the cause if need be yet only if you really have to before F/aid.
Open and keep free the air passage by driving back the victim's head as far as possible.

START ARTIFICIAL RESPIRATION IMMEDIATELY:
If air passage is blocked: Check for strange objects in the mouth & throat & remove them if possible, if not; then turn the victim on its side. Usually it will permit air to pass around the
object.
Have someone call the ambulance loosen up tight clothes around waist & neck if need be. Help maintain free air passage. Keep on doing artificial respiration till it is back to normal; or that a doctor has come.
The victim MUST stay laid down even when respiration is back to normal. In a semi-prone position preferably. Keep checking the victim who can cease to breath again.
Transport the victim to a shelter or hospital in a lay down,position Only. The victim MUST NOT get up nor walk. We assume,here that it happens in "normal" situation.

MOUTH TO MOUTH RESPIRATION & MOUTH TO NOSE: (Babies etc.):
This method can be used to all type respiratory stoppage.
Either: Drowning, strangling suffocation, excess of drugs, electrocution, heart attack, poisoning by gas, smoke inhalation.
REMEMBER to remove either the cause or the victim quickly. Sooner you start the best are your chances. Start anywhere on the beach car bed street boat standing in water etc.
1) Free the respiratory channels. Lift the neck with one hand with the other hand: Pull the head toward the back.
2) Pinch the nostril to close them keep the respiratory channels free while maintaining the neck uplifted.
3) Cover entirely the victim's mouth blow into it check to see if the chest rise showing that air is going in. If not; there is most likely something that blocks the air flow.
4) Remove your mouth. Loosen the nostrils. Check if air is coming out of the lungs & if chest is collapsing.
5) Repeat last 3 phases 12 to 15 times/minute. Keep it up till breathing back to normal or doctor comes.
6) When breathing comes back, MAKE SURE it maintains itself. Keep the victim laid down in semi-prone position.

FOR CHILDREN & BABIES:
You MUST entirely cover the mouth & nose of the child with your own mouth.
Blow every 3 second (20 times /min) yet with less pressure & volume then adults. Small air blow is all that is needed for am child.
Practice it with your wife or hubby it might be fun but also it will teach you best in case of crisis.
For a child you can also try first: To hold him temporarily with its head upside down, holding it by the ankles or over your arm with its head down while giving him 2 or 3 good slap between its shoulder blades
.
BREATHING PASSAGES MUST BE FREE AT ALL TIMES! If they are blocked you will note:
1) No air is coming out.2) Thorax is not rising nor collapsing.3) That your air blow is meeting resistance.
Consequently you MUST verify the neck & head position and also the presence of foreign objects in mouth or throat.

HOW TO FREE RESPIRATORY CHANNEL:

METHOD OF THE HEAD THROWN AT BACK:
Put IMMEDIATELY the victim on its back, neck stretched and head lifted up.
In order to maintain him in this position place a poncho rolled blanket, a pillow etc. Under the victim's shoulder.
But don't waste time looking for those objects, TIME IS VITAL. This method is useful in many cases.

UP-LIFTED JAW METHOD:
When the other don't work.
Bring the jaw as far back as possible. This position removes the tongue base from the bottom of the throat thus easing the air flow to its chest and lungs.
In order to help you do this you can use your thumb or use both hands.
Jaw up lifted with the thumb is the best method to free the jaw unless the victim's condition does not permit it., Place your thumb in the victim's mouth to take a grip of its jaw & pull toward the back. Don't try to retain the tongue.

JAW UP LIFTED WITH BOTH HANDS:
When the jaws are squeezed tightly together & that it is impossible to put your thumb into its mouth then grab with your 2 hands the lower jaw (just under the ear-lobe) to firmly bring it
toward the back. Then in the same movement open the mouth`s victim bringing with the help of your thumbs the inferior lip toward the shin.
If after having tried those 2 methods to try freeing the respiratory passage the victim doesn't breath properly; YOU MUST IMMEDIATELY START THE ARTIFICIAL RESPIRATION.

If you are in doubt whereas the patient is breathing or not then act as if was not breathing. It cannot in no way bring harm to someone who is already breathing.
Usually when someone breathes we can feel & see movements of his chest or perceive or hear his expirations by placing his hand or ear near by his mouth. If the heart of the patient is not beating
do a heart massage.
When 2 persons can be used one does the heart massage while the other one does the artificial respiration. If alone you have to do both as we'll see later on.

MOUTH TO MOUTH RESPIRATION:
1) Victim MUST be on its back, put yourself aside its head. Slide your hand under his neck so that you can maintain his face in a vertical position & to keep it inclined as far back as possible.
2) Use the thumb & index of your other hand to pinch the nostrils of the victim while exercising a pressure on his forehead in such a way as to keep his head at the back. To keep the nose blocked you can press your cheek on his nostrils.
3) Breath deeply & adjust tightly your mouth to his. If it is a baby, cover up his mouth & nose by sealing your lips against the skin of his face.
4) Blow strongly in the mouth of the victim so that the chest rises.
FOR A CHILD DO IT IN SMALL BLOW. If the chest rises it means that
sufficient air is getting in the lungs.
If the chest does not rise correct the situation IMMEDIATELY by adjusting his jaw and blow even stronger.
While doing this MAKE SURE: That air cannot escape by the side of your mouth or the victim's nose.
If the chest is still not rising; turn the head on the side free his respiratory passage by:
Opening his mouth and introducing your fingers down to the tongue base as deep inside his throat as you can, removing in a sweeping movement all vomit or any foreign objects unless those firmly stocked in it.
If it still remains blocked roll the victim on its side then with the hand-palm strike him strongly between the shoulder blades to remove whatever his blocking the passage. Then start the artificial respiration procedure once more.
5) When the victim's chest is rising remove your mouth from his, then listen close to the noise that the air is making coming out of his chest. If the breathing exhalation is noisy lift up higher the jaw of the patient.
6) After each exhalation squeeze the nose & reblow his lungs while MAKING SURE visually that the chest is expanding & contracting.

YOUR FIRST 4 BLOWS MUST BE TOTAL & QUICK.
(Except for a kid which requires small ones.) So that you avoid the lungs to deflate completely.
7) Do this every 5 sec till the victim is conscious. If the victim does not give signs of life do it for 45 minutes at least!
When you blow deeply quickly & for a long time you may get dizzy even faint so you MUST after the first 4 quick blows get back to a normal speed. That way you will be able to do it for a long time.

MOUTH TO NOSE:
It is done the same as for the mouth. It is used when there is a mouth fracture or bad wound to the patient or if the jaw is too tight due to spasms.

PRESSURE ON THE CHEST WITH UP LIFTING OF THE ARMS:
This method is used when the face is too badly injured to do otherwise. It is not as good as mouth to mouth however!
1) Free the respiratory passage of the victim. Lay him on his back his face in vertical position & place a blanket etc. Under the shoulders so that his head is pushed backward.
1b) Put yourself at the height of his head facing the victim's feet. Put a knee down on the ground the other flat near his head & neck and shoulder. In order not to get tired you can alternate your position from time to time.
2) Grab the patient's hands & hold them on his lower ribs while projecting yourself forward in order to create a regular & uniform & regular pressure until you feel a firm resistance. That way you push the air outside of the lungs.
3) Lift up his arms straight up vertically then bring them backward to the ground as far as possible. This increases the lung volume & brings air to the lungs.
4) Replace your hand on his chest & start all over the same movements: press lift stretch & bring back at the rate of 10 to 12 cycles per minute in a regular & uniform way. The first 3 movements (press lift & stretch) MUST be done in the same rhythm BUT: the 4th: (bring back your arms on his chest) MUST be done as quickly as possible.
5) When the patient seems to breath help him by regulating your efforts to help him. Keep up the artificial respiration till he is back to consciousness or that you are replace by a doctor. Or during at least 45 minutes if he does not show signs of life.
6) HOW TO GET REPLACE WHEN YOU GET TOO TIRED: Keep the rhythm move to the side and let him start by taking the wrist when you are bringing them on the ground.

HEART MASSAGE:
When a person's heart ceases to beat, you MUST MASSAGE IT DIRECTLY ON THE CHEST.

TIME IS VITAL. Heart failure stops also the breathing process unless that one came first. Stay calm.
When the heart stops there is no pulsation the victim is limp & THE PUPILS OF THE EYES ARE WIDE OPEN.

TO CHECK IF PULSATION OR NOT: Place the tip of your fingers on the victim's neck along the
windpipe. If you do not feel any pulse do not waste time looking for it.

START IMMEDIATELY the heart massages along with the artificial respiration. The same initiative is to be done with a weak pulse or irregular that is usually a sign before a heart failure. The heart is located between the sternum & the spinal cord.
The pressure done on the sternum pushes the heart against the spinal cord to push off the blood & forces it into the arteries while relaxing the pressure permits the heart to fill itself of
blood.
When you MUST do a heart massage we MUST ALWAYS do the artificial respiration at the same time.
So it is preferable to be 2 to do the task while one does the heart massage the other does the artificial respiration.

If you MUST do both operations, do this:
1) You MUST ALWAYS lay the patient on its back, to massage his heart to allow the blood to flow to reach his brain. A solid surface is needed so use the floor because a bed or sofa is too soft.
In order to help the return of the blood toward the heart lift up the feet 6" while keeping the body horizontally.
2) Place yourself on one side near the body then place the palm of your hand on the inferior part of the sternum but NOT in the soft tissues of the abdomen which are at the sternum's base or
thorax cage.
3) Stretch and lift your fingers in such a way as to make a pressure on the sternum without oppressing the ribs.
Put your other hand over the first one except if it's a child. If it's a child use only the tips of your fingers of one hand.

BASIC PROCEDURE:
Your hands being in the right position, bring back your shoulders directly over the sternum of the person.
Keep your arms straight & press downward with enough strength to lower the sternum about 1 1/2 to 2" maximum.
Too strong a pressure could result in breaking the ribs. So when it is a baby or child use only your finger tips.
Relax the pressure immediately all the while keeping the palm of your hand on the sternum, which will take back its normal position between each compression.

METHOD WHILE USING 2 RESCUERS:*
One does the artificial respiration, the other the massage. This massage MUST be done to the rhythm of 1 compression per sec. (60 per min.) This rhythm is possible because he doesn't have to do
tthe artificial respiration. These compressions MUST be without cease, uninterrupted, softly &
regularly.
In order to keep the rhythm of 60 per min. The rescuer MUST count at high voice (no yell): one-1000, one-2,000, one-3,000, one-4,000, one-5,000.

Each time you say the word "one" you MUST compress the heart. & when you say the word "1,000" you relax the compression. You restart the same cycle all over from:one-1000 to one-5,000 without fail during all the heart massage procedure.
Simultaneously, the other rescuer in charge of the artificial respiration, blows quickly into the patient's mouth every 5 compressions. (Proportion 5 to 1).
When his helper says 5,000. It will be his moment to blow into the mouth of the patient.

WARNING UTMOST IMPORTANT:
WE MUST NEVER STOP THE COMPRESSION MOVEMENT OF THE HEART WHILE THE OTHER IS DOING THE ARTIFICIAL RESPIRATION PROCEDURE.
IT'S AN EXTREMELY IMPORTANT POINT OTHERWISE IT WOULD RESULT IN A COMPLETE FALL OF THE ARTERIAL PRESSURE THUS DEATH.
2 rescuers do a better job if they place themselves separately each on his own side of the patient.
It is then easier to replace one another when they get too tired, & without interrupting sensibly the rhythm of 5 to 1.

THIS CHANGE IS DONE SO:
The one in charge or artificial respiration (A/R) (pressure on the chest with lifting up the arms) takes place on the side of the person, IMMEDIATELY after having inflated the lungs.
Then he brings back his hands over the hands of his companion, who keeps on massaging the heart.
The change of hands will be done on the count of :one-2,000 or one-3,000 in the compression procedure.
It is at that time that they both switch jobs. The next inspiration MUST be done on the count of : one-5,000.

PROCEEDING MEASURES WITH 1 RESCUER:
If only 1 man, he MUST alternate both jobs, at the rhythm of 15/2 (15 heart compressions to 2 quick & complete lungs inflation.)
In order to compensate for the time he uses for A/R he MUST being alone use a rhythm of 80 compressions/ minute.
In order to do so: Count at high voice: One & 2 & 3 & 4 & 5 / 1 & 2 & 3 & 4 & 10 / One & 2 & 3 & 4 & 15.
When you say "15" you MUST give 2 quick & deep blows (within 5 to 6 sec.)
(WITHOUT PERMITTING A COMPLETE EXHALATION BETWEEN EACH INHALATION) ARTERIAL)
Then you start over the process of counting all along while doing the massage.
It is a MUST to persist in doing both methods even if you get tired or dizzy, until help comes along, though a doctor or professional help for at least for 45 min. even if the patient doesn't give signs of life.


HEIMLICH HUG METHOD: (Hug me Baby!)
CAN BE ALSO BE USED FOR DROWNING TO RID LUNGS OF WATER. A person whose throat is jammed by food can't breath, nor talk & can become livid & collapse.

In such case he has but 4 MINUTES TO LIVE UNLESS SAVED BY THE HEIMLICH HUG METHOD.

When the patient is standing or sitting.
1) Stand behind him and grab him around with your arms.
2) Place your fist against his stomach (abdomen) JUST a bit higher then his navel, & under thorax cage, then with the other hand grab firmly your fist.
3) In a sudden gesture, strongly & in an upward fashion push in your fist in the stomach's victim. A strong air blow will then expel the food out of his respiratory passage (throat).
4) Start over many times if need be.

WHEN THE PERSON LAYS ON HIS BACK ON THE FLOOR:
1) Kneel down over the person, your knees on each side of his hips.
2) Superpose your 2 hands over his stomach, just above his navel.
3) In a strong & upward & quick movement, push with the palm of your hand on the abdomen's victim.
4) Start over many times if needed.
5) If a person is down facing the floor, turn him over.

CHILD & BABY CHOKING:
Lay kid on your knees, head down, give 3 to 4 sharp blows, between shoulder blades, to remove the obstruction.

BABY: Hold the baby down by the feet, hit sharply. Yet not toohard between shoulder blades. Give Heimleich Hug if Need be orHeart Massage. Give Artificial Respiration if need be.

ARTIFICIAL RESPIRATION MOUTH TO MOUTH:
1) Raise neck with one hand & bring head backward with the other so that the shin points upward practically vertically. This will open air passages.
Remove all foreign objects in the mouth. Pinch the nostrils, press one hand upon forehead.
2) Take a breath, open widely your mouth & place it upon the victim 's mouth, (baby: mouth & nose both).
MAKE SURE that NO Air is coming out. Blow a full respiration into the lungs of victim (1/2 for baby), Check up if chest is rising up.
3) After each air blow, move away your mouth from his face. Listen to air escaping from victim's lungs & look if his chest is coming down.
You MUST repeat those 3 procedures every 5 seconds, about 12 to 15 time per minute.**

ARTIFICIAL RESPIRATION SYLVESTER:
1) Place the victim on its back, raising up his shoulders with proper prop or support (use blanket, coat etc.). Stretch his neck & bring his head backward as far as possible, to permit air to get in. Remove all foreign objects in mouth.

2) COMPRESSION PHASE: Kneel down at the head of the victim. Grab his wrists & cross them on the inferior (lower) half of the sternum. Bend forward pressing strongly on the chest. This MUST last 2 seconds. Count 1,000 -2,000 then:

3) EXPANSION PHASE: Stop leaning, pressing on chest. Bring upward the victim's arms, on the outside & backward. Count 1,000 -2,000 & MAKE SURE the arms stay straight. Now replace the wrists upon the sternum. Count to 5.
The movements MUST be repeated on rhythm of about 12 times per minute with an adult, more rapidly with a child.