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CPR Basics
 

  1. What is the correct order for the CPR sequence?

  2. Which is true when performing CPR compressions?

  3. Chest compressions should be

  4. A CPR cycle consists of

 
Assess the Scene
Ensure scene is safe
Check 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
 
Assess the Victim
Look for life threatening conditions or injuries
Determine the victims approximate age
CPR guidelines are:
    • Adult CPR - puberty and older
    • Child CPR - 1 year to puberty
    • Infant CPR -birth to 1 year
 
If bystanders are present:
  • Instruct a bystander to call 911
  • Ask for assistance with CPR and proceed to next step
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:
  • FIRST complete five cycles (about 2 minutes) of CPR
  • Call 911 and retrieve AED
  • Perform CPR cycle until EMS takes over or you are too tired to continue

Infants:

  • FIRST complete five cycles (about 2 minutes) of CPR
  • Call 911 and retrieve AED
  • Perform CPR cycle until EMS takes over or you are too tired to continue

Begin CPR
C-A-B (Compressions-Airway-Breathing) Order
• Begin Compressions - 30 compressions at a rate of 100-120/minute SWIFT HARD and CONSISTENT
• Open Airway with head tilt–chin lift method, check breathing, AT THE SAME TIME
• Give 2 rescue Breaths 
 
Compressions
    Keep blood flowing to the brain
    Should be swift, hard and consistent
Hands and Position
   •Adult: Two hands 
   •Child: One hand (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
   • 30 compressions then 2 breaths per cycle
   •100-120 compressions per minute
   
Continue until EMS arrives, someone else takes over or you are too tired to continue
 
Airway
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:
    •Mouth-to-barrier
    •Mouth-to-nose
    •Mouth-to-stoma (An artificial opening in the neck, such as a breathing tube)
CPR Cycle
    •30 compressions / 2 rescue breaths
    •At a rate of 100-120 compressions per minute
    •Check for signs of breathing (rise/fall of chest)
Continue CPR cycle until:
    •AED becomes available
    •Victim shows signs of life
    •A second rescuer takes over
    •EMS takes over
    •You are too tired to continue
 
 
Airway Obstruction
 

  1. The Heimlich maneuver, also known as abdominal thrusts, should be performed from behind on:

  2. The Heimlich maneuver back blows should be performed on a choking infant by:

*If you KNOW the victim is choking

Adult or Child

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

Unresponsive adult or child 

  • Begin CPR
  • Compressions (30)
  • Check Airway Head Tilt/Chin Lift
    • Remove object if dislodged
  • Breaths (2)
  • If breath does NOT go in due to blocked airway
    • Re-tilt head
    • Reattempt breath
    • If breath STILL does not go in, move on to compressions
  • Continue CPR Cycle
  • Remove object if dislodged
  • If victim regains consciousness, move onto their side to recovery position

Infant

Responsive infant: Infant Back Blows

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

Unresponsive infant 

  • Begin CPR
  • Compressions (30)
  • Check airway and open using head tilt/chin lift
  • Perform 5 back blows
    • Remove object if dislodged
  • Breaths (2)
  • If breath does NOT go in due to blocked airway
    • Check airway
    • Perform 5 back blows
    • Check for dislodged item
    • Check airway and re-tilt head
    • Reattempt breath
    • If breath STILL does not go in, move on to compressions
  • Continue infant obstructed airway CPR Cycle:
    • 30 Compressions - Check Airway - Perform 5 Back Blows - Check Airway - Give 2 Breaths - Repeat
  • Remove object if dislodged
  • If victim regains consciousness, encourage vocalization
Tongue and Airway Obstruction
*Airway obstruction in an unresponsive victim lying on his or her back is usually the result of the tongue relaxing in the back of the mouth, restricting air movement. Opening the airway with the head tilt-chin lift method may be all that is needed to correct this problem.
 
Hands Only CPR
Call or direct bystander to call 911. Press hard and fast, about -100-120 times per minute, on the middle of the victim's chest. Continue care until EMS arrives, an AED becomes available or you are too tired to continue.  
 
*Conventional CPR is recommended for children and infants, however due to the asphyxial nature of most pediatric cardiac arrests, rescue breaths may not be possible.  In these instances, the hands only method is preferred to no CPR at all.   
 
Standard First Aid
 

  1. An elderly victim is experiencing shortness of breath, chest pain and sweating. As you are assessing the victim he grabs his chest and loses consciousness. The victim is likely suffering from a ___________. You should ____________ and _______________.

 
First Aid Basics
First aid is the immediate care given to someone in an emergency situation, due to an illness or injury before EMS (Emergency Medical Services) arrives and takes over. Most of the time first aid is provided by a bystander (or by the victim) with minimal or no medical equipment. First aid is usually provided for minor illnesses and injuries. However, first aid may also be provided to someone who has a more serious illness or injury, such as a heart attack or severe bleeding.
Action at an Emergency
In an emergency situation, the bystander is a vital link between the victim and Emergency Medical Services (EMS). When entering the scene of an emergency situation, it is important to recognize the severity of the emergency before deciding how to respond.
Assess the Scene
Always remember to check the scene for safety hazards BEFORE providing care, it is important to ensure if you and the victim(s) are in a safe location, free of imminent danger or hazards.
Determine:
   • if it is safe to help
   • number of victims
   • if you will need additional assistance from EMS
   • what personal protective devices are readily available to you
Safety
    If the area is unsafe for the victim or rescuer, move the victim to a safe location, if can be done safely
    Do not put you or the victim’s safety at risk
    If you cannot safely provide care, do not become another victim, call EMS and wait for EMS to arrive
Activate EMS
•For serious situations, it is best to err on the side of caution and call 911
•Provide vital information to EMS dispatcher
    •Your name and number
    •Location of emergency
    •Information about the type of emergency
    •Number of victims
    •Victim(s) condition
    •What care is being provided at the scene
Assess the Victim
•Check the victim for responsiveness
•Tap on the shoulder and shout, “Are you okay?”
•Ask the victim if you he or she would like you to provide care
•If the victim is face down and unresponsive, turn the victim over
•Check the victim for breathing
    • If victim is NOT breathing – begin CPR
    • If victim is breathing – check the victim and provide care
•Check the victim for obvious signs of injury, such as bleeding, broken bones, burns, or bites
•Look for medical information jewelry to determine if the victim has a serious medical condition
•Place the victim in recovery position (on side) if:
    • the victim has difficulty breathing because of vomiting, or other secretions
    •you have to leave an unresponsive victim to get help
•If the victim shows signs of shock, have the victim lie flat on back
•If the victim does not show signs of trauma or injury, raise the feet about 6-12 inches
•Do not raise the feet if it causes the victim any pain
 
Provide Care
•Decide to provide care
•Determine what type of care is needed
•Begin care immediately – early care is critical for a victim’s survival
Victim Assessment
When providing care to a victim it is important to identify and correct any condition that may not be immediately life threatening, but may have the potential to become life threatening if it is not corrected.
SAMPLE
Gather information about victim using the SAMPLE history method. Ask victim about the following information
    •Signs and symptoms
    •Allergies
    •Medications
    •Past medical history
    •Last meal eaten
    •Events leading to the injury or illness
Medical information tags may identify allergies, medication, or medical condition
 
DOTS
Use the DOTS method to check the victim head to toe for the following conditions
    •Deformity
    •Open wounds
    •Tenderness
    •Swelling
Head to Toe exam
    •Head – look for blood, check eyes, check mouth for loose teeth or blood, check the nose and ears for fluid or blood, look for bruising of the eyes or behind the ears
    •Neck – look for bleeding, distention of the jugular vein, open wounds, or tracheal deviation
    •Chest –look for blood, broken ribs, open wounds, accessory muscle breathing
    •Abdomen –look for bleeding, abdominal wounds, tenderness, bruising
    •Legs –look for bleeding, bruising, open wounds, broken bones, deformities
    •Pelvis –look for bleeding and instability
    •Arms –look for bleeding, bruising, open wounds, broken bones, deformities
 
Ongoing Care until EMS arrives 
    •Monitor the victim’s condition using ABC assessment:
        •Airway – use head tilt-chin lift method
        •Breathing – look, listen and feel for breathing
        •Circulation – check for severe bleeding
    •Treat for shock
        •Help victim lie on back
        •Keep covered and warm
        •Do not give anything to eat or drink
    •Remain with victim and record any changes in the victim’s condition
    •Report your findings and care to EMS when they arrive
    •If victim becomes unresponsive or has agonal breathing (irregular, shallow or gasping) or is not breathing at all – begin CPR immediately.
        •Continue CPR cycle until EMS arrives, a second rescuer takes over or you are too tired to continue
        •If you do not know CPR begin “Hands Only” compressions at a rate of 100-120 per minute
 
*Agonal breathing is a sign of final stages of life. Agonal breathing is an abnormal pattern of breathing and brain stem reflex characterized by gasping, labored breathing, accompanied by strange vocalizations and/or gurgling. It is a sign that the body is not receiving the oxygen it needs. It occurs when a person is actively dying. If a victim is experiencing agonal breathing CPR must begin immediately.
 
Providing Care for Medical Emergencies
Asthma
Look for wheezing, coughing, vomiting, shortness of breath and/or fainting
    •Administer inhaler, if available
    •Encourage victim to remain calm and relax
•If victim loses consciousness call 911 and begin CPR immediately 
    •Remain with victim until EMS arrives 
 
Choking
    •Elicit response to question, “Are you choking?” 
    •Observe signs of obstruction (speaking and breathing)
    •Responsive Adult or Child - begin Heimlich Maneuver ( see Airway Obstruction)
    •Unresponsive Adult, Child– begin CPR (see CPR)
    •ANY choking Infant-begin CPR/Airway Obstruction protocol.
     Check for debris/5 back blows/5 chest compressions
     If victim loses consciousness call 911 and begin CPR immediately
 
Allergic Reaction
    •Administer Epinephrine Pen
    •Call 911
     If victim loses consciousness call 911 (if not already called) and begin CPR immediately 
    •If victim does not respond to first dose, and EMS does not arrive within 5-10 minutes a repeat dose may be administered
 
    ***Anaphylaxis is the most severe form of allergic reaction. It has a rapid onset and may cause death
 
Heart Attack 
    •If victim loses consciousness or is NOT breathing when found - begin CPR immediately
    •Call 911
    •If victim is breathing
        • Encourage victim to remain calm and in a comfortable position (recovery position if possible)
        • Offer 1 adult dose or 2 low dose aspirin, if certain the victim is experiencing a heart attack and has no known allergy
 
Fainting 
Instruct the victim to remain lying flat on the ground until he/she can sit up and feel normal
If the victim fell – check for injuries caused by the fall
Remain with victim until he/she feels normal and alert
    •Can stand and walk without assistance
    •Is aware of what happened and who he/she is
Diabetic Victim
It is important to recognize the signs of a diabetic episode to prevent the progression of symptoms.
Symptoms of a diabetic episode are:
    •A change in behavior
    •Confused, irrational or irritable
    •Sleepiness or lack of response
    •Hunger, thirst or overall weakness
    •Victim appears sweaty and/or pale
 
If the victim can sit up and swallow 
    •Give glucose tablet if available OR
    •Give a food or drink that contains sugar (chocolate does not contain enough sugar)
    •Fruit juice
    •Milk
    •Sugar
    •Honey
    •A regular soft drink
    •Diet foods and drinks do not have sugar
If the victim cannot sit up and swallow
    •Do NOT give food or drink
    •Have victim sit quietly or lie down until EMS arrives
 

  1. Typical signs and symptoms of low blood sugar are confusion, irrational or irritable behavior, overall fatigue, hunger, thirst, sweaty and/or pale skin. If a victim is alert and showing these signs and symptoms, you should ___________and ________________

 
Stroke
Use FAST assessment to determine if stroke is occurring    
  • F - Facial droop
  • A - Arm weakness
  • S - Speech difficulty
  • T - Time to call EMS
    •Encourage the victim to remain calm and quiet
    •DO NOT give anything to eat or drink
    •Monitor victim and be prepared to begin CPR
 
Seizure
    •Protect the victim from injury
    •Move furniture or other unsafe objects out of the way
    •Place a small pad or towel under the victim’s head, if possible
    •Do NOT place objects in the victim’s mouth
    •Encourage the victim to remain calm
    •Remain with the victim until EMS arrives and takes over
 
Shock
Shock is a life-threatening medical condition as a result of insufficient blood flow throughout the body. Shock often accompanies severe injury or illness. Medical shock is a medical emergency and can lead to other conditions such as lack of oxygen in the body's tissues (hypoxia), heart attack (cardiac arrest) or organ damage. It requires immediate treatment as symptoms can worsen rapidly.
*DO NOT move a shock victim with a suspected neck, back, spine or head injury.
    •Help the victim lie on his/her back
    •Cover the victim to keep him/her warm
    •Check the victim using ABC method:
        •Airway – use head tilt-chin lift method
        •Breathing – look, listen and feel for breathing
        •Circulation – check for severe bleeding
    •Record any changes in the victim’s condition
    •Report your findings and care to EMS when they arrive 
 
Providing Care for Injury Emergencies
Massive blood loss, either external or internal, is a leading cause of shock and can be fatal in minutes. Always call 911 for obvious or suspected bleeding.
External Bleeding
    •Treat wound according to severity
    •Apply pressure or tourniquet
    •Immobilize partial amputations
    •Do NOT remove bandages
    •Take care that dressing does not become occlusive (sealing wound) in open chest wounds
    •Provide care for shock, if necessary
        •Victim lies on back
        •Cover and keep warm
        •Do not give anything to eat or drink
 
Internal Bleeding
Internal bleeding is difficult to identify. If the victim has suffered trauma to the head or torso assume they may have internal bleeding.
    •Have the victim lie down and remain still
    •If vomiting occurs, roll victim on his or her side
    •Check the victim using ABC method:
        •Airway – use head tilt-chin lift method
        •Breathing – look, listen and feel for breathing
        •Circulation – check for severe bleeding, rapid swelling or hard, distended torso
    •Provide care for shock, if necessary
        •Victim lies on back
        •Cover and keep warm
        •Do not give anything to eat or drink
    •Record any changes in victim
    •Report findings to EMS when they arrive
 
Nose Bleeds
    •Pinch victim’s nose
    •Tilt the victim’s head forward
    •Keep constant pressure on both sides of the nostrils until the bleeding stops
    •If bleeding continues, press harder
    •Apply a cold pack to the bridge of the nose
    •Call or direct a bystander to call EMS if
        •The bleeding doesn’t stop in approximately 15 minutes
        •Bleeding is heavy (gushing)
        •The victim has trouble breathing
        •Do NOT have victim tilt head back
Bleeding from the Mouth
Determine if the injury is IN the mouth or if the blood is coming from the throat.
    •If you can reach the area
        •Apply pressure with clean, sterile dressings
    •Check the mouth for any missing teeth, or parts of teeth
        •Clean the wound with saline or clean water
        •If the victim has a loose tooth
            •Have the victim bite down on a piece of gauze to keep the tooth in place
            •Call a dentist
            •If the tooth is chipped, clean the area and call a dentist
       •If tooth is missing
           •Apply pressure with gauze to stop bleeding at the empty tooth socket
           •Place tooth in a cup of egg white, coconut water or milk
           •Take victim to dentist or emergency room
Eye Injury
    •Instruct victim to keep eyes closed
    •Use clean water to rinse the eye(s)
    •If the eye(s) have been punctured or penetrated by an object, stabilize and leave the object in place until EMS arrives and takes over
Embedded (Impaled) Objects
    •Expose the injured area
    •Stabilize the object
    •Do NOT remove the object
    •Control bleeding around the object
    •Seek medical attention or wait for EMS to arrive
 

  1. When a victim sustains a cut or torn blood vessel, extreme blood loss can occur within minutes. ________ ________ should be applied immediately to slow or stop the bleeding until EMS arrives.

  2. Which of the following is true about signs of internal bleeding?

  3. When providing care to a victim with an impaled object

  4. If bandages and dressings show signs of being too tight, but bleeding is not controlled, you should

 
Head, Neck or Spine Injury Victim
    •Minimize movement
        •Encourage victim to remain as still as possible
        •Do not apply a cervical collar or move the victim
        •Stabilize the head and neck with your hands, if possible
    •Advise victim to remain calm and still
    •Call 911- Evaluation by a healthcare provider should occur as soon as possible
Move ONLY to move the victim out of a life threatening location to a safe area.
 
Victim with a Broken Bone or Sprain
    •Advise the victim to remain still and avoid using or moving the injured body part
    •Apply a cold pack to the injured area
    •Do NOT try to straighten a bent or deformed body part
    •Do NOT try to move a broken bone that has come through the skin
    •Make a splint if you are unable to access EMS support immediately (example hiking in the woods)
        •Use something to support the arm or leg from moving (magazine, stick, rolled up towels)
        •Place the splint so that it goes beyond the injured area and supports the joints above and below the injury
        •Tie the splint to the injured body part for support
        •Use tape, gauze or cloth to secure it
        •Check to make sure the splint is not too tight
            (You should be able to put a few fingers between the splint and the injured body part)
    •If the injured part is bleeding, apply direct pressure to stop the bleeding and apply dressing to the wound BEFORE applying the splint
    •If there are no materials to make a splint, have the victim self-splint by using his/her arm to hold the injured arm in place
    •Do NOT try to straighten body parts when applying a splint
 

  1. If you assess that a victim has sustained possible head, neck or spinal injury you should

  2. Which of the following is true when providing care to a victim with a possible broken bone?

 
Burn Injuries
    •Victim is on fire
        •Direct the victim to stop, drop and roll
        •Cover the person with a wet blanket to put the fire out
        •Remove the blanket after the fire is out
    •If the victim is burned
        •Determine the type and severity of burn
        •Stop the burning process
        •Open airway and check breathing
     ALWAYS Seek medical attention IF
            •Victim is younger than 5 and older than 55
            •Victim has difficulty breathing
            •Victim has other injuries or electrical injuries
            •Face, feet, hands and/or genitals are burned
            •Child abuse is suspected
            •Second degree burn is larger than 20% BSA
            •Burn is third degree
First Degree Burns (superficial)
    •Cool burn with cold water – no ice
    •Apply moisturizer, such as aloe-vera gel
    •Adult: administer ibuprofen for pain relief
    •Child: administer acetaminophen for pain relief
Second Degree Burns (partial thickness)
    •Cool burn with cold water – no ice
    •Apply antibiotic ointment
    •Cover burn with dry, nonstick, sterile dressing
    •Adult: administer ibuprofen for pain relief
    •Child: administer acetaminophen for pain relief
    •For larger Second Degree Burns – see caring for third degree burns
Third Degree Burns (full thickness with peeling and/or burnt flesh)
    •Seek medical attention immediately
    •If the person is on fire, put the fire out
    •Remove jewelry and clothing that is not stuck to the skin
    •Cover the person with a blanket
    •Open airway and check for breathing
    •Monitor breathing
    •Care for shock – see shock section
    •Call 911 and remain with the victim until EMS arrives
Chemical Burns
    •Flush skin
    •Remove contaminated clothing
    •Cover burn
    •Seek medical care
    •Monitor breathing
    •Care for shock – see shock section
    •Call 911 and remain with the victim until EMS arrives
Electrical Burns
    •Turn off the main power source, if possible
    •Cover burns
    •Check for spinal injuries
    •Assess the victim, once safe
    •Record any changes in the victim’s condition
    •Call 911 and remain with the victim until EMS arrives
 

  1. _________ Degree burns ALWAYS require immediate medical attention.

 
Environmental Emergencies
Insect/Animal Bites and Stings 
Animal Bites
Move away from the animal, if possible
    •Snake bites: Assume it is venomous if you are unsure. DO NOT cut the bite or attempt to suck the venom out by mouth. Call 911. DO NOT apply a tourniquet.
    •Bat bites: Do NOT kill the bat. Catch if possible, Rabies test cannot be completed on a dead bat.
Insect Bites and Stings
Observe the victim and ask about allergies. If the victim has allergies or loses consciousness, call 911 and begin CPR. Administer epi-pen if available.
    •Bee stings: scrape the stinger with a hard card type object.
All Bites and Stings
•Advise the victim to remain still and calm
        •Victim should avoid moving the part of the body that was bitten
    •Remove any clothing that covers the area
    •Flush the wound with running water
    •Clean it with soap and water
    •Stop any bleeding by applying pressure and dressings
    •If a bite breaks the skin, see a healthcare provider
    •Place an ice pack over any area that has bruising or swelling
    •For serious bites, call 911 and remain with victim until EMS arrives
 
Weather Related Emergencies
Heat Cramps 
    •Advise the victim to lie down, rest and cool off
    •Stretch cramped muscle
    •Provide drink that contains electrolytes, such as juice or a sports drink
        •Give the victim water if the others are not available
    •A cool ice pack may be applied to the sore muscle for up to 20 minutes, if the victim can tolerate it.  
    •Call or direct a bystander to call EMS if victim’s condition does not improve
    •Monitor breathing
Heat Exhaustion
    •Stop activity and rest in a cool place
    •Remove excess or tight clothing
    •Provide drink that contains electrolytes, such as juice or a sports drink
    •Give water if other drinks are unavailable
    •Advise victim to lie down, raise legs 6 to 12 inches
    •Apply cool damp cloths to the neck, armpit and groin area, if possible
    •Spray with a cool water spray, if possible
    •Call or direct a bystander to call EMS if victim’s condition does not improve
    •Monitor breathing
Heatstroke
Heatstroke can rapidly become fatal if the victims core body temperature is not lowered.   
    •Begin cooling the victim immediately
    •Place in cool water up to neck, if possible
    •Cool with a cool water spray, if possible
    •Stop cooling the victim once behavior is normal again – continued cooling can lead to hypothermia
    •If the victim is able to drink 
        •Provide drink that contains electrolytes, such as juice or a sports drink
        •Give water if other drinks are unavailable
  Call 911 and remain with victim until EMS arrives and takes over
 
Frostbite
    •Move the victim to a warm place
    •Remove tight clothing and jewelry from the frostbitten area
    •Remove wet clothing 
    •Pat the body dry
    •Put dry clothes on the victim, if possible
    •Cover with a blanket
    •Do not try to thaw the frozen part if you think there may be a chance of refreezing
    •Try not to touch the frostbitten area
    •Do NOT rub the damaged area
    •Remain with victim until EMS arrives
Hypothermia (Low Body Temperature)
    •Move the victim out of the cold
    •Remove wet clothing
    •Pat the body dry
    •Put dry clothes on, if possible
    •Cover with a blanket and any other coverings you may have
    •Cover the head, but not the face
    •Place victim near a heat source and place containers of warm – not hot – water in contact with the skin
    •Remain with victim and record any changes
    •Report changes to EMS when they arrive
 
Poison Emergencies
Many types of products can be poisonous to people.  When victims come into contact with poisonous products either by swallowing, breathing or contact with skin and eyes, serious sickness and even death can occur.  If you are unsure of a victim's exposure, call 911 immediately, before calling poison control
Caring for Poison Emergencies
The number for the American Association of Poison Control Centers (Poison Control) is 
    •1-800-222-1222
    •Follow all workplace guidelines about poisonous items in your workplace
***Naloxone, or Narcan, if available, may be administered if suspected, life-threatening opioid overdose has occurred.
 
AED-Automated External Defibrillator
 
***AED’s are designed for use on adult victims, however most can be used with pediatric victims with proper pediatric pads.
 
Heart Attack vs Cardiac Arrest
A heart attack and cardiac arrest are often confused with each other. Although a heart attack can lead to cardiac arrest, they are different. A heart attack is usually slow or prolonged death or damage to the heart muscle, whereas cardiac arrest is a sudden electrical malfunction caused by an outside source. Cardiac arrest often results in death if not treated quickly. The only effective lifesaving treatment for cardiac arrest, outside of a hospital, is CPR or the use of an AED.
Signs and Symptoms of Heart Attack
        •Pain, fullness, and/or squeezing sensation in the chest
        •Jaw pain, toothache, headache
        •Shortness of breath
        •Nausea, vomiting and/or general upper abdominal discomfort
        •Heartburn and/or indigestion
        •Arm pain (commonly in the left arm, but may be both)
        •Overall fatigue
        •Sweating
        •Some victims (about ¼ of all heart attacks) are silent, without chest pain or symptoms

**Women, the elderly and people with diabetes are more likely to have atypical signs of a heart attack – ache in the chest, heartburn or indigestion, or an overall uncomfortable feeling in the back, jaw, neck or shoulder.

Signs and Symptoms of cardiac arrest
Cardiac arrest symptoms are sudden and immediate and include:
        •Collapse
        •No pulse
        •No breathing
        •Loss of consciousness
Treating a heart attack OR cardiac arrest
If victim is NOT breathing:
    •Call or direct a bystander to call EMS
    •Retrieve AED
    •Check breathing
    •Perform CPR (if the victim is NOT breathing or only gasping)
        •Victims in cardiac arrest often have agonal breathing (also known as agonal gasps)
        •Agonal breaths do not provide adequate oxygen to the body and can be described as gurgling, moaning, snorting, agonal or labored breathing
        •Healthcare providers must be able to distinguish between agonal breathing and adequate breathing
    •Continue CPR Cycles until EMS or second rescuer takes over, AED becomes available or you are too tired to continue.
If victim IS breathing:
    •Call or direct bystander to call EMS
    •Encourage victim to remain calm and in a comfortable position (recovery position if possible)
    •Offer 1 adult dose of aspirin
    •Stay with victim until EMS takes over
CPR must be started and continue until defibrillator (AED) becomes available.  
**If an AED is immediately available, following an adult's collapse, perform 2 minutes of the CPR cycle BEFORE attaching electrodes.
 
AED Use
About AEDs
        •Analyzes the victim’s heart rhythm
        •Determines and advises when shock is needed
        •Delivers electrical shock to victim in cardiac arrest
        •Reestablishes a heart rhythm which will generate a pulse
AED Use Overview 
DO NOT DELIVER SHOCK IF ANY OF THE FOLLOWING CONDITIONS EXIST:
*Someone is touching the victim     *The victim is alert    *The victim is wet or in water.
        •Remove victim from any standing water or metal surfaces
        •Dry chest if noticeably wet
        •Remove enough hair from chest for pads to make good skin contact
        •If victim has a transdermal medication patch, remove the patch and clean area prior to attaching pads
        •Use appropriate AED pads
        •Apply AED pads to bare chest and the cable to AED unit
       •Place the unit between you and victim – by victim’s shoulder
        •Turn on the AED and follow voice prompts
        •Stand clear
        •Wait for unit to analyze the heart rhythm
        •Deliver shock, if needed
        •Perform CPR cycle
 
AED Pad Placement
When placing pads, be sure they do not touch each other
       Adult:
        •Place one pad on the upper right chest
        •Place the second pad on the left of ribcage (4-6 inches below the armpit)
        •If victim has a pacemaker, place the AED pad at least 1 inch to the side of the implanted device
       Child: 
        •Use adult or pediatric pads
        •Place one pad between right nipple and collarbone
        •Place the second pad on the left rib cage (3-4 inches below the armpit)
        Infant: 
        •Use infant pads only
        •One pad should be placed in the center of the CHEST and the second pad to the center of BACK
 

  1. If an AED is immediately available following an adult's collapse, you should:

  2. Before attaching electrodes to a non-responsive victim, you should

 
AED Shock Administration
After pads are placed, wait for AED to analyze the rhythm
If a shock IS indicated
        •Do NOT touch the victim
        •Ensure no one else is touching the victim
        •Press the shock button
After shock is delivered
        •Keep pads on the victim
        •Complete 2 minutes of CPR cycle
        •Reassess the victim’s condition
        •Follow AED voice prompts to repeat cycle
Continue following AED voice prompts, administering CPR cycle and AED shock until
        •The victim shows signs of life
        •A second rescuer or EMS takes over
        •You are too tired to continue     
 
If NO shock is indicated
        •Continue CPR cycle if the victim is unresponsive
        •Reassess the victim’s condition
        •Check heart rhythm with AED at end of each cycle and follow AED voice prompts
        •Continue CPR cycle/AED check until a second rescuer or EMS takes over or you are too tired to continue
 

  1. It is unsafe to deliver a shock if

  2. After delivering a shock, perform 2 minutes of CPR Cycle and

  3. If no shock is indicated from the AED prompt, continue CPR cycle until