1.4.1. The victim does not breathe and has no pulse:
The first gesture in this situation is calling 961 and asking for the help of the qualified and geared medical unit, after which we start CPR. If the victim doesn't breathe, has no pulse and you are sure of the arrival of the medical unit, start the artificial ventilation and the thoracic compressions. They are to be made succesively.
- In case you are the only resquer, the rate ventilation / cardiac massage has to be of 2:15, the entire procedure performed for a minute.
- In case there are two resquers, the rate has to be of 1:5. There are to be made 10 such series, and then reevaluate the patient.
Every set of manoeuvres starts with one ventilation and ends with one ventilation.
The technique of ventilation
Kneel by the patient. Holding the victim's head in hyperextension we keep the victim's mouth slightly open with one hand, while with the other we hold the forehead and we clip the nose. Take a deep breath …
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…place your mouth tight on the victim's mouth and blow the air in for 2-3 seconds. In the mean time check if the chest is rising while you blowing the air.
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Every breath has to be strong enough to make the cjest rise. Hold the head in hyperextension with the chin up taking the mouth away and giving time for the victim's chest to relax. The volume of air we manage to blow is more important than the rythm we blow it.
The technique of external cardiac massage
With the victim placed on his/her back against a solid surface we localize the compression point at the inferior side of the breastbone. The ring finger slides along the edge of the ribs until the xyphoid appendix (the joining of the ribs). At this level, next to that finger we place other two fingers, the midle and the index, then we put the palm of the other hand over those fingers, touching them. This is the place where we perform the thoracic compressions.
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Kneel next to the victim, make two ventilations, and then find the mark point with your ring finger, sliding along the edge of the ribs up to the xiphoyd appoendix. Reaching with your ring finger the xiphoyd appendix, place your middle and index fingers next to it and then place the palm of your other hand, this being the place where we should aplly the compresions.
We place the other hand (the one used to find the spot) over the hand situated on the chestbone without letting the fingers press the thorax.
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With the elbows straight, with the arms perpendicularly on the chestbone, keeping the shoulder line parallel to the longitudinal line of the patiet, we compress so that we push the chest with a depth of 4-5 cm (counting "1, one thousand,
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2 one thousand, 3 one thousand, 4 one thousand, 5"). The frequency of the external compressions has to be of about 80-100 / min.
1.4.2. The victim doesn't breathe but has a pulse:
In this case the first step we take is performing a number of 10 ventillations and then call 961 asking for qualified help. We go back to the victim, reevaluate and then take action depending on the evaluation. In case the patient's state is the same, we continue ventilating the patient checking the pulse from time to time.
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1.4.3. The victim breathes and has a pulse:
If the victim breathes and has a pulse, but is unconsious we will place the victim in the lateral safety position.
Kneeling next to the victim we will clear the airways by hyperextending the head and pulling up the chin. We place the nearest victim's arm in a right angle |
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and the forearm is bent upwards. We will slide the other arm over the chest placing the back of the hand on the victim's cheek. c
We pull up the knee (the one opposed to the resquer), pulling it up and keeping the foot on the ground. With one hand we will grab the opposite shoulder and with the other hand the patient's knee. We will turn him laterally towards the resquer; we make sure the victim leans on the elbow and knee, we put the head back into hyperextension and we open his mouth.
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We call 961 asking for qualified assistance. We return to the victim, reevaluate the situation and supervise the patient until the arrival of the medical unit.
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