FACTS

Children < 1yr

Falls & burns @ home

1-4 yrs old

Inhale or ingest foreign bodies

5-7 yrs old

Traffic & school accident

8-20 years old

Victim of physical assult

NO MATTER WHAT THE CAUSE

When the heart has stopped and

the victim is not breathing, CPR
is the answer.
Without a constant supply of
blood, cells of the body
will start to die.

NO MATTER WHAT THE CAUSE

Brain damage begins within 4 to

6 minutes after cardiac arrest.
Within 8 to 10 minutes, the
damage may be irreversible.

Clinical Death
0-1 min. Cardiac Irritability
1-4 min. - Brain damage - not likely
4-6 min. - Brain damage - possible

Biological Death
6-10 min. Brain damage - very likely
Over 10 min. Irreversible brain
damage

NO MATTER WHAT THE CAUSE

Cardiopulmonary resuscitation
will help to circulate oxygenated
blood until more advanced
medical care can be performed.

Why the need for CPR training?

Most people die of heart attack
before they ever reach a
hospital
Other situations can lead to CP
arrest
CP arrest can occur
anytime & anywhere

Emergency Action Principle :

Plan of action for any
emergency to ensure the
rescuers safety and that of the
victim and bystanders and
increase the victims chances
of survival.

Emergency Action Principle

1. Survey the Scene
2. Activate medical assistance
3. Initial assessment of the victim
4. Secondary assessment of the
victim
5. Referral for further evaluation and
management

1. Survey the Scene

Make sure that the scene of the
emergency is safe for you, the victim
and the bystanders
consider :
- Scene safety
- Mechanism of injury or nature of
illness
- Determine the number of persons /
victim and additional resources.

2. Activate Medical
Assistance
Call First : If adult requires
emergency care
Care First : for infant and
child

Information to be given in activiting

medical assistance
What happened ?
Location ?
Number of persons injured?
Extent of injury and First Aid given?
The telephone number from where you
are calling/
Identity of the person calling.
Drop the phone last

3. Do primary survey
of victim

Check responsiveness
Perform compression
Perform rescue breathing
Open the Airway

4. Do Secondary Assessment
of the Victim
A systematic method of gathering
additional information about injuries or
conditions that may need care
a. Interview the Victim (SAMPLE)
b. Check vital signs : every 15 minutes
if stable condition and every 5
minutes if unstable.
c. Head to toe examination
(DCAPBTLS)

4. a. Interview the victim :

S signs and symptoms
A - Allergies
M - Medicines
P Past Medical History
L - Last oral intake
E - events prior to injury,
incident or illness

4.c. Head to toe examination

D : Deformity
C : Contusion
A : Abrasions
P : Puncture
B : Burn
T : Tenderness
L : Laceration
S : Swelling

5. Referral of Victim for further

Evaluation and Management
refers to the transfer of a

victim to hospital or health

care facility for a definitive
treatment

Body Substance Isolation

Are precautions taken to isolate

or prevent risk of exposure from

any other type of bodily
substance using personal
protective equipment (PPE)

Basic Precautions & Practices

1. Personal Hygiene
2. Protective Equipments
3. Equipments for cleaning
and disinfecting

Golden Rules in Giving EC

DO S :
Do obtain consent when possible
Do think of the worst
Do remember to identify yourself
Do provide comfort and emotional
support
Do respect the victim
(modesty and privacy)

DO S :
Do be as calm and direct as
possible
Do care for the most serious
injuries first
Do assist the victim on medication
Do keep on lookers away from the
injured person
Do handle the victim to the
minimum
Do loosen tight clothing

DONTs :
Do not let the victim see his /her
injuries
Do not leave the victim alone
except to get help
Do not assume that the victims
obvious injuries are the only one
Do not make any unrealistic promises
Do not trust the judgment of
a confused person.

Life Support
The cardiopulmonary
resuscitation : series of
emergency life saving
procedures that are carried out
to prolong the life of a person
with life threatening
emergencies

Types/stages of life support

1. Basic Life Support (BLS)
2. Advanced Cardiac Life Support
(ACLS)
3. Prolonged Life Support
(PLS)

Stage of Life Support

1. Basic Life Support
- an emergency procedure that
consists of recognizing respiratory
or cardiac arrest or both and the
proper application of CPR to
maintain life until a victim recovers
or advanced life
support is available.

Stages of Life Support

1. Basic Life Support
a. CAB Steps
Compression (circulation)
Airway
Breathing (ventilation)
b. Use of supplementary
techniques

Stages of Life Support

2. Advanced cardiac Life Support
(ACLS)
- The use of special equipment to
maintain breathing/circulation for the
victim of cardiac emergency.
- A set of clinical interventions for the
urgent treatment of cardiac arrest
and other life threatening
emergencies and the
K & S to deploy those interventions

Stages of Life Support

a. Definitive therapy drugs,
defibrillation
b. Cardiac monitoring stabilization
c. Transportation
d. Communication

Stage of Life Support

3. Prolonged Life Support

(PLS)
- For post resuscitative and long
term resuscitation with the use of
adjunctive equipment such as
ventilator, cardiac monitor, pulse
oximeter, etc.

Basic Life Support

the foundation for saving

lives following cardiac
arrest.

Fundamental Aspects of BLS :

Immediate recognition of sudden
cardiac arrest (SCA) and activation
of emergency response system
Early cardiopulmonary
resuscitation (CPR)
Rapid defibrillation with
automated external defibrillator
(AED)

Cardiopulmonary
Resuscitation (CPR)

An emergency procedure used

for a person who is not breathing
and whose heart has stopped
breathing ( cardiac arrest)

Cardiopulmonary
Resuscitation (CPR)
Is a series of assessments and
interventions using techniques and
maneuvers made to bring victims of
cardiac and respiratory arrest back
to life.

When to Start CPR

CPR should be started on all nonbreathing, pulseless patients, unless
they are obviously dead or have a
DNR order.
(Responders will need to see a valid
copy of the order to honor it.)

When to Start CPR

It is better to start CPR on a person
that is later declared dead by a
physician than to withhold CPR from
someone that could have been saved.

When in Doubt,
Resuscitate!

Criteria for not starting CPR

All patients in cardiac arrest receive
resuscitation unless:
1.The patient has a valid Do not
Resuscitate
( DNR) order
2. Patient has signs of Irreversible Death
(rigor mortis, decapitation, or dependent
lividity,
decomposition)

Signs of Death
Decapitation: The head is
separated from the rest of the
body.
Rigor mortis : Temporary
stiffening of muscles occurs
several hours after death.

Signs of Death
Evidence of tissue decomposition :
Actual
flesh decay occurs only after a person has
been dead for more than one day.
Dependent lividity : Red or purple
color
occurs on the parts of the patients body
that are closest to the ground.

Criteria for not starting CPR

3. No Physiological benefit can be expected
because vital functions have deteriorated
despite maximal therapy eg. Progressive
shock or cardiogenic shock
4. Withholding attempts to resuscitate in
the delivery room is appropriate for
newly born infants with:

Confirm gestation <23 weeeks or birth

weight <400g
Anencephaly
Confrimed trisomy 13 or 15.
5. Attempts to perform CPR would place the
rescuer at

When to stop CPR

S pontaneous breathing and pulse
has been restored
T urned over to professional help
O perator/ Rescuer is too exhausted
to continue
P hysician Assumes responsibility
S cene becomes unsafe
S igned waiver to stop CPR

Summary of Key Issues and

Major Changes
.

Key issues and major changes in the 2010

AHA Guidelines for CPR and ECC
recommendations for healthcare providers
include the following:

Summary of Key Issues and

Major Changes
Cardiac arrest victims may present
with a short period of seizure-like
activity or agonal gasps that may
confuse potential rescuers,
dispatchers should be specifically
trained to identify these presentations
of cardiac arrest to improve cardiac
arrest recognition.

Summary of Key Issues and

Major Changes
The healthcare provider briefly checks for
no breathing or no normal breathing (ie, no
breathing or only gasping) when the
provider checks responsiveness.
The provider then activates the emergency
response system and retrieves the AED
(or sends someone to do so).

Summary of Key Issues and

Major Changes
The healthcare provider should not spend
more
than 10 seconds checking for a pulse, and if
a
pulse is not definitely felt within 10
seconds,
should begin CPR and use the AED when
available.

Summary of Key Issues and

Major Changes
Look, listen, and feel for
breathing has been removed
from the algorithm.

Summary of Key Issues and

Major Changes
Use of cricoid pressure during
ventilations is generally not
recommended.
Sequence change to chest
compressions before giving rescue
breaths (C-A-B rather than A-B-C).

Summary of Key Issues and Major

Changes
Increased emphasis has been placed on highquality CPR (Parameters of effective, high
quality CPR)
1. Compressions of adequate rate at least 100/min
2. Compression depth of at least 1/3 AP diameter
or
2 inches(5 cm)
3. Allowing complete chest recoil between
compressions
4. Minimizing interruptions in compressions,
5. Avoiding excessive ventilation

Summary of Key Issues and

Major Changes
Beginning CPR with 30
compressions rather than 2
ventilations leads to a shorter
delay to first compression.

Summary of Key Issues and

Major Changes
Compression rate is modified
to at least 100/min from
approximately 100/min

New Sequence

NEW

OLD

RATIONALE

BLS
CHANGES
Airway,
Breathing,

Chest
compressions,
Airway, Breathing
(C-A-B)
New science
indicates the
following order:
1. Check the
patient for
responsiveness
and no breathing.
2. Call for help
and get the AED
3. Check the
pulse.
4. Give 30
comps.

Chest
compressions
(A-B-C)
Previously, after
responsiveness
was assessed, a
call for help was
made, the airway
was opened, the
patient was
checked for
breathing, and 2
breaths were
given, followed by
a pulse check and
compressions

Although
ventilations are an
important part of
resuscitation,
evidence shows
that compressions
are the critical
element in adult
resuscitation.
In the A-B-C
sequence,
compressions are
often delayed by
changing the
sequence to C-AB, rescuers can

NEW

OLD

RATIONALE

Compressions
Compressions
Although
BLSwere
CHANGES
should be
to be
ventilations are
initiated within
given after
an important
10 seconds of
airway and
part of
recognition of breathing were resuscitation,
the arrest.
assessed,
evidence shows
ventilations
that
were given, and compressions
pulses were
are the critical
checked.
element in
adult
resuscitation.
Compressions
are often
delayed while

NEW

OLD

BLS CHANGES

RATIONALE

Faster
Compressions Compressions compressions
should be
were to be
are required
given at a
given at a
to generate
rate of
rate of
the pressures
at least
about
necessary to
100/min.
100/min.
perfuse the
coronary and
Each set of Each cycle of
cerebral
30
30
arteries.
compressions compressions
should take
was to be

NEW

OLD

RATIONALE

Compression
Compression
Deeper
BLS
CHANGES
depths are as
depths were as compressions
follows:
follows:
are required to
Adults: at
Adults: 1 to generate the
least 2 inches
2 inches
pressures
(5 cm)
Children: one necessary to
Children: at
third to one
perfuse the
least 1/3 the
half the
coronary and
depth of the
diameter of the cerebral
chest,
chest
arteries.
approximately 2 Infants: one
inches (5 cm)
third to one
Infants: at
half the
least 1/3 the
diameter of the
depth of the
chest

Rationale For Change

High-quality chest compressions
within CPR continues to be a critical
focal point.
Well-performed compressions
increase the likelihood of survival.

Child/Infant Compression
Rate
2010 Guidelines
Push fast; push at a rate of
at least 100 compressions
per minute.

(Berg, et al. Circulation.

2010;122;S862-S875)

Rationale For Change

It has been found that higher
survival rates are associated with
an increase in the number of
compressions provided per
minute.

Child/Infant Compression Depth

2010 Guidelines
Chest compressions of appropriate
rate and depth. Push fast: push at
a rate of at least 100 compressions
per minute. Push hard: push with
sufficient force to depress at least
one third the anterior-posterior (AP)
diameter of the chest or
approximately 1 inches (4 cm) in
infants and 2 inches (5 cm) in
children.
(Berg, et al. Circulation. 2010;122;S862S875)

Breathing Assessment
2010 Guidelines
After activation of the emergency
response system, all rescuers should
immediately begin CPR for adult victims
who are unresponsive with no breathing or
no normal breathing (only gasping).
(Berg, et al. Circulation. 2010;122;S685-S705)

Highlights
No more look, listen, and feel.
Quick look for no breathing or no
normal breathing.
Agonal breaths remain a concern.
Applies to both lay and healthcare
providers.

CPR Sequence - HCP

2010 Guidelines
For an unresponsive person who is not breathing or
not breathing normally, and has no obvious pulse,
activate EMS and begin CPR with 30 compressions
followed by opening the airway and giving 2
rescue breaths. Repeat cycles of 30:2 (CAB
method).
(Summary from Berg, et al. Circulation.
2010;122;S685-S705)

Highlights
Initial assessment approach:
Assess responsiveness and breathing
Activate EMS
Assess pulse
Perform CPR
CAB begin CPR cycles with
compressions, followed by airway and
breathing.

Rationale For Change

The science indicates the importance
of not delaying chest compressions
to perform rescue breaths.
Early chest compression can
immediately circulate oxygen that is
still in the bloodstream.

Respiratory Arrest
and
Rescue Breathing

Respiratory Emergency and

Artificial Respiration
Respiratory arrest
A condition in which breathing
stops or inadequate, pulse
circulation continue for some
time

Early Warning signs of Respiratory

Arrest

Unable to speak, breathe or

cough
Clutches neck (universal
distress signal)

Bluish color of skin & lips

Causes of Respiratory Arrest

1. Obstruction
1.1 Anatomical : when tongue drops back
and obstruct the throat. Other causes are
acute asthma, diphtheria, swelling and
cough
1.2 Mechanical : when foreign objects
lodge in pharynx or airways; fluid
accumulates in the back of the throat.

Causes of Respiratory
Arrest
2. Diseases
Bronchitis
Pneumonia
COPD and other respiratory illness

Causes of Respiratory
Arrest
3.

Other causes
Electrocution
Circulatory Collapse
Strangulation
Chest Compression
Drowning
Poisoning
Epilepsy , Allergy
Suffocation or Smoke inhalation

Artificial Respiration
(Rescue Breathing)
- procedure of causing air to flow into
and out of the lungs when his natural
breathing ceased or is inadequate
-

technique of breathing air into a

persons lungs to supply him the
oxygen needed to survive

Artificial Respiration
(Rescue Breathing)

Given to a victim who are not

breathing or inadequate but still
have pulse.
Crucial tool to revive the individual
or keep him/her until help comes

Objectives of AR
1.To open airway : head tilt/chin
lift method
2.To ventilate the lungs. To restore
breathing

Ways to ventilate the lungs

1. Mouth to mouth breathing:

This involves the rescuer making
a seal between their mouth and
the patients mouth and blowing,
to pass air into the patients body

Ways to ventilate the lungs

2. Mouth to nose breathing: In

some instances, the rescuer may
need or wish to form a seal with
the patients nose

Ways to ventilate the lungs

3. Mouth to mouth and nose

breathing: Used in infants
( usually
up to around 1 year old), as this
forms
the most effective seal

Ways to ventilate the lungs

4.
Mouth to stoma breathing:
Used
when the mouth and the nose
is inaccessible.
- Usually used in adults

Ways to ventilate the lungs

5. Mouth to face shield breathing:

Invention relates to a device for
performing life saving mouth to
mouth
respiration without the operator
directly
touching the mouth of the patient

Ways to ventilate the lungs

6. Mouth to mask breathing:

Most organizations recommend
the use of some sort of barrier
between rescuer and patient to
reduce cross infection risk. One
popular type is the pocket mask

Ways to ventilate the lungs

7. Bag valve mask device : A

simple
device manually operated by the
rescuer,
which
involves
squeezing a bag to expel air into
the patient

Special Considerations :
Rescuer to avoid pressing soft tissue
under the chin this might obstruct
the airway.
Rescuer not to use the thumb to lift
the chin
Rescuer not to close the victims
mouth completely (unless mouth to
nose is the technique)

Special Considerations :
Each rescue breath should give
enough air to make the chest rise
and be given at 1 second.
Rescuer should avoid delivering
more breaths (more than the number
recommended) or breaths that are
too large or too forceful.

Special Considerations :
Rescuers should take a normal
breath (not a deep breath) mouth to
mouth or mouth-to-barrier device
rescue breaths .

Head Tilt Chin Lift Method

1. Kneel near the casualtys shoulders

2. Place one of your hands on the
casualtys forehead and apply firm,
backward pressure with your palm
to tilt the casualtys head back.

Head Tilt Chin Lift Method

3. Place the fingertips of your other

hand under the tip of the bony part
of the casualtys lower jaw and lift
the jaw to bring the chin forward.
The fingertips should not press deeply into
the soft tissues under the chin since the pressure
could It interfere with the casualtys airway.
Use your fingertips, not your thumb, to lift the chin.

Head Tilt Chin Lift Method

4. Lift the chin forward until the upper and
lower teeth are almost brought together.
The mouth should not be closed as this may block the
airway.
If needed, the thumb may be used to
depress the casualtys lower lip slightly
to keep his mouth open.

Jaw Thrust Method

1. Kneel behind the casualtys head

and rest your elbows on the
surface on which the casualty is
lying.

Jaw Thrust Method

2. Place one hand on each side of the

casualtys head and grasp the
angles of the lower jaw just below
the level of the teeth

Jaw Thrust Method

3. Lift with both hands to move the jaw
forward. This action will also cause
the casualtys head to tilt back.
keep the head and neck from moving more than
necessary.
If mouth to mouth resuscitation, efforts are
not effective, you may need to increase the
backward tilt of the head slightly

Jaw Thrust Method

4. If the casualtys lips are still closed

after the jaw has been moved
forward, use your thumbs to retract
the lower lip and allow air to enter the
casualtys mouth.

Cardiac Emergency and CPR

Cardiac arrest
- Circulation stops; pulse and
breathing stops at the same time
or soon thereafter

Nursing Alert
There are only minor differences in rescue
breathing for adults, children and infants.
Often, the older the victim the greater the head
tilt to help open the airway

Adult

Child

Infant

Opening of
airway (head
tilt chin lift
maneuver

Maximum tilt of
the head

Neutral plus

Neutral position

Location for
checking of
pulse

Carotid pulse

Carotid pulse

Brachial pulse

Method

Mouth to mouth Mouth to mouth Mouth to mouth

or mouth to
or mouth to
and nose
nose
nose

Breaths

Full, slow
breath (1.5 to 2
seconds per
breath)

Full, slow
regulated
breath
(1 to 1.5
seconds per
breath)

Gentle , slow
breath
(1 to 1.5
seconds per
breath)

AR
ventilation/seco
nds
( 2 min frame)

1: 5
(24 cycles)

1:3
( 40 cycles )

1:3
( 40 cycles )

AIRWAY AND BREATHING

NEW

OLD

RATIONALE

Cricoid
If
an
Randomized
BLS CHANGES
pressure is
adequate
studies have
no longer
number of
demonstrated
routinely
rescuers was that cricoid
recommende available,
pressure still
d for use with one could
allows for
ventilations. apply cricoid aspiration.
pressure.
It is also
difficult to
properly train
providers to
perform the

NEW
Look, listen, and
feel for breathing
has been removed
from the sequence
for assessment of
breathing after
opening the airway.

OLD
Look,
listen, and
feel for
breathing
was used to
assess
breathing
after the
Healthcare providers airway was
briefly check for
opened.
breathing when
checking
responsiveness to
detect signs of
cardiac arrest.

RATIONALE
With the new chest
compsfirst
sequence, CPR is
performed if the adult
victim is
unresponsive and not
breathing or not
breathing normally
( only gasping) and
begins with comps
(CAB)

BLS CHANGES

After delivery of 30
comps, lone rescuers

Therefore, breathing
is briefly checked as
part of a check for
cardiac arrest.
After the first set of

Recovery Position
If the victim is unconscious but breathing:
Roll the patient onto one side, as you
support the patients head.
Place the patients face on his or her side
so any secretions drain out of the mouth
and the
tongue wont block the airway.

Recovery Position

Adult and child

Bend Arm
Keep legs straight
Place back of victims hand
against cheek and hold there
Hold victims hand against his
cheek to support head
Pull bent leg and roll victim
toward you.

Recovery Position in CPR

Hands supports head
bent knee prevents rolling
Bent arms gives stability

Possible Complications
Broken ribs
Check hand placement and
continue

Possible Complications
Gastric Distension (air in the
stomach)
Can happen if the airway is not open, retilt head
Make sure breaths are not given too
forcefully or too fast, give in 1 second each
and allow for exhalation
Give breaths only until the chest rises
Be alert for vomiting and keep airway clear

Possible Complications
Chest does not rise
Reposition head and try breath
again. If its still not rising go right
to compressions

Possible Complications
Victim breathes through a stoma
(opening in the neck)
If the chest does not rise with
breaths, cover mouth and nose for
possible air leakage

Important Considerations

ADULT

CHILD

INFANT

Opening the
Airway
Location of
Compression

Maximum tilt
of the head
Center of the
chest

Neutral
position
Center of the
chest

Manner of
Compression

Heel of the
hand, other
hand on top

Heel of the
hand

Neutral
position
One (I)
finger width
below the
nipple line
Fingers

( 1 hand
depending on the
size of the child )

(middle and ring

fingertips)

Depth chest
2 inches (5
2 inches (5
1 inches
compression
cm)
cm)
(4cm)
R ratio of chest
30:2
30:2
30:2
ompression to
( 5 cycles)
( 5 cycles)
( 5 cycles)
ventilations
(2 min frame )
CPR counting
1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,1
9,20,1,2,3,4,5,6,7,8,9 and 1 (2 ventilations) up

Sequence

Foreign Body Airway

Obstruction Management
(FBAO)

Foreign Body Airway Obstruction

(FBAO)
a condition when solid material
like chunked foods, coins,
vomitus, small toys, etc. are
blocking the airway.

Causes of Airway Obstruction

1. Improper chewing of large
pieces of food
2. Excessive Alcohol Intake
a. Relaxation of the tongue back
into the throat
b. Aspirated vomitus
(stomach content)

Causes of Airway Obstruction

3. The presence of loose upper and
lower dentures
4. For older children who are
running while eating
5. For smaller children of hand to
mouth stage left unattended

Foreign Body Airway Obstruction

Management
Two Types of Obstruction

1. Anatomical
2. Mechanical

Two Types of Obstruction

1. Anatomical Obstruction
Happens when the tongue drops
back and obstructs the throat.
Other causes are acute asthma,

croup, diphtheria, swelling

and cough (whooping)

Two Types of Obstruction

2. Mechanical Obstruction
When foreign objects lodge in the
pharynx or airways; fluids
accumulate in the back in the
throat.

Foreign Body Airway Obstruction

Management

Classification of
Obstruction
1. Mild
2. Severe

Classification of Obstruction
1. Mild Obstruction
A. Signs
1. Good air exchange
2. Responsive and can cough
forcefully
3. May wheeze between cough
4. Has increased respiratory
difficulty.

1. Mild Obstruction
B. Rescuer Actions
As long as good air exchange
continues.
a. Courage the victim to continue
spontaneous coughing and
breathing efforts
b. Do not interfere with the victims
own attempts to expel the foreign
body, but stay with him and
monitor his condition.

Classification of Obstruction
2. Severe Obstruction
A. Signs
1. Poor or no air exchange
2. Weak or ineffective cough or no
cough at all.
3. High-pitched noise while
inhaling or no noise at all.
4. Increase respiratory difficulty

2. Severe Obstruction
A. Signs
5. Cyanotic
6. Unable to speak
7. Clutching the neck with the thumb
and fingers making the universal
sign of choking
8. Movement of air is absent.

Universal Sign of Choking

. Is a sign Wherein the victim

is clutching his/her neck with

one or both hands and gasping
for breath.

Are you choking?

Mild Obstruction
Victim is able to cough
or is gagging
Victim is able to speak
and breath

Encourage victim to
cough and monitor
them in case the airway
becomes blocked

Severe Obstruction
Victim has ineffective
cough
Victim is unable to speak
or breath
Victim is displaying the
Universal Sign
for choking

Prepare to help victim

Abdominal Thrust
an emergency procedure for
removing a foreign object lodged
in the airway that is preventing a
person from breathing.
Note : AT should not be used
infants under 1 year of age due to
the risk of causing injury.

Management of Foreign Body

Airway Obstructions
Airway obstruction in an adult or
child
If the victim is conscious, stand behind
them and perform abdominal thrusts.
If the victim is obese or pregnant, stand
behind them and perform chest thrusts
instead of abdominal thrusts.

Management of Foreign Body

Airway Obstructions
If the victim becomes unresponsive:
Ensure that the EMS system has
been activated.
Perform CPR, remembering to
check the mouth for foreign
objects before each breath.

Steps for Managing Airway Obstruction in a

Conscious Adult or Child

1. Look for signs of

choking.

2. Place your fist

with the thumb side
against the patients
abdomen, just
above the navel.

3. Grasp the fist

with your other
hand and press into
the abdomen with
quick inward and
upward thrusts.

Foreign Body Airway Obstruction

Management
Airway clear-monitor
Give 5 blows

until help arrives

Still choking
If obviously pregnant or
known to be pregnant :
give 5 chest thrusts

Give 5 abdominal
thrusts

Still choking

Airway clear-monitor
until help arrives
If victim/patient becomes
unconscious, provide
intervention for unconscious
choking victim

Performing Abdominal Thrust under

Special Considerations :
Obviously pregnant and very
Obese victim
The main difference in performing
abdominal thrust on this group of
people is the placement of the fists.
instead of using abdominal thrust,
chest thrust are used.
the fists are placed against the middle
of the breastbone and do chest thrust.

Caution : for pregnant and

obese victim
if the pregnant and obese
become unconscious, call for
HELP and perform CPR

Infant Choking
(Birth to 1 year)

Recognize choking
Cannot cry or make normal
sounds
Silent cough
Breathing with high-pitched
noises
May look blue, frightened

Management
Give 5 back slaps:
Hold the infant facedown and
support the jaw and head

Management
Give 5 chest thrusts:
Turn the infant
over while supporting the head

Management
Alternate 5 back slaps and
5 chest thrusts until
Object comes out
or
Infant can cry forcefully
or
Infant stops responding

Management
If the infant stops responding
Begin steps of CPR
Each time you open the airway, look for
the object (remove it if seen)
After 5 cycles, phone EMS
Resume CPR until infant starts to move
or EMS rescuers take over

FBAO Management :
Adult / Child / Infant
1. Determine scene safety
2. Introduce yourself to the victim,
guardian or bystander
3. Determine level of breathing difficulty
by checking :
a. Infant : ineffective cough, weak or
absence of cry
b. Child/adult : by asking if the
victim is choking.

FBAO Management :
Adult / Child / Infant
4. Properly position the victim
a. Infant : support the infant on
the rescuers knee or lap
b. Child / adult : assume
straddle position behind
the victim

FBAO Management :
Adult / Child / Infant
5. Locate proper site :
a. Infant : give 5 back slaps and
5 chest thrusts using fingers
techniques.
b. Child / adult : for abdominal
thrust, properly position balled
fist on the patient, properly
perform abdominal thrust

FBAO Management : Adult / Child /

Infant
6. Carefully lay down unconscious patient.
7.Call for help to activate Medical Assistance
(for pediatrics and adults) and perform
CPR.
8.Check oral cavity for presence of
obstruction.
- Is foreign body is visible,
perform finger sweep.
- if not visible, properly administer,
first rescue breathing.

FBAO Management : Adult / Child / Infant

9. If air bounce back, re-position victims
head and properly administer second
RB
10. After 2 minutes, if not yet done,
activate EMS
11. If still unconscious, perform CPR and
apply AED if available.
12. If victim becomes conscious,
properly placed in recovery
position

References
2010 International Consensus on
Cardiopulmonary Resuscitation and Emergency
Cardiovascular Care Science With Treatment
Recommendations
2010 American Heart Association and American
Red Cross International Consensus on First Aid
Science With Treatment Recommendations
2010 American Heart Association Guidelines for
Cardiopulmonary Resuscitation and Emergency
Cardiovascular Care
2010 American Heart Association and American
Red Cross Guidelines for First Aid