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Clinical Learning Guide

Cardiac compression for adult, children and infant

STEP/TASK Application of cardiac compression in adults 1. Place your interlocked hands in the middle of the lower half of the sternum 2. Position yourself vertically above the victim's chest and with your arm straight depress the chest by 4-5 cm. aiming for a rate of 100 compressions per minute. 3. After each compression, release the pressure on the chest without losing contact between your hands and the sternum 4. Compression and release should take an equal amount of time, compression/release ratio = 1:1 5. Give 30 chest compressions followed by 2 ventilations 6. When 2 or more rescuers are available, switch chest compressors every 2 minutes (or after about 5 cycles of compressions and ventilations at a ratio of 30:2) to prevent decreases in the quality of compressions 7. Once the airway has been secured, continue chest compressions uninterrupted at a rate of 100 compressions per minute and ventilate the lungs at approximately 10 breaths per minute. 8. Only stop compressions for defibrillation or pulse checks. Paediatric Cardiac Compression If the infant or child is Unresponsive, Not breathing, Has no pulse (or you are unsure whether there is a pulse), Start Chest Compressions: Cardiac compression in children Child guidelines apply to children approximately 1 year of age until puberty 1. With the heel of 1 or 2 hands 2. Compress the lower half of the sternum 3. At least ⅓ of the AP dimension of the chest or approximately 5 cm (2 inches) 4. Rate of at least 100/min 5. Allow complete chest recoil after each compression 6. Do not press on the xiphoid or the ribs 7. Single rescuer: Begin cycles of 30 compressions/2 breathing Two rescuers: Begin cycles of 15 compressions/2breathings Cardiac Compression in infant Infant Guidelines apply to infants < approximately 1 year of age. 1. The lone healthcare provider should use the 2-finger chest compression technique : Compress the sternum with 2 fingers , Just below the intermammary line 2. Push with sufficient force to Depress at least ⅓ the anteriorposterior (AP) diameter of the chest or approximately 1- 1.5 inches (4 cm): 3. Encircle the infant's chest with both hands; Spread your fingers around the thorax, Place your thumbs together over the lower third of the sternum. Forcefully compress the sternum with your thumbs 4. Rate of at least 100/min 5.Allow complete chest recoil after each compression 6.Do not press on the xiphoid or the ribs 7.Single rescuer: Begin cycles of 30 compressions/2 breathing 8.Two rescuers: Begin cycles of 15 compressions/2breathings 9.Allow complete chest recoil after each compression

AP

IP

NP

AP = Adequately Performed IP = Inadequately Performed NP = Not Performed

Once chest compressions have been started, a trained rescuer should deliver rescue breaths by mouth-to-mouth or bag-mask to provide oxygenation and ventilation, compression to ventilation ratio of 30 chest compressions to 2 ventilations When 2 or more rescuers are available,switch chest compressors every 2 minutes (or after about 5 cycles of compressions and ventilations at a ratio of 30:2) to prevent decreases in the quality of compressions

Cardiac Compression in infant

Cardiac compression in adult