PERFORMANCE CHECKLIST

PERFORM MOUTH-TO-MOUTH RESUSCITATION

Situation: You have just found a casualty who appears to be unconscious. (Note: Checklist assumes the casualty's airway is blocked and pulse is still present.)

GO NO GO

Checks for responsiveness.

Calls for help.

Positions casualty on his back with his arms at his side (if not already in that position).

Performs quick finger sweep.

Selects appropriate method of opening airway (head-tilt/chin-lift or jaw thrust).

Question: When is the jaw thrust preferred over the head-tilt/chin-lift?

Answer:

Head-Tilt/Chin-Lift

Places one hand on casualty's forehead and presses with palm of hand to tilt head back.

Places fingertips of other hand under tip of casualty's jaw and lifts. jaw forward

Jaw Thrust

Rests elbows on surface on which casualty is lying.

Grasps angles of casualty's jaw (one hand on each side) and lifts jaw forward.

Checks casualty for breathing (looks for chest rising and falling, listens for sounds of breathing, and feels with cheek for air flow).

Seals nostrils closed and seals mouth over casualty's mouth while maintaining open airway. One hand maintains pressure on the casualty's forehead.

Administers two full breaths.

Releases casualty's nostrils and breaks seal over mouth.

If chest does not rise and fall, repositions airway and administers two breaths again.

If airway still blocked, administers finger sweep and appropriate manual thrusts.

Finger Sweep

Grasps tongue and lower jaw between thumb and index finger and lifts jaw open.

Inserts index finger of other hand along inside of cheek to base of tongue and uses a hooking motion to remove any visible obstruction.

Question: When are chest thrusts preferred over abdominal thrusts?

Answer:

Modified Abdominal Thrust

Kneels astride the casualty's thighs.

Places heel of one hand just above casualty's navel on midline, places heel of other hand on top of first, and points fingers toward casualty's head.

Delivers a forward, upward thrust; then relaxes the pressure.

Performs 6 to 10 thrusts.

Performs a finger sweep.

Repeats attempt to ventilate casualty.

Continues cycle of abdominal thrusts, finger sweep, and two ventilations until the obstruction is expelled.

Modified Chest Thrust

Kneels beside casualty's chest.

Locates compression site by running fingers along bottom of rib cage to locate notch where rib and sternum meet and placing heel of second hand on sternum one fingerwidth above notch.

Places heel of first hand on heel of second hand and positions shoulders over the compression site. Fingers must not rest on casualty's chest.

Depresses sternum 1 to 2 inches [simulated if a person is used as the casualty], then relaxes the pressure.

Performs 6 to 10 thrusts.

Performs finger sweep.

Repeats attempt to ventilate casualty.

Continues cycle of chest thrusts, finger sweep, and two ventilations unit the the obstruction is expelled.

Checks carotid pulse with fingertips (5 to 10 seconds).

Ventilates the casualty at the rate of one cycle (deep breath, pinch nose and and seal mouth, blow, break seal and release nose) every 5 seconds.

Rechecks the pulse after 1 minute.

Goes for help if pulse not found; continues ventilations if pulse is present.

Continues to monitor casualty's breathing after casualty resumes breathing on his own.

OVERALL EVALUATION GO NO GO

(A no-go on any step gives an overall evaluation of no-go.)