taskchp3

Task

Restore respiration by opening the airway, performing manual thrusts and finger sweeps to remove airway obstructions, and administering mouth-to-mouth (or mouth-to-nose) resuscitation.

Conditions

Given an adult casualty who is unconscious and does not appear to be breathing. You are not in a chemical environment.

Standard

Perform mouth-to-mouth resuscitation following the correct sequence. Continue giving breaths at the rate of about 10 to 12 per minute until the casualty starts to breathe on their own, you are relieved by a qualified person, or you are too tired to go on. Score a GO on the performance checklist.

Site Preparation

For training and testing, you must use a resuscitation training mannequin . Have a bottle of alcohol and swabs or cotton available. Place the mannequin on the floor and alcohol and cotton balls on the table. Clean the mannequin’s nose and mouth before each soldier is evaluated.

Student Equipment

Mannequin (if available)

Cotton balls

Alcohol

Scenario

Tell the soldier to do, in order, all necessary steps to restore breathing.

Performance Measures	Results
PERFORM MOUTH-TO-MOUTH RESUSCITATION
1. Checks for responsiveness.	Go	No-go
2. Calls for help.	Go	No-go
3. Positions casualty on his back with his arms at his side (if not already in that position).	Go	No-go
4. Performs quick finger sweep.	Go	No-go
5. Selects appropriate method of opening airway (head-tilt/chin-lift or jaw thrust).	Go	No-go
6. Question: When is the jaw thrust preferred over the head-tilt/chin lift?	Go	No-go
HEAD -TILT CHIN-LIFT
7. Places one hand on casualty's forehead and presses with palm of hand to tilt head back.	Go	No-go
8. Places fingertips of other hand under tip of .casualty's jaw and lifts jaw forward.	Go	No-go
JAW THRUST
9. Rests elbows on surface on which casualty is lying.	Go	No-go
10. Grasps angles of casualty's jaw (one hand on each side) and lifts jaw forward.	Go	No-go
11. Checks casualty for breathing (looks for chest rising and falling, listens for sounds of breathing, and feels with cheek for air flow).	Go	No-go
12. Seals nostrils closed and seals mouth over casualty's mouth while maintaining open airway. One hand maintains pressure on the casualty’s forehead.	Go	No-go
13. Administers two full breaths.	Go	No-go
14. Releases casualty's nostrils and breaks seal over mouth.	Go	No-go
15. If chest does not rise and fall, repositions airway and administers two breaths again.	Go	No-go
16. If airway still blocked, administers finger sweep and appropriate manual thrusts.	Go	No-go
FINGER SWEEP
17. Grasps tongue and lower jaw between thumb and index finger and lifts jaw open.	Go	No-go
18. Inserts index finger of other hand along inside of cheek to base of tongue and uses a hooking motion to remove any visible obstruction.	Go	No-go
19. Question: When are chest thrusts preferred over abdominal thrusts?	Go	No-go
MODIFIED ABDOMINAL THRUST
20. Kneels astride the casualty's thighs.	Go	No-go
21. Places heel of one hand just above casualty's navel on mid-line, places heel of other hand on top of first, and points fingers toward casualty's head.	Go	No-go
22. Delivers a forward, upward thrust; then relaxes the pressure.	Go	No-go
23. Performs 6 to 10 thrusts.	Go	No-go
24. Performs a finger sweep.	Go	No-go
25. Repeats attempt to ventilate casualty.	Go	No-go
26. Continues cycle of abdominal thrusts, finger sweep, and two ventilation’s until the obstructions expelled.	Go	No-go
MODIFIED CHEST THRUST
27. Kneels beside casualty's chest.	Go	No-go
28. 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 finger-width above notch.	Go	No-go
29. 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.	Go	No-go
30. Depresses sternum 1 1/2 to 2 inches [simulated if a person is used as the casualty], then relaxes the pressure.	Go	No-go
31. Performs 6 to 10 thrusts.	Go	No-go
32. Performs finger sweep.	Go	No-go
33. Repeats attempt to ventilate casualty.	Go	No-go
34. Continues cycle of chest thrusts, finger sweep, and two ventilation’s unit the obstruction is expelled.	Go	No-go
35. Checks carotid pulse with fingertips (5 to 10 seconds).	Go	No-go
36. Ventilates the casualty at the rate of one cycle (deep breath, pinch nose and seal mouth, blow, break seal and release nose) every 5 seconds.	Go	No-go
37. Rechecks the pulse after 1 minute.	Go	No-go
38. Goes for help if pulse not found; continues ventilation’s if pulse is present.	Go	No-go
39. Continues to monitor casualty's breathing after casualty resumes breathing on his own.	Go	No-go
17. OVERALL EVALUATION	Go	No-go

Score the student GO if all performance measures are go. Score the student NO GO if any performance measure is no-go. If the student scores a NO GO, show the student what was done wrong and how to do it correctly.