15. After 15 compressions, you must give the victim 2
ventilations. Continue for four full cycles of
15 compressions and 2 ventilations. Then take 5 seconds
to check for the carotid pulse and spontaneous
breathing. When there are still no signs of recovery,
continue CPR. If a periodic check reveals a return of
pulse and respiration, discontinue CPR; but closely
monitor the victim's pulse and respirations, and be
prepared to start CPR again, if required. When a pulse
is present but no respiration, continue to give the victim
Figure 10-11.--Xiphoid process.
one ventilation every 5 seconds and check his pulse
frequently.
Before moving on to the next technique, let us
review the following steps for one-rescuer CPR:
1. Determine whether the victim is conscious.
2. Open the airway (it maybe necessary to remove
the airway obstruction).
3. Look, listen, and feel.
4. Ventilate for four cycles.
5. Check his pulse-if none, call for help.
6. Begin the compression-ventilation ratio of 15 to
2 for four complete cycles.
7. Check again for a pulse and breathing. If no
Figure 10-12.--Interlocking fingers to help keep fingers off the
change, continue the compression-ventilation ratio of 15
chest wall.
to 2 until the victim is responsive, until you are properly
relieved, until you can no longer continue because of
off the xiphoid process (fig. 10-11). A fracture in this
exhaustion, or until the victim is pronounced dead by a
area could lacerate the liver.
medical officer.
Place the heel of one hand directly on the lower half
of the sternum two fingers up from the notch and the
The diagrams in figures 10-13 and 10-14 show the
heel of the other on top of the first hand. Interlock your
step-by-step methods discussed in this chapter, and it
fingers or extend them straight out, and KEEP THEM
serves as a good review.
OFF THE VICTIM'S CHEST! (See fig. 10-12.)
With your elbows locked, apply vertical pressure
TRANSPORTATION OF SICK AND
straight down to depress the sternum (adult) from 1 1/2
INJURED
to 2 inches. Then release the pressure, keeping the heels
of your hands in place on his chest. This process
Knowing how to transport a seriously injured
compresses the heart between the sternum and the
casualty is one of the most important parts of first aid.
victim's back thus pumping blood to the vital parts of
Careless or rough handling not only increases the
the body.
seriousness of his injury but may also cause his death.
When you use the proper technique, a more
Unless there is a good reason for transporting a casualty,
effective compression will result, and you will feel less
do not attempt this until some means of medical
fatigue. Ineffective compression occurs when the
evacuation is provided. Sometimes when the situation
elbows of the rescuer are not locked, he is not directly
is urgent and you know that no medical evacuation
over the sternum, or his hands are improperly placed on
facilities are available, you may have to transport the
the sternum.
casualty yourself. This is the reason why you should
When one rescuer performs CPR, the ratio of
know the different ways of transporting a casualty. Give
compressions to ventilations is 15 to 2, and it is
the appropriate frost aid before leaving with him. If he
performed at a rate of 80 compressions per minute.
has a broken bone, do not transport him until you have
Vocalize "l, and 2, and 3," and so forth, until you reach
splinted or immobilized it.
10-8
