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Emergency Situations—CPR by a Health-care Provider

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Task Infant (<1 yr) Child (1 yr to Adolescent) Adult (>Adolescent)
EMS

Unwitnessed: Perform 5 CPR cycles then activate EMS

Witnessed: Active EMS immediately

Activate immediately
Airway Head tilt–chin lift (Jaw thrust if neck trauma is suspected)
Breaths (initial) 2 breaths @ 1 sec each
Obstructed airway Back blows & chest thrusts Abdominal thrusts
Rescue breathing only 1 breath every 3–5 sec 1 breath every 5–6 sec
Circulation check Brachial or femoral Carotid or femoral Carotid
Compression landmarks Just below nipple line Between nipples (center of chest)
Compression technique 2 fingers or 2 thumbs encircling chest Heel of 1 hand Heel of 1 hand & other hand on top
Compression depth ⅓ to ½ depth of chest 1½–2 inches
Compressions: Ventilations

1 rescuer = 30:2

2 rescuers = 15:2

30:2
AED Not recommended

Unwitnessed: Use child pads after 5 cycles of CPR

Witnessed: Use AED as soon as it is available

5 cycles of CPR before shock

Note: If 2 rescuers are available, one should activate EMS while the other begins CPR

Source: AHA (2005).

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Emergency Situations—Trauma

Suspected Spinal Injury

  • Assess athlete's level of consciousness, airway, breathing, circulation, & neurological status; if athlete is unconscious & prone, place scissors under athlete's nose to assess breathing (scissors should fog when athlete is breathing)

  • Do NOT move athlete unless essential to establish/maintain an airway

  • Face mask should be removed immediately regardless of respiratory status

    • Stabilize the head & neck by placing index fingers in helmet ear holes

    • Unscrew or cut clips near ear holes to allow face mask to be swung away

  • Helmet & chin strap should remain in place unless:

    • Helmet & chin strap do not hold head securely

    • Face mask cannot be removed in <1–2 min.

    • Helmet prevents immobilization for transport

  • If helmet is to be removed

    • One medical professional should stabilize head t/o entire process by firmly grasping base of the occiput & maxilla

    • Another medical professional should:

      • Cut, do NOT unsnap, chin strap

      • Deflate air pads

      • Remove cheek pads by sliding 2 tongue depressors between the cheek pads & helmet; twist tongue depressors to unsnap pads

      • Tilt the helmet anteriorly to clear the occiput & slide the helmet off the athlete's head

      • Do NOT spread the sides of the helmet because this will squeeze the forehead & occiput

      • Remove shoulder pads by cutting center straps

      • Don a rigid cervical collar

  • If athlete does not have a pulse, cut open jersey & shoulder pads down the center of the chest to perform CPR

  • Posturing that may indicate TBI

    • Decerebrate: head retracted & all extremities extended

    • Decorticate: LE extended but UE flexed at elbow & wrist, fists clenched

 

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Spine Boarding Technique

Lifting ...

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