Two-rescuer CPR. Note: Two-rescuer CPR for children ages 1 to 8 years can be performed similarly to that for adults with appropriate changes in chest compressions and ventilations. (Modified from Chandra, NC, and Hazinski, MF [ cds] : Textbook of Basic Life Support for Healthcare Providers, American Heart Association, Dallas, 1997.)
Step Objective Actions
1. AIRWAY One rescuer (ventilator): Assessment: determine unresponsiveness. Tap or gently shake shoulder.
Shout, "Are you okay?"
Gill for help. Activate EMS.
Position the victim. Turn on back if necessary (4-10 sec).
Open the airway. Use a proper technique to open airway.
2. BREATHING Assessment: determine breathlessness. Look, listen, and feel (3-5 sec).
Ventilate twice. Observe chest rise: 1-1.5 sec/inspiration.
3. CIRCULATION Assessment: determine pulselessness. Feel for carotid pulse (5-10 sec).
State assessment results. Say, "No pulse."
Other rescuer (compressor): Get into position for compressions. Hand, shoulders in correct position.
Locate landmark notch. Landmark check.
4. COMPRESSION/ VENTILATION CYCLES Compressor: begin chest compressions. Correct ratio compressions/venlilations: 5:1
Compression rate: 80-100/min (5 compressions/3-4 sec).
Say any helpful mnemonic.
Slop compressing for each ventilation.
Ventilator: ventilate after every 5th compression and check compression effectiveness, (Minimum of 10 cycles.) Ventilate 1 time (1.5-2 sec/inspiration).
Check pulse occasionally to assess compressions.
5. CALL FOR SWITCH Compressor: coll for switch when fatigued. Give clear signal Io change.
Compressor completes 5th compression.
Ventilator completes ventilation after 5th compression.
6. SWITCH Simultaneously switch:
Ventilator: move to chest. Move to chest.
Become compressor.
Get into position for compressions.
Locate landmark notch.
Compressor: move Io head. Move to head.
Become ventilator.
Check carotid pulse (5 sec).
Say, "No pulse."
Ventilate once (1.5-2 sec/inspiration).
7. CONTINUE CPR Resume compression/ventilation Resume Step 4.